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News article 6 Feb 2017
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Female Genital Mutilation research papers

WHO guidance on the management of health complications from female genital mutilation

Today is International Day of Zero Tolerance to Female Genital Mutilation. Various activities and events are held each year to promote the UN’s campaign to raise awareness and educate people about the dangers of Female Genital Mutilation (FGM).

FGM involves full or partial removal of external genitalia or injury to the female genital organs for non-medical reasons. The procedure has no known health benefits, but more importantly women who have undergone FGM suffer immediate and long term health consequences. The practice is prevalent in 30 countries in Africa, Asia and the Middle East, and due to increased international migration, is now present worldwide. Healthcare workers in all countries may need to provide care for women who have undergone FGM, yet they are often unaware of the harmful effects of the practice and are inadequately trained to manage the effects properly.

In 2015, the World Health Organization (WHO) published evidence-informed recommendations on the management of health complications of FGM targeted at healthcare providers involved in the care of women or girls living with the effects of the procedure. The recommendations were developed using WHO’s standard guideline development process and included both evidence relating to the effects of interventions to manage health complications, and systematic reviews of qualitative evidence on the values and preferences of clients and healthcare providers.

All the research evidence used in the guideline has been reproduced in a special supplement published in the International Journal of Gynecology and Obstetrics. The series includes evidence reviews on the effects of: a) de-infibulation for improving health outcomes among girls and women living with FGM, b) interventions for improving sexual function and relieving genital pain among girls and women living with FGM, c) psychological and counselling interventions for girls and women living with FGM and d) educational interventions for improving knowledge and attitudes of girls and women and health providers towards FGM.

Three qualitative evidences syntheses addressed questions relating to women’s and healthcare providers’ knowledge and experience of the interventions, their attitudes regarding acceptability, appropriateness and motivation to adopt them and contextual barriers and facilitators to implementation of the interventions. These syntheses suggest women may not be willing to be de-infibulated and providers find it difficult to perform the procedure when required, provide convincing evidence as to why psychological and counselling interventions may be beneficial for women and girls living with FGM, and highlight poor communication between women living with FGM and healthcare workers; signalling a need for health education and information interventions.