Management of Female Genital Mutilation/Cutting-Related Obstetric Complications: A Training Evaluation

Abstract

Although female genital mutilation/cutting (FGM/C) is a prevalent practice in Liberia, healthcare workers lack the capacity to provide adequate care for FGM/C survivors. Therefore, Liberian nurses, physician assistants, midwives and trained traditional midwives were trained in sexual, obstetric and psychosocial care for FGM/C survivors in 2019. Through questionnaires, we assessed knowledge acquisition, trainee attitudes towards FGM/C care and acceptability to implement WHO-endorsed recommendations. The questionnaires were analyzed using descriptive statistics for quantitative data and an inductive approach for qualitative data. A total of 99 female and 34 male trainees participated. Most trainees perceived FGM/C as harmful to women’s health, as a violation of women’s rights and showed a willingness to change their clinical practice. While 82.8% (n = 74/90) perceived their role in advocating against FGM/C, 10.0% (n = 9/90) felt that they should train traditional circumcisers to practice FGM/C safely. The pre-training FGM/C knowledge test demonstrated higher scores among physician assistants (13.86 ± 3.02 points) than among nurses (12.11 ± 3.12 points) and midwives (11.75 ± 2.27 points). After the training, the mean test score increased by 1.69 points, from 12.18 (±2.91) points to 13.87 (±2.65) points. The trainings successfully increased theoretical knowledge of FGM/C-caused health effects and healthcare workers’ demonstrated willingness to implement evidence-based guidelines when providing care to FMG/C survivors.

Evaluating the long-term impact of large-scale trainings: an exposure based cross-sectional study on female genital mutilation-related knowledge, attitudes and practices among Sudanese midwives in Khartoum State

“…Furthermore, there is a literature gap on trainings’ effectiveness on intentions to change clinical practice or actual changes in clinical practice in either a study setting or for real-world training interventions 8 9. We also found no study assessing training effects beyond 6 months of training.…”

“…7 The retrospective, exposure-based study design was a practical approach to inform policy-makers and programme managers who require timely data for decision-making but may not have the financial budgets to conduct prospective studies. 24 Finally, we used objective questions to assess actual knowledge instead of midwives’ perceptions as was done previously 9 to generate non-biased data for decision-makers involved in training programmes and quality of care.…”

Acceptability of a Smartphone Application to Enhance Healthcare to Female Genital Mutilation Survivors in Liberia: A Qualitative Study

“…The workshops were guided by the WHO’s handbook ‘Care of girls and women living with female genital mutilation’ [ 14 ] and were attended by a total of 133 HCPs. The results of the effectiveness evaluation of the workshops are published elsewhere [ 18 ].…”

Legal Awareness and Practices of Female Genital Mutilation/Cutting (FGM/C) among United Arab Emirates Medical Practitioners

“…Obstetric complications include perineal and episiotomy tears and prolonged labor. Moreover, these may obstruct assessment and treatment by health-care workers, including during intrapartum vaginal examination or in catheterization [ 14 ]. Post-traumatic stress disorder (PTSD), affective disorders, anxiety, somatization, and depression are the most common psychological complications [ 15 ].…”