on Global Consultation

Female Genital Mutilation/Cutting Genital Female Technical Report

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Global Consultation on Female Genital Mutilation/Cutting

Technical Report

Prepared by Gender, Human Rights and Culture Branch Technical Division

Contents

List of Abbreviations and Acronyms ...... viii Acknowledgements ...... x Foreword ...... xii Executive Summary ...... 1 Introduction ...... 2

I. Opening Statements ...... 4 A . Welcoming Remarks by Mr . Benson Morah, Director, UNFPA Country Technical Services Team, Addis Ababa ...... 5 B . Keynote Address by Ms . Fama Hane Ba, Director, Africa Division, UNFPA ...... 6

Summary of Presentations and Discussions ...... 9

II. Prevalence of FGM/C ...... 10 A . Global Trend and Prevalence of FGM/C: Development of Data Analysis Tools for Measuring Changes in FGM/C Practice ...... 11 (Ms. Maria Gabriella De Vita, Child Protection Specialist, Gender Equality and Social Change, Child Protection Section, Programme Division, UNICEF) B . Linkages of Maternal and Newborn Mortality with FGM/C ...... 13 (Dr. Guyo Jaldesa, Consultant, Obstetrician and Gynaecologist, Principal Investigator, WHO) C . Promulgation of Laws ...... 14 (Ms. Faiza Jama Mohamed, Regional Director Africa, Equality Now)

III. FGM/C Changing Patterns and Practices ...... 18 A . Latest Developments in Social Sciences; FGM/C as a Self-Enforcing Social Convention: Basic Principles ...... 19 (Ms. Francesca Moneti, Senior Child Rights Officer, UNICEF Innocenti Research Centre) B . The Medicalization of FGM/C: Trends and Global View ...... 21 (Dr. Elise B. Johansen, Technical Officer, WHO) C . The Medicalization of FGM/C: Case Study in Egypt ...... 22 (Dr. Mohamed Farid, Project Officer, Reproductive Health Services, Ministry of Health and Population, Egypt) D . Emerging Community Strategies to Maintain FGM/C Practice: Changing Patterns and Practices – The Kenyan Perspective ...... 24 (Dr. Kemal Mustafa, UNFPA Representative, Kenya) E . Emerging Community Strategies to Maintain FGM/C Practice in Uganda ...... 25 (Dr. Hassan Mohtashami, UNFPA Representative, a.i., Uganda) IV. FGM/C: A Threat to Human Rights and to the Achievement of Millennium Development Goals . . . 26 (Ms. Seynabou Tall, Gender Adviser, UNFPA Country Technical Services Team, Addis Ababa)

V. Cost Implications of FGM/C Practice ...... 30 A . FGM/C in Relation to Women’s and Girls’ Rights: Experiences of No Peace without Justice ...... 31 (Ms. Alvilda Jablonko, FGM/C Programme, No Peace without Justice) B . Denial of Women’s Rights and Insights on New Approaches to Gender Equity: “CARE’s Strategic Impact Inquiry on Women’s Empowerment and FGM/C Abandonment in Awash” ...... 32 (Ms. Haregewien Admassu, Gender Adviser, CARE Ethiopia) C . Psychological and Sociocultural Implications ...... 32 (Ms. Faiza Benhadid, Gender Adviser, Country Technical Services Team, Amman) D . Economic and Health Costs ...... 33 (Dr. Tshiya Subayi-Cuppen, Dr. Khama Rogo and Dr. Gebreselassie Okubagzhi, the World Bank Group)

VI. Experiences/Lessons Learned and Best Practices in the Abandonment of FGM/C ...... 34 A . The Politics of FGM/C, Partnership-building and Community Accountability Mechanism: Case Study, Kapchorwa District, Uganda ...... 35 (Ms. Margaret Thuo, Adviser, Behaviour Change Communication and Advocacy, UNFPA Country Technical Services Team, Addis Ababa) B . Working with Maasai Communities ...... 36 (Ms. Judith Kunyiha Karogo, Programme Officer, UNFPA Kenya) C . The Inter-Africa Committee on Traditional Practices (IAC): Programme Strategy ...... 37 (Mr. Isatou Touray, Secretary General, IAC) D . Sociocultural Contribution to the Abandonment of FGM/C ...... 38 (Mr. Ali Hashim Sarag, Sociocultural/Religious Expert, Sudan) E . Lessons Learned from Operations Research ...... 39 (Ms. Maryam Sheikh Abdi, Programme Officer, the Population Council, Nairobi)

VII. Strategies that Work: Scaling up and Lobbying for a Global Effort / 42 A . Community-led Developments Using Social Convention Theory, Diffusion Models and Social Networking ...... 43 (Mr. Malick Diagne, Deputy Director, Tostan) B . Community Conversation Model ...... 44 (Dr. Bogaletch Gebre, Founder, Kembatta Mentti Gezzima Tope, Ethiopia) C . Coordinated Strategy for the Abandonment of FGM/C: Main Elements, Goals and Objectives . . . . 46 (Ms. Maria Gabriella De Vita, Child Protection Specialist, Gender Equality and Social Change, Child Protection Section, Programme Division, UNICEF) D . Experiences in FGM/C Interventions with Norwegian Support ...... 48 (Dr. Berit Audstveg, Senior Adviser, NORAD) E . FGM/C Abandonment: Mali Experience ...... 50 (Mme. Keita Josephine Traore, Director, National Programme for the Abandonment of FGM/C, Mali) F . Monitoring and Evaluation, Including Development Indicators ...... 50 (Ms. Laura Raney, Programme Associate, FRONTIERS, The Population Council, Washington, D.C.) VIII. Identification of Gaps in Policies and Laws on FGM/C: Panel Discussion ...... 54 A . Support for International Instruments and Harmonization of Traditional/Religious and Statutory Laws ...... 55 (Advocate Ibrahim Lethome Asmani, Kenya High Court) B . Enforcement of Existing Laws and Policies pertaining to the Abandonment of FGM/C ...... 56 (His Worship Simon Peter Odoo, Senior Magistrate, Kapchorwa, Uganda) C . Ensuring Public Understanding of the Relevant Legal Provisions (Legal Literacy) ...... 58 (Ms. Mariam Lamizana, Honorary President, IAC) D . Advocating for Political and Community Accountability in the Abandonment of FGM/C ...... 58 (Imam Afiz Ambekema, Benin)

IX. Culturally Sensitive Approaches for Sustainable Abandonment of FGM/C: Panel Discussion . . . . 60 A . Culturally Sensitive Communication Approaches to Support Shifts in FGM/C related Social Norms . 61 (Ms. Tabeyin Gedlu, Programme Communication Officer, UNICEF Ethiopia) B . Five Dimensional Approaches in Community Mobilization: Ethiopia’s Experience ...... 62 (Mr. Abebe Kebede, Executive Director, Ethiopia Committee on Traditional Practices) C . Regional Experiences ...... 63 (Ms. Faiza Mohamed, Regional Director, Equality Now) D . UNFPA Perspectives on Culturally Sensitive Approaches ...... 66 (Ms. Miriam Jato, Senior Gender Adviser, Africa Division, UNFPA) E . The Face of FGM/C in Southern and Central Africa ...... 67 (Ms. Safiatu Singhateh, Gender, Population and Development Adviser, UNFPA Country Technical Services Team, Harare)

X. Panel Discussion: Building the Capacity of Managers and Implementers for Planning, Implementing, Evaluating and Scaling up FGM/C Innovative Interventions ...... 70 Contributors: Dr. Magdi Hemy, Director, Health Programmes, CARITAS, Egypt Ms. Beatrice Chelangat, Coordinator, REACH Uganda Ms. Safia Elmi Djinril, Director of Mother and Child Health, Djibouti Ms. Fatma Abdel Fattal, Executive Director, Sudanese Network on FGM/C

XI. Panel Discussion: Resource Mobilization for Scaling up FGM/C Abandonment Efforts Globally . . . 72 A . Guiding Principles for Resource Mobilization ...... 73 (Ms. Fama Hane Ba, Director, Africa Division, UNFPA) B . Belgium’s Contribution to the Abandonment of Harmful Practices, including FGM/C ...... 73 (Ms. Cecile Charot, Deputy Adviser, Ministry of Foreign Affairs and Development Cooperation, Belgium) C . The Case for Investing in the Abandonment of FGM/C ...... 74 (Ms. Layla Shaaban, Programme Analyst, Office of Population and Reproductive Health, USAID) D . Norway’s Interventions Concerning FGM/C ...... 76 (Dr. Berit Audstveg, Senior Adviser, NORAD) XII. Global Partnership-building for the Abandonment of FGM/C ...... 78 A . Fostering Joint Programming to Accelerate Change: Example of the UNFPA-UNICEF Joint Programme and Trust Fund ...... 79 (Ms. Aminata Toure, Chief, Gender, Human Rights and Culture Branch, UNFPA) B . Inter-Agency Group on FGM/C ...... 81 (Ms. Bintou Sanogoh, Director, UNFPA Country Technical Services Team Dakar, and Dr. Morissanda Kouyate, Director of Operations, IAC, Addis Ababa) C . Donors’ Working Group on the Elaboration of a Common Framework for the Abandonment of FGM/C ...... 82 (Ms. Francesca Moneti, Senior Child Rights Officer, UNICEF Innocenti Research Centre) D . Global Collaboration in Monitoring and Evaluation of FGM/C ...... 83 (Ms. Ann P. McCauley, Ph.D., Senior Reproductive Health Technical Adviser/Programme Officer, USAID/East Africa Mission E . Research on Emerging Issues: Towards a Global Research Strategy for the Abandonment of FGM/C 84 (Dr. Mary Anne Burke, Health Analyst/Statistician, Global Forum for Health Research)

XIII. Final Conclusions and Recommendations ...... 86 A . The Way Forward ...... 87 B . Final Declaration of Participants ...... 87 C . Closing Remarks ...... 89

Annexes ...... 90 1 . List of Participants ...... 91 2 . Summary of WHO Study Group on Female Genital Mutilation and Obstetric Outcome ...... 95

List of Abbreviations and Acronyms GECPD (Gambia) Clubs Fathers’ GAMCOTRAP FGM/C EGLDAM EDHS DWG DHS DASECA CSTAA CST CRDH CPTAFE CONA-CIAF CNLPE CI-AF CEWLA CEP CDF CCE-CC CBO CARE ARP APDF AMSOPT AJM AIDOS p a g e viii mary and vocational education vocational and mary pri operates that organization Somalia-based Development, and Peace for Centre Education Galkayo mutilation/cutting genital Female Mahber) Aswegaj Dergitoch Lemadawi Goji (Ethiopia Traditional on Practices Committee Ethiopia Survey Health and Demographic Egyptian Group Working Donors Survey Health and Demographic UNFPA Asia, Central and Europe States, of Arab Division Team, Ababa Addis Technical Services Country Team, UNFPA Technical Services Country Development Human in Research for Centre The Inter-Africa the Traditional of on Practices Committee affiliate Guinea, in mutilation genital female end to working organization Enfants) (leading des et Femmes des Sante La Affectant Traditionelles Pratiques Les sur Coordination de lule Cel (La Guinea Infants, and Women of Health the Affecting TraditionalPractices on Cell Coordination al’enfant), et Mali mere Chad, femme ala nefastes traditionnelles pratiques (Comite on Traditional du Comite Inter-Africain national Practices les Committee contre Inter- Africa de Lutte Infant, and Mother to Damaging Practices Traditional against Fight the of Committee National Faso Burkina FGM/C, against Committee National children’s health women’s and affecting Traditional on Practices Inter-Africa Committee Geneva-based Assistance Legal Women Egyptian for Centre Programme Empowerment Community Facilitator Dialogue Community Conversation Community through Enhancement Capacity Community organization Community-based poverty global fighting organization Humanitarian of Passage Rite Alternative Maliennes) Femmes des Droits des Defense La and Progres Le pour (Association Women Malian of Rights the of Advancement and Protection the for Association le Traditionnelles) Pratiques des pour l’Orientation et Suivi Malienne (Association Practices Traditional in Directions Overseeing for Association Malian Maliennes) Juristes (l’Association des Association Lawyers’ Women Malian Sviluppo) lo per Donne Italiana (Associazione Development in Women for Association Italian - - WOWAP WHO USAID UNIFEM UNICEF UNFPA UNFIP UNECA UNCT TBA SVRI SII REACH PNLE PATH PASAF Macro ORC NUEYS NPWJ NORAD NGO NAFGEM MYWO MICS MDG LHRC KMG IRC IAC HUNDEE HIV/AIDS GTZ “Women Wake“Women Up”,FGM/C Tanzanian fighting NGO Organization World Health Development International for Agency States United Women for Fund Development Nations United Children’s Fund Nations United Fund Population Nations United Partnerships International for Fund Nations United Africa for Commission Economic Nations United Team Country Nations United attendant Traditional birth Initiative Research Violence Sexual (CARE) Inquiry Impact Strategic (Project) Health Community and Educative Reproductive d‘Excision) Pratique la contre Lutte de National (Programme Excision of Practice the against Fight the in Programme National Health Technology and Appropriate for Program Infants and l’Enfant) de et Femme la de Women Sante ala Prejudiciables of Practiques Les d’Appui Contre Lutte ala (Project Health the to Harmful are that Practices against Fight the Support to Project firm technology information and consulting, management Research, Youths Students of Eritrean and Union National Justice without Peace No Cooperation Development for Agency Norwegian the organization Non-governmental of Tanzania Republic United FGM/C, against Network Ya (Maendeleo Wanawake Kenya Organization) Progress, Women for Movement Survey Cluster Indicator Multiple Goal Development Millennium of Tanzania Republic United Centre, Rights Human and Legal organization) development community Tope integrated (Woman-focused Gezzima Mentti Kembatta UNICEF Centre, Research Innocenti Traditional on Practices Inter-Africa Committee Ethiopia Organization, Development Grass-roots Oromo syndrome immunodeficiency virus/acquired immunodeficiency Human of Germany Cooperation Development

p a g e ix Acknowledgements from Africa and CST advisers in the Africa and DASECA regions for their leadership throughout the consultation the throughout leadership their for regions DASECA and Africa the in advisers CST and Africa from Services TeamCountry directors Technical (CST) offices, fromcountry officers programme consultation; in the global at sentatives the and level and for country participation for mobilizing support NGOs totheir overwhelming participate those for especially Africa and for the Arab and States, Europe Asia Central (DASECA) and regions; the UNFPA Repre directors, division geographical the support; technical and financial provided which Division, Technical the purpose; that for website a up setting for and consultation of the coverage media wide ensuring for Division, Relations External togo Ms thanks Special institutions of Tanzania; religious Republic (LHRC), and United Centre Rights Human and Legal FGM/C; on Network Sudanese the Ethiopia; (KMG), Tope Gezzima Mentti Kembatta Uganda; Project, (REACH) Health Community and Educative Reproductive Tostan; consultation; the at represented those especially Africa, in branches national all and the Inter-Africa (IAC) especially Committee (CI-AF), on in (IAC)TraditionalGeneva in Practices Office Ababa Addis Regional its partners NGO to goes appreciation special practices, best and experience field valuable their sharing For Now Equality and (AIDOS) Global Forum for Health No Research, Peace without the Justice, CARE, Italian for Association Women in Development Council, Population The Fund, (USAID), Global Wallace Development International for Agency States United the Aid, Irish and (NORAD) Cooperation Development for Agency Norwegian The Netherlands, the Belgium, World the Bank, (WHO), Organization Health World the (UNIFEM), Women for Fund Development Nations United (UNICEF), Fund Children’s Nations United (UNECA), Africa for Commission Economic Nations United the mention to want especially consultation the for Ababa Addis to come We to want who to responded the call to thank partners positively our their staff and professional development funded consultation the after and during event an such hold to sible many distinguished persons and organizations and persons of distinguished many efforts of result the was (FGM/C) Mutilation/Cutting Genital Female on Consultation Global the of success The p a g e x Thoraya Obaid, the UNFPA Executive Director, for her inspiring support; the Information and and Information the support; inspiring Director, her for UNFPAthe Executive Obaid, . Thoraya Therefore, we need to convey our appreciation to each one who played a key role before, before, role key a played who one each to appreciation our convey to need we Therefore, . . . The quality of their contribution has made it possible to come this far this come to possible it made has contribution their of quality The . Without their hard work and contribution, it would have been impos been have would it contribution, and work hard their Without . . We . . - - bara Ryan for her assistance in editing the report the editing in assistance her for Ryan bara Ms and support, logistical and planning invaluable CSTAA—fortheir the of Secretary—all Senior TekleMariam, Ms Documentalist; Lulu, Shewaye in staff administration Addis Ms especially Ababa, Ms and report, this compiled and consultation the coordinated who Advocacy, and Communication Change Adviser, Behaviour Thuo, logistics undertaking and agencies various by partici pation promoting paper, concept initial the draft to team his mobilizing for and leadership excellent his for Morah, (CSTAA), Team,Ababa Addis Mr Technical Services Country the of Director the especially Weacknowledge Seynabou Tall, Gender Adviser who assisted in the coordination of the Consultation the of coordination the in assisted who Adviser Gender Tall, Seynabou . Akeleselassie Mekuria, Local Area Network (LAN) Manager; and Ms and Manager; (LAN) Network Area Local Mekuria, Akeleselassie . Chief, Gender, Human Rights and Culture Branch, Technical UNFPA Branch, Division, Culture and Rights Human Gender, Chief, . Bethlehem Solomon, Senior Administration/Finance Assistant; Ms Assistant; . Senior Administration/Finance Solomon, Bethlehem In his team, we want to recognize, in particular, Ms particular, in recognize, to want we team, his In . We thank the the thank We . Toure Aminata Meskerem Meskerem . Margaret Margaret . Benson Benson . Bar . p a g e xi - - . Foreword and how those teams could address it in their development assistance and plans and assistance development their in it address could teams those how and capacity building TeamsCountry (UNCTs) in of and the achievement how MDGs will development about FGM/C gain knowledge impacts practice and theory both use to able be will activists, rights support addressed be to need that challenges and gaps FGM/C of abandoning abandonment FGM/C the in involved movement actors of variety a for resource excellent an is Report Technical this Overall, elsewhere it find to difficult be would it and here, all (NGOs)—is organizations governmental non and partners development scholars, religious professionals, medical build partnerships and global ing resources mobilizing implementers, for capacity building enforcement, law in gaps closing for needs the process abandonment the accelerating for basis a as theories of application the as well as studies case costs health and economic its as well as (MDGs) Goals ment Develop of to Millennium FGM/C the threat poses the achievement analyses and medicalization, including practices, tal mutilation/cutting (FGM/C) and with its linkages maternal and health newborn This contains publication rich content on global research findingsconcerning trends and the prevalence of femalegeni p a g e xii Implementers of FGM/C abandonment interventions, including NGOs, civil society organizations and human human and organizations civil society NGOs, including interventions, of FGM/C abandonment . Implementers Professional advocates will learn of the latest techniques and challenges in advocating for the acceleration for the acceleration in advocating and challenges ofwill learn the techniques latest advocates . Professional Researchers will be able to ascertain the situation ofthe situation globally, the will FGM/C tobe able movement including ascertain . Researchers This extensive knowledge—which was shared by research institutions, foundations, lawyers, lawyers, foundations, institutions, research by shared was knowledge—which extensive This . Development partners will gain new insight on where to focus their their focus to where on insight new gain will partners Development . . It identifies important lessons and discusses in detail detail in discusses and lessons important identifies It . . It describes changing patterns . and patterns changing It describes Policy actors and United Nations Nations United and actors Policy . It addresses addresses It . - - - Executive Summary in culturally sensitive approaches in and challenges emerging culturally sensitive approaches beto working seems ofwhat laws asand indicators as examples well policies in gaps identifies of development the including evaluation, and monitoring assessment, FGM/C, of donment aban the for strategy coordinated a model, conversation community a theory, convention social using development research operations and conversations community FGM/C, of politics the including experiences, field of array an provides VI process interventions abandonment advocates and for implementers ing capacity rights practice this sustain to trends emerging and medicalization norms, social self-enforcing including practices, FGM/C of study deeper a is enforcement or implementation of level their including countries, in laws and policies FGM/C-related and and process consultation in of 13 the consultation global sessions This covers Technicaldeliberations Report Protocol”) (the “Maputo of Women in Africa Rights the Union’son Protocol African the and Child of the Rights the on Convention the Women, the including Convention tional on conventions and the declarations, Elimination of All Forms of against Discrimination by interna guided of FGM/C a within generation, abandonment the to accelerate are needed action and commitment through generations children and women of millions to deaths and suffering untold caused has that practice a FGM/C, of abandon ment the to commitment its by guided practitioners and experts global together brought UNFPA2007, July In into being excised into being coerced or consent informed giving of incapable either are who women and girls adolescent infants, female of rights deaths infant as well as Africa in reported weight birth low and infant the of tion resuscita the death, episiotomies, for need the labour, prolonged tears, perineal delivery, after stays hospital longer bleeding, extensive for risks sections, Caesarean have to likely more significantly were FGM/C undergone had who A WHO study in 2006 on FGM/C and obstetric outcomes in six that, African confirmed countries in women deliveries, groups ethnic different among and countries practising in cent 5per to low as as cent per 90 from of ranges FGM/C Yemen and Arabia Saudi Malaysia northern and Jordan, southern Indonesia Iraq, in India, particularly Asia, Western in in reported populations been also has certain practice The among especially Asia, in countries some in practised also is United the States New Zealand and Canada, Australia, in Europe, as well in28 Africa as immigrants countries The World Health Organization (WHO) estimates that about 100-140 million women have been subjected to FGM/C in Session . V Session at looks the and economic cost health of costs implications psychological, FGM/C, including According to UNICEF, approximately 3 million girls are at risk of being mutilated/cut each year mutilated/cut to each . ofAccording UNICEF, at risk being are girls 3 million approximately The final session, XIII, presents conclusions and the way forward, including the final declaration final the including way forward, the and conclusions presents XIII, session, final .The Session VII provides details of strategies that would be considered good practices, including community-led community-led including practices, good considered that be would of details strategies VII provides . Session The objective of the meeting was to tell the world that the abandonment of FGM/C is urgent and that that and urgent is FGM/C of abandonment the that world the tell to was meeting the of objective The . FGM/C is, therefore, a global concern aglobal therefore, is, .FGM/C Session IV covers the link between FGM/C practice and the achievement of MDGs and human human and MDGs of achievement the and practice FGM/C between link the covers IV Session . . Session II covers global trends, linkages with maternal and newborn morbidity and mortality . and II with mortality Session morbidity linkages maternal covers and newborn global trends, Session XII addresses the critical importance of a global partnership in the abandonment in abandonment the of partnership a global importance critical the XII addresses . Session Thus, the practice of FGM/C contributed to the high rates of maternal death death maternal of rates high the to contributed FGM/C of practice the Thus, . This practice is not just a health issue; it is also a violation of the human human the of violation a also is it issue; health a just not is practice This . Session XI provides details on resource mobilization toup FGM/C scale mobilization on resource details XI provides . Session . Session . X Session on of concentrates the build critical importance Session I . is Session on for the the rationale Session IX provides experiences experiences IX provides . Session The prevalence prevalence . The Session VIII VIII Session . . Session III III Session . . Session . Session FGM/C

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Introduction cations of the practice, including bleeding and painincludingpractice,bleedingandthecations of compli immediate the reduce to K) vitamin and tetanus anti- antibiotics, anaesthesia, (local drugs and equipment complicationsdiate to and/orhealth facilities to to professionals reduce imme ly the educated and urbanized—are taking their daughters health ofconsequences FGM/C, more families—especial communities some in practice the perform to reported been also have FGM/C out carrying mid- personnel—are health allied and nurses providers—doctors, wives, health trained Increasingly, abandoned and addressed be must FGM/C health, maternal improving and mortality child ment commit global a is MDGs the of achievement addition, critical is community international bythe women and col of against Discrimination Women and the Maputo Proto of Forms All Elimination the on Convention the including Several call declarations for the of abandonment FGM/C, mortality infant increased possibly, on and, mortality the profound ofeffects FGM/C on maternal morbidity and coercion or age to due consent informed giving of incapable are who women and girls adolescent infants, of rights human the violates FGM/C viewfrom violationsthathidden are rights human tating devas most the of one is and girls and women many of health sexual and psychological physical, the to damage irreversible and significant causes practice this Indeed, generations through women millionsof among pain and suffering created has which FGM/C, the of to abandonment commitment its by guided genital female mutilation/cutting, on forum global a to practitioners and experts together bringing of idea the conceived UNFPA Rationale for aGlobal FGM/C Consultation p a g e 2 Indeed, . the Indeed, tocommitment the protection of children To achieve goals 4 and 5, aimed at decreasing decreasing at aimed 5, and 4 goals achieve To . . optl laes n vtrnr doctors veterinary and cleaners Hospital . With the increasing awareness of negativeincreasingawarenessof the With . elh rvdr otn s hospital use often providers Health Recent studies indicate indicate studies Recent . . . High .

In In . ------. . nia Tanza of Republic United the and Togo Senegal, Niger, Mauritania, Kenya, Guinea, Egypt Ghana, Ethiopia, 2008), (in Eritrea, Djibouti, d’Ivoire, Cote Chad, Republic, African Central Faso, Burkina FGM/C—Benin, against downward is in prevalence trend the years, over many sustained were programmes abandonment FGM/C where Kenya, and support greater for commitment in and abandonment in globally wasted been not has practice this of abandonment the towards spent money misconceptions and spirituality, gender, myths tion, dimensions tenacious many decades of ment yetover FGM/C, has much the nothing changed so abandon the towards that expended been has been money much has years few last the in argument The practice of this of medicalization prohibition the for WHOandtheir partnerstake aleading role inadvocating UNICEF, UNFPA, that requires practice this fighting fore, right it make not does FGM/C of medicalization deem the practice “safe” for their daughters to continue as mothers maintained is therefore prevalence ideas and new thinking will generate new commitments commitments new generate will thinking new and ideas toprocess the accelerate FGM/C abandonment as so working not is what and working is what review critically and learned lessons and findings new ences; declining be to seems funding activities, abandonment FGM/C ing promot organizations of number increasing the Despite FGM/C about educated be professionals medical and the lawthat communities requires example, laws enacted also practised are in place tice In Nigeria, 12 states enacted laws against the prac the against laws enacted states 12 Nigeria, In . In Uganda, community bylaws against the practice practice the against bylaws community Uganda, In . In several countries, including Eritrea, Ethiopia Ethiopia Eritrea, including countries, several In . It is critical to remember that the practice has has practice the that remember to critical is It . Developed countries where FGM/C where is countries . being Developed Therefore, agencies need to share experi share to need agencies Therefore, . n fia 1 cutis rmlae laws promulgated countries 17 Africa, In . Indeed, changes are taking place place taking are changes Indeed, . It is associated with tradi with associated is It . In the United States, for for States, United the In . . . However, the Sharing . Sharing There . . The . The ------commitment in FGM/C abandonment A task force was was force task A abandonment FGM/C in commitment demonstrated had who staff senior own its as well as (CBOs)financially organizations NGOs community-based and active supporting to itself committed UNFPA accordingly participate to others porting sup and sources funding own global their using the consultation in participate to brochure agencies upon advocacy called that consultation global a developed activities consultation pre consul guide to and global tation FGM/C the of added value the on UNFPA within clarity create to developed was paper concept A Preparations  (f) (e)  (d)  (c)  (b)  (a)  to: were consultation of the tives 2007 August 3 to July 30 from held was which Consultation Global a through abandonment bring together its and to partners its staff to discuss decided FGM/C UNFPA above, cited issues the address To results best the likelyto produce more approaches on based implementation programme and funding for ment process within ageneration within process ment abandon the accelerate to how on consensus Build other among organizations; and Nations United society civil sector, private the NGOs, agencies, funding institutions, research als, profession among activities abandonment FGM/C to attention increased for partnerships Strengthen up interventions; abandonment FGM/C scaling and evaluating monitoring, in together work to organizations and of agencies capacity implementing the building for mechanisms Propose accountability; and commitment understanding, public and munity com promote to approaches sensitive culturally ing develop for and programmes abandonment FGM/C for funding greater attracting for strategies Consider gaps; those to close strategies sible pos consider and policies and laws in gaps Identify practices; best and learned lessons experiences, findings, research new Share The specific objec specific The . . Meanwhile, Meanwhile, . . UNFPA UNFPA . ------• • • • • • included: participants) of list for 2 annex (see levels regional and global at organizations various from drawn consultation, the in part took participants 86 than More Participants created within UNFPA to address both technical and and issues logistics technical both address to UNFPA within created

on FGM on Network Sudanese the Tostan;Ethiopia;and in KMG Uganda;countries;inREACH selected from branches national the and Ababa Addis in Office Regional its TraditionalonCommittee (IAC); PracticesGeneva, in National NGOs and human rights groups—Inter-Africa Now Equality and AIDOS CARE, Justice, out cil, Global Forum for Health No Research, Peace with Coun Population The Fund, Global NGOs—Wallace international and institutions research Foundations, USAID and NORAD Netherlands, the Aid, Irish embassies—Belgium, their and partners Donor Nations—UNECA, World Bank the and WHO UNICEF, UNIFEM, United the of Representatives countries African from yers law and officials government and Parliamentarians Director Executive to the Assistant Personal and Division; Africa Adviser, Gender Division; Africa tor, Direc and Culture Branch; the Rights Gender, Human of Headquarters—Chief UNFPA of staff senior and Regions; Asia Central and Europe States, Arab the and Africa in Advisers CST and Africa from directors CST offices, country from Officers Programme and UNFPA senior staff, including UNFPA Representatives Religious institutions were also represented also were institutions .Religious .

