MEDICALISATION OF FGM
Medicalization of FGM are “situations in which FGM is practiced by any category of health personnel, whether in a public or private clinic, at home or elsewhere” (World Health Organization, 2010). Doctors, assistant doctors, clinicians, nurses, midwives, trained traditional birth attendants and other personnel responsible for providing health care to the population, in both the private and public sectors, as well as retired health workers who continue to perform FGM/C. (World Health Organization, 2010)
With the exception of Egypt, where doctors are the main practitioners of FGM, it is mostly nurses and midwives who practice FGM in countries with a high rate of medicalization of FGM (Population Council report, February 2017, p.13).
Where is medicalization of FGM an issue ?
According to a Population Council’s report in February 2017, this practice concerns 26% of women having suffered from FGM (meaning a total of 16 million women and girls). 91% of these operations took place in Egypt, Sudan as well as Nigeria. There is also a substantial rise of the medicalised practice of FGM in Guinea and Kenya (Shell-Duncan B., Njue C. and Moore Z., 2017), as well as Indonesia, Malaysia, Mali and Yemen (28toomany, 2016).
“Drawing on self-reported data on medicalization from women aged 15-49 in 25 countries, we find that 74% of women who have undergone FGM/C report having been cut by a traditional practitioner. 26% of women with FGM/C – totalling nearly 15 million women – report having been cut by a medical professional. Of these, 51% live in Egypt alone, and another 34% live in Sudan. Medicalization rates, defined as the percent of FGM/C performed by a medical professional (doctor, nurse, midwife, or other health care worker), are highest in 5 countries: Egypt (38%), Sudan (67%), Guinea (15%), Kenya (15%) and Nigeria (13%). Comparing data on mothers age 15- 49 and their daughters, rates of medicalization are rising substantially in all of these countries except Nigeria.” (p.10)
An upward trend
To identify current trends and understand how medicalization evolves over time, it is interesting to focus on the prevalence rate according to age. In doing so, Population Council noticed that the percentage of girls between 0 to 14 years old concerned by medicalization is systematically higher than the one for women between 15 to 49 years old. It appears that parents resort more to health care professionals to cut their daughters.
The increase is especially high in Egypt where 75% of the girls have undergone FGM practiced by a health care provider while only 15% of women are concerned, but also in Guinea where 30% of girls are concerned by medicalization against only 5% of women.
28toomany, 2016, The Medicalization of FGM, Access here
Chege J., Askew I. and Liku J., 2001, An assessment of the alternative rites approach for encouraging abandonment of female genital mutilation in Kenya, Access here
El-Gibaly O. and Aziz M., 2019, Health care providers’ and mothers’ perceptions about the medicalization of female genital mutilation or cutting in Egypt: A cross-sectional qualitative study, Access here
Human Rights Europe, 2010, Violence Against Women: Teliwel Diallo On Female Genital Mutilation, Access here (video)
Jaldesa G. W. , Askew I., Njue C. and Wanjiru M., 2005, Female Genital Cutting among the Somali of Kenya and Management of its Complications, Access here
Kenya National Bureau of Statistics (KNBS), 2010, DHS Final Reports, Access here
Kenya National Bureau of Statistics Nairobi, 2014, Demographic and health Survey, Access here
Kimani S. and Kabiru C., Population Council, 2018, Shifts in Female Genital Mutilation/Cutting: Perspectives of Families and Health Care Providers. Evidence to End FGM/C: Research to Help Women Thrive., Access here
Kimani S., Kabiru C. W., Mutechi-Strachan J. and Guyo J., 2020, Female genital mutilation/cutting: Emerging factors sustaining medicalization related changes in selected Kenyan communities, Access here
Kimani S., Muteshi J. and Jaldesa G., 2018, Medicalization of FGM/C among the Abagusii of Kenya, Access here
Kimani S. and Shell-Duncan B., 2018, Medicalized Female Genital Mutilation/Cutting: Contentious Practices and Persistent Debates, Access here
Njue C. and Askew I., 2004, Medicalization of Female Genital Cutting Among the Abagusii in Nyanza Province, Access here
Obianwu O., Adetunji A., Dirisu O., Population Council, 2018. “Understanding medicalisation of Female Genital Mutilation/Cutting (FGM/C): a qualitative study of parents and health workers in Nigeria. Evidence to End FGM/C: Research to Help Women Thrive, Access here
Population Reference Bureau, 2018, Understanding the Impact of Medicalisation on Female Genital Mutilation/Cutting, Access here
PRB, 2020, Understanding the Impact of Medicalisation on Female Genital Mutilation/Cutting, Access here
Refaat A., 2009, Medicalization of female genital cutting in Egypt, Access here
Richard F. and Decoster K., 2016, Why we should be against the medicalisation of Female Genital Mutilation, Evidence to End FGM/C: Research to Help Girls and Women Thrive consortium Access here Access here
Serour G., 2013, Medicalization of female genital mutilation / cutting, Access here
Shell-Duncan B., 2001, The medicalization of female “circumcision”: harm reduction or promotion of a dangerous practice?, Access here
Shell-Duncan B., Njue C. and Moore Z., 2017, The Medicalization of Female Genital Mutilation/Cutting:What do the Data Reveal?, Access here
UNICEF, 2017, Baseline Study Report: Female Genital Mutilation/ Cutting and Child Marriage among the Rendille, Access here
World Health Organization, 2010, Global strategy to stop health-care providers from performing female genital mutilation, Access here
Yussuf M., Matanda D. and Powell R. A., 2020, Exploring the capacity of the Somaliland healthcare system to manage female genital mutilation/cutting-related complications and prevent the medicalization of the practice: A cross-sectional study, Access here
More articles and resources from the Population Council available here
Figures on the medicalization of FGM by country are also available on the UNICEF website.
« The Community of Practice on Female Genital Mutilation » is part of the « Building Bridges between Africa and Europe to tackle FGM » project, supported by the « UNFPA-UNICEF Joint Programme on the Elimination of FGM ».
The project is coordinated by AIDOS in partnership with GAMS Belgium.
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