“…The remaining two unavailable tools had been administered in Sweden [19] and UK [20]. The available questionnaires we fully reviewed were from the UK [21–23], Australia [24, 25], Belgium [26, 27], Switzerland [28, 29], the U.S. [30, 31], Spain [32], Sweden [33], the Gambia (same questionnaire in two included studies) [7, 8], Nigeria [34] and Sudan [35]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…In the UK and in Belgium, some specific topics covered included highly debated subjects such as medical and legal controversies regarding FGM and cosmetic surgery, appropriate terminology to use when speaking to a woman affected by FGM, personal opinions concerning pricking and piercing classified as FGM type IV and differences between FGM and male circumcision [21, 22, 26, 27]. …”
Section: Resultsmentioning
confidence: 99%
“…In agreement with such resources, the main expectations regarding KAP of the healthcare professionals interviewed were for instance not performing C-section in case of FGM type III; offering defibulation to treat or avoid urogynecological, sexual and obstetric complications; being against reinfibulation and any form of medicalization; being aware that FGM is illegal, a human rights violation and a dangerous practice responsible for several short and long term complications. Some of the questionnaires were informally piloted or pre-tested for acceptability, content, clarity and feedback in small groups of caregivers or students [7, 8, 17, 23, 25, 26, 33, 34]. Only two questionnaires, implemented in Belgium and U.K., were based on previous questionnaires used in another country [23, 27].…”
Section: Resultsmentioning
confidence: 99%
“…Only in Switzerland, Belgium and the Gambia the questionnaires were administered more than once [7, 8, 26–29]. Two papers reported administering the same instrument to assess an improvement of knowledge, attitude and practice after a training intervention [21, 31].…”
IntroductionImproving healthcare providers’ capacities of prevention and treatment of female genital mutilation (FGM) is important given the fact that 200 million women and girls globally are living with FGM. However, training programs are lacking and often not evaluated. Validated and standardized tools to assess providers’ knowledge, attitude and practice (KAP) regarding FGM are lacking. Therefore, little evidence exists on the impact of training efforts on healthcare providers’ KAP on FGM. The aim of our paper is to systematically review the available published and grey literature on the existing quantitative tools (e.g. scales, questionnaires) measuring healthcare students’ and providers’ KAP on FGM.Main bodyWe systematically reviewed the published and grey literature on any quantitative assessment/measurement/evaluation of KAP of healthcare students and providers about FGM from January 1st, 1995 to July 12th, 2016. Twenty-nine papers met our inclusion criteria. We reviewed 18 full text questionnaires implemented and administered to healthcare professionals (students, nurses, midwives and physicians) in high and low income countries. The questionnaires assessed basic KAP on FGM. Some included personal and cultural beliefs, past clinical experiences, personal awareness of available clinical guidelines and laws, previous training on FGM, training needs, caregiver’s confidence in management of women with FGM, communication and personal perceptions. Identified gaps included the medical, psychological or surgical treatments indicated to improve girls and women’s health; correct diagnosis, recording ad reporting capacities; clitoral reconstruction and psychosexual care of circumcised women. Cultural and personal beliefs on FGM were investigated only in high prevalence countries. Few questionnaires addressed care of children, child protection strategies, treatment of short-term complications, and prevention.ConclusionThere is a need for implementation and testing of interventions aimed at improving healthcare professionals’ and students’ capacities of diagnosis, care and prevention of FGM. Designing tools for measuring the outcomes of such interventions is a critical aspect. A unique, reproducible and standardized questionnaire could be created to measure the effect of a particular training program. Such a tool would also allow comparisons between settings, countries and interventions. An ideal tool would test the clinical capacities of providers in managing complications and communicating with clients with FGM as well as changes in KAP.
