Health care-seeking patterns for female genital mutilation/cutting among young Somalis in Norway

Abstract

BackgroundFemale genital mutilation/cutting (FGM/C) is a great concern, considering all the potential health implications. Use of health care services related to FGM/C by women who have been subjected to FGM/C in Norway remains to be understood. This study aims to explore the health care-seeking patterns for FGM/C-related health care problems, among young Somalis in Norway.MethodsA cross-sectional study involving 325 young Somalis in Oslo was conducted in 2014 using respondent-driven sampling (RDS) technique. The RDS was initiated by a small number of recruited seeds, who were given coded coupons to recruit their peers to participate in the study. Eligible recruiters who participated in the study and redeemed their coupons created the first wave of respondents. The first wave further recruited their peers, the second wave. The cycle continued to attain the needed samples. Using interviews and structured questionnaires, data on socio-demographic, FGM/C status and FGM/C-related use of health care were obtained. Logistic regressions were used to compute the odds ratio (OR) and the confidence interval (CI) for the associations between demographic variables, to circumcision status and health care-seeking for FGM/C. This study will focus on the 159 female participants of the total 325.ResultsWhile 51.6% of the 159 women were subjected to FGM/C, only 20.3% of them used health care services for FGM/C-related problems. Women’s FGM/C status was associated with age ≥ 12 years at migration, experience of stigma regarding FGM/C practice (p < 0.05), support of FGM/C practice, and place of birth of women (p < 0.05).ConclusionOnly one-fifth of the women with FGM/C sought care for FGM/C-related health problems. Our study does not provide the answers to why only a few of them sought care for FGM/C. However, as a large proportion of women did not seek care, it is important to investigate the reasons for this. For, we propose to conduct further research targeting girls and women who have undergone FGM/C to assess challenges in accessing health care services for proper intervention.

Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study

“…Consistent with other studies [32] health care providers were noted to express shock, disgust, and disbelief upon encountering women with FGM/C. Similar reaction characterized with stigmatization and ostracism towards women with FGM/ C has been reported among professionals from noncutting communities or communities that perform a different type of FGM/C [36,38]. Such reactions disregard the feelings of women who have perceived their genitalia to be normal since childhoodthe so called normalization [32].…”

“…Clinicians were also noted to respond in shock, disbelief, as well as display of psychological and physical distress when they encountered women with FGM/C [32]. Related to aforementioned, stigmatization and ostracism on women with FGM/C by health care providers from non-cutting community affected health seeking [36,38]. Additionally, the health care providers were reported to lack capacity to implement FGM/ C-related management interventions as a result of poor or lack of training [46,47].…”

“…Additionally, the health care providers were reported to lack capacity to implement FGM/ C-related management interventions as a result of poor or lack of training [46,47]. The women with FGM/C also faced barriers to health seeking associated with lack of a well-functioning referral system [38,43,48].…”

“…Although women/girls living with FGM/C are at high risk for health complications [3,23], they face additional challenges in care-seeking for the consequences and where available, it has been reported as sub-optimal [37][38][39]. Challenges in obtaining medical interventions for FGM/C-related complications are implicated with poor health statistics in communities with high prevalence [2,4].…”

Barriers to access to the Norwegian healthcare system among sub-Saharan African immigrant women exposed to female genital cutting

“…Presently in 2019, Norway has 47276 immigrant women from sub-Saharan African FGC practicing countries [15]. In 2013, 44,467 such female immigrants were residing in Norway, and half of them were estimated to have been subjected to type III (also known as infibulation the most severe form) of FGC prior to migration [16,17]. In Norway, these women are offered reconstructive surgery-called de-infibulation-to alleviate some of the complications resulting from infibulation [18].…”