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Female Genital Mutilation in Africa: an Analysis of Current Abandonment Approaches

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Female Genital Mutilation in Africa: an Analysis of Current Abandonment Approaches Female genital mutilation in Africa An analysis of current abandonment approaches December 2005 A.C.S. Plaza, 4th Floor, Lenana Road P.O. Box 76634, Nairobi, 00508 Tel: 254.20.3877177 Fax: 254.20.3877172 email: [email protected] www.path.org Suggested citation: Muteshi J, Sass J. Female Genital Mutilation in Africa: An Analysis of Current Abandonment Approaches. Nairobi: PATH; 2005. Copyright © 2006, Program for Appropriate Technology in Health (PATH). All rights reserved. The material in this document may be freely used for education or noncommercial purposes, provided the material is accompanied by an acknowledgement line. Table of contents Acronyms ............................................................................................................................ 3 Executive summary ............................................................................................................ 4 1 Introduction ................................................................................................................ 6 2 FGM prevalence.......................................................................................................... 7 FGM prevalence by residence ..................................................................................... 8 FGM prevalence by ethnicity ...................................................................................... 9 FGM prevalence by education..................................................................................... 9 FGM prevalence by religion.......................................................................................10 3 Circumstances surrounding the practice ..................................................................10 Type of FGM performed ............................................................................................10 Age at which FGM is performed ................................................................................11 Person performing FGM.............................................................................................12 4 Rationale for FGM.....................................................................................................13 Religious beliefs.........................................................................................................13 Personal beliefs ..........................................................................................................14 Societal beliefs ...........................................................................................................15 5 Abandonment approaches.........................................................................................17 History of abandonment approaches...........................................................................17 Human rights approach...............................................................................................19 Legal approach...........................................................................................................21 Health risk approach...................................................................................................22 Training health workers as change agents...................................................................23 Training and converting circumcisers .........................................................................25 Alternative rites approach...........................................................................................27 Positive deviance approach.........................................................................................29 Comprehensive social development approach.............................................................31 6 Abandonment programs—key stakeholders ............................................................32 Government officials..................................................................................................33 Religious and community leaders ...............................................................................33 Youth .........................................................................................................................34 Teachers and education sector staff ............................................................................35 Men............................................................................................................................36 Health workers ...........................................................................................................37 Traditional circumcisers .............................................................................................38 7 Abandonment programs—key supporting elements................................................38 Research.....................................................................................................................38 Monitoring and evaluation..........................................................................................39 Training .....................................................................................................................40 Materials ....................................................................................................................41 Advocacy ...................................................................................................................43 Sustainable funding arrangements ..............................................................................44 8 Conclusions and lessons learned................................................................................45 9 References ..................................................................................................................47 Appendix 1: FGM abandonment programs and research interventions in Africa.........57 Appendix 2: Donors and technical assistance for FGM abandonment ...........................67 2 Acronyms AMWIK Association of Media Women in Kenya APAC Association des Professionnelles Africaines de la Communication (Association of African Communication Professionals) BAFROW Foundation for Research on Women’s Health, Productivity, and the Environment C4C Communication for Change CAR Central African Republic CEDPA Center for Development and Population Activities CEDAW Convention on the Elimination of all forms of Discrimination Against Women CEOSS Coptic Evangelic Organization for Social Services CEWLA Center for Egyptian Women’s Legal Assistance CNAPN Comité National pour l’Eradication des Pratiques Néfastes à la Santé (National Committee for the Eradication of Harmful Traditional Practices to Health) COST Coptic Organization for Services and Training CPTAFE Cellule de Coordination sur les Pratiques Traditionelles Affectant la Santé des Femmes et des Enfants (Coordination Unit on Harmful Traditional Practices to the Health of Women and Children) DHS Demographic and Health Survey FGC female genital cutting FGM female genital mutilation GTZ Deutsche Gesellschaft für Technische Zusammenarbeit ICPD International Conferences on Population and Development IEC information, education, and communication MYWO Maendeleo Ya Wanawake Organization NGO nongovernmental organization PATH Program for Appropriate Technology in Health PRB Population Reference Bureau RAINBO Research, Action, and Information Network for the Bodily Integrity of Women REACH Reproductive Education and Community Health REM Review, Evaluation, and Monitoring RIJOPD Réseau des Journalistes en Population et Développement (Network of Journalists in Population and Development) UNICEF United Nations Children’s Fund UNFPA United Nations Population Fund USAID U.S. Agency for International Development WHO World Health Organization 3 Executive summary Female genital mutilation (FGM), or female genital cutting, also known as female circumcision, is a traditional practice that involves the partial or total removal or alteration of girls’ or women’s genitalia. For those who support the continuation of the practice, FGM is considered to be a thread in the social fabric that defines a woman’s social standing and ultimately a community’s identity. FGM is often practiced out of respect for and in conformity to society’s culture and traditions. Others see it as a religious obligation, or a rite of passage into womanhood that ensures a girl’s virginity and consequently her value and that of her family and the increased likelihood of good marriage prospects. Also underpinning the practice are prescribed gender roles and understandings of men’s and women’s sexuality. The World Health Organization estimates that some 130 million women worldwide have undergone the practice, and every year another 2 million girls and young women are at risk. Nearly universal in a few African countries, FGM is practiced by various groups in at least 25 others. Through immigration and population movements, it has also spread to Europe, North and South America, and Australia and New Zealand. FGM is performed among different ethnic and religious groups, in urban and rural areas, and among all education levels and social classes. There is, however, considerable variability across and within countries regarding these factors, as well as in the type of FGM practiced, the age at which FGM occurs, the type of practitioner who performs FGM, and the rituals and traditions surrounding the practice. The increasing recognition of FGM as an issue of global concern has seen evolving collaborations between nations; donors; international, regional
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