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Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Table of Contents Table of Contents . 1 Acronyms and Abbreviations . 2 Foreword . 3 Acknowledgments . 4 1. Introduction . 11 1.1 Background . 11 1.2 Justification . 12 1.3 The Assessment: Purpose and Objective . 12 1.4 The World Bank in Somalia . 13 1.5 UNFPAin Somalia . .. 13. 1.6 Assessment Methodology and Process . 13 1.7 Structure of the Report . 14 1.8 Limitations of the Assessment . 14 2. Background on FGM/FGC in the Somali Context . 17 2.1 Brief Background on FGM/FGC in Africa and in the Somali context . 17 2.2 Case Studies of Community-Based Behaviour: Change Interventions and Lessons Learnt . 27 3. Assessment Findings . 35 3.1 Positive Responses from International Partners and Civil Society Organizations . 35 3.2 Responses from Regional Authorities . 36 3.3 Responses from Communities . 37 3.4 Lessons Learnt and Best Practices . 38 3.5 FGM/FGC Elimination in Somalia: Opportunities and Constraints . 51 4. Key Issues and Recommendations . 61 4.1 Responses from International Partners and Civil Society Organizations . 61 4.2 Responses from Regional Authorities . 62 4.3 Responses from Communities . 63 4.4 Examining Projects: Lessons Learnt and Best Practices . 63 4.5 Opportunities and Constraints for Reengagement on FGM/FGC Elimination in Somalia . 64 Annex 1 . 73 Annex 2 . 113 Annex 3 . 129 Annex 4 . 131 Female Genital Mutilation / Cutting in Somalia 1 Acronyms and Abbreviations AID . .Association for Integration and Development AIDOS . .Italian Association for Women in Development AIDS . .Acquired Immune Deficiency Syndrome BCC . .Behaviour Change Communication BCI . .Behaviour Change Intervention CARE . .Cooperative for Assistance and Relief Everywhere CBO . .Community-Based Organization CEOSS . .Coptic Evangelical Organization for Social Services COGWO . .Coalition for Grassroots Women Organizations DHS . .Demographic Health Survey FAO . .Food and Agriculture Organization of the United Nations FC . .Female Circumcision FGC . .Female Genital Cutting FGM/FGC . .Female Genital Mutilation GC . .Genital Cutting GECPD . .Galckayo Education Center for Peace and Development HAVOYOCO . .Horn of Africa Voluntary Youth Committee HMIS . .Health Management Information System IEC . .Information, Education and Communication IFRC . .International Federation of Red Cross and Red Crescent Societies IPPF . .International Planned Parenthood Federation IRC . .International Rescue Committee KAPB . .Knowledge Attitudes, Practices and Beliefs LICUS . .Low-Income Countries Under Stress MCH . .Mother and Child Healthcare MYWO . .Maendeleo Ya Wanawake Organization NCA . .Norwegian Church Aid NGO . .Non Governmental Organization NPA . .Norwegian People’s Aid PATH . .Program for Appropriate Health Technology PBUH . .Peace Be Upon Him PSA . .Puntland Student Association PYA . .Puntland Youth Association RAINBO . .Research, Action and Information Network for Bodily Integrity of Women REACH . .Reproductive, Education and Community Health Project RH/FP . .Reproductive Health / Family Planning SACB . .Somalia Aid Coordination Body SFHCA . .Somalia Family Health Care Association TBA . .Traditional Birth Attendant U.N. .United Nations UNDP . .United Nations Development Program UNFPA . .United Nations Population Fund UNHCR . .United Nations High Commission for Refugees UNICEF . .United Nations Children’s Fund UNIFEM . .United Nations Women’s Fund USAID . .United States Agency for International Development WAWA . .We Are Women Activists WFP . .World Food Program WHO . .World Health Organization YES . .Youth Employment for Somalia 2 Female Genital Mutilation / Cutting in Somalia Foreword The World Bank and the United Nations Population Fund (UNFPA) are pleased to present this assessment of female genital mutilation (FGM)/female genital cutting (FGC) programs in Somalia as a framework for intervention. This report resulted from consultations with various stakeholders in Nairobi and Somalia. It represents the first attempt in assessing the progress made towards the eradication of FGM/FGC in Somalia. The report highlights the enormous cost and high prevalence of FGM/FGC in Somalia. It explores the health, religious, cultural, economic and human rights perspectives of FGM/FGC. It captures responses from Somalis, civil society, communities, regional authorities and global partners. Since FGM/FGC is deeply engrained, innovative traditional measures are required to initiate behaviour change. The report examines ways of achieving such changes. The lessons learnt from FGM/FGC programs