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Full-Text Articles in International Public Health

The Medicalisation Of Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Population Council Jan 2019

The Medicalisation Of Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Population Council

Reproductive Health

This evidence brief summarizes key findings from a study that sought to understand the shifts in FGM/C including medicalization among several communities Kenya. The study finds that medicalization is increasing because: 1) it is perceived to be safer because the procedure is reportedly performed under sterile conditions by trained health professionals; 2) it is believed to shorten the recovery period; and 3) it is a response to the law prohibiting the practice because it allows FGM/C to be performed in secret. These findings indicate that medicalization is an adaptation to awareness of the health complications associated with FGM/C and the …


Reference Guide: Factorial Focus Group Analysis Methods For Studying Social Norm Change, Bettina Shell-Duncan, Amadou Moreau, Katherine Wander, Sarah Smith Jan 2019

Reference Guide: Factorial Focus Group Analysis Methods For Studying Social Norm Change, Bettina Shell-Duncan, Amadou Moreau, Katherine Wander, Sarah Smith

Reproductive Health

The factorial focus group methodology described in this guide provides a powerful means of illuminating the social norms that uphold female genital mutilation/cutting (FGM/C), and the ways in which meanings have at times become contested or rejected. The methods described here can be applied to the study of a wide range of behaviors influenced by social norms, such as early marriage, adoption of contraception, and more.


Fgm/C And Ecm: Drawing Lessons From Research, Jacinta Muteshi-Strachan Jan 2019

Fgm/C And Ecm: Drawing Lessons From Research, Jacinta Muteshi-Strachan

Reproductive Health

No abstract provided.


"No To Circumcision": The Road To Effective Social Marketing Campaigns In Egypt, Salma Abou Hussein, Sarah Ghattass Jan 2019

"No To Circumcision": The Road To Effective Social Marketing Campaigns In Egypt, Salma Abou Hussein, Sarah Ghattass

Reproductive Health

To inform the design and scale up of initiatives that can drive a change in attitudes and behaviors toward FGM/C abandonment, there is a rising need to understand the perspectives of individuals who are exposed to social marketing campaigns (SMCs), which are a key intervention to promote the abandonment of the practice. This working paper presents the findings of a study that sought to understand how, where, and why SMCs for FGM/C abandonment are working, and with what impact, to inform design and scale-up of campaigns that can foster new perspectives, expectations, and behaviors.


Associations Between Fgm/C And Hiv In Ethiopia, The Gambia, Kenya, And Sierra Leone: A Limited Analysis Of Demographic And Health Survey Data, Yetunde A. Noah Pinheiro, Zhuzhi Moore, David Gathara Jan 2019

Associations Between Fgm/C And Hiv In Ethiopia, The Gambia, Kenya, And Sierra Leone: A Limited Analysis Of Demographic And Health Survey Data, Yetunde A. Noah Pinheiro, Zhuzhi Moore, David Gathara

Reproductive Health

Studies investigating the association between male circumcision and HIV have demonstrated the protective effect of male circumcision. In some settings, FGM/C and male circumcision are considered “equivalent” procedures. This working paper presents findings of a study that investigates the effect of FGM/C on the likelihood of HIV infection for women in practicing communities in Ethiopia, Gambia, Kenya, and Sierra Leone.


Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya—Brief, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan Jan 2019

Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya—Brief, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan

Reproductive Health

This policy brief summarizes key findings from a study that examined whether there are shifts in norms and practices related to FGM/C among communities in Narok (predominantly inhabited by Maasai) and Kisii (predominantly inhabited by Abagusii) counties in Kenya. Although Kisii and Narok are FGM/C hotspots, practicing communities in these counties are reassessing norms and traditions in light of the current social and legal climate. These changes may provide a useful starting point for intervention programs that seek to create dialogue and critical reflection on the practice of FGM/C in an effort to accelerate its abandonment. Programmatic recommendations include: engaging …


Using Demographic And Health Surveys In The Campaign To End Fgm/C: A Kenyan Example, Dennis Matanda, Caroline W. Kabiru Jan 2019

