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High-quality healthcare needed for girls and women who have experienced female genital mutilation

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Special supplement published on the International Day of Zero Tolerance for Female Genital Mutilation.

6 February 2017: WHO joins individuals and organizations worldwide in marking the International day of zero tolerance for female genital mutilation (FGM). Over 200 million girls and women living worldwide have experienced this harmful practice, and this important event aims to raise awareness of this global problem.

FGM includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. It has no health benefits and is a grave violation of the human rights of girls and women.

Special supplement

On the occasion of the International Day of Zero Tolerance for FGM, a special supplement entitled Management of health outcomes of female genital mutilation: Systematic reviews and evidence synthesis, has been published in the International Journal of Gynecology and Obstetrics (IJGO).

This special supplement, co-authored and guest edited by staff from WHO Department of Reproductive Health and Research including HRP, focuses on the evidence base of best available health interventions for girls and women living with FGM. It contains 10 systematic reviews and 3 qualitative evidence syntheses, which were carried out to inform the development of the first WHO Guidelines on the management of health complications from female genital mutilation.

Reach girls and women with care

FGM can cause a number of negative outcomes for health and well-being in the short-term including shock, severe bleeding and problems urinating; and in the long-term including cysts, infections as well as complications in childbirth, increased risk of newborn mortality, pain during sexual intercourse, psychological problems, and death.

The co-authors of the special supplement note that while work to prevent FGM is of key importance, there is an urgent need to reach and support women and girls who have experienced FGM with high quality healthcare. The reviews included in the special supplement show that health-care providers want and need to be supported with appropriate information and training, to help them better care for the girls and women who have already experienced FGM.

The WHO Guidelines on the management of health complications from female genital mutilation equip providers with key knowledge to help them recognize and address the health complications of FGM.

Invest in health-care providers

The reviews in the special supplement highlight the importance of investing in the training of health-care providers to both prevent FGM and to treat its complications. Evidence shows that women want health providers to be knowledgeable and well-informed about FGM. In addition, providers themselves want to be better informed and better trained in order to recognise FGM and treat its potential adverse health outcomes.

Ian Askew, Director of WHO Department of Reproductive Health and Research including HRP comments, “Countries need to work to ensure that health workers are given the right training, and that action is taken at national and community levels to work towards the abandonment of FGM. When health-care workers are given the support they need, they can be important agents for change in their communities.”

Research gaps

The co-authors of the reviews call for more high-quality research to be done on FGM, as well as on interventions to prevent FGM and to treat its potential adverse health outcomes, particularly in countries where the practice is highly prevalent. Significant research gaps exist, and there is very limited high-quality evidence available on what works to prevent and manage the complications of FGM.

High-quality evidence is important in order to ensure the effectiveness of recommended interventions – and to ensure that health providers are well-informed and knowledgeable in order to provide high-quality healthcare to the girls and women who have experienced FGM.

WHO response

In 2008, the World Health Assembly passed resolution WHA61.16 on the elimination of FGM, emphasizing the need for action from all sectors - health, education, finance, justice and women's affairs.

WHO is leading research in countries to generate evidence on what works to reduce medicalization of FGM. WHO is also building evidence on the causes and consequences of the practice, how to work towards its abandonment and how to care for those who have already experienced it. In addition, WHO is also advocating internationally and regionally with the aim of supporting local efforts to end FGM within a generation.

In addition to the afore-mentioned guidelines, WHO is also working to deliver a training toolkit to support health workers in the provision of medical care and counselling to girls and women living with FGM and to promote the role of health workers as agents of change in their communities.

Credit: http://who.int/reproductivehealth/topics/fgm/health-outcomes-fgm/en/