Outpatients’ Perspectives on Problems and Needs Related to Female Genital Mutilation/Cutting: A Qualitative Study from Somaliland

Abstract

Aim. To explore female outpatients’ perspectives on problems related to female genital mutilation/cutting (FGM/C) and their views on information, care, and counseling.Setting. An FGM/C support center at a maternity clinic in Hargeisa, Somaliland.Methods. A qualitative, descriptive study, using content analysis of seven semistructured interviews with female outpatients.Results. All participants had been ignorant of the etiology of their FGM/C-related complications and hesitant to seek care. All had undergone infibulation but did not wish the same for their daughters. In recent years they had learnt through religious leaders and media campaigns that infibulation was unapproved by Islam. A less severe FGM/C type, “Sunna,” was more accepted; however, few could define what “Sunna” meant. Condemning and ridiculing attitudes against uncircumcised women prevailed in their community.Conclusions. New ideas and concepts related to FGM/C enter the common discourse in the Somali society while traditional norms and values still prevail. Religion was shown to have a strong impact on FGM/C practices and beliefs. Interventions aiming to raise awareness of health consequences of all types of FGM/C, as well as where to seek care for complications, are needed in Somaliland. Involvement of religious leaders in anti-FGM/C programs is essential.

Use of a bibliometric literature review to assess medical research capacity in post‐conflict and developing countries: Somaliland 1991–2013

“…After screening for duplicates, the literature search identified a total of 83 articles for assessment. Thirty‐five articles met the eligibility criteria after screening by title and abstract, but four of these were excluded after full text review . The most common reasons for exclusion were as follows: non‐experimental reports ( n = 16), social science and/or health policy studies without study subjects from Somaliland ( n = 13), non‐human or animal studies ( n = 12), and abstracts or letters ( n = 8).…”

Psychological and counselling interventions for female genital mutilation

“…The qualitative synthesis (detailed methods described in Stein et al . in this Supplement) included two studies describing the context of psychological intervention provision for women living with FGM and three studies on women's views and providers’ experiences of counselling interventions . Three studies were conducted in low‐income countries (one in the Gambia and two Somaliland) and two in high‐income countries (one in Switzerland and one in the Netherlands).…”

“…The study from the Gambia included women who had migrated to Norway as well as traditional practitioners in the Gambia and explored the traditional folk psychology and care provided to girls undergoing FGM and compared this with mainstream psychological care. The two Somaliland studies were conducted in the same FGM support center at a maternity clinic in Hargeisa—one included women's views on counselling for problems related to FGM and the other midwives’ views on providing care and counselling . The study conducted in the Netherlands included women who had migrated from Somalia, Sudan, Eritrea, Ethiopia, or Sierra Leone and explored their experience of mental/psychosocial problems and coping mechanisms, and the Swiss study explored FGM complications, care, and counselling with women from Eritrea and Somalia .…”

Female Genital Cutting: Confronting Cultural Challenges and Health Complications Across the Lifespan

“…By contrast, in subgroups such as the Arab Bedouin tribes of southern Israel, the ritual remains culturally important but has been reduced to a clitoral nick with one or two stitches [35]. Although attitudes are changing, FGC has been a deeply rooted societal norm and a number of cultural beliefs contribute to its significance [14,36,37]. It is a tradition and social obligation that brings honor to the girl and her family.…”

“…Often women do not understand the cause of their symptoms, unless they learn about the health complications of FGC through educational efforts or discover relief from symptoms after undergoing defibulation by a healthcare professional [37].…”