Participants Participants .

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I. Opening Statements  IA. strategies for accelerating FGM/C abandonment FGM/C accelerating for strategies on learned lessons and experiences of sharing continual for forum interactive an therefore is Asset Knowledge information of repository living web-based Asset Knowledge FGM/C an that UNFPA established had observed he In this respect, of FGM/C the abandonment in contexts cultural various avoid as repeating so mistakes and to work promote, as not quickly as does possible, or works what about tices prac good and to devoted experiences primarily sharing Mr Mr. man rights of women and young girls,” Mr girls,” young and of women rights man hu fundamental the of violation a is which FGM/C, of issue the of importance the of indicative as consultation tion consulta the in participate to opportunity the have not did who those reach to possible as widely as report the accommodated be not could people many therefore and anticipated, than more much FGM/C of to the together coming world, the subject discuss critical over all from organizations traditional and religious ing mental institutions and civil society organizations, includ govern partners, development organizations, Nations United other associates, and friends colleagues, of ence Ababa Addis of city historic and beautiful the in FGM/C on consultation Morah emphasized that the consultation would be be would consultation the that emphasized Morah . Addis Ababa Director, Country Technical Services Team, Welcoming Remarks by Mr. Benson Morah, . “UNFPA takes this huge ofexpression interest in the He observed that the level of interest was was interest of level the that observed He .

UNFPA welcomed participants to the global global the to participants welcomed UNFPA Director, Morah, Benson CSTAA, on behalf of He noted his appreciation for the pres the for appreciation his noted He . He promised to circulate circulate to promised He . Kolde se i a is Asset Knowledge A . Morah said .Morah The FGM/C FGM/C The . . . ------. tive approaches in abandonment interventions abandonment in tive approaches sensi culturally using while faster, practice the of ment toabandon make partnerships of value the emphasized knowledge-sharing enhance to as so ers stakehold other to up it open to plans were there staff, UNFPA to limited was Asset Knowledge the to access key were interaction and partnership alive, Mr Morah observed that for the repository to remain remain to repository the for that observed Morah . In closing, he he closing, In . Although Although . .

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- - -  IB. psychological scars psychological and physical lasting behind leaving health, their mises compro seriously and girls and women of rights human basic the violates that practice this of abandonment the toneed to communities themselves recommit accelerate widespread Iraq in communities Kurdish certain in and Yemen Oman, (Gaza), Territory estinian Pal Occupied Jordan, in as well as Malaysia and nesia Indo India, as such countries Asian of parts in exist to to be excised Africa to back taken or borders their within on operated tradition of grip the escape to unable times some are Europe, Western as well as States United the living in western such countries as Canada Australia, and and practised, traditionally was FGM/C where countries from of immigrants daughters even that out pointed She practice cultural and tradition rooted deeply and complex this to conform to order in year this tice prac this through go to forced be would who countries, African 28 from predominantly girls, and women million world the across to girls may this practice havesubjected been Ms of FGM/C abandonment the in to a accelerate movement FGM/C for and partnership on dialogue for call UNFPA the to response whelming over the for representing, was she whom Director, tive Execu the and herself of behalf on appreciation special Ms remarks, opening her In p a g e 6 Director, Africa Division, UNFPA Keynote Address by Fama Ms. Hane Ba, Ba noted that as many as 140 million women and and women million 140 as many as that noted Ba . She said, “Indeed, our thoughts also go to the 2-3 to the go also thoughts our “Indeed, said, She . Development partners, governments and and governments partners, Development . . Various forms of FGM/C are also reported . . Fama Hane Ba expressed expressed Ba Hane Fama . Therefore, the practice is is practice the Therefore, . . ” Many are are Many . ------birth birth compared with infants of mothers without FGM/C including II types and III, were at FGM/C, an risk increased of dying in child of forms extensive undergone had contribution of FGM/C to maternal and infant morbid infant and maternal to FGM/C of contribution orrhage (annexorrhage 1) in and hospital, also of from post suffering haem partum stay extended an a and episiotomy an requiring section, Caesarean of risk greater significantly a ran not, had who those with compared FGM/C, undergone had who ies stud objective in proved been not had but known were infertility to and mortality and morbidity newborn and maternal to FGM/C of contributions the recently, Until 3 2 1 dants and under unhygienic conditions unhygienic under and dants atten skilled without delivered FGM/C undergone had group control a did than infertility of most the undergone risk higher of forms FGM/C had a extensive significantly had who women that factors,” risk other for controlling Khar “after confirmed in Sudan, toum, women infertile 66 involving study Another complications of obstetric risk the higher the ting, mutilation/cut genital the extensive more the Indeed,

2005 Jul 30-Aug 5; 366(9483):347-9 5; 30-Aug Jul 2005 L SE-17176, Sweden Stockholm Institutet, Karolinska Health, International mutilation in girlhood in Sudan: a case-control study a case-control in Sudan: in girlhood mutilation S ; Ibid Almroth, L Almroth, cetfgm www study WHO group countries: on and http://mutilation female outcome, genital obstetric African six in study prospective orative collab WHO outcome: obstetric and mutilation genital Female A WHO six-country study confirmed that women women that confirmed study six-country WHO A . M . . . Elfadil; and S and Elfadil; . . who . pdf . . int/reproductive-health/publications/articles/lan Almroth@telia ; S ; Elmusharaf; N Elmusharaf; . 1 . Moreover, the infants of who mothers Bergström, “Primary infertility after genital genital after infertility “Primary Bergström, . . com, Journal reference: The Lancet Lancet The reference: Journal com, El Hadi: A Hadi: El . Obeid; M Obeid; . Many women who who women Many . . 3 Therefore, the the Therefore, . . A ” Division of ” Division El Sheikh Sheikh El . . . ------2 - -

4 I Type follows: FGM/C of types broad of four A classification overestimated be cannot settings, African in and nomadic rural especially and mortality, ity the definition given above given definition the under falls that procedure other any and it; narrowing or of or for tightening the tovagina purpose bleeding cause the into herbs or substances corrosive of introduction (b)  (a)  including: results, positive some to led have partners UNFPA of efforts ing fund and programming concerted the years, the Over ( orifice vaginal the surrounding tissue of scraping sue; tis surrounding and clitoris the of burning by terization cau labia; and/or clitoris the of stretching labia; and/or IV Type opening vaginal (infibulation) the of stitching/narrowing and talia III Type minora labia of the sion Type II clitoris entire the or of part sion

angurya (Geneva, WHO, 2006) WHO, (Geneva, tal Mutilation “A of Geni Female Overview Factual Organization, World Health seemed to be stagnating in Burkina Faso (one of the the of(one Faso Burkina in stagnating be to seemed years some for on going been had interventions FGM/C trea, Kenya, Mali and in countries Nigeria, which anti- age groups older in women than FGM/C to subjected been have to likely less were years 15-19 aged women surveys, two least at in collected were data where FGM/C countries of prevalence the of Reduction practice; of this disapproving men and girls women, of numbers increased to leading girls, and of women rights the violates it that and FGM/C health of effects harmful the about awareness Widespread — excision of the prepuce, with or without exci without or with prepuce, the of excision — — excision of the clitoris with or partial total exci us o ctig f h vgn ( vagina the of cutting or cuts) hs a go news good was This . ecso o pr o al f h etra geni external the of all or part of excision — — pricking, piercing or incising of the clitoris clitoris the of incising or piercing pricking, — . Progress in Sexual and Reproductive Health Reproductive and Sexual in ” Progress Prevalence decline . was decline Prevalence also visible in Eri . 4

However, prevalence prevalence However, . gishiri In some some In . cuts); , No , 72 72 . ------(c)  5 Ms solutions devise and practice harmful this on reflect their creates leaders a forum in which communities could and communities with dialoguing that realization the of and are achieving greater than success because formerly ing to have the in practice abandoned many communities change behaviour sustain to approaches sensitive culturally and enforcement law combining strategies imple programmatic innovative are menting organizations many that encouraging is It countries host in practice the continue to communi FGM/C practising from ties immigrants prohibit to laws FGM/C anti- promulgated have States United the and Zealand New Canada, Australia, Europe, Western in countries 13 FGM/C countries in host their practise to continued have populations immigrant Some cess, many communities are saying no to FGM/C to no saying are communities many cess, generations for practised been had which FGM/C, regarding contracts social redefine and examine to communities empowering are approaches communities within FGM/C the of nature the of understanding complex and deep a generate to ing, question strategic and listening active telling, story as participatory such strategies, of sensitive culturally range and methodologies wide a uses dialogue munity

State, 2001 State, f h Udr ertr fr lbl far, U Affairs, Global for Secretary Under the of Office Issues, Women’s International for Coordinator Senior the Recommenda Enforcement; of by Office Report on How Work tions to FGM, to Best Eliminate Their and FGM Prohibiting Laws (FGM); Mutilation Genital Female of Practice the of Prevalence Ba observed that community conversation or com or conversation community that observed Ba . other laws other or anti-FGM/C on based violators prosecuted Western Asia and Africa in countries 28 of 4 only that revealed 2000 in published study a Unfortunately, place in also are anti-FGM/C on policies and Laws a concern; Tanzaniaof Republic United the and Egypt programmes), anti-FGM/C extensive with countries . . . 5

Local organizations are work are organizations Local . As a consequence, about about . a As consequence, hog ti pro this Through . . S Department of of Department . This was was This . These These . This This . . p a g e 7 ------. “Innovative effective and strategies to need be tolerance to FGM/C be backed must by solid actions.” in zero all and up stepped the practising communities, (b)  6 Ms FGM/C to abandon building consensus- to leading action and learning participatory used is approach education and erment communities their in families who are role models in abandoning FGM/C with those publicizes approach deviant positive the Egypt, In are encouraged mechanisms accountability community and days the of without hood practice FGM/C into adult girls ushering and education sexuality moting pro by ceremonies rites-of-passage of aspects positive (ARPs) passage of rites native alter are supporting communities In Kenya and Uganda, Ethiopia in KMG by as well as Senegal and Mali Djibouti, Faso, Burkina Tostan in by extensively used being is approach (a)  following: the especially challenges, ing and toemerg to address practice this subjected cultural being are who girls and women of rights the protect to community international the of efforts the acknowledge consultation the during ed p a g e 8 ment (Geneva, Switzerland, WHO, 1997), [3], 20 p 20 [3], 1997), WHO, Switzerland, (Geneva, ment a mutilation: joint WHO genital Female / / UNICEF UNFPA state Ba noted that these approaches would be elaborat be would approaches these that noted Ba . enforcement agencies, especially in environments environments in especially agencies, enforcement law- to complaining ever their avoid to practice the to girls younger and infants of subjection Increasing form of medicalization and any form of FGM/C; form any and of medicalization form any denouncing CEF a categorically issued statement daughters providers their health by having “cut” by practice the of effects health immediate the minimize to try parents more of medicalization the Increasing as practice more and . . In Senegal, a community empow community a Senegal, In . She emphasized the need to need the emphasized She . . H, NP ad UNI and UNFPA WHO, . This approach supports supports approach This . . In cultural Uganda, It promotes promotes It . . 6

------(d)  (c)  accelerate the abandonment of FGM/C abandonment the accelerate to map road global a of development the for elements key define and change hasten to approach multisectoral of aspects the FGM/C and practice the critical need for a multifaceted the on toreflect able be would participants Ms consultation, this in participants the of background and diversity the Noting of MDGs achievement the also of but FGM/C donment not only the aban as accelerating well, thereby pledging own to their do partners implementing and funding both for calls and programming grass-roots advocacy for support their and increase to pledged have partners its actions solid by backed be must FGM/C to tolerance zero and communities, practising the all in up stepped be to need strategies effective and Innovative anti-FGM/C strong been have not interventions where countries other in stagnation the and rates prevalence in trend downward the by strated demon are interventions participatory grass-roots of FGM/C against fight the for resources tional addi mobilizing by practice the against advocacy its of tempo the increase must community international The health surveys (DHSs) and other national surveys national other (DHSs) and surveys health all countries include FGM/C in their and demographic not as for interventions, of prevalence effectiveness the monitoring on data obtaining in difficulty The continues; girls and of women integrity change bodily the on assault the because behaviour unacceptable an but, unfortunately, behaviour of change and levels knowledge in shifts of indicative is which practice, the of donment aban total of instead cut lesser the towards trend A of FGM/C; abandonment the supporting vigorously are institutions law-enforcement where Ba expressed the belief that that belief the expressed Ba . . . UNFPA and and UNFPA . The fruits fruits The . . . - - - - Summary of Presentations and Discussions

p a9 g e II. Prevalence of FGM/C  IIA. • • • on: based is estimate This mutilated/cut annually of at risk being are girls 3 million 7 are data the and comparable harmonized been have modules UNICEF by (MICS) Survey Cluster cators Indi Multiple the and Macro ORC by DHS the namely used, been have surveys household national main Two Effort Measurement 2. FGM/C of form some undergone have world the in girls and women million 140 and 100 between estimate, WHO a to According Magnitude 1. trend prevailing the and efforts measurement Ms UNICEF, Division, York New Programme Specialist, Equality Gender and Social Child Change, Protection Section, Protection Child Vita, De Gabriella Maria Ms.

Progress in Sexual and Reproductive Health Research, World World Research, Health No Organization, Health Reproductive and Sexual in Progress Maria Gabriella De Vita made a presentation on on presentation a made Vita De Gabriella Maria . DHS available data as of 2000 as data available DHS mortality to infant due Loss Yemen and Sudan the of Egypt, Africa, prevalence sub-Saharan in and cohort 15-24-year-old born females of Number Measuring Changes in FGM/C Practice Development of Data Analysis Tools for Global Trend and Prevalence of FGM/C: . . . 72, 2006 72, 7 UNICEF further estimated that that estimated further UNICEF The FGM/C FGM/C The . . - . Current measurement efforts demonstrate the the demonstrate efforts following: measurement Current FGM/C Prevalence at National Level Missing dataorFGM notwidelypracticed of highprevalence rates Survey datanot available butevidence 90 45 . 10 0 . 9% –10% . 1% –45% . 1% –90% 1% –98. 1%

p a g e 11 p a g e 12 Prevalence of FGM/C by DHS Cote d’Ivoire U.RTanzania U.RTanzania Kenya Kenya Cameroon EAST AFRICA Niger Niger Ghana Benin Nigeria Nigeria Republic Central African Chad Cote d’Ivoire SOUTH WEST AFRICA Senegal Mauritania Burkina Faso Burkina Faso NORTH WEST AFRICA Mali Mali Mali Guinea Guinea NORTH WEST AFRICA Ethiopia Ethiopia Sudan (North) Eritrea Eritrea Egypt Egypt Egypt AFRICA NORTH EAST YEAR YEAR YEAR YEAR YEAR 2000 2000 2004 2004 2004 2006 2002 2005 2005 2005 2005 2005 2005 2003 2003 2003 2001 2001 2001 1990 1994 1994 1998 1998 1999 1996 1999 1999 1996 1999 1995 1995 43% 45% 43% 15% 18% 32% 38% 14% PREVALENCE 2% 5% 9% 17% 19% 25% 45% PREVALENCE 28% 71% 77% 72% PREVALENCE Not yet available 92% 94% 96% 99% PREVALENCE 74% 80% 89% 89% 95% 96% 97% 97% PREVALENCE SAMPLE SAMPLE SAMPLE SAMPLE SAMPLE 124 777 14070 14602 12849 10329 14779 14583 6445 19474 15367 15573 2040 8099 9704 8206 5860 6087 5884 5054 7620 7954 8754 7728 9223 6753 7577 8120 7881 6219 8195 5691 5391 • • • Ms Recommendations4. levels regional and subregional country, at mapping by substantiated was prevalence lower have mothers 30-49-year-old of daughters with compared as mothers 20-29-year-old of daughters among rates prevalence desire would one as quickly as not although generations, younger among declining is tice ranges age and differentials rural/urban tional levels in each country, especially along ethnic lines, of as clusters regional well countries among as at subna prevalence of patterns varying showed analysis Survey Mapping 3. basis for advocating for the abandonment of FGM/C abandonment the for advocating for basis able data for within studies comparative regions and as a avail disseminate and successes programme celebrate to available currently data use to made suggestions eral followed discussion Extensive this with sev presentation Discussion range below 15 below range age the for possibly prevalence measure to technique a survey the of the implementation before actual years 15 or 10 often past, the in situations regions and countries among comparable is that manner a in indicators other subnational and rates prevalence and national provide surveys Household De Vita made the following recommendations: following the made Vita .De the change and the lessons learned lessons the and change the determine may that dynamics social the prevalence, in changes with associated factors identify to level local the at needed is trends of analysis in-depth An level subnational the at efforts advocacy and interventions programmatic of impact and design the strengthen significantly can it as ed recommend is level subnational the at and socioeconomic variables by data of desegregation Detailed variances ethnic and regional to reflect adapted and multicountry be should programming FGM/C Daughters of educated mothers also tended to tended also mothers educated of Daughters . . . The data on FGM/C prevalence prevalence FGM/C on data The . There were lower lower were There . There is need for for need is There . . FGM/C prac FGM/C . They show show They . . - - - - - IIB.  8 Dr. more into interventions expanding for and campaigns bynificantly the lack oftoneeded sustain resources their them dismantle and weaken tackle, to interventions specific developing to view a with FGM/C of practice the port sup that pillars social the are what and who standing under for made was a case data, to research addition In and obstetric outcomes obstetric and FGM/C on countries African six in study collaborative Dr Organization sepsis wound of result a as heal to failure and pain; resultant the to due struggle girls’ the and girls of down holding or rectum; fracture dislocation resulting from the forceful and perineum vagina, urethra, the of tissue adjacent the to injury retention; urinary infections; acute controlled; not if death to lead could that haemorrhage included: ous the studies, known physical of complications FGM/C operation, bleeding during sexual intercourse as a result result a as intercourse sexual during bleeding operation, the to subsequent haemorrhaging but directly FGM/C complications sexual and cyst and/or and clitoral psychological neuroma, abscess, vulva, the of keloids multiple included FGM/C with ated

ru o fml gntl uiain n oserc outcome obstetric and mutilation http://www genital female study on WHO group countries: African six in study prospective orative collab WHO outcome: obstetric and mutilation genital “Female cles/lancetfgm Guyo Jaldesa’s presentation was based on the WHO WHO the on based was presentation Jaldesa’s Guyo . Mortality with FGM/C Linkages of Maternal and Newborn These efforts were reported to be hampered sig hampered be to reported were efforts These . te kon ogtr cmlctos associ complications long-term known Other .

naecologist, Principal Investigator, World Health Health World Investigator, Principal naecologist, Gy and Obstetrician Consultant, Jaldesa, Guyo . who . pdf . int/reproductive-health/publications/arti . . 8 No studies link HIV/AIDS link studies No . and He observed that, from previ from that, observed He . ------” - - the interventions the own to community the engaging human-rights- and approach a based to programmes anchoring holistic a manner, in programming people, young in investing funding, long-term sustained providing by attainable is change desired that show Tanzania of Republic United areas rvd aporae iest o tps f FGM/C of types of diversity appropriate provide cities capital in hospitals teaching to hospitals rural isolated relatively from varied centres Sudan and Senegal Nigeria, Kenya, Ghana, Faso, common—Burkina is FGM/C where countries six in tres cen obstetric 28 at women 28,393 involved study The FGM/C with women in complications obstetric of treatment and prevention the to relevant information clinical obtaining of aim ary hospital in birth giving while FGM/C of history a with women among complications obstetric of incidence the estimate to and complications of tionship types different between FGM/C and obstetric rela the evaluate to was study the of aim primary The study the justified this and lacking, was FGM/C of consequences medical and psychosexual social, the regarding large- evidence scale situation, this addressing at aimed made were recommendations and resolutions numerous Although transmission of HIV sources potential all are where infibulationsprevent or impede vaginal intercourse of lasting damage to the genital area and anal intercourse Several examples from Eritrea, Kenya and the the and Kenya Eritrea, from examples Several . . . . The study had a second a had study The . They were chosen to chosen were They . . The The . p a g e The . 13 - - -  IIC. erdn Tetet r Punishment or or Treatment Degrading Inhuman Cruel, Other and Torture against vention Con Nations United the of meaning the within torture constituted that violation rights human fundamental a Ms Ms. differ the population, study the among babies the of of FGM/C result a as deliveries 1,000 per die babies 20 to 10 additional an context African the in that estimated is It III FGM/C with those in higher cent per 55 and II; FGM/C with those in higher cent per 32 I; FGM/C with those in higher cent per 15 with FGM/C: mothers to born those for higher much also was birth after immediately and during babies among rate III) FGM/C with women in higher cent per (66 FGM/C had had mothers whose babies resuscitate childbirth during ger dan substantial in babies women’s the put FGM/C that with compared those women without FGM/C haemorrhage partum post suffered who III of with in women FGM/C the numbers cent increase per any form ofundergone FGM/C not had who those with compared sections Caesarean more cent per 30 average on have to likely more were (TypeIII) FGM/C of form serious most the to subjected been had who women section, Caesarean of case the In of FGM/C forms ent differ with women among outcomes infant or adverse maternal specific having of risk the estimated analysis p a g e 14 . Faiza Jama Mohamed observed that FGM/C was was FGM/C that observed Mohamed Jama Faiza Promulgation of Laws . Although there was no in difference birth weight

rica, Equality Now Equality rica, Af Director Regional Mohamed, Jama Faiza . hr ws n nrae ne to need increased an was There . . . Similarly, there was a 70 . The study also found . ec, govern Hence, The death death The . ------strategies the of one be must but FGM/C ending in effective not FGM/C to end an bring to stakeholders different by used gies strate the of component essential and part integral an to acquiescence” torture “official constituted inaction ment vices takes account of this practice of this account takes vices ser health infant and maternal in training that and ensure practice harmful this of abandonment encourage abandonment its to contribute and practice cultural untouchable an is tion mutila genital that arguments the overcome advocates help greatly would reproduction, on especially effects, Dr issue rights human a as well as children, and women of doubt that FGM/C reasonable was a a issue, health killer medical harm physical of long-term evidence conclusive first the rights provided a study the as issue, cutting genital against campaigned long Dr worse even been haveto likely were home staff experienced of help at the without delivered who babies and women countless FGM/C undergone had who women with dealing to used were staffs obstetric which earlier in life suffered had mothers their injuries of result a as babies tissues excised cut/ in of elasticity to lack the due problems mechanical of hypothesis the supports mortality perinatal in ence Jaldesa . noted that Jaldesa its about harmful reliable evidence groups rights human while that, observed Jaldesa . . She noted that the use of the law was critical as critical was law of the use the that noted She . Legislation, as a distinct and only strategy, is is strategy, only and distinct a as Legislation, . . This research was out carried in hospitals in This is evidence of collateral damage to damage collateral of evidence is This . . Concerted efforts were needed to needed were efforts Concerted . The consequences for the the for consequences The . . It proved beyond a beyond . proved It - - - . h ofne o scn-ere felony second-degree a to offence the victim the to law,injury pian in results the of death the practice the or,victim in Ethio when apply punishments stiff Togo, and Senegal Niger, ity law the in Togoand culpabil such implies personnel, cal licenses of their suspension the including of FGM/C, practice the in engaging personnel health or the medical for punishment enhance Senegal and Niger Guinea, Eritrea, Faso, by both or fine or punishable imprisonment either are infractions and old), years 18 than own its law on law distinct a is the Niger in whereas laws, nal of crimi the laws the are part Senegal, and Ghana Chad, assault an as FGM/C define Senegal and Niger Ghana, d’Ivoire, Cote Chad, Faso, Burkina of ways different in FGM/C define laws Various to 5,000 1,000 pounds Egyptian of penalty a with years two of maximum a to months three from ranging sentence a for provides law nationwide practice FGM/C the criminalizes that legislation promulgated had Egypt 2008), (July report nurses, practice the performing from and doctors including anyone, forbids pletely com that decree ministerial a place in had Egypt and practice, the against laws had Nigeria of Republic eral punishments and in analysed terms of scope oftheir definitions, culpability be could which FGM/C against laws enacted had zania) nia, Niger, TogoSenegal, and the United Republic of Tan Maurita Kenya, Guinea, Ghana, Ethiopia, Eritrea, bouti, Dji d’Ivoire, Cote Chad, Republic, African Central Faso, Burkina (Benin, countries African 16 that remarked She criminalize the practice of FGM/C on children (i children on FGM/C of practice the criminalize punishments general prescribe Tanzania of Republic United the and Mauritania Kenya, African Ghana, Ethiopia, Central Djibouti, of Republic, laws the punishment, regards As terms these defining without excision and/or FGM/C of tice In Benin, Burkina Faso, Cote d’Ivoire, Eritrea, Guinea, Guinea, Eritrea, d’Ivoire, Cote Faso, Burkina Benin, In . All the laws in other countries penalize the prac the penalize countries other in laws the All . . The law in Chad mentions culpability for medi for culpability mentions Chad in law The . In Benin, Kenya and Mauritania, the laws the Mauritania, and Kenya Benin, In . In addition, several states in the Fed the in states several addition, In . . The Ghanaian law equates equates law Ghanaian The . At the time of writing this this writing of time the At . The laws in Burkina Burkina in laws The . n ukn Faso, Burkina In . The law in the the in law The . The laws The . . e . The The . , less less , ------(b) (a)  regard: this in five keyissues highlighted implementation their from and laws the of content the in both countries, these of experience the prac tised is FGM/C where origin of countries from nities commu immigrant among practice the curb to FGM/C against laws enacted have States, United the and dom King United the Sweden, Norway, Denmark, Australia, Canada, including countries, several Africa, Outside ratified that the they and international regional instruments have in contained standards rights human the laws national into translate to States several of failure the is this all in Guinea in case the is as law, the of implementation facilitate to regulations procedural of law the of application the defeating thereby liability, criminal from relations tain cer exempts often which practice, the of determinant sociocultural the given implementation, in challenges regimes law criminal ing exist of context the to FGM/C of definition the confine principles rights human by guided not is far so laws these of implementation the Similarly, practice the of punishment even or culpability of scope FGM/C around in the issues definition, rights the human None of the laws cited above has taken into consideration punishable are accomplices Ghana, in assent presidential awaiting bill approved recently Togo,the in and and Senegal trea, court the by mined to byto perpetrator, deter the be of an extent victim the compensation for provides Tanzania of Republic United  dren for excision in countries with no law against against FGM/C; law no with countries in excision for dren chil their law, take the evade to bid a in who, ents par prosecute to successfully used the been of has law jurisdiction extraterritorial of principle The countries; these in FGM/C of charge a to vic defence a not the is tim of consent the Africa, in countries Unlike African countries could draw several lessons from from lessons several draw could countries African . . . Under the laws of Burkina Faso, Eri Faso, Burkina of laws the Under . This has presented various various presented has This . Also, there is the challenge challenge the is there Also, . An underlying factor factor underlying An . Several of these laws these of Several . Ms . Mohamed Mohamed .

