A range of interventions have been carried out over the past few decades to promote the abandonment of female genital mutilation (FGM). While these efforts have had varied success, the prevalence of FGM is reducing in nearly all the countries in which it is traditionally practiced. In most cases, however, this decrease has been slow, raising questions about the efficacy of interventions to eliminate FGM. This paper assesses existing evidence on the effectiveness of the most common approaches over the past 30-40 years: health risk approaches, conversion of excisers, training of health professionals as change agents, alternative rituals, community-led approaches, public statements and legal measures. The authors then offer guidance on how best to design and implement programmes that promote the abandonment of FGM.
Key Findings:
Many surveys have found women who express a negative attitude to the continuation of FGM, but who still intend to let their daughters undergo the practice. A major reason for this apparent contradiction between attitude and behaviour is a social and cultural pressure to uphold the tradition. Therefore, the importance of a community-wide change to enable individual families to abandon FGM is now widely recognised. Experience shows that large-scale abandonment can only be expected when FGM is no longer an all-dominant social norm and families can abandon the practice without the risk of stigmatisation and exclusion.
Recommendations:
- A comprehensive and holistic programme for the abandonment of FGM, including different types of activities, is the best way to facilitate positive change given that: targeting FGM seems to be most effective and well-received when a broader approach is used, assisting the community with other challenges; the conversion of community leaders to speak out against FGM and a favourable legal framework create an enabling environment; and peer groups are crucial since the majority of people are only willing to accept and adapt to information when it comes from people similar to themselves.
- Effective FGM interventions must have a thorough design and planning oriented toward local adaptation – the basic content of which should be a situation analysis and baseline assessment prior to any intervention – in order to establish a community’s readiness to change, as well as other factors related to FGM (decision-making processes, power dynamics, meanings attributed to the FGM, etc.).
- Another best practice is including plans and procedures for monitoring the process, including thorough documentation of each step of the intervention. Additionally, the outputs and outcomes should be evaluated either to compare the situation before and after, and/or to establish a comparison site.
- Interventions require substantial time, which may vary considerably between communities, before they can result in actual change. Therefore, long-term interventions are better-suited to promoting and achieving their outcomes regarding the abandonment of FGM.