Using Demographic And Health Surveys In The Campaign To End Fgm/C: A Kenyan Example, Dennis Matanda, Caroline W. Kabiru

Reproductive Health

In order to design effective interventions to end female genital mutilation/cutting (FGM/C), we need to map where FGM/C is practiced and what factors influence it. Data from the Demographic and Health Surveys (DHS), nationally representative surveys conducted in low- and middle-income countries every five years, give us the opportunity to explore how FGM/C is influenced by both individual and community-level factors. Where FGM/C prevalence is not uniform, various research and analysis techniques can be used to improve estimates and draw further information from DHS data. This brief shares insights from two studies carried out in Kenya using DHS data collected …


Reference Guide For Data Collection: Qualitative Social Network Interviews, Bettina Shell-Duncan, Amadou Moreau, Sarah Smith, Holly B. Shakya Jan 2019

Reference Guide For Data Collection: Qualitative Social Network Interviews, Bettina Shell-Duncan, Amadou Moreau, Sarah Smith, Holly B. Shakya

Reproductive Health

The purpose of this document is to guide researchers who plan to use qualitative social network methods drawing on our experiences implementing a qualitative study entitled, “The End of Female Genital Mutilation/Cutting in Senegal: Tracing Social Networks, Investigating the Role of Gender and Intergenerational Influence.” Qualitative fieldwork was carried out in two contrasting settings in Senegal: 1) a region with a low prevalence of female genital mutilation/cutting (FGM/C) characterized by ethnic heterogeneity, and 2) a region with a high prevalence of FGM/C characterized by relative ethnic homogeneity. The goal of this research was to investigate the ways in which social …


Changes In Fgm/C In Somaliland: Medical Narrative Driving Shift In Types Of Cutting, Richard A. Powell, Mohamed Yussuf Jan 2018

Changes In Fgm/C In Somaliland: Medical Narrative Driving Shift In Types Of Cutting, Richard A. Powell, Mohamed Yussuf

Reproductive Health

In Somalia, female genital mutilation/cutting (FGM/C) prevalence is nearly universal at 98 percent. This qualitative study sought to explore: 1) views and experiences of married and unmarried men and women on FGM/C and potential changes in its practice; 2) individual, family, and societal factors contributing to any changes, or continuation of FGM/C; 3) the knowledge, views, and experiences of healthcare workers who offer FGM/C services and their role as change agents rather than providers; and 4) how healthcare systems’ capacities can be strengthened for management and prevention. The study finds that normative changes appear to be occurring in Somaliland society …


Collaborative Work With Somaliland Stakeholders To Increase Evidence Based Decision Making In Fgm/C, Chantalle Okondo Jan 2018

Collaborative Work With Somaliland Stakeholders To Increase Evidence Based Decision Making In Fgm/C, Chantalle Okondo

Reproductive Health

The Population Council collaborated with partners Orchid Project and Somaliland Family Health Association to pilot a new approach to disseminating research findings in order to increase the impact of evidence-based decisionmaking in program, policy, and investments in female genital mutilation/cutting (FGM/C). This brief reports on a recent workshop that utilized an open space approach to encourage review of recent key evidence on FGM/C in Somaliland; explore UNICEF’s six elements of abandonment and their relevance to the Somaliland context; link research with decisionmaking; and develop action plans. Participants identified six key themes for further reflection: behavioral/social change, medicalization, policy, child rights, …


Exploring The Nigerian Health System's Response To Female Genital Mutilation/Cutting, Otibho Obianwu Jan 2018

Exploring The Nigerian Health System's Response To Female Genital Mutilation/Cutting, Otibho Obianwu

Reproductive Health

Although Nigeria has shown a steady long-term decline in female genital mutilation/cutting (FGM/C) prevalence, the practice remains widespread. This study brief outlines the Population Council’s Evidence to End FGM/C research program, which, in collaboration with the Federal Ministry of Health, will conduct a diagnostic assessment in order to: 1) examine how the healthcare sector supports the prevention of FGM/C; 2) determine the role of the healthcare sector in the management of FGM/C-related complications and the quality of care offered to clients; and 3) identify possible solutions for strengthening the healthcare system’s capacity to manage and prevent FGM/C. Findings are intended …