p a g e 15 ------. Mohamed remarked for legislation that, the“Ms. against practice of all legislation on child rights.” accordance with universal rights the human as standards basis comprehensive rights child-protection based frameworks in of FGM/C African to be effective, governments to need develop deliver on their commitments their on deliver to fail they when accountable governments hold must NGOs whereas action, of plan adopted an through port sup bilateral and multilateral using protocol the under noted obligations the on act must governments Further, victims of potential protection the and victims to support comprehensive of provision the measures, legislative through practice the of prohibition around revolve which Women, of Rights the on Protocol Union’s African the of 5 Article under obligations their policy child frameworks sound of development participatory and inclusive the in lead the take must levels international rights child on legislation all of basis the as standards rights human universal with accordance in frameworks tection child-pro based rights comprehensive develop to need governments African effective, be to FGM/C of practice Ms (e)  (d)  (c)  p a g e 16 Mohamed remarked that, for legislation against the the against legislation for that, remarked Mohamed . for the most part, FGM/C remains a taboo subject ataboo remains FGM/C part, most the for and, have education public minimal countries African above, mentioned countries non-African the Unlike whatsoever; arise not do laws African the in regulations procedural of lawlack the by presented loopholes the criminal and frameworks into integrated well are Sweden and France in offences FGM/C-related for Prosecutions offenders; to would-be rent deter effective an as serve to as severe so are tries, coun African in those with compared punishments, the Under laws in France and Australia, Germany, the In addition, child rights agencies at national and and national at agencies rights child addition, In . The laws must be inclusive with no exceptions exceptions no with inclusive be must laws The . . It is also that imperative States African fulfil . . . - - - - by the police, the group succeeded in saving many girls many saving in succeeded group the police, the by of their daily and interventions protective backed actions, reported was FGM/C of threat a when calls centre when at risk and police to responded officials their community the within alive debate the keeping in but information circulating and facilitating in proved structure community a valuable them resource not only protect to intervening and cases potential and cases FGM/C on reporting and monitoring region, the in people more to out reaching and community the activities of implementation efficient the in immensely helped which telephones, mobile and bicycles materials, educational gained momentum the sustain to defenders rights human of team trained a up set and law FGM/C the in training sensi police and community tization did (LHRC) Centre Rights and Human Legal Tanzania, of Republic United Morogoro, In abandonment FGM/C have accelerating in made activists these progress the show here provided FGM/C eradicating at outreach aimed activities and education local increasing and FGM/C of abandonment the for advocating champions policy and stakeholders new of number the expanding are ists With on guaranteed resources a term longer basis, activ countries African 17 in groups 20 than more of campaigns porting sup is which Fund”, FGM/C “The FGM/C, End to ism Activ Grassroots for Fund the created and resources Nairobi in office and concerns Africa its Now, with it Equality when opened frustrations their shared activists African 2000, In . This group played several roles: sensitizing sensitizing roles: several played group This . Subsequently, Equality Now mobilized mobilized Now Equality Subsequently, . The team was equipped with with equipped was team The . Girls ran to the the to ran Girls . Two examples examples Two . . As a result result a As . This This . - - - - . to keep the debate alive, instituting a child-protection child-protection a instituting alive, debate the keep to communities within defenders rights human anchoring holistically, problem the approaching youth, in Investing FGM/C doning aban of change desired the about bring gradually and interventions anti-FGM/C to sustain crucial was funding long-term that showed FGM/C End to Activism roots Grass for Fund the of partners the of experiences The parents young among especially noted was decline the and period), four-year each (in prevalence FGM/C in cent per 6 of decline a showed DHSs last the 2007 March in practice the outlaw to reluctant, been previously had which government, the encouraged villages their in FGM/C on ban a declared openly Aditekelezan—had and Geleb munities—Asmat, FGM/C to regard with children future their of that and integrity bodily their on fully aware and able to became decisions make informed FGM/C of tice prac the surrounding stereotypes the question to and issue the in interest their capture to drama and music theatre, activities, competitions, writing as such awareness strategies using and sensitization age-friendly campaigns their on toembark information and tools necessary with them equipped and clubs youth anti-FGM/C the trained villages surrounding the and school) each schools to sensitize both the school population (150-200 eight in members) 25-30 (of clubs anti-FGM/C up set it where Barka, Gash and Anseba regions, two in efforts being including impressionable more information, to receptive more were they Students youth—as parents—the and future Youth targeted (NUEYS) Eritrean of Union National The it to end support public cant signifi and problem the about awareness widespread confirmed was prevalence a drop in 3 cent in FGM/C per DHS, the last Nationwide, region this in declined reportedly rate prevalence The The clubs engaged school youth through through youth school engaged clubs The . As a result, youth in these two regions regions two these in youth result, a As . . The union largely concentrated its its concentrated largely union . The By the end of 2006, three com three 2006, of end the By . There also appeared to be be to appeared also There . . . The Union Union The . hs move This . Both of Both . - - - - - . • • • • • the namely: situation, global address to made were recommendations Several of law rule the enforcing in as well as interventions abandonment FGM/C support to gets to bud allocating in especially emphasized accountability, demonstrate was role proactive government’s The agents and institutions of law-enforcement the capacity and lence and in building incidence generations; younger what understand sustains the preva measuring practice; to and sexuality and FGM/C about misconceptions tify iden to research qualitative promoting interventions; to plan data using systematically namely: abandonment, FGM/C accelerating for critical be to found ses were sions plenary during discussed ideas key of number A Discussions Recommendations and Plenary support for the practice the for support dismantling gradually in effective found and strategies tried were these run—all locally was that mechanism Enforce the rule of law as part of government government of part as law responsibility of rule the Enforce partners development among regional—and national, levels—community, for Increase accountability FGM/C at programmes all DHS the as such surveys national in Systematically include and use FGM/C data collected of reproduction age the before girls younger for modules collection data Develop learned lessons and dynamics social prevalence, changing with ated associ factors identify subnational—to and national levels—regional, multiple at trends of analysis and quantitative) (qualitative and research more Produce . .

p a g e 17 - - - - - . III. FGM/C Changing Patterns and Practices  IIIA. is immediately in their interest to persuade others of of others persuade to interest their in immediately is subgroup non-cutting the within those for choices marriage increases cutting abandon has to that agreed group core the families, other cutting recruiting abandon By to community the in families other to recruit group of initial this interest in the immediately is it FGM/C, abandon to decides group intra-marrying larger a within families of core initial an if theory, tion munity at sary the to outset of gain the the support entire com neces not is it abandonment, mass such at To succeed awhole as community intra-marrying the by abandonment dinate To change the it convention, towould be coor necessary of and status that family’s daughters the marriageability own; on its to do the practice so would ruin abandon can do to choose community that in families other what on depends do to chooses family one what group intra-marrying the within daughters their of status and marriageability the 9 Ms Social1. processes Ms. self-enforcing social convention theory identified by identified Schelling Thomas theory convention social self-enforcing the of dynamics social the resemble FGM/C of cesses

Thomas C Thomas lows of Harvard University, 1960, 1980) 1960, University, Harvard of lows rnec Mnt osre ta te oil pro social the that observed Moneti Francesca . . Convention: Basic Principles FGM/C aSelf-enforcing as Social Latest Developments in Social Sciences; Following the logic of Schelling’s social conven social Schelling’s of logic the Following . Schelling, Schelling, .

UNICEF Innocenti Research Centre Research UNICEF Innocenti Officer, Rights Child Senior Moneti, Francesca . 9 Families carry out FGM/C to ensure ensure to FGM/C out carry Families the Strategy of Conflict Conflict of Strategy the For marriage and for status, status, for and marriage For . . (President and Fel and (President No one family family one No . . Similarly, it it Similarly, ------. . dinated abandonment when most people are assured assured are people most when abandonment dinated witnessed is practice of the the ending whereby a declaration, public example, for recognition, social of moment a be also must There effort donment aban organized an of absence the in unlikely be would which enrolled, be must practice the abandon to willing (past the a proportion tippingpoint)sufficient of families spontaneously about tion of to cutting a convention of would not come cutting conven a from shift the that unlikely is do—it to choose one tofamily chooses do on depends what other families of Because the conventional nature of the practice—what toto FGM/C return is reason no there thus and linked to marriage, longer no the population of most for irreversible becomes convention new the to create a tipping point to group intra-marrying the of proportion enough large a become point, some at must, group core growing the ple to (aself-sustaining become “critical mass”) peo of number sufficient a mobilize must above tioned Schelling by identified shift convention of type the in thresholds two are There ed abandonment coordinat towards organized is process this that vided pro networks, social through communities or families to other spread can community or family one of actions disadvantages the After the convention shift, the practice is the practice shift, the convention . After . . . In other words, the knowledge and and knowledge the words, other In . After the core group is mobilized, mobilized, is group core the After . . Once past the tipping point, a shift This would be a moment of coor of moment a be would This . First, the initial core group men group core initial the First, . Second, . Second,

p a g e 19 ------that made: FGM/C are assumptions “Three linked is to marriageability, value among their available choices.” marriageability that and people always move to the highestpossible that the typical family marriageability or daughter prefers to non- (c)  (b)  (a)  to: needs practice the to abandon decision The Implications for programming 2. choices available their that and always people move to the value possible among highest non-marriageability to marriageability fers pre daughter or family typical the that marriageability, to linked is FGM/C that made: are assumptions Three assured be daughters uncut their of status and marriageability the would practice then the ending are people other most that p a g e 20 ule b nw nweg, nldn riig aware raising including knowledge, new by fuelled is discussion the as insofar empowering, be and sion discus non-judgemental and non-coercive Reflect taboo; or sensitive are that subjects of speak to possible it make and dialogue Facilitate decision; by the disadvantaged is family or girl single no that so ways other in connected closely is or of choice a that a intra-marries group Be collective . . Only Only . - - - powerful families in Sudan in families powerful by abandonment the example, for occurs, this which by modalities the into insights important lend studies Such of FGM/C the practice abandon families have individual to possible is it that study ethnographic from known is change promote who individuals of group initial an of organization the to lead that factors the explain not way same the in behave will and identical practices of harmful abandonment the of dynamics social the of nation expla full a provide not does theory convention Social commitment international and measures legislative and social of tion introduc the and media, the by played be to role key a and awareness-raising dialogue at the national level, with including change, support to environment enabling an strategic most are decides group doning focusing on diffusion, nearby communities that the aban organized undertake also but abandonment of news the spread to information of means traditional on rely can same the do to others convince to FGM/C abandon to chosen have or wish who those of interest inherent of the because spread can movement abandonment The (e)  (d)  their positive values; values; positive their promote to ways better find to people enables that an from understanding derived ofand ness the harm, with the commitment to abandon FGM/C to abandon commitment the with that everyone can trust that others will follow through so declaration) public a as (for FGM/C example, don aban to commitment their concerning communities Rest on a public on and explicit the affirmation part of voice; their strengthening providing public, in speak to women and girls for by opportunities relations gender unequal Overcome . It assumes that every individual is is individual every that assumes It . . It also requires requires . It also It also does does also It . . It It . It It . - - - - . IIIB.  Dr. insert legal regulations to prevent the medicalization medicalization FGM/C of the prevent to regulations legal insert and counteract to need the emphasize to revised been 1997 in published UNFPA UNI and CEF with statement joint a in it condemned strongly and 1982, in FGM/C of medicalization the condemned medicalization of definition the in be included should re-infibulation of practice the that said She facilities private or public in officers health or doctors medical midwives nurses, whether personnel, medical trained professionally by FGM/C of performance the as Dr sionals are increasingly performing FGM/C performing increasingly are sionals profes medical declarations, numerous these Despite of FGM/C tion medicaliza the against resolutions passed Obstetrics, and of Gynaecology Federation International the as such associations, professional and authorities licensing cal target health workers health target that strategies develop and medicalization against work promoting medicalization also are researchers and NGOs ernments, cally prohibits it prohibits cally formed by even medical personnel where the law specifi per being are re-infibulations that indicate reports ica, groups that have toimmigrated Amer Europe and North professional health trained a using practice the to daughters their subjected have women the of third idly in many countries rap spreading is it country, to country from varies tion Elise Johansen clarified the concept of medicalization theof concept medicalization clarified . Elise Johansen Trends And Global View The Medicalization of FGM/C:

Organization Health World Officer, Technical Johansen, B. Elise te Uie Ntos raiain, medi organizations, Nations United Other . It is therefore necessary to intensify the the intensify to necessary therefore is It . . . Although the level of medicaliza of level the Although . In some countries, more than one . In countries, some That statement has has statement That . WHO first first WHO . Some gov Some . Among Among . ------. personal support of the practice the of support personal and requests, community serve to duty of sense a and pressure gain, economic of prospects include FGM/C perform to professionals medical motivate that Factors ment abandon total towards step first necessary or is useful a medicalization that argue others whereas harm-reduction strategy, a as medicalization consider may nel (d)  (c)  (b)  (a)  the in result may FGM/C following: of medicalization The practice this with associated are risks serious and evidence, mented some immediate health risks associated with the the with practice; associated risks health immediate some reduce to intending while society in value women’s a to contribution their uphold culture communities’ and as FGM/C perform professionals medical some personnel cal medi of role professional the of misuse a Constitute practice; the validates it because continuation, encourage to likely more is medicalization that gests practice the of abandonment to leads FGM/C of medicalization the that evidence FGM/C of abandonment the Hinder skill; professional’s the praise and practice the perform professional medical a ing in hav take pride families in and society, respect and the procedure institutionalizes further personnel medical by FGM/C Institutionalize health; women’s and girls’ for beneficial or sound medically as practice the legitimizes wrongly FGM/C Legitimize oee, hs raos r bsd n undocu on based are reasons these However, . . Medical personnel hold power, authority authority power, hold personnel Medical . In countries where FGM/C originates, originates, FGM/C where countries In . The medicalization of FGM FGM of medicalization The . The performance of FGM/C FGM/C of performance The . Some medical person medical Some . Rather, research sug research Rather, . There is no no is There .

p a g e 21 ------IIIC.  Dr.  (f) (e)  uss n mdie “o o harm” not “do physicians, midwives and that nurses requires specifically which practice, health governing code ofethical the is a violation sionals unethical profes health by FGM/C of is performance the Moreover, and reasons non-therapeutic for organs calization of FGM/C constitutes wilful damage to healthy conditions unsanitary in performed operations unskilled of dangers the avoid to attempt an in personnel medical of advice the seeking are Egypt in in the settings clinical belief that it is safer in professionals health by undertaken being is FGM/C Dr Egypt tion, p a g e 22 oae Frd oe ta te eiaiain of medicalization the that noted Farid Mohamed . f ptet o hoe eia procedures medical choose to patient a of right the upholding of name the in re-infibulations of form the in FGM/C perform personnel medical ed, immigrat have FGM/C practise that groups where rights human of question the Confuse practice; ahealth-promoting as of adoption FGM/C as it can then easily be perceived the promote further will this personnel, medical by this is practice a tradition where areas into moving when practice the up pick dis FGM/C of that tradition no have who populations documented placed been has it migration, and FGM/C of spread the Foster patients’ requests if the act constitutes a human human a violation; constitutes rights act the if requests patients’ respect to entitled not are personnel medical ever, Case Study in Egypt The Medicalization of FGM/C:

elh evcs Mnsr o Hat ad Popula and Health of Reproductive Ministry Services, Health Officer, Project Farid, Mohamed . If the is practice performed In situations of conflict conflict of situations In . However, the medi However, the . H, h Inter the WHO, . More families . More families In countries countries In . How . ------. aged 10-18 years in Egypt was 50 was Egypt in years 10-18 aged girls among FGM/C of prevalence the Study, National According to the ofMinistry Health and Population 2005 of reproductive (15-49) age FGM/C1. women status among mates that, over the next decade in will there Egypt, be mates a overthat, decade the next aged 10-17 years was 65 girls among FGM/C of prevalence the that shows 2005 (EDHS) Survey Health and Demographic Egyptian the or in health establishments under any circumstances any under establishments health in or professionals health by performed be not should it that advised and FGM/C of medicalization the to opposition and have Obstetricians; all Gynaecologists their declared of Federation International the and Midwives Confed of eration International the Nurses, of Council national the people.” people.” the of health the safeguard to physician the of mission the is “It (g)  obstetrical complications associated with FGM/C documentedtheaddresslong-termnot does tionand homes families’ in performed often still is practice the and experience, the of part important an is pain that belief cultural the uphold to order in willersanaesthesianotuse performingwhenFGM/C Not reduce complications associated with FGM/C that that they may be even more severe sanitaryconditionsthatare or notnecessarily mean that the procedure does is less severe professional trained a by performed is FGM/C . 5 per cent —Helsinki Declaration, 1948 Declaration, —Helsinki . Some reports suggest reports Some . The same study esti . 3 per cent per 3 Some health work . health Some Medicaliza . Similarly, . . That . . - - - - vention vention for any natural of part the female external genital inter surgical of type any or deformation excision, any performing from personnel) related or (paramedical ers and oth staff) and (physicians nursing providers service health any prohibits 28/6/2007 of decree fourth The Gynaecology and Obstetrics of head the by approved be should that cases private), indicated highly for except or (public facility health any in FGM/C prohibits 1996, hospitals central and public in ties facili equipped than other places in and practitioners non-medical by performed being from FGM/C prohibits Health of istry Min the of clinics in performed being from FGM/C its of 1959 prohib FGM/C Decree Ministerial Egyptian The decrees Legal 3. • • • • families: Egyptian among FGM/C supporting for given were reasons following the 2005, EDHS to According FGM/C Reasons for supporting 2. class wealth and 85 class ofcent per girls in the lowest wealth highest the in girls of cent per status—36 wealth with and attainment educational mother’s the with decreases of to girls excised or be expected excised proportion The level national the on undertaken are FGM/C combating actions further and practice the supporting attitudes in occur changes further unless birthday 18th their by excised been have will girls 10 in 5 about 2015, excised are who women adult young of proportions the in decline steady en’s health or that it may lead to agirl’s death lead may it that or en’s health that FGM/C had on any wom consequences adverse than Less half (45 per cent) of did women not believe adultery FGM/C prevents and virginity preserves that agreed women of cent) per (50 Half husband to her faithful remain would awoman that About 60 per cent of women saw FGM/C as ensuring be excised to wife the preferred husband the that thought 70 of cent About 15-49 per ever-married age women . The second Ministerial Decree (1994) (1994) Decree Ministerial second The . However, the survey suggests that, in in that, suggests survey the However, . The third decree, in in decree, third The . . ------. passed in June 2008 at the time of writing this report this of writing time the at 2008 June in passed implementation prompt and approval for Assembly) (People’s parliament Egyptian the to sented FGM/C criminalizing for legislation Egyptian prepare to constituted was rior, Inte and Health Justice, of Ministries the including and permanent in infirmity resulting actions performing for jail) in years seven to (three punishment severe merit crimes andwound-inflicting the illegalpractice ofmedicine intentional committed, have been crimes two a or nurse, is this not a operation doctor who performs If the person ignorance or negligence of consequence a as occurring or intended whether crime, a is body human the of any part of mutilation law, criminal Egyptian to According Syndicate Medical the and of Health Ministry the both from punishment and topenalties subjected be ethical code governing the profession and medical would the of regulations and laws the violated having as ered consid be would actions these performed who sionals premises other any in or establishments non-governmental or governmental in whether organs Source: of Reproductive Age (15-49) FGM/C Status Women among •  • At home Place FGM/C performed •  • Trained medicalpersonnel FGM/C Person whoperformed she was excised Mean ageofdaughter when continue) (Believe practice should Attitudes towards FGM/C Prevalence ofFGM/C Indicator ment Private healthestablish- barber) Non-medical (TBA/ A higher committee headed by the First Lady, First the by headed committee higher A . Dr. Mohamed Farid, Ministry of Health and Population, Egypt. This law was expected to be pre be to expected was law This . 1995 45% 82% 97% 67% 55% 33% 9 2000 62% 65% 38% 97% 35% 75% Those profes Those . This law was was law This . 9 . 2005 68% 96% 25% 75% p a g e . Both 10 23 – – . - - - - . IIID.  Dr. participants, especially those of Somali origin, who who origin, Somali of those especially participants, symposium among tensions the highlighted clips The 2007 June in Mombasa in held Symposium, Scholars and Clerics Muslim Mombasa the from clips featuring Dr p a g e 24 Kemal Mustafa presented an eight-minute video video eight-minute an presented Mustafa Kemal . Practices –The Kenyan Perspective FGM/C Practice: Changing Patterns and Emerging Community Strategies to Maintain

Kemal Mustafa, UNFPA Representative, Kenya UNFPA Mustafa, Kemal Representative, . (d)  (c)  (b)  (a)  discussed, and namely: presented were learned lessons Four of feminism ideology western the ing propagat and culture their renounce to them forcing of had fear that a agenda the symposium hidden expressed the Muslim faithful Muslim the among obligation religious a as practice the validate as such words of use The and; women for obligation Islamic an as practice the of validity the to as doubt raises also but effects harmful the of unaware those on among FGM/C discussion Open awareness raises addressed; to be needs feminism, of ideologies western propagate or culture of donment FGM/C has a to hidden agenda renounce aban the towards campaign the that suspicion with FGM/C abandoning at aimed tions interven to barrier significant a is baggage Cultural of FGM/C abandonment the towards activities synergizes and strengthens tion interven of area same the in partners with Working . Sunnah . ; . may inadvertently inadvertently may This, coupled coupled This, . - - - - IIIE. Dr. creating a closed society aclosed creating inaccessibility and remoteness, education, girls’ of level lower the included practice FGM/C sustaining factors youth female the over substantially the decreased among especially years, forces and security CBOs NGOs, officials, par government of local members liament, and leaders, religious Association, Elders Sabiny the with works project the Kapchorwa, In leaders community unifying and mobilizing in nerships Dr • • • • namely: of strategies, anumber utilized years, by formore 10 than the UNFPAoffice supported country intervention community-based a project, REACH The practice the propagate who practitioners the for income of source a and tification; iden religious has that practice cultural a marriage); for readiness and (virginity,morality sexuality women’s trol con to desire community’s the adulthood; to childhood from passage of rite a as done practice or custom a ly: name out FGM/C, for carrying members by community Dr Mohtashami emphasized the value of building part building of value the emphasized Mohtashami . given reasons key highlighted Mohtashami Hassan . Annual Culture Day Culture Annual “surgeons” to reformed heifers of provision the and sensitization Grass-roots educators of peer mobilization and Recruitment to sub-county FGM/C against acampaign for advocate each in recruited were volunteers opposition the over win to Advocacy Maintain FGM/C Practice in Uganda Emerging Community Strategies to Uganda a.i., Representative, UNFPA Mohtashami, Hassan As a result, the incidence of FGM/C FGM/C of incidence the result, a As . Dr . Mohtashami pointed out that the the that out pointed Mohtashami . . . Community Community . - - - - - . • • • • made: were recommendations Several personnel ofmedical behaviours and attitudes the ofchanging aim fundamental the with counselling, provide and compli cations manage to personnel medical of capacity building the for need critical the emphasized plenary The Discussions Recommendations and Plenary addressing reproductive-health-related issues as as issues rights human and gender as well issues by reproductive-health-related comprehensive addressing interventions FGM/C Make interventions targets primary as abandonment women and girls address FGM/C that Ensure medicalization against regulations lawsand Enforce curriculum medical the in FGM/C Include .

p a g e 25 - IV. FGM/C A Threat to Human Rights and to the Achievement of ­Millennium Development Goals mance, with some girls dropping out of school to get get tomarried school of out dropping girls some with mance, perfor poor and drop-outs absenteeism, in result pain practice the with associated problems health and in learning disturbances include on education education of universal promotion FGM/C is a threat to MDG 2 it because the compromises 2:AchieveGoal education primary universal mental integrity and physical of violation the in result can that rights human fundamental of deprivation a and tunity it is of resources; truly afinancial lack ofshortage oppor FGM/C of consequences the treat to spent and mobilized are resources important because Ms Eradicate 1: Goal hunger poverty and extreme Ms. Ms likely to affect the achievement of the first six MDGs six first of the achievement the likely to affect 2015 by achieved be to of and development indicators targets ing measurable 2002, this was agenda into refined eight goalsestablish development sustainable stimulate to and disease and hunger poverty, combat to way effective an as en promote and equality gender the of empowerment wom to States Member commits 2000) (September laration Tall observed that FGM/C was a threat to MDG 1 MDG to threat a was FGM/C that observed Tall . enbu al bevd ht h Mlenu Dec Millennium the that observed Tall Seynabou . . . try Technical Services Team, Addis Ababa Team, Technical Ababa Addis try Services Coun UNFPA, Adviser, Gender Tall, Seynabou Unless FGM/C is abandoned, it is is it abandoned, is FGM/C Unless . The effects of FGM/C effects . The Poverty is not only a only not is Poverty . The trauma and and trauma The . In In . . ------boys have the chance to to go school chance have the boys as well as girls that ensure to seeks and women against FGM/C including girls, and women against committed violence of acts of cause major the is oflife area every in inequality Gender 3:AchieveGoal equality gender girls and women to HIV and AIDS and to HIV women and girls of vulnerability the increase to likely are intercourse ual sex during tears the and instruments of unsterilized use the far, so evidence documented no is there Although 6: CombatGoal HIV/AIDS trauma and der disor psychological tears, causes often and canal birth the as labour, it prolongs obstructs dangerous extremely but also not painful only excruciatingly childbirth making period, partum post the and childbirth pregnancy, with ity ductive health outcomes, including high maternal mortal repro adverse to hence, and, services and information to access in reduced result of lack empowerment and ity motherhood safe to threat a is FGM/C 5:Goal Improve maternal health excised are who women among childbirth during deaths neonatal and of stillbirths risk increased the of evidence substantial provides study WHO a consultation, this in discussed already As Reduce 4: Goal child mortality Major health complications . of Major complications health FGM/C are associated . Goal 3 challenges discrimination discrimination challenges 3 Goal . . . . Gender inequal Gender .

