Abstract:Background
Guinea has a high prevalence of female genital mutilation (FGM) (95%) and it is a major concern affecting the health and the welfare of women and girls. Population-based surveys suggest that health care providers are implicated in carrying out the practice (medicalization). To understand the attitudes of health care providers related to FGM and its medicalization as well as the potential role of the health sector in addressing this practice, a study was conducted in Guinea to inform the development … Show more
“…Our study found that some health care providers held a positive attitude towards FGM, whether they had undergone FGM themselves or had maintained the tradition for their daughters, indicating that it might not always be clear how to distinguish between the personal beliefs and professional obligations of providers. The present study also found that the perceived ‘harm reduction’ argument was used to justify health care providers performing FGM in Guinea, as was reported in other studies [ 11 – 13 , 15 , 18 , 21 ].…”
Section: Discussionsupporting
confidence: 84%
“…We present quantitative and qualitative findings using a conceptual framework that emerged during the data analysis, which includes three categories of factors that influence health care providers’ beliefs and decision-making about FGM, its medicalization and the care provided to women and girls at risk of or affected by FGM. Figure 1 presents the conceptual framework, which describes: (1) the factors intrinsic to the health system, which affect service provision; (2) the factors related to the health care provider herself/himself and (3) the community factors that drive demand and influence the provider, some of which have been described previously [ 11 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…As was described previously [ 11 ], health care providers themselves saw value in the practice as reported in their responses to a questionnaire on knowledge, attitudes, and practices. Thirty-eight percent of the respondents felt that FGM prevented promiscuity and infidelity, with 75% of nurses and 63% of auxiliary health providers supporting this belief.…”
Section: Resultsmentioning
confidence: 99%
“…Armonk, New York, USA) for analysis by a trained data specialist in Guinea. Descriptive statistics as well as summary results of the knowledge, attitudes, and practices of the health providers were generated and have been published [ 11 ]. Bivariate analyses to compare response options among sub-groups of respondents based on selected socio-demographic characteristics were carried out and are presented in this paper.…”
Background
Despite efforts to reduce the burden of female genital mutilation (FGM) in Guinea, the practice remains prevalent, and health care providers are increasingly being implicated in its medicalization. This formative study was conducted to understand the factors that facilitate or impede the health sector in providing FGM prevention and care services to inform the development of health sector-based interventions.
Methods
Between April and May 2018, a mixed methods formative study was carried out using a rapid assessment methodology in three regions of Guinea—Faranah, Labe and Conakry. A structured questionnaire was completed by one hundred and fifty health care providers of different cadres and 37 semi-structured interviews were conducted with health care providers, women seeking services at public health clinics and key stakeholders, including health systems managers, heads of professional associations and schools of nursing, midwifery, and medicine as well as representatives of the Ministry of Health. Eleven focus group discussions were conducted with female and male community members.
Results
This study revealed health systems factors, attitudinal factors held by health care providers, and other factors, that may not only promote FGM medicalization but also impede a comprehensive health sector response. Our findings confirm that there is currently no standardized pre-service training on how to assess, document and manage complications of FGM nor are there interventions to promote the prevention of the practice within the health sector. This research also demonstrates the deeply held beliefs of health care providers and community members that perpetuate this practice, and which need to be addressed as part of a health sector approach to FGM prevention.
Conclusion
As integral members of FGM practicing communities, health care providers understand community beliefs and norms, making them potential change agents. The health sector can support them by incorporating FGM content into their clinical training, ensuring accountability to legal and policy standards, and promoting FGM abandonment as part of a multi-sectoral approach. The findings from this formative research have informed the development of a health sector intervention that is being field tested as part of a multi-country implementation research study in Guinea, Kenya, and Somalia.
“…Our study found that some health care providers held a positive attitude towards FGM, whether they had undergone FGM themselves or had maintained the tradition for their daughters, indicating that it might not always be clear how to distinguish between the personal beliefs and professional obligations of providers. The present study also found that the perceived ‘harm reduction’ argument was used to justify health care providers performing FGM in Guinea, as was reported in other studies [ 11 – 13 , 15 , 18 , 21 ].…”
Section: Discussionsupporting
confidence: 84%
“…We present quantitative and qualitative findings using a conceptual framework that emerged during the data analysis, which includes three categories of factors that influence health care providers’ beliefs and decision-making about FGM, its medicalization and the care provided to women and girls at risk of or affected by FGM. Figure 1 presents the conceptual framework, which describes: (1) the factors intrinsic to the health system, which affect service provision; (2) the factors related to the health care provider herself/himself and (3) the community factors that drive demand and influence the provider, some of which have been described previously [ 11 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…As was described previously [ 11 ], health care providers themselves saw value in the practice as reported in their responses to a questionnaire on knowledge, attitudes, and practices. Thirty-eight percent of the respondents felt that FGM prevented promiscuity and infidelity, with 75% of nurses and 63% of auxiliary health providers supporting this belief.…”
Section: Resultsmentioning
confidence: 99%
“…Armonk, New York, USA) for analysis by a trained data specialist in Guinea. Descriptive statistics as well as summary results of the knowledge, attitudes, and practices of the health providers were generated and have been published [ 11 ]. Bivariate analyses to compare response options among sub-groups of respondents based on selected socio-demographic characteristics were carried out and are presented in this paper.…”
Background
Despite efforts to reduce the burden of female genital mutilation (FGM) in Guinea, the practice remains prevalent, and health care providers are increasingly being implicated in its medicalization. This formative study was conducted to understand the factors that facilitate or impede the health sector in providing FGM prevention and care services to inform the development of health sector-based interventions.