Medicalisation Of Female Genital Mutilation/Cutting In Sudan: Shift In Types And Providers, Nafisa Bedri, Huda Sherfi, Ghada Rudwan, Sara Elhadi, Wafa Elamin Jan 2018

Medicalisation Of Female Genital Mutilation/Cutting In Sudan: Shift In Types And Providers, Nafisa Bedri, Huda Sherfi, Ghada Rudwan, Sara Elhadi, Wafa Elamin

Reproductive Health

This study by the Population Council and the Gender and Reproductive Health and Rights Resource and Advocacy Center aimed to inform the development of future interventions by generating evidence on the drivers of the shifts in the practice of female genital cutting/mutilation (FGM/C) in Sudan. Researchers conducted a community-based cross-sectional, comparative, mixed-methods study that examined shifts in the type of cut, its level and significance, as well as the supply and demand factors associated with medicalization. They also explored interventions and alternative approaches that may prevent medicalization and the sustenance of the practice of FGM/C, including re-infibulation. The study finds …


Shifts In Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Samuel Kimani, Caroline W. Kabiru Jan 2018

Shifts In Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Samuel Kimani, Caroline W. Kabiru

Reproductive Health

Despite compelling reasons and efforts to eradicate female genital mutilation/cutting (FGM/C) in Kenya, the practice has persisted, albeit with some changes. This study sought to understand the shifts in FGM/C among families and healthcare providers from selected Kenyan communities that practice FGM/C. Our findings highlight similarities and differences across three distinct Kenyan communities. FGM/C appears to persist through two models: first, shifts (changes) in the practice, notably cutting at a younger age, lesser cutting; and second, through stability and consistency with minimal change. The two diverse models appear to rely on and sustain social norms that support FGM/C in these …


Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan Jan 2018

Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan

Reproductive Health

In Kenya, there has been a steady and marked decline in the prevalence of female genital mutilation/cutting (FGM/C) but there is great variance in the prevalence of FGM/C across the country, with prevalence remaining high among certain ethnic groups such as Somali, Samburu, Kisii, and the Maasai. The objectives of this study were: 1) to explore whether and how unprogrammed factors or programmed FGM/C interventions (alternative rites of passage, legal and policy measures, religious-oriented approaches, promotion of girls’ education, intergenerational dialogues, use of rescue centers, and other undocumented approaches) influence community values deliberation in Narok and Kisii counties; 2) to …


Trends In Medicalisation Of Female Genital Mutilation/Cutting: What Do The Data Reveal?, Bettina Shell-Duncan, Carolyne Njue, Zhuzhi Moore Jan 2018

Trends In Medicalisation Of Female Genital Mutilation/Cutting: What Do The Data Reveal?, Bettina Shell-Duncan, Carolyne Njue, Zhuzhi Moore

Reproductive Health

Despite the emergence of international consensus that female genital mutilation/cutting (FGM/C) is a violation of human rights, a focus on medicalization remains salient because of concerns that FGM/C is increasingly being performed by healthcare professionals and may be impeding progress toward abandonment of FGM/C. To investigate these claims, this study draws on nationally representative survey data from 26 countries, and addresses the following three questions: 1) What are the major patterns and trends in medicalisation? 2) Is there an association between medicalization and rates of change in prevalence of FGM/C? and 3) Is there an association between medicalization and support …


Understanding Medicalisation Of Female Genital Mutilation/Cutting (Fgm/C): A Qualitative Study Of Parents And Health Workers In Nigeria, Otibho Obianwu, Adetayo Adetunji, Osasuyi Dirisu Jan 2018

Understanding Medicalisation Of Female Genital Mutilation/Cutting (Fgm/C): A Qualitative Study Of Parents And Health Workers In Nigeria, Otibho Obianwu, Adetayo Adetunji, Osasuyi Dirisu