p a g e 27 - - - - - Tall“Ms. international notedunder that, law, violencepunish women.” against States obligated are to prevent, investigate and ued as full and equal participants equal and full as ued val be would women which in societies creating to key wide world suffer women that injustice social of forms many cultures many in autonomy and sexuality women’s controlling at aimed violations FGM/C is a of manifestation gender-based human-rights Ms aspects, rights human Regarding • following: the including FGM/C, of abandonment the enforcing for responsibility to more take used to governments be with advocate can instruments of number a addition, In measures.” protective effective lishing estab and for violence, in penalties imposing and investigating diligence due exhibit must they … and women, against violence eliminate to obligation their avoid to consideration religious or tradition, custom, any invoke not should “States that: provides Women against of Violence Elimination violence women against punish and investigate prevent, to obligated Ms rights to link human its and FGM/C on dialogue a of initiation the in principle key a is rights discrimination from to free right be and to right choose/decide rights, sexual life, right toright to integrity, health, and mental physical to right the as such rights human various to threat a is the range of that factors perpetuate the practice is point for a ible and addressing interdependent starting indivis are rights cultural and economic social, political, powerlessness economic and social women’s of context the in FGM/C sets spective p a g e 28 Tall noted that, under international law, States are are States law, international under that, noted Tall . crimination against Women, 1979 (of the 28 African African 28 (of the 1979 Women, against crimination Dis of Forms All of Elimination the on Convention The abandonment of this practice is considered considered is practice this of abandonment The . The United Nations Declaration on the the on Declaration Nations United The . Indeed, the universality of human human of universality the Indeed, . G/ i, ned oe of one indeed, is, FGM/C . Recognizing that civil, civil, that Recognizing . A human rights per rights human A . . Tall observed that that Tall . observed . FGM/C ------• • • • • jing, 1995) 1995) jing, (Bei Women on Conference World Fourth the and 1994), (Cairo, Development and Population on ence Confer International 1993), (Vienna, Rights Human on Conference World conferences: Nations United 2003 Women’s on Rights, Rights Human Additional Protocol to the African Charter on People’s 2001 girls, and women of health the affecting practices customary or traditional on 56/128 Resolution Nations United the of 1990 Child, Welfare and Rights the on Charter African 1989 Child, of the Rights the on Convention Convention) the fied rati had 26 practised, is FGM/C which in countries - - - p a g e 29 V. Cost Implications of FGM/C Practice VA.  Ms. Ms. as international and regional meetings often co-hosted co-hosted often meetings regional and international as paigns and of the such keyimplementation programmes, cam political through explicitly debate public fostered Ms (d)  (c)  (b)  (a)  NPWJ of include: objectives Specific girls’ rights women’s and protecting and of promoting context the in abandonment, FGM/C to favourable iour behav and attitudes changing to contributing ronment envi social and legal a political, to was develop gramme Pro FGM/C NPWJ the of objective overall the that said (NPWJ) Justice without Peace No organization, her Ms . Jablonko noted that NPWJ has raised and awareness by made efforts the highlighted Jablonko Alvilda . ing to challenge the social convention social the to challenge ing will girls and of women protection the for tools legal providing and FGM/C prohibiting for mechanisms legislative for establishing capacity technical Building strategies; donment FGM/C aban of effective tothe development enable as so society, civil and governments within donment aban FGM/C for advocates of capacity the Building convention; social self-reinforcing tothe as weaken Breaking the culture of silence surrounding FGM/C so violation; rights of FGM/C a as human in recognition countries target the in Protocol Maputo the of implementation and ratification of favour in will political a Creating Without Justice Girls’ Rights: Experiences of No Peace FGM/C in Relation to Women’s and without Justice without Alvilda Jablonko, FGM/C No Programme, Peace . She She . . ------opia and Sudan and opia NPWJ FGM/C Ethi its is 2008, work in focusing Eritrea, justice criminal international of issues on communities local engaging areas conflict post and con flict in programmes outreach implementing also is It conflicts by affected areas in law humanitarian tional interna of violations of documentation wide-scale and mapping” “conflict in experience field unique a acquired instruments rights human international on negotiations in assisting for and lation legis drafting for governments to experts legal of ment second the through assistance, technical ranging wide results the and drive political the both of ownership stakeholders’ attain to society in actors other and NGOs institutions, partner public among ships of fostering the and held were they which in country the of government the with organized and by on FGM/C adopted in January 2006 January in adopted FGM/C on timely and law Italian the as such effective legislation, FGM/C of application an facilitate to States, Member Union European of ministries relevant the and Traditional Practices Harmful against Network European the of members with particular, in organizations, women’s can NPWJ partners with European and Afri and European with . NPWJ partners Very important, NPWJ has has NPWJ important, Very . NPWJ is also undertaking undertaking also is NPWJ . . In 2007 and and 2007 In .

p a g e 31 ------. VC.  VB.  FGM/C Abandonment in Awash” Impact Inquiry on Women’s Empowerment and Approaches to Gender Equity: “CARE’s Strategic Denial of Women’s Rights and Insights on New Psychological and Sociocultural Implications Ms. Ms. Ms. any temptation to have premarital sexual experiences or or experiences sexual to havepremarital temptation any tosaid to women’s barriers and constitute desires sexual marriage after chastity their and riage uality the and guarantees virginity of women before mar women’ssex controls FGM/C that is belief popular The to adulthood child girl the of passage the mark they as insofar communities, tain cer within ceremonies initiation of ritual element crucial Ms Ms ment ment of women and the of advancement equality gender The organization’s inaugural SII centred on the empower denial rights and poverty of causes underlying the ing impact been have world the around programmes CARE how and whether determining at aims SII that said She egy (SII)Inquiry Impact by launched CARE USA in 2005 p a g e 32 Faiza Benhadid observed that FGM/C constitutes a constitutes FGM/C that observed Benhadid Faiza . Strat the to reference made Admassu Haregewien . try Technical Services Team, Technical Amman try Services Coun UNFPAAdviser, Gender Benhadid, Faiza Ethiopia CARE Adviser, Gender Admassu, Haregewien . FGM/C is also also is FGM/C . ------. . . status cannot be achieved be cannot status women’s in improvements stereotypes; gender negative perpetuate that relationships power accepted change to collectively working structures or community for change ual realized and without sustained change within the individ be cannot status women’s in improvements that was SII relationships and structures individuals/agencies, among balance the on based ment of women’s empower a theory around SII its built CARE is of major importance for their societal recognition societal their for importance ofis major to of the they number children have status is subordinated to and, marriage in the same logic, women’s norm, the is practice this where societies most married get not would daughters their it, without sons often invoked by mothers to FGM/C support is that, FGM/C mention not does Koran Holy Koran the by mandated is it that belief erroneous but sincere the of because practised often is FGM/C practise Protestants and Muslims Jews, Copts, Catholics, mists, practice the tomaintain reason the often and tions adulterous relationships For example, without poor women becoming actors actors becoming women poor without example, For . Within Muslim communities, FGM/C FGM/C communities, Muslim Within . . Religion is also a source of tradi . The conclusion from the the from conclusion The . Therefore, marriage marriage . Therefore, One of the rea the of One . However, the the However, . Yet . in Ani . . - - - - - VD.  nine sexuality are also thought and drafted according according drafted and thought also are sexuality nine religious and cultural, political social, psychological, physiological, domains: many Ms Dr. and identify the social costs related to FGM/C to related costs social the identify and structure infra and salaries staff maintenance, facility on spending vidual or family spending and public expenditures such as indi example, complications—for of treatment on tures expendi personal to related costs direct the calculate to important for advocacy purposes is FGM/C costing that noted Group, Bank World the of Dr economic cost is economic implications critical on data compile to FGM/C on study analytic an Thus, . poverty household deepen which debts of accumulation the in to and leads resulting high cost ofinvestment treatment, and savings household erodes education, for potential that girls’ limits earnings, family reveal in decline a to leads FGM/C regions other from studies countries, can Afri many by conducted be to yet have studies FGM/C households and systems health to related costs economic particular, in and, calculated be can difficulties, costs above-mentioned the Despite services to integrated in FGM/C utable attrib costs specific separate to challenge enormous an providedintegratedinan facilitylevel, theat ismanner it to be are expected FGM/C most activities because more, . Gebreselassie Okubagzhi, presenting a paper on behalf Benhadid concluded that feminine sexuality covered sexuality that feminine concluded . Benhadid Economic and Health Costs

. Gebreselassie Okubagzhi, the World Bank Group World the Bank Okubagzhi, Gebreselassie Dr. and Rogo Khama Dr. Subayi-Cuppen, Tshiya However, it is difficult to costpain and suffering These dimensions of femi of dimensions These . . It may be relatively easy Although detailed detailed Although . . The of results such . Further . ------Plenary Discussions Recommendations and Plenary culture and sexuality masculine corollaries: its and sexuality feminine to referring without FGM/C to refer to context this in incomprehensible be would it principles theological and moral ethical, to • • • that: were made Recommendations initiatives abandonment FGM/C could be to used to for advocate more resources support costs health and social economic, logical, psycho including costs, related FGM/C on odologies meth costing developing and FGM/C; of consequences with and FGM/C; and the psycho-social dealing physical marriage de-link to strategies appropriate practices; developing FGM/C challenge to men involving tions); quota religious using (even sexuality about messages underlying the positive developing ofFGM/C; dynamics sexual-cultural understand presentations to need these the emphasizing followed discussion Extensive munity and international advocacy and for designing designing programmes national evidence-based for and advocacy international and munity com effective launching for essential be would study a Appropriate programmes be designed to address address dominance male and patriarchy to designed be programmes Appropriate implemented and developed be ment abandon FGM/C address to programmes Holistic Africa in especially FGM/C on ies HIV/AIDSand similar cost stud undertake and costs malaria as such exercises, costing health other from learn FGM/C abandon to movement the in Partners . . These costs costs These . . Therefore, Therefore, .

p a g e 33 ------VI. Experiences/Lessons Learned and Best Practices in the ­Abandonment of FGM/C VIA.  District Local Government commissioned a commissioned study in Local Government District 1991 culture Sabiny the to threat external an as seen was this as encountered, was groups religious and community the of members enlightened more by Attempts to eliminate FGM/C were initiated in the 1980s politics The 1. of FGM/C Ms. mothers were district this in years 17 and 12 between aged girls age same the of males of cent 8 per with compared school, secondary completed had cent and were education aged 20+ ondary years were 6 sec completed who females and males school, ondary (92 cent 91 was school primary in children of net enrolment total the census, 2002 the to according example, ber Decem of month the during years) even (in bi-annually performed is which marriage, to and adulthood to sage FGM/C as a rite of practise pas traditionally Sabiny The the and FGM/C to eliminate efforts Uganda, District, Kapchorwa in tribe Sabiny Ms Team, Ababa Addis G/ afcs h euain f h gr child girl the of education the affects FGM/C . Margaret Thuo recounted the experiences of the the of experiences the recounted Thuo Margaret . Of all females aged 20+ years, only 3 only years, 20+ aged females all Of . District, Uganda Mechanism: Case Study, Kapchorwa Building and Community Accountability The Politics of FGM/C, Partnership- . . 2 per cent for females) in this district this in females) for cent per 2

Advocacy, UNFPA/Country Technical Services Services Technical UNFPA/Country Advocacy, and Change Adviser, Thuo, Margaret Behaviour Heavy opposition from the community community the from opposition Heavy . As a result of this resistance, the the resistance, this of result a As . . Also, 6 Also, . . 1 per cent of cent per 1 . 6 per cent cent per 6 In sec In . . 8 per per 8 . 2 per For For . . 8 - - - - killing, in December 2002, of the Kapchorwa Chief Dis Chief Kapchorwa the of 2002, December in killing, the to led this and politicians to threat a tradition, became they the of continuation the opposed who those FGM/C to no saying ties communi many with successful, forms becoming was REACH many takes FGM/C of politics The sustained not were to funding mobilize group period previous the 36 excision supported that families to money, including gifts, provide to money enough ed practice the of ment abandon the for advocated who community the of bers mem by messages counteract to and excision promote to and teachers, leaders government local officers, ment govern magistrates, included who group, FGM/C pro the by used were which loopholes left it move, positive above and years 18 aged females for optional FGM/C make to resolution new a passed resolution the of implications the discuss to Kapchorwa to flew ministers two and parliament, to matter the report to mobilized girls some Association Elders Sabiny the of Members excised be to girls force to used unfortunately was which manda tory, FGM/C make to resolution a passed Council FGM/C retain to voted majority The on the views of the Sabiny regarding community FGM/C . 3 per cent increase in the incidence of FGM/C over FGM/C of incidence the in increase cent per 3 . The District Council apologized and and apologized Council District The . However, efforts of the pro-FGM/C pro-FGM/C the of However, . efforts The pro-FGM/C group contribut group pro-FGM/C The . In addition to being seen as as seen being to addition In . y 98 tee a a was there 1998, By . Although this was a was this Although . Thus, the District District the Thus, . By 2002, 2002, By . .

p a g e 35 ------. VIB.  Ms. Ms. community the in it did not to allow their daughters be excised but promoted few enlightened and educated the that observed was It unequalled were women’s rights land and rights—home property her all lost she tradition, the defied she when and relatives by wife a as inherited be After the husband’s the death, Coordinator was forced to Coordinator of REACH the husband the killed also camp project REACH the of signatory the also was who Officer, Administrative trict G/ abandonment FGM/C for advocate strong a and councillor a became later who CBO Rights Human own his started and activist rights human district the in practice FGM/C the tocontinue resolution original the signed who Kamuron, Peter including opposition, greatest the over won has REACH problems, motivated politically these Despite votes of losing fear for FGM/C against out speak to commitment lacked FGM/C stopping in sense majority over power political base for the generations uninformed its sustaining on bent was group this that was nomenon oad te bnomn o FGM/C of abandonment the towards District— Baringo in Njemps the and District Samburu in Samburu the District, Narok in Maasai munities—the com speaking Maa three with working in experience The purpose of this was presentation to share the Kenyan p a g e 36 Her determination and commitment to fight for fight to commitment and determination Her . Another . pro Another FGM/C was Yapkwopei, Mary activist Working with Maasai Communities Unfortunately, some political leaders who saw saw who leaders political some Unfortunately, . Judith Kunyiha Karogo, Programme Officer, Officer, ­UNFPA Kenya Programme Karogo, Kunyiha Judith The only explanation for this phe this for explanation only The . In January 2003, the pro-FGM/C pro-FGM/C the 2003, January In . By 2006, five subcounties had had subcounties five 2006, By . . e ae bcm a became later He . h tre com three The . . - - - . (a)  learned: Lessons 2. ties ties are in engaged dialogue on of the harmful effects the communities Nakuru of Diocese Catholic Kalenjin-speaking the through the and Njemps the among implemented being is mobilization Community mobilization Community 1. where FGM/C prevalence rose in four subcounties in in 2006 subcounties four in rose prevalence FGM/C where stronghold, opposition the in challenges still are There by 2011 counties sub all in FGM/C of abandonment total the together planning in community the of majority the and NGOs organizations, faith-based parliamentarians, joined police had the and prosecutor the magistrate, senior wa’s prevalence FGM/C zero registered towards the abandonment of FGM/C abandonment towards the three and phases distinct munities represent approaches (e)  (d)  (c)  (b)  and and use totheir arguments win them over arguments their and opponents political your Know it is really tough really is it your and Encourage tosupport staff keep going when key; is munity com the within awareness Developing Remember! issues; FGM/C beyond them with work and girls and boys forget not Do voice; important others and activists “surgeons”, rights human female elders, agencies, enforcement law- stakeholders—parliamentarians, all with Work opposition; the ens . . . Select them carefully carefully them Select . By 2007, Kapchor 2007, By . . They all have an an have all They . The communi The . . This weak - - - - - VIC.  Mr. marriage forced early and FGM/C escape to house a safe and refuge seeking of girls need growing the to response in developed was District, Narok in sai Maa the among use in approach, home” “rescue The Rescue 3. Home society the in women as acknowledged and accepted are process the from graduate who girls in Narok Maasai the among well worked has approach This another to excision from girls young stage protecting while one from transition the adopts and accepts that approach sensitive culturally a represents ARPs of implementation and design the womanhood, into childhood from passage of rite a is FGM/C Where Alternative2. rites of passage abandonment towards its interventions community-driven possible and practice Some of the challenges include: challenges of the Some change the embraced not had who community the in individuals by forcibly excised being of risk at remained but change to need the accepted als achieved many among been had FGM/C the of effects harmful the of ization internal when clear became houses safe these for sity The community designs alternative rites, and the the and rites, alternative designs community The . Practices: Programme Strategy The Inter-Africa Committee on Traditional Committee on Traditional on Practices Committee Africa Inter General, Secretary Touray, Isatou In this respect, different . individu In different this respect, . . . . h neces The . - - - - epe o hne hi on odtos hog advo through conditions own their change to people empowering in grounded are IAC of activities gramme Mr (d) (c)  (b)  (a)  stu ory nomd atcpns ht h pro the that participants informed Touray Isatou . Cultural “baggage” and fear of moving from from moving FGM/C to prohibit Weak law enforcement of fear tradition; and “baggage” Cultural difficult; tocommunities access and intervention making rain, ter rugged in coverage of areas geographical Vast maintain; to expensive are they necessary, are homes rescue increase to continue numbers their and education, as well as necessities basic need houses homes rescue of Sustainability Girls resident in the the in resident Girls . Although Although . .

p a g e 37 - - - “Mr. Touray observed that the advocacy work in had resulted VID.  reproductive rights.” women’s reproductive being healthaviolation as and of women’s communities’ recognition of FGM/C on having as harmful effects ai fr eptaig FGM/C perpetrating for a as basis used is which Sunna, word the of understanding Mr Mr. sustainable likelyto are be that and environment immediate their in available are that based on their choice of enterprises business small-scale opportunities employment alternative with supported rights and health reproductive children’s and women’s on FGM/C to of effects empowered harmful the are understand excisers level, community the At levels different at interventions subsequent of programming and planning into feed ings find the and interventions, the of component major a is youth and men women, leaders, opinion local leaders, religious especially actors, critical with works and child the of interest best the on focusing approach practices traditional on harmful campaigns information and training through and cacy FGM/C of instead (FGV) violation genital female as such gion, reli Islamic to the acceptable be might that terminology Hadith the in specified as Sunna of types different discussed and Sunna of cept p a g e 38 Ali Hashim Sarag observed the confusion and poor poor and confusion the observed Sarag Hashim Ali . Abandonment of FGM/C Sociocultural Contribution to the He recommended the following: the recommended .He pert, Sudan pert, Ex Sociocultural/Religious Sarag, Hashim Ali He suggested some changes in in changes some suggested He . . . IAC uses a rights-based . IAC a uses rights-based e lrfe te con the clarified He . They are are They . Research Research . - - - - national committees in various countries various in committees national by done already work the on advocacy model toTostan as such organizations other for way the paved IAC by made a public todeclaration abandon FGM/C in Gambia the 18 excisers and communities 68 example, communities many by FGM/C of abandonment the rights reproductive women’s of violation a being as and health reproductive women’s on effects ful harm having as FGM/C of recognition communities’ in Mr society civil and institutions cational edu agencies, law-enforcement and judiciary the bers, At mem the level, IACpolicy Assembly National targets (d)  (c)  (b)  (a)  . Touray observed that the advocacy work had resulted education into the school curriculum at all levels all at curriculum school into the education and principles rights human of mainstreaming The of women; of rights violation and A that approach comprehensive on focuses the rights FGM/C; against traditional fight the in leaders religious and of engagement and selection Strategic leaders; religious among cacy advo to key a as Koran the of understanding Good . . hs e to led This . The effort . The effort . For For . - - - -  VIE. providers were still not forthcoming to educate clients to educate forthcoming not still were providers changed, were attitudes some and improved knowledge abandonment FGM/C towards attitudes itive improving health providers’ and knowledge creating pos at aimed course training three-day a Mali, involved 1998, in in providers health addressing for strategy The supply the to reduce trying than rather place in put be demand reducing at aimed strategy a that recommended Council Population The borders across and villages in other found be not harmful is FGM/C that believed them of most social and status, gained had excisers that found also evaluation blindness as such reasons, medical or age old of excision niece—in or daughter replacement—a a trained already FGM/C had abandoned who as those ineffective, largely and revenue alternative education through Mali in excisers converting at aimed NGOs 1998, in strategy single-intervention a In from learned single interventions Lessons 1. Ms. ment efforts into community reproductive health reproductive into community efforts ment abandon FGM/C of integration the and ARPs methods, such tic as used multiple approaches intervention Tostan ing excisers and providers whereas the health-care holis ment abandon FGM/C encourage to interventions holistic and interventions single were used strategies key Two Programme Health Reproductive in Frontiers Council’s research Population by The operations countries African in some undertaken from learned lessons important Ms Maryam Sheikh Abdi shared with participants participants with shared Abdi Sheikh Maryam . The single-intervention strategy involved strategy address . The single-intervention Lessons Learned from Operations Research Moreover, alternative practitioners could easily easily could practitioners alternative Moreover, . Some excisers abandoned the practice because because the practice . abandoned excisers Some Population Council, Nairobi Council, Population the Officer, Programme Abdi, Sheikh Maryam Evaluation showed this strategy as as strategy this showed Evaluation . . Therefore, . Therefore, Although Although . . The The . . - - - - - . port sup GTZ with also NGOs, various by Faso Burkina rural (GTZ) Germany of Cooperation Development of support the with Senegal of parts different in tested was approach public in ceremonies pledge nal commu organize would they FGM/C, for value more no held was “cutting” of meaning the on discussion village-wide rights human and hygiene health, for the group same of women on such topics as women’s programme literacy seven-month a involves approach declarations public and education Women’s • • • • • • including: ventions, inter holistic several monitored Council Population The from learned holistic Lessons interventions2. as well as FGM/C of implications the about community the cate edu and skills their enhance first, attitudes providers’ the practice of effects harmful about communities educate to as so providers for curriculum training the in it included and FGM/C in on clinics a ban issued of Health Ministry The mittee against FGM/C (CNLPE) and partners partners and (CNLPE) approach) (law+education+multisectoral FGM/C against mittee Com National the with interventions Faso Burkina interventions clinic and community Kenya (CARE) education tive health reproduc of FGM/C into integration community The Kenya of in FGM/C medicalization The MYWO) Organization, Wanawake Ya (Maendeleo Progress Women for passage—Movement of rites Alternative (Tostan) declaration public and programme education Basic The long-term impact was also tested with support was also tested . with impact long-term support The When the villagers were convinced that there was was there that convinced were villagers the When . The replicability of this approach was tested in in tested was approach this of replicability The . . The lesson learned . was learned the The lesson toneed address The scaling up of this this of up scaling The . At the same time, a time, same the At . h Tostan The .

p a g e 39 ------“Two key were strategies used single interventions abandonment.” holisticand interventions to encourage FGM/C sensitization community by accompanied or preceded be must tives “graduation” for ceremony public a and womanhood to puberty ARPs from girls, for education life-skills and health ductive repro FGM/C, on education community-wide involved Kenya in and programme ARP the (PATH)MYWO, by implemented Health and Technology Appropriate for programme ARP The witnessed were villages of numerous declarations lic girls 0-10 of years age excised of percentage decreasing a and FGM/C of tion nity, in especially the of improvement hygiene, denuncia commu the within change behaviour positive created and attitudes negative decreased health, reproductive and rights human in knowledge increased successfully approach Tostan the that were findings immediate The (CRDH) UNICEF ment and Develop Human in Research for Centre The Macro, of p a g e 40 h assmn fud ht uh alterna such that found assessment The . ARPs depended upon the meaning of the the of meaning the upon depended ARPs . Supported by The Programme Programme The by Supported . Through a diffusion system, pub system, a . diffusion Through . . ------preference for professional providers for professional preference the and infection of fear to due preferred being was tion ages younger at cut being were girls that and secrecy into practice the driven had criminalization agents change as providers health using of feasibility the determine to and FGM/C of medicalization the behind motivations understand to as so community Abagusii Kenya’s in providers health Medicalization Abagusii and Meru the among example, for of practice FGM/C and the linkage with a rite of passage, G/ aog h community the among FGM/C practising for rationale key commu a was religion Somali that showed the among study universal Type where nearly Kenya,is in III nity diagnostic entailed tions These interven interventions: clinic and community Kenyan cut be longer no would villages their in girls that declaration public a made Ethiopia in elders 70local which of result a as practice, the on debate nity dimensions sexual about knowledge psycho and social FGM/C—physical, of effects harmful increased demonstrated findings personnel medical of involvement the and ments state and declarations public campaigns, educational Kenya in camps refugee Somali in and pia in ties into health Ethio programmes reproductive CARE activi FGM/C anti of integration the involved approach Approach Integrated Education—CARE Community addressed be providers for motivation financial the that and rights in human trained be providers that enforced, and disseminated be laws demands cultural for concern hygiene and and pressure safety, community a cent), per (60 financial was cutting for rationale ers’ in drse te ecpin f G/ a a Islamic an as FGM/C of perception the addressed tion A diagnostic study examined the role of role the examined study diagnostic A . It was therefore recommended that that recommended therefore was It . The approach also elicited commu elicited also approach The . . The findings showed that that showed findings The . n nomd interven informed An . . The health provid .health The Medicaliza . . It included included It . . Findings Findings This This . The The . ------ing up abandonment were as follows: as were abandonment up ing speed in programmes all to common factors Identified inabandonment elements Common 3. Faso: Burkina in Interventions health motherhood/reproductive safe in viders pro by training services health to strengthen a was need was also found that provisionservice was poor, and there consensus on the Islamiccorrect stand on the practice build to leaders religious with worked and requirement (h)  (g)   (f) (e)  (d)  (c)  (b)  (a)  that: found evaluation The decentralized was system of this operation The implications if were perpetrators arrested or condemned FGM/C, and on especially the health consequences legal of risks the on communities of education the and work advocacy and building capacity 12); 11 00 80 excision (SOS denunciation for line telephone free a law; the of tutions insti justice and communication, defence, social, health, army, the including institutions, 13 of composed body declining was FGM/C whether to determine undertaken was strategy oftion CNLPE the education) migration, environment, cultural (new cutting not of compatibility perceived the in increase an was There and law the of denunciation; because FGM/C practising complex of perceived ity the in increase an was There Muslims; did than earlier FGM/C abandoned had Christians pace; accelerating an at ago years eight five to started abandonment the that testified People resistance; stronger had still areas some if even es, was There a in decrease the in practice most provinc of age; years 10 than less girls There was a decrease of the prevalence among young frequently formerly; than less daughters their cut women Young cent; per 50 than less of rate prevalence a had provinces Four CNLPE strategies consisted of: implementation implementation of: consisted strategies CNLPE . . In Burkina Faso, an evalua an Faso, Burkina In CNLPE is a government government a is CNLPE . . . . It ------. (e)  (d)  (c)  (b)  (a)  to: were empowerment Recommendations women’s and equality gender thering fur to key as seen was communities in empowerment women’s promote and discrimination gender broader Using the issue of FGM/C as to an challenge opportunity was proposed also movement the resistance undermine to them recruiting and youths, school of out including to critical be determined was zones, resistance strong in working those particularly power ers’ and gatekeep politicians’ games arguments, opponents’ concerning especially stressed, was stakeholders all of sions discus the from drawn were ideas good of number A Discussions Key and Plenary Recommendations (g)  (f) (e) (d)  (c)  (b)  (a)  Make operations research one component of the the of programme component one research operations Make MDGs; to achieve efforts and gramming pro into analysis and budgeting gender Mainstream programmes; ful success for necessity a as rights, and health ductive repro and gender and issues rights human including programming, to approach comprehensive a Adopt interventions; key to programme is boys and men of involvement the that Recognize FGM/C of interventions; success the for vari necessary in sectors ous stakeholders key with partnerships Build veillance system veillance sur the maintain to communities of Responsibility key actors; to become of leaders Involvement abandonment; of communicating system Organized channels); different using and (constant communities of education Long-term mechanism; nation system with operating a Decentralized strong coordi tions; interven- holistic well-structured, Comprehensive, (media); democracy and (law) policy environment: Enabling The need for accurate analysis of the positions positions the of analysis accurate for need The . Reinforcing support to anti-FGM/C activists, activists, toanti-FGM/C support Reinforcing . . . Investing in young people, people, in young . Investing

p a g e 41 ------. . VII. Strategies That Work: Scaling Up and Lobbying for a Global Effort VIIA.  skills management and micro-credit numeracy, and hygiene, literacy health, solving, problem rights, human racy, democ including areas, many in experience and skills with knowledge, The participants empowers programme poetry and theatre dance, song, dialogue, discussion, as such communication, of means familiar uses and months 30 lasts Programme Empowerment Community the of version current the community, host the as group ethnic same the from facilitators volunteer Tostan-trained by implemented and languages local in serving was it communities the and of priorities needs real the to respond Pro and evolve to Empowerment gramme Community evaluations Tostan external the on allowed and participants from back feed continual on emphasis an years, 15 past the Over Tostan be to of initiation the hence programme, issue the under addressed special a as community the by identified was FGM/C and 1980s, and 1970s the during in Senegal programme education formal non a developed had director executive its also is who Melching, Molly the in communities Gambia 40 and Somalia 42 in Guinea, communities in communities 140 Senegal, in munities com 303 in NGO government-registered a as operates Mr Mr. aik ige nomd atcpns ht Tostan that participants informed Diagne Malick . In addition, Tostan’s innovative “Organized Diffu “Organized Tostan’sinnovative addition, In . . The Tostan Programme was founded in 1991 by in 1991 founded was Tostan . The Programme Models and Social Networking Social Convention Theory, Diffusion Community-led Developments Using Malick Diagne, Deputy Director, Tostan Director, Deputy Diagne, Malick . Operating Operating . She She . - - - - - at large community at the with and members family with and friends topics programme share and adopt participants impact: programme increases exponentially sion Model” (j) (i) (h)  (g)  (f) (e) (d)  (c) (b) (a)  include: gramme Pro Positive Empowerment from the results Community marriage child and FGM/C of abandonment the including rights, human of respect the to essential areas in consensus national and regional about brings action and knowledge of diffusion communities surrounding with knowledge and tion Active peace committees for conflict resolution conflict for committees peace Active activities; clean-up Regular and nutrition services; health community good planning, family of Promotion AIDS; HIV/ of prevention and about knowledge Increased consultations; post-natal and prenatal Increased rates; vaccination in increases Dramatic community; the of members all among communication Improved campaigns; registration birth and School mortality; maternal and infant in Reduction and Guinea in Senegal; communities 1,700 than marriage more early in and FGM/C of abandonment The In turn, each community shares new informa new shares community each turn, In . .

p a g e . 43 This This . - - VIIB.  Dr. reality on the ground the on reality the to relevant rights human making thereby congress, in and society and women hold that economic systems socio-political ecological, linking their thus in women communities, of needs strategic the with munities cooperation com of needs practical the and link to is strategy core Its collaboration understanding, and trust building times, all at accountable and transparent being them, for not and communities with working ing, learn by teaching life, of way people’s to dignity ing giv and respecting of principles the on based is KMG literacy environmental as information well and economics as business, financial, gender education/ rights concerning civil/legal awareness, body especially concepts, essential, is gap edge deliberately or knowingly Few, if any, in parents the their world children would hurt bad of acts and faith misconceptions times, at and, gaps it sustain and change effect to capacities have munities com that assumption the on works KMG respect, this rights human and democracy livelihood, gender, environment, health, on programmes created has KMG empowermentwomen’sand equality gender opment, devel concerning communities among beliefs cultural harmonize to steps took that organization development community integrated focused, woman governmental, rights human women’s with odds at fundamentally be never should culture But culture with associated always is children, girl and en wom concerning particularly rights, human on debate Dr

p a g e . 44 This is often hampered by information or knowledge knowledge or information by hampered often is This . Bogaletch Gebre observed that the international international the that observed Gebre Bogaletch . Community Conversation Model zima Topezima (KMG), Ethiopia Gez Mentti Kembatta Founder, Gebre, Bogaletch .