Methods
Between April and May 2018, a mixed methods formative study was carried out using a rapid assessment methodology in three regions of Guinea—Faranah, Labe and Conakry. A structured questionnaire was completed by one hundred and fifty health care providers of different cadres and 37 semi-structured interviews were conducted with health care providers, women seeking services at public health clinics and key stakeholders, including health systems managers, heads of professional associations and schools of nursing, midwifery, and medicine as well as representatives of the Ministry of Health. Eleven focus group discussions were conducted with female and male community members.
Results
This study revealed health systems factors, attitudinal factors held by health care providers, and other factors, that may not only promote FGM medicalization but also impede a comprehensive health sector response. Our findings confirm that there is currently no standardized pre-service training on how to assess, document and manage complications of FGM nor are there interventions to promote the prevention of the practice within the health sector. This research also demonstrates the deeply held beliefs of health care providers and community members that perpetuate this practice, and which need to be addressed as part of a health sector approach to FGM prevention.
Conclusion
As integral members of FGM practicing communities, health care providers understand community beliefs and norms, making them potential change agents. The health sector can support them by incorporating FGM content into their clinical training, ensuring accountability to legal and policy standards, and promoting FGM abandonment as part of a multi-sectoral approach. The findings from this formative research have informed the development of a health sector intervention that is being field tested as part of a multi-country implementation research study in Guinea, Kenya, and Somalia.
“…This is why it is important to understand this topic in order to get the opinions of women in the community on the violence perpetrated against them. It was noted that female genital mutilation (FGM), another form of GBV which is deeply rooted in Guinea (95% of women aged 15-49 have undergone FGM/Cutting), will not be included in this study due to its scope, associated factors and specific characteristics [6,7].…”
Background: Gender-based violence exists and is increasing worldwide, with higher rates in African regions where gender inequality persists. It affects adolescent girls and adult women. In Guinea, violence against women is a widespread phenomenon. Indeed, 9 out of 10 women aged from 15 to 64 have been victim of at least one act of violence. The objective of this study is to explore the perceptions of women in the community about the violence that they have undergone.
Methods:It is a qualitative study using focus group discussions (FGD) with women aged 15-49 in three health districts.Results: Of the 18 FGD conducted, young women aged 20 to 24 were the most represented (33%). The main types of Gender-based violence include physical violence, sexual violence (rape) and verbal violence. These types of violence are committed by husbands and boyfriends as well as parents of young girls in a context of forced marriage. The consequences of this violence are injuries, unwanted pregnancies, induced abortions, woman humiliation, depression, divorce and abandonment of the children by the husbands. Women's attitudes to this violence are essentially to remain silent for fear to be stigmatized, health care seeking and filing complaints to the gendarmerie/police or to the leaders of district and notables.
Conclusion:GBV is recurrent in Guinea in all its forms. The perpetrators are intimate partners, family members and unknown aggressors. This phenomenon requires sustained attention of the authorities and a commitment of all the stakeholders in order to highlight the problem and make advocation for women so that these acts of violence can be reduced.
According to the World Health Organization (WHO), customary female genital modification practices common in parts of Africa, South and Southeast Asia, and the Middle East are inherently patriarchal: they reflect deep-rooted inequality between the sexes characterized by male dominance and constitute an extreme form of discrimination against women. However, scholars have noted that while many societies have genital modification rites only for boys, with no equivalent rite for girls, the inverse does not hold. Rather, almost all societies that practice ritual female genital modification also practice ritual male genital modification, often for comparable reasons on children of similar ages, with the female rites led by women and the male rites led by men. In contrast, then, to the situation for boys in various cultures, girls are not singled out for genital modification on account of their sex or gender; nor do the social meanings of the female rites necessarily reflect a lower status. In some cases, the women’s rite serves to promote female within-sex bonding and network building—as the men’s rite typically does for males—thereby counterbalancing gendered asymmetries in political power and weakening male dominance in certain spheres. In such cases, and to that extent, the female rites can be described as counter-patriarchal. Selective efforts to discourage female genital modifications may thus inadvertently undermine women-centered communal networks while leaving male bonding rites intact. Scholars and activists should not rely on misleading generalizations from the WHO about the relationship between genital cutting and the social positioning of women as compared to men. To illustrate the complexity of this relationship, we compare patterns of practice across contemporary societies while also highlighting anthropological data regarding pre-industrial societies. Regarding the latter, we find no association between the presence of a female initiation rite and a key aspect of patriarchy as it is classically understood, namely, social endorsement of a gendered double-standard regarding premarital sexual activity. We situate this finding within the broader literature and discuss potential implications.
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