Female Genital Cutting FGC Abandonment

1
Female Genital Cutting (FGC) Abandonment
US Agency for International Development
(USAID) Mini-University
Global Leadership Priority
Abdelhadi Eltahir, MD, MPH Senior Technical
Advisor, USAID Washington, May 10, 2004
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Definitions
FGC is a harmful, traditional practice that
violates the health and human rights of women and
hinders development (USAID FGC Policy)
FGM is a variety of operations involving partial
or total removal of the female external genital
organs WHO
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Regions where FGC/FGM reported
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FGC Prevalence among women 15-49 yrs
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FGC is a Multi-Sector Issue
Protecting human rights is a major component for
sustaining democracy, African women have decided
that FGC is a human rights issue and its
elimination efforts will be more successful if it
is embarked on from a human rights perspective.

• DEVELOPMENT
• POLITICAL
• GENDER
• RELIGIOUS
• HUMAN RIGHTS
• HEALTH

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Current Interventions and Approaches

• Health Risk Approach
• Alternative Rite of Passage
• Medicalization
• Conversion Strategy
• Law Enforcement
• Social mobilization
• Positive Deviance

7
Legislations Against FGC in African countries

• Guinea - 1965
• Ghana - 1994
• Burkina Faso - 1995
• Djibouti 1995
• Egypt Decree 1997
• Ivory Coast - 1997

• Tanzania - 1998
• Togo - 1998
• Senegal 1999
• Kenya 2001
• Benin 2003
• Chad - 2003

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How FGC activities fit within health strategies
Advance and Support voluntary Family Planning and
Reproductive Health Programs

• FGC Abandonment is integral to FP/RH programs
• Will be incorporated in policy dialogue, advocacy
  and services delivery.
• Lessons learned, best practices and knowledge
  generated by the FGC GLP will be widely
  disseminated for implementation of effective and
  sustainable FP/RH programs

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How FGC activities fit within health strategies
(Contd)
Reduction in deaths and adverse health outcomes
to women as a result of childbirth

• FGC long-term complications include increased
  risk during child birth.
• FGC abandonment activities (e.g. training of
  health care provider) can reduce the incidence of
  complications leading to improved maternal health.

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How FGC activities fit within health strategies
(Contd)
Improvement of infant and child health and
nutrition and reduction in infant and child
mortality

• Abandoning FGC among girls, an important step
  towards improving child health and reducing
  infant and child mortality.
• FGC abandonment reduces the risk of birth
  complications among affected women thereby
  decreasing the risk of infant and neonatal
  mortality.

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How FGC activities fit within health strategies
(Contd)

• Reduction of HIV/AIDS transmission
• The practice of FGC poses significant risk for
  HIV transmission
• Repeated use of cutting instruments
• Increased trauma during sexual intercourse
• Potential increased need for blood transfusions
• Presence of genital ulcers and dermoid cysts

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Accomplishments and Results

• Donors Working Group on FGC
• Standardized FGC Indicators
• Generate Donors Matrix
• Improved Information-Sharing through list-serve
• Measure DHS contribution
• FGC added to DHS Stat compiler

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Accomplishments and Results

• Zero Tolerance International Day
• 2-day events in February 2004
• Promotion of Legislations against FGC
• USAID continues to encourage governments to
  enact anti-FGC laws and policies

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Results (cont.)
Cost Shifting Trend Core to Field Support
USAID/Ethiopia
USAID/Guinea
USAID/Egypt
FS/Core ? 100
FS/Core ? 50
FS/Core ? 75
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Changes in Intention not to Cut Daughters in
Future
Accomplishments and Results
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Accomplishments and Results
Percentage of clients in favor of abandoning FGC
(N364)

• PRIME Mali

0.7
60.4
0.6
0.5
0.4
24.0
0.3
0.2
0.1
0
February 2002
June 2003
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Accomplishments and Results
Percentage of clients who intend to have FGC
performed on their daughters (N367)

• PRIME Mali

0.8
68.0
0.7
0.6
42.4
0.5
0.4
0.3
0.2
0.1
0
February 2002
June 2003
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Accomplishments and Results (cont.)

• TOSTAN Evaluation in Senegal reported a
  significant increase in knowledge of
  contraceptive methods.
• Women 63 at baseline 99 at end-line
• Men 69 at baseline 98 at end-line