. M i a idgnu non- indigenous an is KMG . hrfr, iln te knowl the filling Therefore, . . In In ------. . .

 (f) (e)  (d) (c)  (b) (a)  as are Conversation follows: Community of principles The response national the into people the of voices the bringing thus epidemic, sustain and generate to locally responses and appropriate effective control the and community the in groups among contracts social examine communities, and als individu within epidemic the of nature the of standing under complex and deep a generate to is Conversation Community of aim the AIDS, and HIV to respect With out inside from is “transformation and within” lies answer “the that principle the on based others with issues these discuss and on reflect to and lives people’s affect neighbours, and families their of those and practices, and values behaviour, their how tion discrimina or fear without introspec sharing, and reflection dialogue, tion, interaction, inclusive and active for opportunity an provides Conversation Community skills, and tools transformative and participatory using community the of expression of means a as (UNDP) Programme Development Nations United the by duced intro (CCE-CC) programme—was Conversation munity Com the through – Enhancement Capacity Community to guide the process the to guide teamwork and respect trust, mutual learning, Mutual and; girls and women of inclusion and participation the on focus A sensitivity; Gender ces; experien- community and family local, to Sensitivity intervention; “expert” than rather Facilitation, changes; transfer and sustain own, generate, identify, to capacities have Communities The programme empowers people to think through tothrough think people empowers programme . The . . . ” It is is It . By By . ------(g)   (f) (e)  (d)  (c)  (b)  (a) were: programme this through achieved results major Some resources and capacities of local mobilizing as well for as change the responsibility and of ownership strengthening a and relations power in shift social a learning, collective generated Conversation Community Action Imple- Methodological Framework Community Conversation gain the confidence to talk and raise their voices in voices their raise and talk to confidence the gain The role and ofposition women improved (as women epidemic; the fuel that practices to harmful stop action taking idirs and leaders clan leaders, Religious discrimination; and stigma of decreased because openly out coming AIDS and HIV with living People community; of the to members support rial care Increased and financialand psychological, mate especially harmful, are FGM/C; that practices in Decline girls; and boys young men, women, leaders, religious among testing and counselling voluntary Increased AIDS; and HIV about knowledge Increased ­Reflections mentation Review Decision Making&Planning Relationship Building Community ­Facilitated ­Process Change Identification of Concerns of Concerns Exploration . - ers, cousins and other community members community other and cousins ers, their fathers, sons, households—husbands, within uncles, broth are oppressors women’s suburbs, northern the in located are oppressors where apartheid racial Unlike citizens active to objects being of state a from transformation through go must themselves they change, of agency social pal princi the be and struggle the lead to women for fore, fate woman’s a and “natural” normal, as violence accepted Dr Sadly, themselves women with begin must women of inequality the against struggle the apartheid, racial killed and shot or discarded used, abused, deformed, and mutilated maimed, raped, resources controlling and accessing in opportunities of equality to the right and of the person security and the integrity life, to right the dignity, to right the relations, sexual in and equality in law and under the law, equal rights in marriage denied are women exist, discrimination and segregation slaves and servants oppressed into group another turning by another nate domi can in that group no one society towards ensuring and their capacities communities at looks one way the the concerning mindset in shift a and commitment requires Conversation Dr methodology of the application wider for potential its demonstrating AIDS, and HIV beyond activities developmental other for point ser vices and information extension health and agriculture mobilization, social in especially interventions, munity com its for strategy a as Conversation Community ed in accept Ethiopia structure the government In addition, (h) Gebre pointed out that, to be effective Community Community effective be to that, out pointed Gebre . Resonance effect (sharing information) (sharing effect Resonance HIV); for test husbands their that to request and guest a with sex to no say to men, of presence the . Women bear the and silently violence suffer Community Conversation also served as an entry entry an as served also Conversation Community . Women are lynched, chased, abducted and and abducted chased, lynched, are Women . Gebre continued, women have culturally culturally have women continued, Gebre . . . Human rights principles are directed . As in racial apartheid, in which which in apartheid, racial in As . As with the fight against against fight the with As . . . Therefore, Therefore, . . There p a g e 45 ------located are “Unlike where racial oppressors apartheid VIIC.  other and community members.” cousins brothers, uncles, sons, fathers, their households—husbands, women’s suburbs, in the northern within are oppressors ol la t edn FMC n snl generation single a in which FGM/C ending communities to lead in could dynamics social certain of emergence the leverage to way a as learning adult and tion genera one in Mutilation/Cutting Genital Female don Aban to Strategy Coordinated the programming, to Ms UNICEF, YorkNew Division, Programme Section, Protection Child Ms. Ms. violence, gender-based against mobilization social nity commu of tool a as critical becomes CCE–CC where is towards female children particularly the household, within rights human of notion the and tolerance respect, and children their of cultures bring to of opportunity special a have therefore teachers first the are Women household the within voice their gain politically—to and socially ecologically, comprehensively—economically, household the within begin to has equality and freedom for struggle women’s p a g e 46 . Maria Gabriella De Vita discussed a new approach approach new a discussed Vita De Gabriella Maria . She described it as human rights based education education based rights human as it described She Main Elements, Goals and Objectives Abandonment of FGM/C: Coordinated Strategy for the cialist, Gender Equality and Social Change, Change, Social and Equality Gender cialist, Spe Vita, De Child Protection Gabriella Maria Women must be empowered empowered be must Women . . This - - - - . . nationally agreed time for abandonment for time agreed nationally inter an an including objectives, support and which goal international evidence empirical and theory demic aca of convergence the on built was programme The and the right to a healthy life as human beings human as life to ahealthy right the and dignity to right the women for secure to and apartheid gender against coalition global ofa creation towardsthe Dr males and of females integrity the for people, entire the of wholeness and survival tothe committed is different be to has equality and freedom for struggle Women’s struggle their in support gain and consensus build to similarities and affinities their to according countries groups that as commitments such religious FGM/C, perpetuate that factors on and ters linked networks to the potential for marriage of daugh of social through propagation ethnicity, as such determinants FGM/C, main the upon build dimensions gic Gebre concluded by asking participants to work work to participants asking by concluded Gebre . It must address “solidarity of humanity” that that humanity” of “solidarity address must It . . . It is a subregional approach approach subregional a is It The strate The . . . - - - - . ters’ potential for marriage for ters’ potential that FGM/C tion is and assumes linked mainly to daugh conven social self-enforcing a as FGM/C views Mackie rights education helps to devalue daughters’ genital cut genital daughters’ to devalue helps education rights noted that that empirical evidence demonstrates human- is there thus, tono reason return to FGM/C and, marriageability daughter’s a to linked longer no is universal and rapid be will change the and point” “tipping a create to tion popula the of proportion large-enough a be will there self-sustaining becomes group the and marriage, for opportunities daughters’ their widen to people of number sufficient FGM/C a mobilizes group abandon core to group—decides marrying intra- an is, network—that social appropriate an within process the facilitate may networks or network social appropriate an Utilizing abandonment into true translated be will excise to not intention the and diminished, are excision tinue tion to abandon inten their affirm to together come society of members so do to decision coordinated a through time same the at mutilation/cutting genital daughters’ abandon families tosary collectively, coordinate whereby all abandonment do others what on contingent is behaviour and interdependent, is place making in put societies that enforcement of mechanisms through shunned and outcast an be would daughter family’s the of status and marriageability the ruin would so do to because own, its choose will lies each what family because chooses they think other fami marriage to linked an point in equilibrium a game coordination society-wide 11 10 theory Jeffrey game by of Mackie application the utilizes approach new The

Association, June 2003) June Association, Mackie, Gerry American Sociological Association, 1996) Association, Sociological American Mason, Mackie Jeffrey . This may be by facilitated a all whereby public pledge a Harmless Practice? Practice? Harmless a No one family abandons the practice on on practice the abandons family one No . Thus, enforcement mechanisms to con mechanisms enforcement . Thus, To abandon the practice, it is neces is it practice, the To . abandon FGM/C is performed on daughters daughters on performed is FGM/C . After the convention shift, FGM/C FGM/C shift, convention the After . An initial core group of families families of group core initial An . Evolutionary Game Theory Theory Game Evolutionary . . 10 Following this theory, Gerry Gerry theory, this Following . 11 Thus, in view,his FGM/C is Thus, (American Anthropological Anthropological (American A non-cut daughter daughter non-cut A . At a certain time, time, certain a At . . . Ms (Washington, (Washington, Decision- . . . De Vita The The . ------and persistence of FGM/C of persistence and universality the for accounts probably Marriageability evidence empirical on based years, eight to five of period prevalence a in over reduction cent per 40 a be to intended 2015” by Countries Many in (23-25 Generation years), with Successes Demonstrated goal is “Ending Female Genital Mutilation/Cutting in One FGM/C ending of year the as 2010 set which 2002, in formulated goal the supersede would goal The children on session special 2002 the to follow-up a as Assembly General the of session during December 2007 consensus the wider for presented be would goal Ms shifts convention group, widening it and reaching a tipping point where the core first the of formation the accelerating thereby ting, membership to a secret society (Sierra Leone) (Sierra society to asecret membership gaining in step specific a as or (Kenya); adulthood into passage rite of a to take fulfil must adolescent an step ic a as specif Sudan); (Somalia, code modesty and honour (Somalia, obligations Sudan); as a step to comply with an ceived as step a aspecific girltake must toreligious fulfil perpetuation its to contribute and ognizes that other add norms to significance the practice De Vita remarked that an internationally formulated formulated internationally an that remarked Vita De . . . However, Gerry Mackie rec Mackie However, . Gerry Demonstrated success is is success Demonstrated . FGM/C may be per be may FGM/C . . The new new The .

p a g e 47 - - - . De Vita remarked“Ms. thatinternationally an formulated VIID.  the 2002 on children.” session special afollow-up ofas the Assembly session General December to goal would during the for wider2007 be presented consensus Dr. population entire programme of the phase last the in seen be would to spreading spontaneous Sudden acknowledgement public after years five to three gests sug which experience, existing to referring by except advance in calculated be cannot and variable is period apparent be not would results when period multiple-year a over needed be would resources results sus ver programming of timing the review to necessary be programming of way classical the in sion revi some demands approach programmatic new The onstrated that the early Norwegian work on FGM/C FGM/C on work Norwegian early the that onstrated dem Ethiopia and Eritrea in projects of review 2007 A 2009 and 2008 between undertaken be to evaluation an for efforts global of context the in efforts FGM/C for aid national inter Norwegian by provided support the documented that assessment an from findings main the on reflected support Norwegian with interventions FGM/C Dr p a g e 48 . Berit Audstveg focused on the experience of of experience the on focused Audstveg Berit . . The assessment was expected to pave the way way the pave to expected was assessment The with Norwegian Support Experiences in FGM/C Interventions Berit Audstveg, Senior Adviser, NORAD Adviser, NORAD Senior Audstveg, Berit A considerable investment in funding and and funding in investment considerable A . The length of this this of length The . First, it would would it First, . . Her talk talk Her . - - - - - . themes—marriageability and sexual morals sexual and themes—marriageability social conventions social men, and girls and byboys, are self-enforcing sanctioned and women between living of standards different ever wher inequality, gender of issues general to applied be point ping tip a reaching and acknowledgement public achieving ing a in shift convention through a reaching critical mass, achiev at aim would programming for Communication health, cleanliness, beauty etc beauty cleanliness, health, (religious, countries among varied FGM/C for rationale FGM/C ban that laws had Tanzania of Republic ed Sudan and Ethiopia and trea Eri in decline modest more a and Tanzania of Republic United the and Kenya in prevalence in reduction stantial The assessment revealed several trends approach ahealth using practices”, tional UNICEF and UNFPA CARE, and FOKUS Children, the Save Aid, Church gian Norwe especially NGOs, supported 1980s) the (since The implications of such an approach could could approach an such of implications The . Eritrea, Ethiopia, Kenya, Sudan and the Unit the and Sudan Kenya, Ethiopia, Eritrea, . No reduction was recorded in Somalia Somalia in recorded was reduction No . . h fcs a o “amu tradi “harmful on was focus The . . ) but with some common common some with but ) . There was a sub . . The The . ------and the mapping of excisers (number, age) was under was age) (number, excisers of mapping the agents, and change as trained were members Committee organizations youth and workers health excisers, ers, lead religious elders, teachers, activists, women’s tors, administra communities, local the in persons influential sub-Zobaat the level comprising established was mittee sub-Zobas 12 has which Debub, Eri of Women trean Union National the by implemented Eritrea, in project FGM/C UNFPA-initiated a supported NORAD evaluation effective and monitoring data, authorities of approach sector the into integrated degree small a to only were institutions central by undertaken grammes pro to support of lack a with scattered, geographically competence-building and tion rehabilita treatment, on focus little with prevention, on in supported Sudan and were Somalia projects few a only 2003, of Plan Action national the for country pilot a Ethiopia, in were authorities national to provided support little with Nations, United the and Norwegian projects NGO to given in was support that identified were support shortcomings the of Some thinking religious individuals’ and institutions religious to down religion by and mandated not practice traditional and cultural a is FGM/C that ing decreas were ages the medicalization of because but puberty, around place took often excision Tanzania, of Republic United the and Kenya northern Ethiopia, ern life of year first their during excised were girls of cent per 90 about Ethiopia, and Eritrea of highlands in Eritrea and Ethiopia Muslims among FGM/C of types invasive less to lations increasing pia Ethio and Eritrea in recorded not was FGM/C of ization Sudan of exception the with areas, in urban than rural in higher was FGM/C of prevalence The Knowledge about the health hazards of FGM/C was was FGM/C of hazards health the about Knowledge . Religious leaders were speaking up and declaring declaring and up speaking were leaders Religious . . There was a tendency to change from infibu from to change a was tendency . There A baseline study was undertaken in Zoba in Zoba undertaken was study . A baseline Emphasis on project purposes was was purposes project on Emphasis . While many projects supported supported projects many While . Among orthodox . Christians in Among orthodox the Many projects lacked baseline baseline lacked projects Many . This trend has yet to trickle trickle to yet has trend This . The projects were often often were projects The . An anti-FGM/C com anti-FGM/C An . . The medical The . In south In . Projects Projects . ------. (d)  (c) (b)  (a)  results: to positive contributed factors following The interventions FGM/C to rights human and empowerment tie to how changes at attitudinal aimed efforts by other if not complemented tion of excision incidences reduc the on effect little has FGM/C against ban legal questioned was power and ity established be system positive entirely not was excisers to micro-credit of provision the with forums discussion groups’ smaller for plan to need a was there gatherings, community tolarge tion in the FGM/C campaigns and care pregnancy delivery should providers participate therefore and age, of month one and week one between donment aban FGM/C in group yet target important an gatherings, are youths community at present were lescents ado few that indicated 2007 March in review project A of FGM/C abandonment the to accelerate campaign the in used also were media The communication for medium a as used also were shows video where sub-Zobas 12 all in level community the at taken community development community and rights, and health reproductive and sexual AIDS, more no FGM/C”; on and the use ofsuch as points entry HIV and “declaration a with marriage as such tion of a approach”, FGM/C free zone; the “Kembatta declara common a with Tostanapproach, the Using of youths; participation the Emphasizing TV); and legal sector, media through and radio communication sector, (social approaches multisectoral using and Mobilizing local communities (individuals and groups) women; against violence as FGM/C on and women against discrimination on focus a with rights, human and ity equal gender towards directed approaches Using . FGM/C campaigns were abandonment conducted . In most girls are Eritrea, excised they when are . It was recommended that a monitoring monitoring a that recommended was It . The use of people with author with people of use The . . It was also that, found in addi . . t a osre ta a that observed was It . Also, it was unclear it . was unclear Also, Experience Experience .

p a g e 49 ------. VIIF.   VIIE. Mme FGM/Cof Ms. Mme. Ms D.C. and capacity building capacity and levels subnational and national at advocacy community, the in communication change behaviour namely, gies, research thorough after (PASAF) l’Enfant de et Femme la de Sante la a Prejudiciables tiques Women of Health Infants— and the to Harmful are that Practices She on remarked the tothe Fight against Project Support FGM/C practise south the in cent per 87 and north the in cent per 91 is Mali in FGM/C of lence a wt nw sus n pritn peoea n to and phenomena persistent and issues new with iar famil become to order in issues explore to conducted explanation logical clear no is there which for situations understand to trying questions, ing p a g e 50 ar Rny bevd ht eerh s bu ask about is research that observed Raney Laura . Keita Josephine Traore observed that the preva the that observed Traore Josephine Keita . Including Development Indicators Monitoring and Evaluation, FGM/C Abandonment: Mali Experience Funded through UNFPA, PASAF was designed designed was PASAF UNFPA, through Funded .

TIERS, The Population Council, Washington, Washington, Council, Population The FRON TIERS, Associate, Programme Raney, Laura rjc dApi l Lte ote e Prac Les Contre Lutte la a d’Appui Project . tional Programme for the Abandonment Abandonment the for Na Programme tional Director, Traore, Josephine Keita . The project used three strate three used project The . Certain ethnic groups do not not do groups ethnic Certain . Social research is is research Social . ------meetings meetings and a established databank ary Febru 6 on year every held FGM/C, of abandonment the on day national the through and programmes reach paign into the FGM/C cam were mainstreamed rights Human Ms explanation is done is it why identifying descriptive; is community a in is observed what ing situations describe and events by and observing recount FGM/C; and provide a legal framework for action for framework alegal provide and FGM/C; Combat to Programme National a create violated; were who girls and women empower to are FGM/C of ment abandon the accelerating for learned lessons main The achieved was prevalence in reduction cent per 40 a and FGM/C, against a declaration made villages 2,100 that in practice, the of abandonment the in strides sive types of research provide programmes with an evidence evidence an with programmes provide ofresearch types process programming the in to problems solutions knowledge and ry The programme put in place quarterly coordination coordination quarterly place in put programme The . Raney observed that basic research generates theo generates research that basic observed . Raney on pol priiae truh col out school through participated people Young . . Applied research identifies and offers and offers identifies research . Applied Reporting the frequency of cutting of cutting frequency the . Reporting . Mali made impres . . Both .Both ------r mvn twrs rjc goals project towards moving are of results reveal monitoring the toextent which activities resources of use efficient planned—ensures as out carried arebeing activities those toties whether out find activi programme of tracking routine Monitoring—the channels communication different of acceptance and use the and conditions; ing liv and education religion, of influence the practice; the continuing for rationale and intention activities; FGM/C anti- of acceptance and perception FGM/C; regarding togroups population different of attributed perceptions practice; the values social context; sociocultural the ing the of prevalence FGM/C various age among groups; includ complications, its and practice the understand managers programme helps research FGM/C-related solved avail are problems similar when how reveal not does or literature able be, should what and is discrepancies what between example, for sense, common or rience expe by answered be cannot problems and questions some that said she to question, this answer Ms time? the all necessary research Is issue the is imagines, someone what on not deduction, and welfare girls’ to threat a as practice the regards community target a whether instance, for addressed; be to needing issues activities programme base to which on basis sound a and problem a of nature underlying the of understanding clear a with manager base learned; output indicators measure quantifiable results results quantifiable measure indicators output learned; lessons the and stage each at the encountered document challenges indicators process project; the to uted financial—contrib and resources—human the measure critical is monitoring Indicator-based to achieve need they changes interim what and go to want they where from, starting are they where know to managers helps toring Furthermore, research provides a programme programme a provides research Furthermore, . . In these instances, research is necessary is research instances, these .In Activities based on scientific observation observation scientific on based Activities . . . Research can help identify FGM/C . netkn moni Undertaking . Input indicators indicators Input . Raney asked Raney . . The The . In In . ------(b)  (a)  that: were made Recommendations dominance male and of patriarchy issues addressing for especially crucial, as seen was interventions FGM/C rate disapproval and parents of intention mindsets, in change actual groups, different among perceptions of measurement the include must abandonment FGM/C towards arguments developing for base good a be would this and FGM/C, about myths including causes, rooted deeply identify to interventions C-abandonment of FGM/ the for effectiveness place measuring baselines emphasized was programme FGM/C-abandonment any of progress ing strategies promis up scaling for critical as seen was governments schemes micro-credit economic and social literacy, hygiene of including and women, empowerment the with programmes FGM/C anti- combine interventions holistic comprehensive that and accountability munities’ responsibility com of measure a as abandonment FGM/C on system to their own be should establish encouraged surveillance the many ideas from the discussion was that communities on all presentations was a discussion rich There Discussions Recommendations and Plenary vention and what one hopes to achieve hopes one what and vention inter of goal the on based chosen be should Indicators (outcome indicator) practice in achange are rates lence preva whereas indicator, output change behaviour a is practice a of ment abandon or reduction and empowerment women’s in changes members, community various among ventions of the inter impact change, ger social term and measure are lon indicators outcome the that project; during arise agt gne eult a a udryn factor underlying an as equality gender targets that approach multidimensional a for need is There rights; of human violation a is it because form, any in FGM/C for ance toler zero be should there therefore, and, exist not does justice partial or rights partial of concept The Research was seen as critical to help put in in put tohelp critical as seen was Research . Monitoring . and evaluation Monitoring to the measure For example, the intention not to cut cut to not intention the example, For . Strengthening partnership with with partnership Strengthening . Research would also help help also would . Research Male involvement in in involvement Male . . . It was agreed Indicators Indicators . Among . Among

p a g e 51 . ------. . “Among the many was from the ideas discussion that of communities’ accountability.” responsibilityand surveillance system on FGM/C ameasure as abandonment communities should be encouraged to their establish own (e)  (d)  (c)  p a g e 52 interventions; these in seat driving the in be should Governments strengthen synergies strengthen and among duplication avoid to promoted be should interventions actors of coordination Systematic China; in held campaign foot whole the with ymous promoting the whole which body campaign, is synon Positive should be cultural such aspects promoted, as problem; of the magnitude the identify and evidence provide to especially conducted be should Research . - p a g e 53 VIII.

p a g e 54  Panel Discussion Policies andLaws onFGM/C: Identification of Gapsin VIIIA.  • • • namely: Instruments, of international number a to reference made Asmani Lethome Ibrahim Advocate A FGM/C is seldom considered a priority in many countries curse of a toparental fear due offenders tofail report enforcementlawSomeagencies goodwillhence lackand religion and culture people’s with interfering fear others relevantignorantthearepeopleprovisions,legalof while laws as well and instruments as in their enforcement body human to harm causes that act any criminalizes code penal Kenyan The Elimination of All Forms of Discrimination against Women the on Convention the including instruments, international human rights issues other and FGM/C to relating matters in laws Islamic with conflict not does law statutory Kenyan that observed He • • • • 1979:   1966: Rights of Human Declaration Universal 1948: 1997:  Action for Platform Beijing 1995: Rights Human on Declaration Vienna 1993:  1989: dvocate Ibrahim Lethome Asmani, Kenya Court High Asmani, Lethome dvocate Ibrahim (Art Rights People’s and Human on Charter African 5a) (Arts Women against Discrimination of Forms All of Elimination the on Convention 19 (Arts Child the of Rights the on Convention Rights Rights Political and Civil on Covenant International Religious and Statutory Laws and Harmonization of Traditional/ Support for International Instruments . 1, 37 a and 24 37 aand 1, 18 (3)) .18 . Kenya signed and ratified a number of However, there are gaps in these these in gaps are there However, . . 3) 2f and and 2f . Some . Some Also . Also . . . . tance of taking expert advice (Koran: 16: 43); Allah con 43);Allah 16: (Koran: advice expert taking of tance 195) 2: (Koran: unlawful is harm causing and organs healthy cutting and body, human the to harmful anything condemns law Islamic that from Islam by the practice demonstrating de-linking practice the for rationale the counter to used be can law Islamic in messages Positive integrity mental and to physical right and pain from free life to right living, healthy and health to right cultures, harmful against protected be to right against, discriminated be to not right motherhood, safe to right marriage, in sex enjoy to right life, in choice a make to violates FGM/C right life, to right the that especially: rights, human women’s argue to critical therefore is It laws statutory and international in rights to human similar are that rights years, 1,400 than more for rights human recognized has Islam that participants informed practice the condemn guidelines riah (tohara) requirement Islamic an cleanliness is Chastity ensures and women of desires sexual the controlling by chastity ensures FGM/C that Prophet Abraham FGM/C by that about in it including Islam, was practised requirement religious Islamic an is FGM/C that been has rationale FGM/C—TypeIII of form worst the practises nity commu the and cent per 95 is FGM/C the of prevalence where community Somali Muslim predominantly The the among worked he that observed with Council, Population consultant a also is who Ibrahim, Advocate There have been many misconceptions misconceptions many been have There . . Further, the Somali community argues sa epaie te impor the emphasizes Islam . Such messages include: include: messages Such . eetees Sha Nevertheless, . Advocate Ibrahim Ibrahim Advocate . .