“…The remaining two unavailable tools had been administered in Sweden [19] and UK [20]. The available questionnaires we fully reviewed were from the UK [21–23], Australia [24, 25], Belgium [26, 27], Switzerland [28, 29], the U.S. [30, 31], Spain [32], Sweden [33], the Gambia (same questionnaire in two included studies) [7, 8], Nigeria [34] and Sudan [35]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…In the UK and in Belgium, some specific topics covered included highly debated subjects such as medical and legal controversies regarding FGM and cosmetic surgery, appropriate terminology to use when speaking to a woman affected by FGM, personal opinions concerning pricking and piercing classified as FGM type IV and differences between FGM and male circumcision [21, 22, 26, 27]. …”
Section: Resultsmentioning
confidence: 99%
“…In agreement with such resources, the main expectations regarding KAP of the healthcare professionals interviewed were for instance not performing C-section in case of FGM type III; offering defibulation to treat or avoid urogynecological, sexual and obstetric complications; being against reinfibulation and any form of medicalization; being aware that FGM is illegal, a human rights violation and a dangerous practice responsible for several short and long term complications. Some of the questionnaires were informally piloted or pre-tested for acceptability, content, clarity and feedback in small groups of caregivers or students [7, 8, 17, 23, 25, 26, 33, 34]. Only two questionnaires, implemented in Belgium and U.K., were based on previous questionnaires used in another country [23, 27].…”
Section: Resultsmentioning
confidence: 99%
“…Only in Switzerland, Belgium and the Gambia the questionnaires were administered more than once [7, 8, 26–29]. Two papers reported administering the same instrument to assess an improvement of knowledge, attitude and practice after a training intervention [21, 31].…”
IntroductionImproving healthcare providers’ capacities of prevention and treatment of female genital mutilation (FGM) is important given the fact that 200 million women and girls globally are living with FGM. However, training programs are lacking and often not evaluated. Validated and standardized tools to assess providers’ knowledge, attitude and practice (KAP) regarding FGM are lacking. Therefore, little evidence exists on the impact of training efforts on healthcare providers’ KAP on FGM. The aim of our paper is to systematically review the available published and grey literature on the existing quantitative tools (e.g. scales, questionnaires) measuring healthcare students’ and providers’ KAP on FGM.Main bodyWe systematically reviewed the published and grey literature on any quantitative assessment/measurement/evaluation of KAP of healthcare students and providers about FGM from January 1st, 1995 to July 12th, 2016. Twenty-nine papers met our inclusion criteria. We reviewed 18 full text questionnaires implemented and administered to healthcare professionals (students, nurses, midwives and physicians) in high and low income countries. The questionnaires assessed basic KAP on FGM. Some included personal and cultural beliefs, past clinical experiences, personal awareness of available clinical guidelines and laws, previous training on FGM, training needs, caregiver’s confidence in management of women with FGM, communication and personal perceptions. Identified gaps included the medical, psychological or surgical treatments indicated to improve girls and women’s health; correct diagnosis, recording ad reporting capacities; clitoral reconstruction and psychosexual care of circumcised women. Cultural and personal beliefs on FGM were investigated only in high prevalence countries. Few questionnaires addressed care of children, child protection strategies, treatment of short-term complications, and prevention.ConclusionThere is a need for implementation and testing of interventions aimed at improving healthcare professionals’ and students’ capacities of diagnosis, care and prevention of FGM. Designing tools for measuring the outcomes of such interventions is a critical aspect. A unique, reproducible and standardized questionnaire could be created to measure the effect of a particular training program. Such a tool would also allow comparisons between settings, countries and interventions. An ideal tool would test the clinical capacities of providers in managing complications and communicating with clients with FGM as well as changes in KAP.
“…This study has highlighted some important barriers in providing optimal care for women with FGM and adequate prevention of FGM in girls, including the lack of technical and legal knowledge, the limited skills to deal with cultural diversity and the lack of guidelines and protocols that can support midwives when confronted with FGM. These gaps were equally identified by a recent KAP survey among midwives in Belgium 3. The need for more information on FGM in humanitarian crisis settings that is pointed out by this study is of particular importance.…”
Objective
To explore the perspectives of midwives and obstetrician/gynaecologists providing maternity care to women living with female genital mutilation/cutting (FGM/C) in a high asylum‐seeker dispersal area in the North West of England.
Methods
We carried out a qualitative study in four hospitals providing maternal health services within the North West of England, with the highest population of asylum‐seeking individuals (many from high‐prevalence FGM/C countries) in the UK. Participants included 13 practicing midwives and an obstetrician/gynaecologist. In‐depth interviews were conducted with study participants. Data collection and analysis were carried out concurrently until theoretical saturation was reached. Data were analysed thematically to generate three key overarching themes.
Results
There is a disconnect between Home Office dispersal policy and healthcare policy. Participants indicated that there was inconsistent identification or disclosure of FGM/C, constraining appropriate follow‐up and care prior to labour and childbirth. All participants noted existing safeguarding policies and protocols, which were seen by most as being important to protect female dependants, but potentially detrimental to the patient‐provider relationship and to the woman's care. Unique challenges around accessing and maintaining continuity of care for asylum‐seeking women due to dispersal schemes were indicated. All participants highlighted a lack of specialised training for FGM/C to support provision of clinically appropriate and culturally sensitive care.
Conclusions
There is a clear need for harmony between health and social policy as well as specialised training that centres holistic wellbeing for the woman living with FGM/C, particularly where there are increased numbers of asylum‐seeking women from high‐prevalence FGM/C countries.
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