Reproductive Health

This community-based, cross-sectional qualitative study was conducted in four communities in Nigeria’s Delta, and was conceptualized to address gaps in our understanding of medicalization of female genital mutilation/cutting (FGM/C) and to provide critical evidence needed to effectively design abandonment interventions. The study findings reveal that the social norms driving FGM/C practice remain entrenched despite a shift to medicalization. They also reflect the tendency of parents and health workers to view FGM/C, whether traditional or medicalized, as a minor procedure with few complications and significant benefits that would positively impact a daughter’s future status as a wife and mother. Findings reveal …


Understanding The Key Elements For Designing And Implementing Social Marketing Campaigns To Inform The Development Of Creative Approaches For Fgm/C Abandonment In Sudan, Widad Ali A/Rahman, Samia Al Nagar, Randa H. Gindeel, Arwa Salah Jan 2018

Understanding The Key Elements For Designing And Implementing Social Marketing Campaigns To Inform The Development Of Creative Approaches For Fgm/C Abandonment In Sudan, Widad Ali A/Rahman, Samia Al Nagar, Randa H. Gindeel, Arwa Salah

Reproductive Health

Social marketing campaigns (SMCs) have gained prominence in female genital mutilation/cutting (FGM/C) abandonment efforts, but there is a dearth of information on how these programs are designed and implemented, and their perceived impact. Understanding the implementation process and the effectiveness of these campaigns is critical for drawing lessons to improve existing programs and inform the design and scale up of SMCs in other regions/countries. This mixed-method study sought to address this gap by assessing the design and implementation of existing SMC programs in Sudan. While the study findings demonstrate several strengths of existing programs, including strong partnerships and extensive needs …


Exploring The Association Between Fgm/C And Early/Child Marriage: A Review Of The Evidence, Jamlick Karumbi, David Gathara, Jacinta Muteshi-Strachan Jan 2017

Exploring The Association Between Fgm/C And Early/Child Marriage: A Review Of The Evidence, Jamlick Karumbi, David Gathara, Jacinta Muteshi-Strachan

Reproductive Health

Female genital mutilation/cutting (FGM/C) has been frequently linked to marriageability and thought to be associated with child marriage, yet there is remarkably little rigorous research to clarify the relationship between these two practices to inform discussions and responses. Furthermore, trends are also shifting in the timing of FGM/C from adolescence to early childhood, and the implications this might have on the links between early/child marriage and FGM/C are not well understood. This review of current available evidence aims to assess the association between FGM/C and early/child marriage in contexts where both practices are carried out. The social and cultural norms …


Exploring The Association Between Fgm/C And Fistula: A Review Of The Evidence, Pooja Sripad, Charity Ndwiga, Kaji Tamanna Keya Jan 2017

Exploring The Association Between Fgm/C And Fistula: A Review Of The Evidence, Pooja Sripad, Charity Ndwiga, Kaji Tamanna Keya

Reproductive Health

Female genital mutilation/cutting (FGM/C) and fistula are both conditions that have a range of health, socioeconomic, and lifestyle causes and consequences for women globally. There have been sparse empirical and conceptual efforts to look at how these two conditions manifest and relate to one another. This rigorous review of the literature aims to fill this research gap by assessing the state of evidence on the association of FGM/C and fistula and conceptually mapping this association within broader social, political, and health-systems contexts. Based on the findings, the authors of this report have developed a conceptual mapping framework to situate the …


Female Genital Cutting In Somaliland: Baseline Assessment, Katy Newell-Jones Jan 2017

Female Genital Cutting In Somaliland: Baseline Assessment, Katy Newell-Jones

Reproductive Health

This report summarizes research findings into the prevalence and attitudes around female genital cutting (FGC) in 20 communities across five regions of Somaliland. There was a specific focus on young people, who accounted for 47 percent of the interviewees, and also on the role of schools in promoting abandonment of cutting. This research found that the prevalence of FGC in the five regions studied is 98.9 percent across all age groups in city, semi-city, and village communities. The findings indicate that decisionmaking in relation to FGC has less to do with having accurate knowledge, and more to do with the …