p a g e . The The . 55 - - - - . VIIIB.  nisms could be marshalled to fight FGM/C to fight marshalled be could nisms practice this of abandonment the towards contribute greatly would against Women of on of All the Elimination vention Forms Discrimination Con the and Child the of Rights the on Convention the Rights, and Cultural Social tional Covenant on Economic, Interna the Rights, People’s and Human on Charter can Afri the as such instruments, international and regional FGM/C of abandonment the accelerate to invoked be can that framework legal the provide Act Code Penal the and Constitution the both womanhood to transition a and ceremony initiation an the as among communities Tepeth and districts Pokot Sabiny, five in practised is FGM/C that participants informed Odoo Peter Simon Worship His H ( upbringing good emphasizes 119); 4: Islam (Koran: creation change who those demns total change total declare to scholars Somali 11 led arguments above The of authority positions in bad correct (Koran: practices 3: 110) and especially those nothing (Koran: 13: 11) does one that mean not does God in trust and Allah, ing of disobey expense at the pressure to cumb community 8-9) 81: (Koran: infanticide female example, for practices, cultural harmful condemns Islam offence an before punishment no and ings, p a g e 56 chorwa, Uganda chorwa, Kap Magistrate, Senior Odoo, Peter Simon Worship is Pertaining to the Abandonment of FGM/C Enforcement of Existing Laws and Policies Instruments and statutes provided a good good a provided statutes and Instruments . lo a ubr f nocmn mecha enforcement of number a Also, . . These legal if regimes, applied, properly . Every Muslim has an obligation to . This is in addition to other other to addition in is This . tarbiya One should not suc not should One . ) and moral teach moral and ) . In Uganda, Uganda, In . In addition, addition, In . ------prohibitedthisbyConstitution” interestor ofwomen whichor undermine their status, are traditionstomsand whichagainstaredignity,the welfare ishment” pun or treatment degrading or inhuman cruel, or torture inArticle 24: “No person shall be subjected to any form of rights”humanprovide and protect which organisations, governmental non of dence (ii) that State “the shall the and guarantee respect indepen v paragraph in provides Constitution Ugandan the Policy, State of Principles Directive and Objectives National its In and, void and null hence, unconstitutional declared be FGM/C of practice and custom the that seeking petition a made activities, rights human in working Assembly Legislative East African the of member a Byamukama, Dora Honourable can make a an party petition aggrieved which by procedures provide constitutions written Most ing the FGM/C practice FGM/C the ing chang towards way long a go should literacy legal side of consideration religious and cultural along sensitivities in are harmony rights human on conventions is it critical to that demonstrate Muslim law and international materials, and messages of development the ing elders and leaders religious especially used, be should community target the in opportunities available practice by Islam prohibited cultural hence, and, harmful a is it that proof a by lowed fol religion, from practice the de-link to used be law should Islamic practised, is FGM/C where areas Muslim work to which within framework legal Also, Article 33(6) states: “Laws, Cultures, Cus Cultures, “Laws, 33(6)states: Article Also, . . . . The 1995 Constitution1995states The . It is uponthebasisisIttheof . To sustainability, ensure In predominantly predominantly In . For example, . the For example, . Finally, the Regard . ------shall, to the extent of the inconsistency, be void” be inconsistency, of the extent to the shall, the Constitution shall prevail, and is that other laws custom or any custom or law inconsistent other with any any of the provisions “If of this Constitution, clearly: stating by FGM/C foregoingConstitutionthethat outlaws practicesas such fact” the after accessory an “being is offence criminal Another commit the criminal offence of wounding her victim internal organ, membrane or sense thedestructionorpermanent disability of any external or through permanently, victim the maim may it or harm, bodily actual occasioning assault of offence criminal the constitutes which “harm”, to amount may operation The means: harm Grievous harm” “grievous of that offence, criminal a constitutes which genitalia female’s the to damage serious cause sometimes “surgeons” operations, their performing In leaders community and surgeons so-called Kapchorwa, addressed he where in experience his related and FGM/C on education legal for need the out pointed magistrate The imprisonment life including sanctions, penal heavy carry of compounding a felony FGM/C has commit been performed the criminal offence nationalofboundaries sides both on are tribes similar and another, to country politicalboundaries artificial by nature the of porous This is and compounded common FGM/C of act an performing after law the from away toeither the “surgeon” or any of the participants who run any external or internal organ membrane or sense.” sense.” or membrane organ internal or any external or toanyor permanent seriousinjuries to disfigurement permanent to extends which or health injure to likely is which or health injures permanently or seriously or “any harm which amounts to maim or harm, dangerous Uganda doesn’t allow FGM/C—any culture that is against “I especially informed the surgeons that the Constitution of . This would apply to a person who gives sanctuary sanctuary gives who person a to apply would This He quoted his own speech: own his quoted .He . Those who hide informationhidewho after Those . Most of these criminal offences . It is easy to cross from one one fromcross to easy is It . The surgeon may also .

. . . . commitment and enforcement of the law of the enforcement and commitment political education, legal dialogue, community including trick” the do will “dialogue that newspaper Vision New the in wrote who change of wind a is there campaigns, FGM/C facing challenges several despite that, said magistrate the conclusion, In with interfere cannot they which practice cultural a be to FGM/C perceive they as FGM/C, of victims protect to unwilling are police Some Kenya and Uganda between borders across practised is the use of force or actual threats willing to do anything to frustrate the campaign, including votes losing of fear for FGM/C against out speak to reluctant still are leaders Political districts five the in however,remain challenges, Several arrested sur of being fear for run the on were geons because cent per 30 by declined FGM/C period, in FGM/C to never swore participate surgeons and mentors threat, and education both After shillings 200,000 or serve a sentence of seven years.” ting’, she would be charged in‘cut found court is anyone if [and] that or. . . payFGM/C ne from adesist offi Uganda contradictstheConstitution. warnedI all thesurgeons to culture law. Sabiny the against is woman a of integrity the He quoted Professor Sheme Masaba, a Sabiny, a Masaba, Sheme Professor quoted He . mlirne apoc i te key, the is approach multipronged A . . There are also people people also are There . In some cases, FGM/C . In cases, some During the cutting cutting the . During . . p a g e 57 - - . . VIIIC.  VIIID.  I Ms. to paradise of a man is a woman” a is man a of paradise to object an not is she man; that enjoyment man can have” and peace for woman a created “God says: Koran the of women of dignity the preserving in and FGM/C of abandonment the promoting in toplay excised never was et only Mohammed’s daughter who him, Fatma, survived dominated approach to control women’s sexuality male- a is FGM/C that observed Ambekema Afiz Imam FGM/C, but the law was not enforced not was law the but FGM/C, education legal and women for activities income-generating leaders, with lobbying and advocacy mobilization, community cally specifi strategies, of number a with approach an uses enforcement law include should which paign, cam abandonment FGM/C any in approach holistic a Ms p a g e 58 mam Afiz Ambekema, Benin Ambekema, Afiz mam aim aiaa mhszd h iprac of importance the emphasized Lamizana Mariam . Relevant Legal Provisions (Legal Literacy) Ensuring Public Understanding of the FGM/C Accountability in the Abandonment of Advocating for Political and Community Africa Committee on Traditional on Practices Committee Africa Inter- President, Honorary Lamizana, Mariam Therefore, religion has a large part part large a has religion Therefore, . Burkina Faso enacted a law Faso banning enacted . Burkina The Koran also says: “The key “The says: also Koran The . . A woman is a to partner a Chapter 30, verse, 32 verse, 30, Chapter . God created a man in in man a created God . Using the media, media, the Using . The IAC The . . Proph - - - strategy to accelerate FGM/C abandonment FGM/C to accelerate strategy building that with partnership all be a stakeholders major and from this obnoxious act obnoxious this from and women of welfare the protect to leaders religious wants should be careful and about what they society tell their followers on influence great have leaders Religious wife his Sarah, with made never was foreskin his nant made in the book of Genesis for Abraham to remove integrity woman’s a destroys which clitoris), anyone to permission FGM/C the perform (restructuring that function created for God a specific organ an is clitoris the because wrong is clitoris the ing to recreate them the way he wants? Similarly, restructur image own his campaign against FGM/C against campaign issues FGM/C on officers law-enforcement and lawyers trates, practice the about silent keep who politicians female and FGM/C d’Ivoire practise who Cote from immigrants with dealing prison, in excisers putting example, for prosecution, in challenges in and judges’ prosecuting taking legal actions resulting communities, to education legal provides IAC As a result, police officers are promoting the the promoting are officers police result, a As . So who is man to amputate others so as as so others amputate to man is who So . A hs lo rie magis trained also has IAC . Ms . Honesty is one of the chal the of one is Honesty . Lamizana recommended recommended Lamizana . God . did God not give . The cove The . . There are . . God - - - - ulm utr i concerned is culture Muslim as far as darkness total in occurs intercourse sexual of act the because gravity its or is excision what know not weakened be must FGM/C of painful culture of name the in women innocent maims and hurts only it value; cal plenary from practi no of was genitalia female cutting that observed came ideas Important Discussion Recommendations and Plenary customs and be by taboos swayed not are they that so intellect with speak to leaders manner polite a in and audiences to facts provide freely who leaders religious them with baggage up with a come that statement is clear and another one challenge to need scholars people to give they information wrong the for face leaders religious that lenges (c)  (b)  (a)  that: were made recommendations Specific gatherings religious and tions institu their in issue FGM/C the address to motivated are leaders religious that so networks leaders’ religious witnessed been has FGM/C of abandonment the used, been has approach rights-based a which in communities Muslim people their guiding for responsible are they because leaders religious among needed is tion n Crsin ao lw ae o te Bible in are laws these that demonstrate the should messages on based law canon Christian and be should FGM/C Koran the on based law Islamic science, by on informed materials and Messages FGM/C; lawson der cross-bor towards promulgating critical as seen was institutions subregional and regional with lobbying and on FGM/C mothers be should supported fathers between discourse private and Public FGM/C; on tives perspec their get to as so represented be scholars In the next FGM/C Christian and consultation, Jewish Thus, the pillars that sustain the continuation continuation the sustain that pillars the Thus, . Consequently, advocacy should be aimed at at aimed be should advocacy Consequently, . Therefore, activists need to select select to need activists Therefore, . It was noted that change was also also was change that noted was It . Imam Afiz called upon religious religious upon called Afiz Imam . . Some cultural Imams carry . hrfr, oe educa more Therefore, . Most Muslim leaders do do leaders Muslim Most . . They are accountable accountable are They . In predominantly predominantly In . Participants Participants . In addition, . In addition, Religious Religious . The The . - - - - - (e)  (d)  Governments should lead coordinated efforts coordinated lead should Governments media and professionals medical among and level country the at leaders religious among debate and dialogue sustain to established be should Networks central; makeshould and human rights gender place in put be one country to another as well as programmes should from crossing those and populations border of duct and the media leaders religious include framework legal existing the accordingly them orient to crucial is it law, and the of knowledge enforcement officialsand institutions have insufficient used be should constitution the country’s within action/litigation civil exist, not do laws undertaken be should activities literacy Legal consistency; to ensure stakeholders among harmonized be messages all and harmful, is FGM/C that prove must messages such Similarly, religion from practice the de-link clearly therefore, and, practice the of abandonment the with harmony . Other groups that should be oriented in oriented be should that groups Other . Inter-border laws which define the con In promoting legal literacy, activists activists literacy, legal promoting In . fe, law- Often, . . Where Where . p a g e 59 - . . IX. Culturally Sensitive Approaches for Sustainable Abandonment of FGM/C: Panel Discussion  IXA. nance regulates gender relations gender regulates nance domi male and patriarchal, are societies ethnic Most Reasons1. forpractice the Ms. practise them practise that communities by harmful considered not are riage pastoralists lowland as well as communities Ethiopia’shighland of peasantry producing crop the among widespread are beneficial, or harmful Ms iinl prah o odc discussions conduct to approach ditional resolution tra this (CDFs)use Facilitators conflict Dialogue Community for used is dialogue facilitators trained that so by led dialogue voiceless community a in the involved be to could all voice a give and space ate cre to venture new a as launched was dialogue nity slow been has creation awareness through FGM/C ending towards Progress early and granted for marriage FGM/C take women education, no or little age pre-adolescent a at off girls marrying and organs female of parts erogenous the cutting through fidelity and virginity safeguarding for measures harsh male a for would it than consequences serious more carries females for freedom fidelity marital and chastity premarital women’s on value high a place societies the line, male the in ity Tabeyin Gedlu noted that traditional practices, practices, traditional that noted Gedlu Tabeyin . Related Social Norms Approaches to in SupportShifts FGM/C Culturally Sensitive Communication: Officer, UNICEF Ethiopia Communication ­Officer, Programme Gedlu, Tabeyin . . In most communities of Ethiopia, of communities most In . Therefore, in 2003, commu 2003, in Therefore, . These communities institute institute communities These . FGM/C and early mar early and FGM/C . To . respectabil ensure . Therefore, Therefore, . Prayer is is Prayer Having Having . Sexual Sexual . ------(c)  (b)  (a)  learned Lessons 2. from fear of violating religious obligations religious of violating fear from members community many relieved has basis religious no have marriage early and FGM/C that knowledge The individual the on imposed is community levels higher or district at reached those than levels village/community at reached pledges decisions and implement readily more communities Also, structure administrative the from recruited those than effective more are community the from trained and ed them don aban to consensus a reach they harmful, are practices pace own their at openly and freely practices marriage early and FGM/C discussing in communities assists dialogue Community initi sessions ate to used is and agenda the on item first the always erdcie ras r ueu i hlig commu helping in useful are organs reproductive female of functions the on and anatomy presentations simple basic flip-chart and FGM/C on Films be; would measures legal than practices traditional harmful ing abandon in effective more are level community the at employed mechanisms enforcement Traditional motivation; to declining leading and repetitive manageable, less be to found insight attain act to to and time enough allow but short too nor long too neither be should dialogue Community It has also been found that facilitators recruit that facilitators found . been It also has . Prolonged community dialogue has been been has dialogue community Prolonged . When they are convinced that these these that convinced are they When . . The will of the the of will The . .

p a g e 61 - - - - - . IXB.  sions was developed, along with a booklet, audio, video video audio, booklet, a with along developed, was sions dimen five the on based manual training-of-trainers A information and religion gender, rights, groups target among and regions three the in villages/Kebeles) (rural sites selected in 2006 and 2005 during approach a five-dimensional implemented and introduced leaders, group age tive reproduc the in women of gap by knowledge the bridging practice the for demand reduce to developed was Regions” Oromia and Somali Harari, in lation/Cutting Muti Genital Female Eliminate to Leaders Community and Women of Role the “Expanding entitled project A dialogue community and of intra-familial lack der inequality, lack of informationand the and education, of ers and of FGM/C, practitioners because gen extreme prepuce the FGM/C for religious reasons and promote the removal of regions Somali and Oromia Harari, Afar, the in highest is alence Mr (e)  (d)  Mr. p a g e 62 . Abebe Kebede reported that, in Ethiopia, FGM/C prev attitude; in attitude; changes accelerating in and understanding nity results and prevent relapse prevent and sustain results mechanisms follow-up Community-based change; CDFs contribute to the of success of dialogue, leading towards backstopping and monitoring Consistent Mobilization: Ethiopia’s Experience Five Dimensional Approaches in Community . The fivedimensions were:health, law and human . Most communities, especially men, support support men, especially communities, Most mittee on Traditional (EGLDAM) on Practices mittee Abebe Kebede, Executive Director, Ethiopia Com However, women are the primary demand primary the are women However, . The project, supported by community community by supported project, The . The replication of expe of replication The . . . ------(c)  (b)  (a)  following: the included project of the Results FGM/C on ban aunanimous for to advocate FGM/C against rules community and decisions leaders’ munity com announce to hearing public a by followed was tion leaders community and regional for levels various at out carried mobilization were sessions Training community for materials CD-ROM and  (f) of a public rally against FGM/C against rally of apublic Association Farmers Awumer the at spectators 700 and Jijiga in spectators 300 young men and were women, topresented more than by prepared shows, and musical dramas anti-FGM/C and site, each at written were poems Anti-FGM/C Association); Farmers Burqa and (Harar sites two at leaders religiouspolitical by banned publicly was FGM/C and Association), Farmers Awumer and district Manna (Jijiga, sites three at declared publicly and written were penalties and rules Anti-FGM/C men; unmarried and women unmarried par mothers, offathers, ticipation equal with conversation, community through mobilized were members community 525 of total A reduction and abandonment of FGM/C abandonment and reduction gradual the for essential absolutely are ity-building capac community and interventions Community-led time; short areasonably in area larger a of coverage permit would another to munity com village one from FGM/C abandoning in rience A national forum of religious leaders was held held was leaders religious of forum national A . Community mobiliza Community . Jijiga was also the site the also was . Jijiga . . . - - - - - . IXC.  Ms. Ms.  (f) (e)  (d)  there there are pillars that its sustain existence tip on its unless stand that cannot triangle of an inverted tinuation of the practice ing toFGM/C, it is what analyse con sustains important end towards interventions designing before Obviously, form FGM/C to end movement African of an part that organizations the of experiences campaign time of period longer a for interventions sustaining to tributed con greatly organizations the offered Fund FGM/C the Fund”) FGM/C (“the FGM/C End to Activism Grass-roots for Equality Now mobilized resources and launched the Fund members of community practices and attitudes to work andthe at communities transforming influencing resourced sufficiently not were organizations local that concern the and FGM/C was up came that issues main priorities their about learn to organizations Kenya, in 2000, it consulted with African women’s rights Equality Now opened its Africa Regional Officein Nairobi, Ms Faiza Mohamed informed participants that when when that participants informed Mohamed Faiza . prayers; Friday in proclamations religious anti-FGM/C made Jijiga of mosques 13 all of leaders/Imams Religious FGM/C; banned unanimously institutions regional and national highest the from leaders gious reli Christian and Muslim prominent 83 of total A non-excised; to be proud and lucky were they that proclaimed publicly girls non-excised 21 of total A The new and long-term funding opportunity that opportunity . funding new long-term and The Regional Experiences This brief presentation attempts to capture the the capture to attempts presentation brief This . Equality Now Equality Faiza Africa, Regional Director Jama Mohamed, . Ms . Mohamed used the analogy . To the address One of the the of One . . . - - - - that ending that the of ending practice FGM/C out reaching required found was it girls, and women engaging to addition In Targeting1. communities (h)  (g) il, os rlgos edr, etc leaders, religious boys, girls, women, men, excisers, cultures, were—governments, pillars these what and who well knew communities their pillar each dismantling and weakening for interventions made tailor- with up to come and it support that pillars the tify centuries old of practice FGM/C, there was need to iden strategies are described below described are strategies solutions for search the in participation campaign their of work led and awareness the topublic issues increased and FGM/C, end to activities their in members diverse community engaged They successfully FGM/C that tosustain the pillars dismantle efforts their FGM/C Fund various undertook in interventions partners to interventions areas more their expand to and campaigns their sustain to resources sufficient of lack the by hampered supports those of rid to strategies get over various adopted the years activists etc boat, the rocking of fear relations, power gender- gain, economic (ignorance, practice the ported  15-31 years publicly promised to FGM/C stop promised publicly years 15-31 FGM/C past the for practised had who (TBAs) dants atten birth traditional and excisers famous Seven district; Manna in members community 522 gathered that declaration public anti-FGM/C an led and organized who force, police zonal Jimma the of officers police mobilized by list crime the on included was FGM/C African activists who were fighting the practice in practice the fighting were who activists African . . However, their efforts had been been had efforts their However, . . . ad h te sup they why —and Some of their their of Some . . ) These These . . p a g e 63 - - - . “Among the many was from the ideas discussion that of communities’ accountability.” responsibilityand surveillance system on FGM/C ameasure as abandonment communities should be encouraged to their establish own nel, religious experts and excisers nel, experts religious person health for lawyers, youth, paigns and workshops cam sensitization public makers, decision of levels ous vari at aimed forums advocacy held IAC, the of affiliate and Guinea in FGM/C end to working organization ing lead the (CPTAFE), Infants and Women of Health the Affecting TraditionalPractices on Cell Coordination The afew to name zania, Tanof Republic United the in LHRC, as such defenders schools, in rights human community and Eritrea; in clubs NUEYS, as such anti-FGM/C Gambia; the in clubs” “fathers of establishment the through members munity in FGM/C their succeeded com engaging Fund partners fabric-dyeing and making soap in engaged association the of part became then women practice the of out women several getting in ed succeed and excisers practising among activities tion sensitiza dyeing, fabric and soap-making to addition in roads village able impass across people transporting by income earn to used being were carts donkey the pots, the produce not market the to pots their transport to carts donkey and business their manage to how on (AMSOPT) Practices Traditional in Directions Overseeing for training Association Malian the received from having basis, full-time a on making pottery- in engaged were Kansamana and Dangassa in others among zania, Tan of Republic United the and Mali Kenya, Guinea, in practice the abandoning were who excisers of number increasing the by part in evidenced was approach sive youth and fathers ment, ing excisers, religious law policymakers, leaders, enforce includ society, throughout stakeholders or actors all to p a g e 64 During the rainy season, when they could could they when season, rainy the During . Another group in Bamako undertook, undertook, Bamako in group Another . . For example, in Mali, two groups groups two Mali, in example, For . The importance of this inclu this of importance The . . . Many of groups these Those Those . ------the Gambia Committee against Traditional Practices Practices Traditional against Committee Gambia to the channels CEWLA, as such legal FGM/C, of abandonment the address used have organizations Many Targeting3. law law and enforcement 2007 February in practice inspired the further togovernment pass a law against the move this and campaign; youth’soutreach of result a as FGM/C against ban a declared publicly villages three of subject FGM/C a was taboo where communities marginalized the of one targeted CEWLA movement FGM/C anti the in youth engaged NUEYS, and NAFGEM CEWLA, including groups, of ber practice the discontinue generations future and will also require sensitizing today’s youth so that the next Beyond engaging community actors, abandoning FGM/C Targeting2. youth Kenya; and Voice of Women, in Burkina Faso Voice and Kenya; Burkina in of Women, in Project, Women and Girls Marakwet the Tanzania;of Republic United the in (NAFGEM), FGM/C against work the and education; Net vocational that primary operates organization Somalia-based a (GECPD), Development and Peace for Centre in Education Mali; Galkayo (APDF) tection and Advancement of the Rights of Malian Women to end the including the practice, for Association the Pro tools advocacy and FGM/C about information seminate Other organizations were using media community to dis Sudan in Authority, Development Sudan the and Djibouti; in Women, Djibouti of Union National the Guinea; in CPTAFE, Ethiopia; in (HUNDEE), zation Organi Development Grass-roots Oromo the Egypt; in (CEWLA), Assistance Women Legal for Egyptian Centre the Tanzania; of Republic United the (WOWAP), in Up” Wake “Women, including radios, community were using . In Eritrea, the elders elders the . In Eritrea, . . In Egypt, Egypt, In . A num A . - - - - - Employ Employ a holistic approach learned Lessons 4. together countries several from organizations bringing workshop regional a hosted FGM/C, of which Abolishment the for Committee the National and (AJM) Association Lawyers’ Women Malian enacted law a getting towards working were APDF organizations Both and Mali Social in coalition the Health of and Development coordinator the AMSOPT, with nered part Now Equality exist, not does law FGM/C anti an progress make to required are efforts continued and issue, the on agencies enforcement law laws those of absence the in occur not would intervention religion and/or culture issue tradition, private by a as mandated actors other and police by seen ly tool critical a is it aban FGM/C, to don which through tool sole the be cannot law enforced be must they they where exist, and do created, be must they exist, laws no LHRC and Women of Voice (GAMCOTRAP), imperative to have in place a community support group, group, support community a place in have to imperative above envisaged momentum the maintain to ficult resources other and human of terms in stretched often are campaigners anti-FGM/C other structures Utilizesupport existing community event off and on and should be not sustained activities be sensitization an experiences their to relation in practice the question to begin and FGM/C of practice the around internalize the issues the communities doing, stakeholders all involving FGM/C of issue the on debates regular Hold excisers the including possible in all engaging that the havestakeholders a role, as inclusive as being also but strategies and approaches FGM/C of ment to abandon realize necessary is approach holistic a that show partners Fund of experiences the and FGM/C tain . Ongoing sensitization must be undertaken with with undertaken be must sensitization Ongoing . AMSOPT worked in collaboration with the the with collaboration in worked AMSOPT . This means not only employing many many employing only not means This . It is important to sustain discussion discussion to sustain is important . It . . Analysis of the pillars that sus Information-sharing and and Information-sharing . G/ i frequent is FGM/C . . Although using the the using Although This makes it dif it makes This . . . In Mali, where where Mali, In Activists and . Activists . Where Where . Police Police In so so In . It is is It . ------. g rnes h lw o n consequence no of laws the renders egy strat implementation corresponding a without laws the workers social and enforcers law involving mechanism protection a place in Put of FGM/C risk at when turn could girls to whom guardians become community the within alive debate the ing in and and information facilitating disseminating in keep resources valuable proved have structures supervisory possible as widely as reach the extend to order in gained have they information the on pass and FGM/C, to end committed are who of people composed future youth in Invest child the on rests this which in situation present the than rather general in the community to mutilation of evidence providing and reporting children tect pro to obliged are agents state as who officers, ment enforce law the of role the recognizes that framework child-protection a within situated are laws the that tive change that about tobring help would community/communities over in years several tions and their campaigns the same generation single a in local organizations is critical if real change is to take place funding long-term Ensure to FGM/C regard with children their of that and integrity bodily their on decisions informed make to able be FGM/C will they future, of In practice the surrounding stereotypes the question to them enables also but issue the in interest their captures only not drama and music theatre, tions, competi writing as such strategies using activities tion Investing in youth through age-friendly sensitiza age-friendly through in youth . Investing . . This would effectively shift the burden of burden the shift effectively would This . Youth are the leaders and parents of the the of parents and leaders the are Youth . It has been seen that the existence of existence the that seen been has It . . The presence of these organiza these of presence The . Long-term funding to support support to funding Long-term . . t s impera is It . Community Community . They also also They .

