Beyond illegality: Primary healthcare providers' perspectives on elimination of female genital mutilation/cutting.

Abstract

Aims and objectives: To report primary healthcare providers' perspectives on elimination of female genital mutilation/cutting (FGM/C). Background: Eradication of FGM/C by 2030 is one of the United Nations Sustainable Development goals. World Health Organization recognises the unique role of nurses and other primary healthcare providers. However, their voices on the current legislative approach are underreported. These voices are important in informing directions that can expedite achievement of the global goal. Design: Qualitative interpretivist phenomenology. Methods: This qualitative study used purposive sampling approach and involved 19 individual interviews conducted face to face or by telephone with Australian primary healthcare providers. Data collected between October and December 2019 were transcribed verbatim and thematically analysed. Three themes exploring Australian healthcare providers' perspectives on elimination of FGM/C were identified, namely understanding Australian laws against FGM/C; perspectives on culturally sensitive education; and exploring public awareness raising activities in Australia. This study was guided by Consolidated Criteria for Reporting Qualitative Research, the checklist for qualitative studies.Results: "Understanding Australian laws against FGM/C" identified participants' knowledge that FGM/C is illegal in Australia and that mandatory reporting applies if a child is or at risk of being taken oversees for the procedure. Through "Perspectives on culturally sensitive education," the participants argued that education is the key to questioning the practice of FGM/C. "Exploring public awareness-raising activities in Australia" described the need for collective action germane to FGM/C eradication. Conclusions:This study emphasised that laws and legislation prohibiting FGM/C need to be complemented with culturally sensitive education and public awareness-raising activities, to produce optimal outcome for the elimination of FGM/C in Australia.Relevance to clinical practice: Voices of these healthcare providers are crucial for FGM/C to be eradicated. Listening and acting on these voices are important in achieving the global sustainable development goal of eradicating FGM/C.

Female Genital Mutilation as a Social Norm: Examining the Beliefs and Attitudes of Women in This Diaspora

“…When dealing with social conventions, we must understand their dual nature by which they simultaneously regulate behaviour and provide the normative principles that guide these behaviours (Al-Amoudi & Latsis, 2014; Miller Moya, 2009). Therefore, any approach to tackling FGM must be comprehensive and should consider the behaviour of the practice itself and the underlying interrelated factors that maintain this behaviour (Johansen, 2019) as well as revealing the precise laws and complementary measures required to further the goal of the abandonment of FGM (Muthumbi et al, 2015; Ogunsiji & Ussher, 2021). Likewise, Mohamud et al (2021) advocate a ‘whole systems approach’, alluding that partial approaches may lead to increased medicalization or a defensive reaction to cultural ‘intrusion’.…”

Do No Harm? Discrepancies across Canadian Healthcare Policy and Obstetrics and Gynaecology Training for Treating Women affected by Female Genital Cutting

“…According to Payne et al (2019) "there are significant immediate and long-term risks associated with FGM/C including obstetric, neonatal, urologic, gynecologic, infectious, sexual, and psychological health consequences" (p. 857). Based on the vast array of potential health consequences, there needs to be more distinction in the medical literature on the different types of FGC, and how HCPs must be able to identify the varying physical severity of the four types along with the health consequences that may result (Earp & Johnsdotter, 2021;Ogunsiji & Ussher, 2021;Werunga et al, 2016). These long-term health consequences are especially a concern with the more physically invasive types of FGC like Type 2 (excision) and Type 3 (infibulation).…”

“…Ultimately, politics and power dynamics influence this hierarchy, especially in the western context where FGC is condemned and illegal. As a result, much of the existing literature on FGC is concerned with prevention and intervention rather than treatment, especially in the context of medical professionals' roles (Bedri et al, 2019;Higginbothan, 2015;Johansen et al, 2018;Klein et al, 2018;Koukoui, 2017;Nabaneh & Muula, 2019;Ogunsiji & Ussher, 2021;Payne et al, 2019;Shell-Duncan, 2008).…”

“…One major area of the literature discusses the importance of health care providers in preventing and eliminating the practice of FGC, especially through sexual health education for women and girls (Bedri et al, 2019;Nabaneh & Muula, 2019;Ogunsiji & Ussher, 2021;Payne et al, 2019;Perron et al, 2020). HCPs are a strategic source for identifying instances of FGC in adult women along with the continued prevalence of the practice on young girls.…”