Female Genital Mutilation/Cutting In Kenya: Is Change Taking Place? Descriptive Statistics From Four Waves Of Demographic And Health Surveys, Bettina Shell-Duncan, David Gathara, Zhuzhi Moore Jan 2017

Female Genital Mutilation/Cutting In Kenya: Is Change Taking Place? Descriptive Statistics From Four Waves Of Demographic And Health Surveys, Bettina Shell-Duncan, David Gathara, Zhuzhi Moore

Reproductive Health

Nationally representative survey data on female genital mutilation/cutting (FGM/C) in Kenya are available from four waves of Demographic and Health Surveys. These survey data provide a rich and detailed picture of when, where, and how FGM/C has been carried out, and trends in changes in the practice. National prevalence data from successive waves of surveys show a steady decrease in the prevalence of FGM/C among women aged 15–49. While the data reported here are descriptive, they provide useful insights on the progress of FGM/C abandonment at national and subnational levels. These findings are useful for policymakers in steering discussions on …


Female Genital Mutilation/Cutting In Nigeria: A Scoping Review, Blessing U. Mberu Jan 2017

Female Genital Mutilation/Cutting In Nigeria: A Scoping Review, Blessing U. Mberu

Reproductive Health

This report’s overarching objective is the examination of key trends in the evidence base of female genital mutilation and cutting (FGM/C) and gaps in knowledge for Nigeria, building on a scoping review of peer-reviewed and "grey" literature along with quantitative analysis of relevant data. What is clear from prevalence levels identified over the last 15 years is how widespread different types of FGM/C are, in Nigeria’s different ethno-geographical zones, and the little change that has taken place over time, despite increased international, and renewed national, political commitment to eradicate the practice. The findings show that much work remains to be …


Modeling And Mapping Of Girls' Female Genital Mutilation/Cutting (Fgm/C) In The Context Of Economic, Social, And Regional Disparities: Kenya Demographic And Health Surveys 1998-2014, Ngianga-Bakwin Kandala, Damaris Kinyoki, Ahmed Sarki, David Gathara, Paul Komba, Bettina Shell-Duncan Jan 2017

Modeling And Mapping Of Girls' Female Genital Mutilation/Cutting (Fgm/C) In The Context Of Economic, Social, And Regional Disparities: Kenya Demographic And Health Surveys 1998-2014, Ngianga-Bakwin Kandala, Damaris Kinyoki, Ahmed Sarki, David Gathara, Paul Komba, Bettina Shell-Duncan

Reproductive Health

The aim of this research study is analysis of successive household data for estimating and revealing trends, similarities, and differences in geographic patterns for the burden of female genital mutilation/cutting (FGM/C) and related risk factors among girls ages 14 and younger in Kenya. This Evidence to End FGM/C study, from a coalition led by the Population Council, is intended to contribute to a deeper understanding of the recent burden of FGM/C among the girls within this very young age group, and to enhance knowledge of the geographic distribution of this practice over time. The report will inform current elimination efforts …


Rapid Evidence Assessment: Quality Of Studies Assessing Interventions To Support Fgm/C Abandonment, Tammary Esho, Jamlick Karumbi, Carolyne Njue Jan 2017

Rapid Evidence Assessment: Quality Of Studies Assessing Interventions To Support Fgm/C Abandonment, Tammary Esho, Jamlick Karumbi, Carolyne Njue

Reproductive Health

The last decade has seen increased focus and investment in interventions to eliminate female genital mutilation/cutting (FGM/C), along with the need to accelerate its abandonment. The UK Department for International Development (DFID) commissioned the Evidence to End FGM/C: Research to Help Girls and Women Thrive project to: 1) assess the quality of studies that have evaluated different interventions for the prevention of FGM/C, and 2) describe the FGM/C interventions that were evaluated by high-quality studies. The quality of evidence on the effectiveness and impact of FGM/C interventions is generally moderate to low. In addition, few baseline surveys are conducted prior …