p a g e 65 ------. IXD.  Ms. Ms. is an analytical and programming tool that helps policy helps that tool programming and analytical an is programmes of ownership and tance accep community strong enhance to tool programming lens” culture “the promoting is and developed UNFPA resources and have human and institutional, financial programmes, their seek outreach and havestructures strong counsel, and and advice them to listen who people the among credibility and legitimacy have community, the in live organizations based faith- and religious with working for reasons many are partnerships and alliances strengthen to tutions insti religious and structures power and local with engage partner identify, to needs it that learned UNFPA move ahead to way the planning jointly and insights, and knowledge sharing listening, dialogue, in engaging agents, change greater emphasis on working with and communities local efforts into programming approaches sensitive culturally mainstream systemati to cally initiative an launched UNFPA 2002, In commitments honouring and others of cultures the respecting patient, being for and policy dialogue with stakeholders, partners environment positive a creating them, own to munities com enable that ways in rights human recognized ing context in which are promot interventions implemented, cultural the understanding following: the including fied, identi has UNFPA that approaches sensitive culturally Ms p a g e 66 iim aos rsnain el wt eeet of elements with dealt presentation Jato’s Miriam . Sensitive Approaches UNFPA Perspectives on Culturally . sion, UNFPAsion, Miriam Jato, Adviser,Senior Gender Africa Divi . . They have access to people, they they people, to access have They . On the ground, this demanded a demanded this ground, the On . The “culture lens” lens” “culture The . There There . ------(g)   (f) (e)  (d)  (c)  (a)  namely: lessons, sensitive culturally important these learned UNFPA programming, in using approaches of processes the In (b)  (a)  to: practitioners development enables lens” “culture The sustainability and ownership for conditions create and effectiveness programme strengthen resistance, reduce to as so programming, and and planning assets their in structures values, cultural positive utilize and stand under analyse, practitioners development and makers munity acceptance and ownership and acceptance munity com stronger with programming efficiently, and effectively development more of goals the Achieve context; cultural specific a in living groups interest and ties communi individuals, with dealing for skills Develop subcultures; various the of aspirations and tensions cultural internal Identify rights; of human enjoyment their hinder and ple peo to harmful are that practices social Understand tools”; communication and “negotiation and guage lan acceptable culturally context-specific Develop programming; to development adversaries n gne ise cnrbt t te elbig of families; and children women, well-being men, the to contribute issues gender and rights human how of exploration an through done be can realities own their into rights human recognized universally incorporate to communities Encouraging rfsinl etc professional, and legal political, cultural, (religious, groups sure pres and structures power local influential Identify implemented; are interventions which in societies of realities and context the Understand . ) that can be potential allies or or allies potential be can that ) . . ------ IXE. Ms. Ms. (c)  (b)  Ms Team, Harare Services (d)  to health to of country, some hazardous country are which equally regions African southern and central in common is minora labia practices the of one is means various using labia the and/or clitoris the IV Type as WHO by described are tices ways different in itself presents Africa ern ait Snhth bevd ht G/ i south in FGM/C that observed Singhateh Safiatu . goal of people’s well-being of people’s goal shared the on focusing by tensions potential defuse HIV/AIDS of prevalence the and women against violence of impact the dren, chil and the mothers of health to the as such concern community, of issues on data evidence-based communities with er before is effectively engaging structures necessary pow and agents change of local support the Gaining of programmes; ownership and acceptance wider gaining in strategy invaluable an became change” of “agents local with communities mobilize and tomotivate cy legitima and havewho the capacity individuals fying identi by begins often change behaviour Promoting the interests of diverse stakeholders—from political political stakeholders—from diverse of interests the of understanding an requires effectively Negotiating issues; sensitive to more expanded be can cussions Central Africa The Face of FGM/C in Southern and The manner in which this is done varies from from varies done is this which in manner The . . eomn Avsr UFA onr Technical Country UNFPA Adviser, velopment De and Population Gender, Singhateh, atu Safi The elongation of the clitoris and the the and clitoris the of elongation The . One way to do this is to present present to is this do to way One . uh nomto hls to helps information Such . Once trust develops, dis develops, trust . Once tecig of Stretching . These prac These . Partnering Partnering . ------ (f) (e)  but for that of their male partners male their of that for but pleasure own their for not themselves, women by done region African the throughout common is it but narrowing or sub stances or herbs into corrosive the vagina with of the aim of introduction tightening the is practice Another contours scarred create to buttocks the and thighs the of parts outer and inner the around cuttings ofdeep patterns ing his partner before and during intercourse during and before partner his of thighs inner and buttocks the caresses he as partner male the for sensation some to create believed are tours on formed the girl child before puberty dispel suspicions and promoted local ownership local promoted and suspicions dispel to helped campaigns advocacy in references Islamic audience wide a reaching in effective proved has drama and poetry music, can given culture a within popular are that sources from draw and ies, adversar potential and allies both of views the of ing understand clear a reflect should campaigns subjects These sensitive with deal to easier it make can them to the cultural context in which they are launched Developing campaigns and advocacy closely tailoring possible; become objectives programme for support and understanding which in ground tral neu create help can language value-laden Avoiding programming; effective for grounds it clearly understood, is often todifficult find common sector private the and ers lead cultural organizations, society civil to leaders hs s fr o rts f passage of rites of form a is This . This may or may not be a rite of passage, passage, of rite a be not may or may This . . In for the Uganda, example, use of Afri In Muslim contexts, using using contexts, Muslim In . Until their interests are are interests their Until . Another form is mak is form Another . The scarred . con The scarred . t s per is It . This is is This . p a g e 67 . ------. identified community participants dialogue discussions, plenary “In employing culturally sensitive critical.” is approaches buildingTherefore, the capacity in of managers and implementers empoweringas critical and for accelerating abandonment. (b)  (a)  following: the are genitalia female the with associated harmful practices eliminating in worked have that Approaches obvious are risks health the but pregnancy, prevent to puberty adulthood to girls of passage of rite the of climax the marking them, penetrate then and oil lubricating special with vagina their dilate girls, the of years age and 12 of years to age are introduced young 15 men to 18 countries African southern some in ofTanzaniabyimmigrants lic also and Repub practised of United the parts in certain a few tribes among passage, of rite a is Dance Light Moon The to rape marriage of chances greater stand and respect command test this Sangomas female traditional by out ried Africa South in province Natal zulu ing of girls is in common Swaziland as well as in the Kwa nakedness their expose also which skirts, tasselled short very and breasts exposed with ritual ing girl virgin a be the must that is participating for requirement practice principal cultural this through goes girl every ture; cul Swazi in dance Reed the is passage of rite Another p a g e 68 processes; participatory through designed are programmes tion and nity and that preven ensuring awareness-raising commu the with alliances and partnerships Building practices; of the implications and existence the of awareness Raising . . On the other hand, they may easily fall prey prey fall easily may they hand, other the On . The young men are required . toare young men The required pair up with Thus, the maidens go through a danc a through go maidens the Thus, . uig hs eid grs ewe 8 between girls period, this During . This rite occurs before before occurs rite This . Such testing is car is testing Such . Girls who pass pass who Girls . Virginity test Virginity . A . ------estv apoce i critical is culturally approaches employing sensitive in managers and implementers abandonment ing accelerat for critical and empowering as dialogue nity commu identified participants discussions, plenary In Discussions Recommendations and Plenary debates facilitating for catalysts as stimuli external need tions lishing monitoring and reporting mechanisms for all all for interventions mechanisms reporting and monitoring lishing estab and affected those for counselling protection, child mechanisms community-level establish to ments practices natory discrimi gender against toup actions scale associations women’s and CBOs and NGOs of capacity the building Ms (g)   (f) (e)  (d)  (c)  igae epaie te rtcl motne of importance critical the emphasized Singhateh . with female sexuality female with interfere that religion and culture of issues around at and national district levels to advocate for and rally groups youth and women and activists practitioners, rights human health among alliances Establishing stakeholders; critical other and audiences target the with tested pre are they that and sensitive culturally and gen der- also but explicit are materials and messages communication change behaviour all that Ensuring issues; health reproductive and sexual basic addressing while meanings and aspects tural cul and social positive celebrating and Supporting interventions; into programme values cultural positive incorporating and Assessing processes; all in professionals, media and en wom influential youths, men, and leaders, traditional religious as such stakeholders, significant Involving omnte sol b ecuae t dia to encouraged be should Communities . . h rcmedd obig govern lobbying recommended She . hrfr, ulig h cpct of capacity the building Therefore, . . omnt interven Community . ------(c)  (b)  (a)  that: were recommendations main The mechanism accountability an as tions sanc traditional place in put to encouraged be should springboard a as used be could practised longer no are that practices traditional to reference that sexuality and subjugation female from FGM/C separate to difficult is it that noted Participants culture own their within issues rights human on logue port by development partners, stakeholders and and stakeholders communities sup partners, sustain development to by port continued be should Advocacy southern interventions; for abasis as Africa in observed practices other and FGM/C IV Type on undertaken be should research Further abandonment; its accelerating for critical is ered to weaken the pillars that FGM/C sustain as this empow be should communities dialogue, Through . . They observed observed They . Communities Communities . - - - .

p a g e 69 X. Panel Discussion: Building the Cap acity of ­Managers and ­Implementers for ­Planning, ­Implementing, ­Evalua ting and Scaling Up FGM/C Innovative ­Interventions X.

­Interventions for of acity Cap the Building Discussion: Panel ­Planning, ­Implementing, ­Evalua ting and Scaling Up FGM/C Innovative with unified messages were depicted as crucial to avoid to crucial as depicted were messages unified with and youths in schools universities ministries, government relevant personnel, media communities, legal and medical the among ities activ campaign to conduct capacity need Implementers Advocacy,2. lobbying campaign activities and their to information audience FGM/C pertinent and accurate ensure to personnel media of training the was category programme the into integrated to be package a as emphasized was issues development related other and health reproductive and sexual rights, interventions FGM/C of mentation imple and planning mobilization, resource for capacity the enhance to networking and planning strategic ing, writ technical included mentioned capacities Specific local levels Institutional1. at central capacity-building and Dr. Contributors: eral categories of capacity building were shared and and shared discussed were building capacity of categories eral a sustained acceleration of FGM/C abandonment emphasized towards discussion critical as development and panel capacity-building this to Contributors FGM/C on Network Sudanese Director, Executive Fattal, Abdel Fatma Ms. Djibouti; Health, Child and Mother of Director Djinril, Elmi Safia Ms. Uganda; REACH, dinator, . AIA, gp; s Barc Ceagt Coor Programmes, Chelangat, Beatrice Ms. Health Egypt; ­CARITAS, Director, Hemy, Magdi . Managers and and ­Managers Comprehensive media campaigns media campaigns . Comprehensive Also included in this this in included Also . Training on human human on Training . . Sev - - - - - ations evalu internal in involved be and evaluation of essence area development critical another as viewed was evaluation and reporting The capacity to undertake situation analyses, monitoring, evaluation Situation 3. and monitoring, reporting analysis, nation of initiatives FGM/C nation coordi fostering in and FGM/C of abandonment the in and experience information on emerging issues or trends of sharing the promoting in partners, and stakeholders of all involvement in ensuring effective as described was audiences confusing visits by the central team central the by visits field regular or activities local of monitoring daily take under profiles, village conduct to institutions menting achieved being results the of informed stakeholders all keep ers wouldensure thatcal and implement reporting financial Implementers ­Implementers Improved capacity in this area would help imple help would area this in capacity Improved . . Implementers should appreciate the the appreciate should Implementers . The mechanism of networking networking of mechanism The . Capacity in periodical, techni periodical, in Capacity . .

p a g e 71 ------XI. Panel Discussion: Resource ­Mobilization for ­Scaling Up FGM/C ­Abandonment Efforts Globally XIB.   XIA. Ms. Ms. Ms. ner countries to integrate health and reproductive and and reproductive and health integrate to countries ner part its encourage to continue would Belgium dialogue, poverty of reduction towards ticularly par more and MDGs, the all of achievement the to key society civil Belgian with laboration col full in designed was rights and health reproductive and sexual in activities accurately more frame to note strategic a resolution, parliamentary a 2007, upon April rights reproductive and sexual of part gral inte an as countries developing in FGM/C of donment aban the supported cooperation, international of policy Ms gium Ms mechanisms for monitoring and evaluation to ensure ensure to evaluation and monitoring for and mechanisms programme; a of ownership for community ensuring mechanisms strategies; programme existing into integrated be would FGM/C how frame; time specific a within outcomes desired the on clarity included They mobilization resource in principles guiding important Cecile Charot observed that Belgium, through its its through Belgium, that observed Charot Cecile . . of Harmful Practices, Including FGM/C Belgium’s Contribution to the Abandonment Fama Hane Ba introduced this session by listing listing by session this introduced Ba Hane Fama Guiding eign Affairs and Development Cooperation, Bel Cooperation, eign and Affairs Development For of Ministry Adviser, Deputy Charot, Cecile Division, A Africa P F N Director, ­U Ba, Hane Fama Principles This support was was support This . Through political political Through . Moreover, in in Moreover, . for ------. the economic and political power of women within their their within women of power political and economic the strengthening to education; access universal girls teeing guaran at aimed countries partner its of initiatives the make ofuse them have access women to information about these that rights and the power and to protected are rights these that in sibilities all of areas life are, and enjoy the and same rights, opportunities respon boys and men waythat same the in citizens, full-fledged ties communi their and lives women’s on FGM/C of effects disastrous and multiple the consideration into take to Ms plans sectoral their and reduction poverty for strategies national their into rights sexual mutual mutual accountability banks development regional and Nations United the zations, organi multilateral and resources—bilateral external from and organizations for-profit and non-profit ments, govern local and central communities, within from ing includ externally, and internally mobilized be should outcomes desired the are achieve to resources required financial and resources knowledge es, accountability Resource Charot noted that Belgium encouraged its partners partners its encouraged Belgium that noted Charot . . Women and girls must be and considered treated as . Funding provided should be tied to results for for results to tied be should provided Funding Human resources, institutional resourc institutional resources, Human . In this regard, Belgium would support would support . In Belgium this regard, . Mobilization Governments must guarantee guarantee must . Governments . . Resources Resources

p a g e 73 ------XIC.  Ms. Ms. scale, large a on practised still is FGM/C where tries of coun As part with the dialogue those political partner of information dentiality confi and privacy to right the communication respect that techniques teaching to attention particular with incentives, and retraining training, through skills sional profes their enhance to and staff medical of quality the would Government continue to in improvements support part a is health reproductive and sexual which of be to enhance the quality and of accessibility health care, funds “vertical” of example, for use, ing manner—mak and coordinated in an resources effective available use would it donors, other with working and care health public of accessibility cultural tries’ policies of increasing the financial, geographicaland Belgium would also continue to coun its partner support of victims non-discrimination and for care and ensuring practices, and harmful violence sexual combating and preventing equality, in gender boys promoting and men by responsibility of assumption change and behaviour participation, increase to designed initiatives support also would Government Belgian The condom female the as such commodities contraceptive supporting and microbicides; by providing infections transmitted sexually for measures preventive promoting and developing societies; and communities p a g e 74 Abandonment of FGM/C The Case for Investing in the Population and Reproductive Health, USAID Health, Reproductive and Population of Office Analyst, Programme Shaaban, Layla . . The goal would would goal The . . To this end, end, this To . The The . - - - - - to be made that abandoning FGM/C is an important and FGM/C to is an that be important made abandoning needs still case the concern, of issues other many unlike Ms presentation, her In consideration into taken are rights and health reproductive and ual sex that ensure would Belgium Nations, United the Council of Security the of member non-permanent a As rights and health reproductive and and sexual FGM/C, promote to as such violence of forms all combat to women, of rights the enhance and women empower to community the international and Commission European care health related and sexual and reproductive to right the and flicts, con armed during girls and women FGM/C, of protection like the practices harmful and abandonment the discrimination of security, and integrity dignity, to right out it carrying in plan action Maputo the signed have governments that support and so do to Protocol Maputo the ratified yet not have that States African those age encour to resources diplomatic its use would Belgium communities local in campaigns change behaviour regional and national port authorities traditional the through with dialogue FGM/C abandoning supports that community a approach promoting actions as well as issue this to regard with experience acquired have that nizations fied and signed which most of countries these them also rati compliance with the terms of the Maputo Protocol, which to given is attention special that ensure would Belgium . Belgium would support civil society and local orga local and society civil support would Belgium . In this regard, emphasis would be given to be given women’s would emphasis In regard, this . Belgium would work closely with the the with closely work would Belgium . . Layla Shaaban observed that, that, observed Shaaban Layla . t ol sup would It . ------.

Ms partnerships Networks and 3. to impact maximize efforts existing port sup or on build would that activities supporting for and needs and successes demonstrate to programmes evaluating by for NGOs important to make the most of these resources cycles programming and results-oriented funding short-term by constrained are however, donors, flexibility allow that projects term longer in invest sustained is abandonment until support continued requires that investment indefinite an not but long-term a as framed accordingly be should abandonment FGM/C funding and expectations their adjust to complex and slow been has Ms Resources to2. challenges funding address donors of agenda the on issue the keep to as so created be to need abandonment for arguments Strong keep FGM/C agenda the on abandonment thatmaximize Messages 1. limited resources and mobilization resource effective for tips lowing investment worthwhile tain networks of stakeholders to share information at at information share to stakeholders of networks tain (d)  (c)  (b)  (a)  nity commu the and women of lives the and development and what it to means is important FGM/C abandonment how articulating clearly developed, be to need priorities that sages make towith sense varying audiences various haa pitd u te ed o ul ad main and build to need the out pointed Shaaban . abandonment of process the that noted Shaaban . ate messages for partners in 2007 in partners for ate messages Draw and share from lessons the last 20 years to cre new for involved; to get donors easier it make that opportunities Identify support; to sustain national strategies organizational and existing into messages FGM/C Integrate programmes; and linkages of successful examples sharing and funding for advocate to links these use and rights, human for and health issues, education, other example, to relationship its Demonstrate NGOs and advocates need to: need advocates and .NGOs They can make the case for further funding funding further for case the make can They . . Ms Shaaban highlighted the . fol highlighted Shaaban Therefore, donors need need donors Therefore, . . . Donors should should Donors . Therefore, . it Therefore, is . Many Many . Mes . ------. (e)  (d)  (c)  (b)  (a)  to: important is it regard, this In resources additional for case tothe make gaps and ress prog identify to help would organization each of tages advan comparative the and working are partners where resources increasing for essential are which coordination, and information-sharing better for allow and and regional partnerships global strategies National, Strategies4. for resource mobilization mobilization resource for strategies and ideas of sharing regular the NGOs, issue—within governments, donor agencies—and the of “champions” of support and identification the are issue the to attention draw to associations need to look with for existing opportunities and networks efforts mobilization resource drive to level global the to and level regional the to upward flow tion interventions of related messages the complement to and overlap avoid to level country the at shared be information that essential levels international and regional national, Link these strategies to impact maximize strategies these Link issue; to the champions more bring to and awareness raise to levels global and advocacy regional national, at opportunities existing and using communication for plan a Develop to programming funding; for effective arguments strengthen on evaluations Share the forward; agenda move to how on timeline a with action of plan Define roles foreach organization and develop a clear partner; of each advantages comparative the and Identify what resources are needed for donor outreach . It is also important that informa that important also is It . She said it is is it said She . Also needed needed Also . hr i a is There . Identifying Identifying . .

p a g e 75 - - - . XID.  Dr. young Somali girl met with some religious and spiritual spiritual and religious some with met girl Somali young a which in shown was programme another programme, involved deeply became cians politi and media the and cutting outraged, and shocked authentic were an showing programme a time, prime in broadcast, channel TV tabloid a 1999, In of guidelines development the supported Health involved be to politicians for sensitive too was matter the besides, and, problem” the of care “took that law a was there as dant, Affairs) went against this, arguing that it would be redun Social of Ministry the called (then health with dealt that personnel health for guidelines for need was there that felt practitioners medical Some 1995 in into force law, came which After some public debate, adopted parliament a separate delivery) after re-stitching (including herself cutting the for asked woman the which in another and country the of borders the outside place took cutting the which case in law—a general the under covered not situations two of because FGM/C against act separate a for need a be might there that argued lawyers 1990s, the in Early Act Protection Child the under and body, person’s another harming forbid which Code, Criminal general the under punishable be would FGM/C tor of that performing General concluded Health Norway in up taken was cutting the of where countries common is, still and from was, FGM/C immigrants receive to began Norway when 1980s, the in NGOs and Nations United the by led interventions FGM/C to support its initiated Dr p a g e 76 Berit Audstveg informed participants that Norway Norway that participants informed Audstveg Berit . Norway’s Interventions Concerning FGM/C Berit Audstveg, Senior Adviser, NORAD Senior Audstveg, Berit eetees te ietr eea of General Director the Nevertheless, . . A week after the first first the after week A . However, the ministry ministry the However, . The issue of legality legality of issue The . . The then Direc then The . People People . . - - - . 184 girls with permanent residence in Norway who had had who Norway in residence permanent with girls 184 cut altogether, had, they that confirmed who excisers, of interviews with Somalia to trip a from report a aired fromfit this bene to expected was FGM/C against work the and in, four the of one as rights and health reproductive and sexual with areas, four has It Norway’s under 2007 March in issues, launched was assistance, gender development on strategy new A FGM/C-related conditions treat and age man to services health initiated and FGM/C in interest special a took nurses, health public and midwives with country the throughout established were services such and women, to build up health services for the rehabilitation of excised FGM/C of seriousness the downplaying softness, as seen being was cutting gone health care and for rehabilitation women who had under and lack it of will “softness” proper calling method, dialogue the questioned politicians eral lib some even and steady, was punishment for call The amethod as dialogue sensitive culturally used who agents change of network a of up building the including work, good much 2003 in lowed “tradition” the against in Norway issue an was FGM/C that idea no had they passed, was law the when that accepted parliament, of members ing among the population found direction tal tradition of a bru brave and opponents or strong victims helpless either were women and cruel, as portrayed were men edited cut and had been that the tapes was clear den in her clothes her in den leaders (men), recording the meetings with a camera hid Within weeks, the country had plan an the action country . Within weeks, Nevertheless, the anger . and general despair Nevertheless, Obstetricians and gynaecologists, together together gynaecologists, and Obstetricians . The mainstream broadcasting cooperation cooperation broadcasting . mainstream The . The domestic action plan gave space for for gavespace plan action domestic The . The men advised her toexcised be her advised men . The An international Action Plan fol Plan Action international An . Despite this, it was possible possible was it this, Despite . . Fresh funds were brought brought were funds Fresh . Even the provision of . Politicians, includ . Somali . Somali It . It ------. civmn o MG, a emphasized was MDGs, the of with achievement linkage direct a provide to and equality, health gender reproductive and sexual of context the in with of FGM/C programming integration the for A call perspectives various resource from reiterated of was topic mobilization the discussion, plenary the During Discussion Recommendations and Plenary which were regulated of by law both psychiatry, in cases certain in force of use the and screening tuberculosis were compulsory was care be to implement impossible would it because also and hindered, be could care health to access and violated be would care health in voluntarism of principle fundamental grounds, the that implying ethical on examination compulsory strongly against warned Association Nursing Norwegian the discussed seriously being was genitals girls’ of checking regular dialogue” “enough been had there that again claimed politicians moderate even and renewed, mutilation still undergoing were Norway in residing girls and women Somali that clear became it but questioned, was number the of vacation their during Somalia to gone h priiain f e ad os n ter assump their and boys and men of participation the increase to programmes develop to made were dations girls and women immigrant on assaults new prevent to country own their in rights human use to have may Norwegians work technical good of lot a do so that it to is funds, led to possible the outrage securing way better a in immigrants among FGM/C handle to managed not had gender, including track record in sexual and health and reproductive rights, good a such with country a that paradox a like seemed Dr remarks, concluding her In necessary securing treatment for and excised being from girl a protect authorities—to child-protection or ity—police author relevant the inform to secrecy, professional by were bound otherwise who personnel, for health gation . . . h Nrein eia Ascain and Association Medical Norwegian The . The call for punishment was was punishment for call The . The two cases in which health health in which two cases The . There was already an obli It is also a paradox that that paradox a also is It . Audstveg said that it it that said Audstveg . On the other hand, hand, other the On . . The correctness correctness The . Compulsory, Compulsory, Recommen . - - - - - . and budgets and for budgets is results, necessary costs including needs, of assessment accurate an that reached was consensus mobilization, resource effective discrimination without victims for care ensuring and practices, harmful and equality, violence sexual gender preventing promoting in responsibilities of tion (d)  (c)  (b) (a)  made: were recommendations specific following The sector vate pri the and levels international and regional national, at those as well as communities at in levels available grass-roots resources of harnessing the and sources and partners potential of identification the were essary tion mobiliza- resource for strategies regional Develop stakeholders; all with information share to levels international and al Create at and networks national, partnerships region funding; address to effectively resources Mobilize the support; to sustain agenda public and government on abandonment FGM/C keep and resources limited maximize that messages design Collectively . . . Also nec deemed

p a g e 77 For . - - - XII. Global Partnership-building for the Abandonment for FGM/C XIIA.  (e)  (d)  (c)  (b)  (a)  outcomes Planned 1. Ms. Ms outcomes, as described below described as outcomes, years five within tries coun 17 in prevalence FGM/C cent per 40 by decrease Change” Accelerating Mutilation/Cutting: Genital “Female Fund: Trust and Programme Joint CEF mnt Tue rel dsrbd h UFA UNI UNFPA the described briefly Toure Aminata . policy and programming; and policy of increase understanding this social norm and inform to data MICS and DHS available on based analysed be would FGM/C on data subnational and National of FGM/C; realities to specific applicable them to making view a with with and the community practitioners, academic collaboration in developed further be would norms social harmful of functioning the on theories Existing worldwide; applied and FGM/C towould explicitly agreed be fully developed, of abandonment the for framework common a ners, part development global key with collaboration In level; community the at applied FGM/C and communicated of generated, be abandonment would the of dynamics social the concerning understanding and knowledge New enforc accelerated; be and would prevalence revising of countries in enacting, legislation ing of process The Joint Programme and Trust Fund Change: Example of the UNFPA UNICEF Fostering Joint Programming to Accelerate and Culture Branch, UNFPA Branch, Culture and Rights Human Gender, Chief, Toure, Aminata The initiatives have nine planned planned nine have initiatives The . . The goal . is goal The to - - - - (d)  (c)  (b)  (a)  namely: boundaries, national beyond go which teria cri segmentation developed jointly UNICEF UNFPAand criteria Segmentation 2. (i) (h)  (g)   (f) group; shared languages; shared group; ethnic via countries other on influence practice; the abandoned that countries neighbouring with groups nic groups with countries; shared neighbouring ethnic eth practising Shared connections: Regional/ethnic vicinity; country/ in abandonment of demonstrations Previous of abandonment: History to DHS/MICS; according towards behaviours, practising and (opposition) attitude practice the between Discrepancy Attitude: regions; DHS the in location ing; practice; of practis population of number FGM/C; of prevalence Type/severity practice: the of Status pd priual rpoutv hat srie to FGM/C services address health reproductive particularly oped, devel be would system health the of capacity The change; behaviour foster and agenda public the to FGM/C on keep media local ing with Partnering the media would be expanded, includ be would expanded; FGM/C of abandonment the for cating advo and supporting leaders religious of Networks fostered; and identified partnerships new and consolidated be would women and girls of rights human the to committed tutions insti and organizations with partnerships Existing .