provide the basis for targeted and strategic follow-up initiatives to hasten its eradication. The World Bank and UNFPAhave actively supported the global fight against FGM/FGC, which undermines women's health and well-being. Both institutions believe that where FGM/FGC is universal, it should be integrated into reproductive health, education and social protection strategies. Recommendations outlined here, particularly the six critical foundations necessary for the successful implementation of an FGM/FGC program, should be useful to those fighting against FGM/FGC. We hope the report will provide strategic and long-term interventions, which will ultimately eliminate FGM/FGC in Somalia. Makhtar Diop Fama Ba Country Director Director Kenya, Eritrea, and Somalia Africa Division World Bank United Nations Population Fund Female Genital Mutilation / Cutting in Somalia 3 Acknowledgments This assessment report of FGM/FGC eradication programs in Somalia is the outcome of extensive consultations with partners from Northwest/Somaliland, Northeast/Puntland and Central and Southern Somalia, nongovernmental organizations (NGOs), community-based organizations (CBOs), regional authorities and international partners. The report grew from the collaborative effort of the World Bank and UNFPA, who envisioned a joint assessment of FGM/FGC eradication programs and activities in Somalia as a guide to their current and future interventions. Our gratitude goes to the World Bank – Makhtar Diop, Country Director for Kenya, Eritrea and Somalia and Dr. Khama Rogo, Lead Specialist World Bank and to UNFPA– Fama Ba, Director of the Africa Division, Dr. Akinyele Dairo, Senior Advisor and Dr. Uche Azie, Director of CST/Harare for providing the vision. We are grateful for the guidance and facilitation of Priya Gajraj, Somalia Coordinator at the World Bank. Jacqueline Desbarats and Jeylani Dini of UNFPASomalia, Sylvia Danailov of UNICEF and Isabel Candela of NOVIB (Oxfam Netherlands) offered valuable support to the assessment team. We thank Shamis Salah, Program Assistant at the World Bank, for her administrative support. We acknowledge agencies represented in the Somalia Aid Coordination Body for providing valuable feedback, lists and contact persons of local and international bodies involved in FGM/FGC eradication. We are indebted to various stakeholders, regional authorities, religious leaders, women’s organizations, youth groups, traditional birth attendants, doctors, nurses, international organizations, the United Nations (U.N.) agencies in Somalia who shared their strategies, experiences, and challenges in the campaign against FGM/FGC. Our thanks extend to all partners in Central and Southern Somalia who provided feedback. We thank Ms. Hawa Mohamed, Executive Director of Galckayo Education Center for Peace and Development, who met the assessment team in Garowe and Mr. Osman Mohamed (Shuke), Executive Director of the Puntland Development Research Center, who mobilized women and youth groups while providing insight into Somali culture. Mr. Shuke offered invaluable information on the interaction between the Xeer (Somali customary law), Sharia (Islamic law) and secular laws and how they affect the FGM/FGC discourse. The commitment from all these partners to save Somali girls and women from the devastating effects of FGM/FGC was truly inspirational. Lastly, we thank all persons who commented on the report and whose wisdom is incorporated here. The assessment team—Dr. Asha A. Mohamud, Adolescent Sexual and Reproductive Health Specialist, African Youth Alliance Project, UNFPA Country Support Team, Zimbabwe & Agnes McAntony, Consultant, World Bank 4 Female Genital Mutilation / Cutting in Somalia Executive Summary Between 100 and 140 million women and girls have undergone mutilating operations on their external genitalia, suffering permanent and irreversible health damage. Every year, two million girls are subject to mutilation, which traditional communities call "female circumcision" and the international community terms "female genital mutilation" (FGM), or "female genital cutting" (FGC). FGM/FGC inflicts serious physical, psychological and sexual complications on women and girls. FGM/FGC has relentlessly been condemned by the U.N. and the international community. It was denounced by the U.N. in 1952, at a World Health Organization Regional meeting in Khartoum, in 1979, and in a 1984 conference in Senegal, which was attended by members from 20 African countries. The 1993 Vienna U.N. Convention on Human Rights declared that: "The.
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