Ending The Medicalization Of Female Genital Mutilation/Cutting In Egypt, Sarah Ghattass, Nahla G. Abdel-Tawab, Salma Abou Hussein Jan 2016

Ending The Medicalization Of Female Genital Mutilation/Cutting In Egypt, Sarah Ghattass, Nahla G. Abdel-Tawab, Salma Abou Hussein

Reproductive Health

This policy brief examines the extent of medicalization of female genital mutilation/cutting (FGM/C) in Egypt, the characteristics of girls who were cut by medical personnel, factors that may have contributed to increased medicalization, and potential interventions that could influence both physicians and the public to completely abandon the practice. The data show that younger cohorts of women, those from higher wealth quintiles, higher levels of education, and living in urban regions are more likely to have been cut by medical personnel. More importantly, the analysis shows that despite medicalization being more common among young women with the above-mentioned characteristics, it …


Ending The Medicalization Of Female Genital Mutilation/Cutting In Egypt [Arabic], Sarah Ghattass, Nahla G. Abdel-Tawab, Salma Abou Hussein Jan 2016

Ending The Medicalization Of Female Genital Mutilation/Cutting In Egypt [Arabic], Sarah Ghattass, Nahla G. Abdel-Tawab, Salma Abou Hussein

Reproductive Health

[In Arabic] This policy brief examines the extent of medicalization of female genital mutilation/cutting (FGM/C) in Egypt, the characteristics of girls who were cut by medical personnel, factors that may have contributed to increased medicalization, and potential interventions that could influence both physicians and the public to completely abandon the practice. The data show that younger cohorts of women, those from higher wealth quintiles, higher levels of education, and living in urban regions are more likely to have been cut by medical personnel. More importantly, the analysis shows that despite medicalization being more common among young women with the above-mentioned …


Evidence To End Fgm/C: Research To Help Girls And Women Thrive [Arabic], Population Council Jan 2016

Evidence To End Fgm/C: Research To Help Girls And Women Thrive [Arabic], Population Council

Reproductive Health

[In Arabic] This factsheet describes a new Population Council–led research program, funded by the United Kingdom’s Department for International Development, which will join the UNFPA-UNICEF Joint Programme on FGM/C: Accelerating Change and the Girl Generation in the Campaign to End Female Genital Mutilation/Cutting (FGM/C) within One Generation. The program will generate high-quality evidence to influence strategic investment, policy, and programming to end FGM/C. This five-year program will work in 6–9 sub-Saharan African countries to dramatically expand the body of evidence on the most effective approaches to ending FGM/C. The research program will be organized around four themes: building the picture …


Evidence To End Fgm/C: Research To Help Girls And Women Thrive, Population Council Jan 2016

Evidence To End Fgm/C: Research To Help Girls And Women Thrive, Population Council

Reproductive Health

This factsheet describes a new Population Council–led research program, funded by the United Kingdom’s Department for International Development, which will join the UNFPA-UNICEF Joint Programme on FGM/C: Accelerating Change and the Girl Generation in the Campaign to End Female Genital Mutilation/Cutting (FGM/C) within One Generation. The program will generate high-quality evidence to influence strategic investment, policy, and programming to end FGM/C. This five-year program will work in 6–9 sub-Saharan African countries to dramatically expand the body of evidence on the most effective approaches to ending FGM/C. The research program will be organized around four themes: building the picture of where, …


Root Causes And Persistent Challenges In Accelerating The Abandonment Of Fgm/C, Jacinta Muteshi-Strachan Jan 2016

Root Causes And Persistent Challenges In Accelerating The Abandonment Of Fgm/C, Jacinta Muteshi-Strachan

Reproductive Health

No abstract provided.


The Fgm/C Research Programme, Jacinta Muteshi-Strachan Jan 2016

The Fgm/C Research Programme, Jacinta Muteshi-Strachan

Reproductive Health

No abstract provided.