p a g e 79 ------FGM/C prevalence in 17 countries within five years. Accelerating Change”. The goalby to is decrease cent per 40 Trust and Programme Fund: “Female Genital Mutilation/Cutting: Aminata ToureMs. briefly described the UNFPA UNICEF Joint along ethnic lines and sharing additional perpetrating perpetrating additional sharing and lines ethnic along identified Sudan, and Somalia (Somali), Kenya regions), 4 Region/Block of abandonment process accelerated an of likelihood a is there because country high-priority tion at to 49 the practice, cent per (DHS 2002) the rate 89 between and of per cent, opposi prevalence, 2007 March 20 on enacted to opposition the practice 3 Region/Block law enforcement effective as well as tice, prac the to opposition widespread increasingly is there 2 Region/Block context local the using Mauritania and Guinea in is the replicated Gambia, being towards abandonment a large scale at accelerating is abandonment where countries as identified were Guinea Senegal and Mauritania Guinea-Bissau, Mali, Conakry, Gambia, The 1. Region/Block identified were follows: as countries criteria, above-mentioned the against of subregions/blocks Six of countries Blocks 3.  (f) (e) p a g e 80 the presence of potentially supportive actors and and actors resources supportive potentially of and presence environment the media the community; intellectual/edu cational the and leadership religious and traditional the of attitudes abandonment); towards (commitment CBOs and NGOs organizations, tional interna of and levels, local and national at makers policy and governments communities, of Attitudes environment; Enabling The Senegal experience of public declaration experience . The Senegal . Burkina Faso and northern Ghana, where where Ghana, Fasonorthern and . Burkina Eritrea has increasingly widespread widespread increasingly has Eritrea . Djibouti, Ethiopia (Afar and Somali Somali and (Afar Ethiopia Djibouti, . . A law FGM/C prohibiting was A large discrepancy exists exists discrepancy large A . . . . . This is a - - - - - include: surveys) line (end results gramme would help in and the evaluationfinal ofassessment pro localities selected in conducted be to surveys Baseline Monitoring evaluation4. and media and research institutions research and media the and donors; and NGOs governments, liamentarians, par as such leaders, government and religious tional, tradi communities; include: process abandonment the in critical as identified been have that stakeholders The countries three these across approach movement abandonment powerful a in it rite-of-passage transform and the of weaknesses certain rates prevalence lower showed consistently groups age younger the cent, per 40 below prevalence FGM/C with countries other in as ment and prevalence medium/low abandon of history a have Tanzania of Republic United 6 Region/Block data DHS 1995 with compared as data DHS 2005 to according Egypt 15–49 aged women ever-married for cent per 96 versus 15–17 aged girls for prevalence cent per 77 a by indicated FGM/C, to subjected girls adolescent of number the in decrease prevalence high and ment 5 Region/Block particular in of countries block this on and region African eastern the in impact overall an have may which teachings, religious from FGM/C “de-link” factors . Support for the practice decreased by 14 points points 14 by decreased practice the for Support A religious movement is unfolding in Sudan to Sudan in unfolding is movement religious A . . . This is an indication of change unfolding in in unfolding change of indication an is This gp, u t is itr o abandon of history its to due Egypt, . Kenya (non-Somali), Uganda and the the and Uganda (non-Somali), Kenya . It would be possible to address address to possible be would It . . The 2005 EDHS reports a reports EDHS 2005 The . . . In non-Somali Kenya, Indicators selected selected Indicators . . - - - - - XIIB.  Ms. Ms. and evaluation and monitoring for responsibility take to UNICEF and tion; mobiliza community and advocacy undertake to CI-AF NGOs; and institutions of capacities reinforce and build toWHO dissemination; information and in lead research UNFPA has responsibilities: organization Each specific to mechanisms evaluation and monitoring implementation, of ment on databases creating develop the support and advocacy; FGM/C; reinforce to contribute and strategies and tools information, countries; exchange efforts; NGO support in interventions and capacities reinforce to which operate within Understanding of Memorandum a health; children’s WHO and UNICEF and UNFPA, women’s affecting Traditional Practices on Committee Inter-Africa CI-AF the are: Group Geneva, Inter-agency the in agencies main FGM/C of abandonment the to contribute to established was which FGM/C, on Group agency Ms Ababa Addis Traditional Practices, on Committee Inter-Africa Operations, of Director Kouyate, (c)  (b) (a)  Bintou Sanogoh summarized the role of the Inter- the of role the summarized Sanogoh Bintou . women seeking reproductive health services); health reproductive seeking women public, in (women speaking Women’sempowerment (cut cut); not of or daughters Status practice); the for support or leaders (formal and informal) vis-a-vis FGM/C (opposition to community women, and men of Attitudes The specific objectives of the group are to: are group the of objectives specific The . Inter-agency Group on FGM/C nical Services Team, nical Services Dakar, and Dr. Morissanda Bintou Sanogoh, Director, UNFPA Country Tech . . . The members developed developed members The . The four four The - - - (f) (e)  (d) (e)  (d)  (c)  (b)  (a)  ways: following the in group the guide to developed 2007-2011 was for Action of Plan A Prevalence rate Prevalence activities; FGM/C prevention for allocated resources and action of national plan legislation, of enforcement and Existence FGM/C; to abandon by communities pledges Public First Ladies, national parliamentarians and religious religious and parliamentarians national Ladies, First Inter-agency the Group and its would partners advocate and similarly, lobby with forums; Union African and international at provided especially opportunities actors through policy with lobby and Advocate on level; inter-country consultations the at FGM/C bi-annual institutionalize to and agency every of meetings annual during FGM/C of of cators CI-AF indi the and UNICEF by adopted indicators 10 the of use the promote and level country the at monitoring tions interven FGM/C evaluating and monitoring of tem interventions evaluate and Monitor on FGM/C; agencies development and bilateral orient and UNCTs of groups thematic of capacities Reinforce education; university and ary of incorporation FGM/C in modules primary, second the for lobbying and partnership-building to promote partnerships Promote gaps; a develop research culture and stimulate new learned, research to fill the existing lessons of and use findings the research ensure to research Promote Develop a culture of evaluation and continual continual and evaluation of culture a Develop . . It is to critical take stock of the status . The plan of action is expected is expected of action plan . The Establish a sys a Establish .

p a g e 81 - - - - XIIC.  (g)   (f) Ms. Ms. Ms a coordinated global strategy under the umbrella of the the of umbrella the under strategy global coordinated a promote to agreed DWG the meeting, 2006 its During Fund Global lace Ford the Wal the and Welfare Foundation Public the USAID, Foundation, and Development International for Department Kingdom’s United the Agency, Cooperation Development International Swedish the Italy, Finland, UNICEF, GTZ, World the Bank, Commission, European the WHO, UNFPA, (UNFIP), Partnerships International for Fund Nations United the (DWG)included Group ing p a g e 82 Francesca Moneti observed that the Donors Work Donors the that observed Moneti Francesca . modern and traditional media; traditional and modern including channels, all using leaders traditional and rights activities rights human all in as well as care newborn and maternal and AIDS and HIV health, reproductive and sexual on programmes ongoing in issues FGM/C of ration incorpo the ensure to agencies among Collaborate development; in to UNCTs, and other partners NGOs governments, to Understanding of Memorandum the Disseminate for the Abandonment of FGM/C Elaboration of aCommon Framework Donors’ Working Group on the UNICEF Innocenti Research Centre Research UNICEF Innocenti Officer, Rights Child Senior Moneti, Francesca . . - - - ing explicit partnerships with the large number of actors actors of number large the with partnerships explicit ing women promot at aimed framework common ofa development and children benefiting transformation social large-scale that and stimulates approach supports systemic FGM/C—a of abandonment promote cessfully suc to found been has that approach the endorsed has FGM/C on Statement Inter-agency Nations United is with the consistent framework common emerging The of FGM/C abandonment the for framework common a elaborating resources mobilizing and will political 2015 by FGM/C of abandonment the promote to community international the of efforts intensify to Nations United Planned ContributionPlanned by Agency Each munication Advocacy andcom- pacities strengthening ca- Training and Total partnership Collaboration and evaluation Monitoring and Documentation mation dissemination Research andinfor Intervention This included expanding partnerships, broadening broadening partnerships, expanding included This . . - 2 953 500 1 100000 330 000 343 000 585 000 140 000 455 500 (USD) SUM 100% 19 37 15 . 4 . 11 . 11 . .80 It also included included also It . . 42 24 74 % 61 17 Task Force Leading UNICEF Agency Agency UNFPA WHO CI-AF CI-AF Inter- The The . It It . - - XIID.  Ms. Ms. (c)  (b)  (a)  change social of positive a thus stimulating or out coerced process feeling judged, sensitive including ones such as concerns, FGM/C, with on and solutionsthemselves aproblems define variety of to raise communities encouraging at aims approach The FGM/C to end efforts in role central that are and that not play organizations United Nations a “closed” and “open” procedures, performer of FGM/C, FGM/C, of performer procedures, “open” and “closed” of percentage of daughters, FGM/C status by age, lence FGM/C on data national measure to extensively used been have Ms USAID/East Mission Africa (a)  on: based is approach the communities, Beyond Ann P Ann . gender equality gender including principles, rights human of promotion The generations; across or men with women, among organized be may that dialogue communication—no-directive Participatory skills; and knowledge new vides pro that management and health, reproductive and health in education education—literacy, Empowering ers, including parliamentarians; including ers, lead government and religious traditional, Engaging Common population indicators used are: used preva indicators . population Common Evaluation of FGM/C Global Collaboration in Monitoring and McCauley reiterated that DHSs and MICSs MICSs and DHSs that reiterated McCauley . Health Technical Adviser/Programme Officer, Officer, Adviser/Programme Technical Health Reproductive Senior Ph.D., McCauley, P. Ann . It is based on: based is .It . - - - - other measures of gender equity gender of measures other mechanisms prevalence in decline and monitoring community intent, of state ments public include indicators programme Common are men than FGM/C observed of supportive been more are women countries several has in that it measurements, such Through sex and age by FGM to, opposition or of, support and high and medium prevalence medium and high a with Africa sub-Saharan in countries 16 in FGM/C of prevalence the in reduction major a to lead could 10 years over year a million 24 $US that estimates UNICEF science, social and experience programme from edge process abandonment the of stages different at resources of levels and types different for calls framework common the in reflected approach The (d)  (c)  (b)  holistic mechanism of protection mechanism holistic a provide to society civil and leaders local with ers services, provid service basic and social systems justice and police and welfare legislative, together bring that frameworks child-protection Developing legislation; and policies of reform and review the Undertaking media; local and national with working and society civil and ment govern in allies strategic with partnership in level national the at dialogue supporting and Stimulating . FGM/C may also be linked to linked be also may FGM/C . . For example, excised excised example, For . . ae o knowl on Based .

p a g e 83 - - - - .  XIIE. networks is the Sexual Violence Research Initiative Initiative Research Violence Sexual the is networks initiatives and networks research of ber a num hosted has Forum Global the work, of its part As end towards that research encourages and FGM/C of abandonment the to committed is Forum Global the equity health achieving and health global ing improv to committed is it that and equality gender and rights human equity, of principles by informed is work Dr. indicators have clear also should FGM/C to important are rights human or equity gender of measures which FGM/C of types in changes or performed is FGM/C which at age decreasing medicalization, towards trends example, for time, over repeated are that measures are data Trend makedecisions should men that believe and cases some in justified is beating wife that agree education, lack to women un-excised than likely more are women rumhealth (www populations marginalized and poor of working health the on efforts research global to focus 1998 since Switzerland in foundation international dent indepen an is Research Health for Forum Global The p a g e 84 for the Abandonment of FGM/C Towards aGlobal Research Strategy Research on Emerging Issues: Global Forum for Health Research Health for Forum Global Analyst/Statistician, Health Burke, Anne Mary . It is important for implementers to decide decide to implementers for important is It . org) Dr . Mary Anne Burke explained that its its that explained Burke Anne Mary . Each element of the road map map road the of element Each . . One of these these of One . As such, such, As . . globalfo . . - - - - (b)  (a)  following: the on focus specific a includes agenda research SVRI The Africa of South Council Research Medical the by hosted and world the from around by a group of experts coordinating research guided countries, 80 than more from members 1,000 addressed are violence al sexu of aspects many the that ensure to activists and donors policymakers, researchers, committed of net a work create to 2003 in launched was which (SVRI), Support for FGM/CSupport (in percentages) (DHSs) . Source: Country Demographic andHealthSurveys economic impact of FGM/C; impact economic and psychological social, medical, the of Description methodologies; and stan instruments dardized using settings, cultural various in FGM/C of context social and extent nature, the of Investigation Niger 1998 Mauritania 2000-01 Mali 2001 Guinea 1999 Eritrea 1995 Côte d’Ivoire 1998-99 Burkina Faso 1998-99 Benin 2001 Country Survey . s f 07 i hd ls to close had it 2007, of As . Women 80 64 68 30 32 57 5 21 Men 46 52 23 73 37 5 14 17 - - - and knowledge with other SVRI researchers SVRI other with knowledge and and skills expertise, technical of groups sharing the and workshops; discussion research list-serve websites, SVRI activities, promote could SVRI for network The 12 commitments long-term maintain to governments by commitment greater for lobbying to key as seen was education, girls’ as such MDGs, of achievement the to FGM/C Linking results- externally evaluated be should initiating that interventions based and society civil with strengthening relationships partners, international from resources mobilize to channels parliamentary using on emphasis including plenary, the in discussed were keyideas Many Discussion Recommendations and Plenary (a)  following: the including FGM/C, on agenda research a developing in upon built be could mechanisms and opportunities strategic of number A (c)  (b)  (a)  to: were plenary the in made tions

http://bamako2008 Bamako, Mali, 17-19 Mali, Bamako, 2008; November in held be to Health, for Research on Forum isterial Min Global the towards research FGM/C guide also activists and and NGOs; industry academia; government, in researchers donors; and technology; and science ters ofeducation health, which minis with engage Strategy, to opportunities explore Research would Global proposed The settings cultural various in FGM/C of abandonment the at aimed based programmes empirically of evaluation and Development at accelerating the abandonment of FGM/C; abandonment the accelerating at aimed programmes of implementation the for work frame or map road the in developed indicators Use rights; human and equality gender that measure indicators Develop . org/en/index . Donors were also urged urged also were Donors . . shtml The strategy could could strategy The . Key recommenda Key . 12

. - - - - . (c)  FGM/C including of types and emerging towardstrends medicalization trends, of measurement the Emphasize .

p a g e 85 XIII. Final Conclusions and ­Recommendations XIIIB.  XIIIA.  P P (b)  (a)  namely: forward, agenda on sensus critical steps for moving the FGM/C abandonment abandonment of FGM/C; abandonment the accelerate to opportunities and challenges new of analysis and strategies of review experience-sharing, ed Welcome Ethiopia: by Ababa, Addis in 2007 organized August 3 to July 30 from UNFPA (FGM/C), Mutilation/Cutting Genital Female on Consultation Global the of participants We, articipants made the following Declaration: Declaration: following the made articipants tion tion to continue new sharing good practices, research consulta this on based network electronic an Create programming; and for guidance practical provide and regional advocacy national global, guide to be would document years) (25 generation a within FGM/C of abandonment the accelerating for egies strat working and opportunities challenges, out lays that map road practical and operational an Develop week consultation, analysed key ideas and built a con a built and ideas key analysed consultation, week one- the during proceedings the on reflected articipants this important forum as a space that facilitat that space a as forum important this Final Declaration of Participants The Way Forward The purpose of the the of purpose The . - - - - (e) (d)  (c)  and girls and; girls and women of millions of suffering the and unnecessary continued practice the end to interventions of decades Note circumstance; any under justified be cannot and rights girls’ and en’s wom of violation clear a and girls and women of well- being and health the to harmful is that practice erable intol an is it as FGM/C of tolerance zero our Reaffirm partners; opment devel and organizations society civil partners, national with consultation in FGM/C of abandonment the erate Support  adaptation the for lobby finalize to action of plan input, a prepare and for document the draft of the informed share network progress, the of members Keep get there; there; get to how and years 25 next the in be should we where in Include the content of the road map: we where are, presentations; of the summaries including consultation, the from experiences Publish Asset; edge to FGM/C Knowl linked the be could which website, models working and findings with concern the slow pace of progress despite despite progress of pace slow the concern with the development of a global road map toaccel map road global a of development the . NP cud ot a host could UNFPA .

p a g e 87 - - - - - Call upon upon Call (j) (i) (h)  (g)   (f) (e)  (d)  (c)  (b)  (a)  ➤ on: call participants, the we, Therefore, of practice medicalization FGM/C of form any end an to bring and ics p a g e 88 ment of FGM/C; ment abandon the towards progress monitor to holders stake all involve that mechanisms appropriate Set of FGM/C; abandonment the to accelerate response a coordinated and Implement well-funded, integrated literacy; legal on of and FGM/C gravity the on them educate to through programmes sensitization leaders their and communities Empower FGM/C; with associated complications of management the and counselling in providers, health and institutions enforcement law including capacity, national Build programmes; and policies empowerment women’s and equality equity, gender FGM/C up scale in programmes the context of abandonment effective to resources adequate Provide issues; tive health reproduc and rights human in FGM/C Mainstream practice; of this tims the Uphold of rights female who children are also vic of FGM/C; abandonment the to support men upon call and girls and of women rights human and health the to priority highest Give change; iour behav sustainable for approaches sensitive turally cul implement and levels international and regional national, at networks and partnership broad a Build providers; by health performed when ing includ and FGM/C, of form any enacting banning laws enforcing by others, and Rights, People’s and Human on Charter African the Child, the of Rights the on Convention the Women, against crimination the Convention on the Elimination of All Forms of Dis including children, and women of rights and health the protect that instruments international existing with line in FGM/C of abandonment the Accelerate to: commitment their to increase Governments medical professionals to uphold medical eth medical uphold to professionals medical . ------(c)  (b)  (a)  ➤ to: we recommend Finally, (b)  (a)  ➤ on: call We also (k) Promote gender equality gender Promote and ownership sustainability national towards resources ade quate mobilize and FGM/C solidarity of abandonment promote the in research, continuing Support community-based organizations); and organizations faith-based to support organizations, society civil funding (governments, countries and technical their Increase to partners Development of and; FGM/C form any banning widely religions all of position and the spread life reproductive and sexual healthy a enjoy to right their and integrity bodily to girls and women of rights the on constituencies their Educate practice; of this continuation the to justify used are that communities religious and misconceptions cultures within and myths continuing the Dispel to leaders traditional and Religious abandonment FGM/C monitoring for a platform tion of All Forms of against Women Discrimination as Elimina the for Convention the on report the using and item agenda development national a FGM/C of by accountability making abandonment Demonstrate Addis Ababa, 3 August 2007 3August Ababa, Addis . . . - - XIIIC. Closing Remarks

Fama Hane Ba, Director, Africa Division, ­UNFPA, Ms. closed the global consultation, remarking that the consultation had been enriched by the global diversity and community of purpose. She said:

“We have learned and indeed we are ready now to scale up what has been working very well. We need to mobilize resources and move forward with a sense of urgency. UNFPA is committed to moving forward, and the Executive Director is committed and will be briefed. UNFPA, UNICEF and WHO commit themselves to moving forward.”

p a89 g e Annexes 30 July–3August 2007 Addis Ethiopia Ababa, Global Consultation on FGM/C List of Participants Annex 1 Representatives of Governments Development Partners and United and Development Nations Organizations Agencies and Partners Prof Ms .Aysha Pamukcu Dr Ms .AnnP Ms .Layla M.Shaaban Ms .Sandra Jordan Dr Ms .Carol Hannon Ms .Yelfigne Abegaz Dr Ms .Cecile Charot Ms .Brehane Assefa His Worship SimonPeter Odoo Dr Mrs .SafiaElmiDjinril .KidestLulu .Gebreselassie Okubagzhi .BeritAudstveg .MohamedFarid .MaryAnneBurke .McCauley, Health Analyst/Statistician Consulting Programme Officer Reproductive HealthSpecialist,FGM Focal Person Officer Senior Reproductive HealthTechnical Adviser/ Programme Programme Analyst Office of Population/Reproductive Health Senior Technical Adviser for Communications andOutreach, Africa Region Senior HealthSpecialist,HumanDevelopment Dept.ofthe Development Specialist Gender &CSO Adviser Senior Adviser ment Cooperation, Brussels Deputy Adviser, MinistryofForeign Affairs andDevelop - Ministry ofHealth Magistrate Health andPopulation Project Officer, Reproductive HealthServices, Ministryof Director ofMotherandChildHealth,MinistryHealth Research (Geneva) Global Forum for Health (Washington, D Wallace GlobalFund USAID (Ethiopia) (Kenya) USAID/East Africa Mission USAID (Washington, D D (USAID) (Washington, International Development United States Agency for try Office World Bank/EthiopiaCoun- Irish Aid The NetherlandsEmbassy (NORAD) Development Cooperation Norwegian Agency for Government ofBelgium Ethiopia Kapchorwa, Uganda Egypt Djibouti . C .) . C .) . C .) p a g e 91 p a g e 92 Independent Religious Consultant and Leader Independent United and Development Nations Organizations Agencies and Partners Dr Asmani Advocate Ibrahim Lethome Imam AfizAmbekema Ms .Atsede Zerful Dr Dr Dr Ms .Tabeyin Gedlu Ms .Francesca Moneti Ms .MariaGabriellaDeVita Ms .Ruzuidzo Thokozile Ms .Haregewien Admassu Ms .Sara Buchanan Dr Ms .Maryam SheikhAbdi Ms .Laura Raney Ms .AlvildaJablonko Dr Ms .Faiza Jama Mohamed .ElenaBonometti .AboneshHaileMariam .Guyo Jaldesa .EliseBJohansen .Tekle-ab Mekbib .Niccolo Figa-Talamanca Representative Advocate, High Court Religious leader Head ofOffice/Programme Coordinator Family HealthProgramme Officer Investigator Consultant, Obstetrician andGynaecologist, Principal Technical Officer, FCH/RHR/GRR Programme Communication Officer Senior ChildRightsOfficer Change, ChildProtection Section,Programme Division Child Protection Specialist,GenderEquality andSocial Director, African Centre for GenderandSocialDevelopment Gender Adviser Programme andDevelopment Officer/Gender Adviser Senior Consultant Programme Officer ductive HealthProgramme (FRONTIERS) Programme Associate, Communication Frontiers inRepro- FGM Programme Coordinator Programme Director Regional Director, Africa (AIDOS) Women in Development Italian Association for Kenya Benin (UNIFEM) (Ethiopia) ment Fund for Women United NationsDevelop- Office WHO/Ethiopia Country WHO (Nairobi) (WHO) (Geneva) World HealthOrganization UNICEF (Ethiopia) Centre (Florence) UNICEF Innocenti Research UNICEF (New York) (UNECA) Commission for Africa United NationsEconomic CARE (Ethiopia) CARE (Ethiopia) (Ethiopia) The Population Council (Nairobi) The Population Council (Washington, D The Population Council (NPWJ) No Peace withoutJustice (NPWJ) No Peace withoutJustice Equality Now (Nairobi) . C .) UNFPA Headquarters United NationsPopulation Fund Country TechnicalCountry Teams Services (CSTs) Offices Country Mr Ms .Seynabou Tall Ms .Margaret Thuo Mr Ms .Sawsan Al-Refai Ms .Brenda Malinga Dr Mr Dr Ms .Stella Akinso Mr Mme .Ly Rokiatou Traore Ms .JudithKunyiha-Karogo Dr Mr Mr Mr Ms .Meron Genen Ms .EttaTadesse Dr Ms .SiljeHeitman Mr med Mr Yacine Diallo Mr Mr Ms .JulittaOnabanjo Ms .MiriamJato Ms .AminataToure Ms .Fama HaneBa Mr .Hassan Mohtashami .Suzanne Konate-Maiga .Kemal Mustafa .MoniqueRakotomalala .MichelRosalie .BensonMorah .Athanase Nzokirishaka .Coulibaly Sidiki .Aloysius E.Fomenky .Abreham Gelaw .BerhanuLegesse .DirkJena .Faysal AbdelGadirMoham- .MamadouDicko .Andre Mayouya .Osaretin Adonri Specialist Pop Adviser, Gender Adviser, Behaviour Change Communication/Advocacy Director Gender Programme Officer Programme Officer UNFPA Representative, a.i Deputy Representative UNFPA Representative Programme Adviser UNFPA Representative Programme Officer and Focal Point FGM/C National Programme Officer UNFPA Representative UNFPA LiaisonOfficer for UNECA and African Union National Programme Officer National Programme Officer National Programme Officer UNFPA Representative UNFPA Representative Junior Professional Officer UNFPA Representative UNFPA Representative UNFPA Representative UNFPA Representative UNFPA Representative Personal Assistant to theExecutive Director Senior Adviser, Gender Chief, Gender, HumanRightsandCulture Branch Director Consultant .&Development CSTAA CSTAA (CSTAA) CST, Addis Ababa,Ethiopia Yemen Uganda Uganda Sudan Senegal Nigeria Nigeria Mali Kenya Kenya Ethiopia Ethiopia Ethiopia Ethiopia Ethiopia Ethiopia Eritrea Eritrea Egypt Chad Benin Angola Equality Now (Nairobi) Africa Division Technical Division Africa Division CSTAA CSTAA

p a g e 93 p a g e 94 Country TechnicalCountry Teams Services (CSTs) Ms .Faiza Benhadid Ms .SafiatuSinghateh Ms .Bintou Sanogoh Gender/Sociocultural Adviser Gender Adviser Director CST, Amman,Jordan CST, Harare, Zimbabwe CST, Dakar, Senegal adjusted relative risks of certain obstetric complications complications obstetric certain of risks relative adjusted Findings hospital from discharge maternal until up lowed gathered was factors reproductive and health, demographic, on tion opening vaginal the of narrowing or stitching with genitalia external the of all or part of II, FGM both; removal of clitoris or and labia minora; and FGM III, clitoris, removal or prepuce the of removal I, FGM system: WHO tothe according classified were and FGM, undergone had they not or whether ascertain to delivery before examined were Sudan and Senegal, ria, Nige Kenya, Ghana, Faso, Burkina in centres obstetric 28 at 2003, March, and 2001, November, between ery Methods outcome obstetric on of FGM types of different the effect examines study This (FGM)mutilation genital on is outcome obstetric scarce Background Summary Mutilation and Obstetric Outcome WHO Study Group on Female Genital Study in Six African Countries* Outcome: WHO Collaborative Prospective Female Genital Mutilation and Obstetric Annex 2 Compared with women without FGM, the the FGM, without women with Compared 28 393 women attending for singleton deliv singleton for attending women 393 28 Reliable evidence about the effect of female the effect about Reliable evidence atcpns n ter nat wr fol were infants their and Participants . . Prospective informa Prospective . . - - - - . *  1 1 sarean section cae respectively: III, and II, I, FGM with women in were, 1 (1 and low birthweight 0 birthweight low and FGM outcomes obstetric adverse have to FGM without those than likely more significantly are FGM with Women Interpretation deliveries 100 per deaths perinatal two relative risks 1 death (1 1 stay hospital nal 0 . . tions/articles/lancetfgm ul eot http://www Report: Full 21), 1 21), 1 (1 31 . . . 91 (0 91 10–1 54–2 . .01–1 . . 9, 1 49), 21 (1 21 . . . 15 (0 15 74–1 4; nat euctto 1 resuscitation infant 54); Risks seem to be greater with more extensive toextensive with more greater be seem . Risks . 0; otatm amrhg 1 haemorrhage postpartum 70); .01–1 . . FGM is toestimated lead to an one extra to 11) . . 94–1 6 (1 66 Parity did not significantly affect these these affect significantly not did Parity . .03 (95% CI 0 . 43), 1 43), . 41), 1 41), . . 5 (0 15 31–2 . . pdf . 94 (0 94 69 (1 69 . . . who 10), stillbirth or early neonatal neonatal early or stillbirth 10), 32 (1 32 . 97–1 . int/reproductive-health/publica . . 34–2 . 82–1 . .08–1 5, 1 35), 88–1 07), 1 .07), . 12); extended mater extended 12); . . . 21), 1 62), 1 62), 1 (0 11 . 1 (1 51 . 03 (0 .03 . . 29 29 (1 . . 95–1 29–1 55 (1 55 3 (0 .03 . .09–1 . 8, 1 28), . 6, 1 76), . 89–1 12–2 p a g e 95 . . . . 52), 87– 18), 16), . . 98 98 28 - - -

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