Geneva: The World Health Organization (WHO) today issued a new guideline addressing the increasing trend of female genital mutilation (FGM) being performed by health workers. The report emphasises the urgent need for measures to stop this “medicalisation” of FGM and to involve health professionals in prevention efforts.
Typically carried out on young girls before they reach puberty, FGM includes all procedures that remove or injure parts of the female genitalia for non-medical reasons. Evidence shows that no matter who performs FGM, it causes harm, WHO said, and pointed out that some studies suggest it can even be more dangerous when performed by health workers, since it can result in deeper, more severe cuts.
Although the healthcare sector is crucial in combating FGM and aiding survivors, in several parts of the world, evidence suggests the practice is now increasingly performed by health workers. Data from 2020 indicates that approximately 52 million girls and women underwent FGM at the hands of health workers, representing about one in four cases.
The new WHO guideline, “The prevention of female genital mutilation and clinical management of complications,” highlights that FGM, regardless of who performs it, causes harm. The guideline provides recommendations for the health sector, governments, and communities to prevent FGM and ensure appropriate care for survivors.
Evidence suggests that FGM performed by health workers can lead to more severe complications and that its “medicalisation” also risks unintentionally legitimising the practice and may thereby jeopardise broader efforts to abandon the practice.
For these reasons, WHO’s new guideline recommends professional codes of conduct that expressly prohibit health workers from performing FGM. The guideline also emphasises engaging and training health workers to leverage their respected position in communities for prevention through sensitive communication and education about the risks of FGM. Sensitive communication approaches can help health workers effectively decline requests to perform FGM, while informing people about its serious, immediate and long-term risks.
“Female genital mutilation is a severe violation of girls’ rights and critically endangers their health,” said Dr Pascale Allotey, WHO’s Director for Sexual and Reproductive Health and Research, and the United Nations’ Special Programme for Human Reproduction (HRP). “The health sector has an essential role in preventing FGM – health workers must be agents for change rather than perpetrators of this harmful practice, and must also provide high-quality medical care for those suffering its effects,” she stressed.
Christina Pallitto, Scientist at WHO and HRP, noted the influential role of health workers in shaping attitudes on FGM and their crucial part in prevention and response.
“Research shows that health workers can be influential opinion leaders in changing attitudes on FGM, and play a crucial role in its prevention,” said Pallitto, who led the development of the new guideline. “Engaging doctors, nurses and midwives should be a key element in FGM prevention and response, as countries seek to end the practice and protect the health of women and girls.”
Alongside effective laws and policies, the guideline highlights the need for community education and information. Community awareness-raising activities that involve men and boys can be effective in increasing knowledge about FGM, promoting girls’ rights, and supporting attitudinal changes.
In addition to prevention, the guideline includes several clinical recommendations to help ensure access to empathetic, high-quality medical care for FGM survivors. Given the extent of both short and long-term health issues that result from the practice, survivors may need a range of health services at different life stages, from mental health care to management of obstetric risks and, where appropriate, surgical repairs.
The WHO notes that ending FGM is possible, citing reductions in prevalence in countries like Burkina Faso, Sierra Leone, and Ethiopia through collective action and political commitment. These three countries have seen reductions in prevalence among 15 – 19-year-olds over the past 30 years by as much as 50%, 35% and 30%, respectively.
While the likelihood of a girl undergoing FGM has decreased threefold globally since 1990, the practice remains common in about 30 countries, with an estimated 4 million girls still at risk annually.
– global bihari bureau
