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Female genital mutilation (FGM) is a common cultural practice, which involves the partial or complete removal of the external female genitalia. With increasing immigration from regions where the practice is endemic, there has been a growing prevalence of FGM in the United States and other developed nations. However, most medical professionals lack the baseline knowledge regarding FGM and its associated health complications. Given this increasing trend, dermatologists should anticipate an increasing number of patients with a history of FGM in their practice. While some of the obstetric, gynecologic, and psychologic consequences of FGM have been well-reported, the dermatologic findings are less characterized. Thus, this review article aims to provide dermatologists with a fundamental understanding of the prevalence, cultural significance, and health implications of FGM with a focus on the associated dermatological findings and provides recommendations on how dermatologists can address this sensitive matter.

Female Genital Mutilation (FGM) is a universal issue which affects girls in Africa, the Middle East, Asia and South America, and immigrant communities in Western Europe, North America, Australia and New Zealand. FGM is a cultural practice in approximately 29 countries in Africa, affecting over 140 million girls. FGM is practiced as a rite of passage, where girls are initiated into womanhood. This practice is promoted as a means for incorporation, thus ascribing personhood, and belonging for girls to their communities. African scholars hold conflicting positions about FGM, with some arguing that it is essential for relational fullness and harmony. While others believe FGM is unjustified because of the health and social risks associated with the practice. We argue, applying sustainable social harmony and Gyekye's views on cultural revitalization, that FGM is morally unjustified and should be prohibited. We believe the claims that FGM fosters harmony, a value of Ubuntu, are fallacious, and this perceived harmony is pretentious and unsustainable. We claim that FGM is inauthentic, unjust and steeped in patriarchal underpinnings that are unsustainable, thus it is a disharmonious practice. Cultural practices that are disharmonious should be refined and pruned and must be dynamic and responsive to current realities. [ABSTRACT FROM AUTHOR]

Numerous traditional practices are both beneficial and harmful. Traditional harmful practices, such as female genital mutilation and traditional cervical cauterization, are carried out for a number of reasons but can have negative health and social effects. In addition to deeply held beliefs, a lack of knowledge and awareness of the consequences of these practices contributes to the persistence of these issues. The objective of this study is to examine whether traditional cervical cauterizations were associated with preterm births in Somalia. This prospective cohort study was conducted at our hospital over a one-year period. Seven hundred and two patients were included in this study; these patients were divided into two groups, cauterized and non-cauterized groups, and the two groups were compared on pregnancy outcomes. We examined whether traditional cervical cauterizations were associated with adverse pregnancy outcomes, including preterm births. According to the findings of this study, traditional cervical cauterization was prevalent among patients visiting MSTREH (n = 328, 46.7%). Infections of the uterine cervix and infertility were the two main indications for cauterization, 44.8%, and 34.8%, respectively.Being older, uneducated, and poverty were significantly associated with traditional cauterization (P < 0.001). There was a significant correlation between prior traditional cervical cauterization and the risk of preterm births. Women with prior cauterization were two and half times more likely to deliver a preterm fetus (OR: 2.64, 95% CI 2.15–3.33) compared to non-cauterized mothers. Our findings show that women who have previously undergone traditional cervical cauterization have a significantly higher risk of preterm birth and negative pregnancy outcomes than non-cauterized women. Health professionals, particularly those who are close to the community, are crucial in developing and putting into practice plans to end harmful traditions in Somalia. [ABSTRACT FROM AUTHOR]

External female genital mutilation (EFGM) is the strategy employed by male spiders to ensure paternity during sexual conflict over female remating. Three orb-web spider species have been identified to engage in EFGM, wherein males remove the female's genital scape, which is crucial for successful genital coupling. Mutilated females lose their remating ability. Despite the apparent fitness advantage of mutilator males over non-mutilators, mutilation success rates vary across these species. The extent to which females engage in aggression and sexual cannibalism as potential countermeasures against EFGM is also variable. In this study, two consecutive staged matings were conducted in Cyclosa confusa and C. vallata spiders to determine the rate of successful mutilation and the influence of sexual cannibalism and female aggression. Both species exhibited low rates of sexual cannibalism and female aggression. While most matings involving unmated C. vallata females resulted in successful mutilation, one-third of C. confusa females retained an intact scape after mating. Additionally, mutilation rates in C. confusa increased with male size and weight and decreased with female weight. In contrast to previous studies on other species, our results revealed low mutilation success with low sexual cannibalism and female aggression in C. confusa. [ABSTRACT FROM AUTHOR]

Gender‐based violence (GBV) and, more specifically, violence against women (VAW) are commonly considered a consequence of a patriarchal structure—a social system granting the senior male absolute authority over the family and the community as a whole. Anthropologists have documented that human male dominance is rooted in evolution, with male violent behavior observed among the great apes. Given that evolution is a continuous process, human progress over millennia has modified pre‐existing behavior, demonstrating that humans can move beyond ancestral ways of life over time. Precisely because of the imperative to change and improve, at the global international level as well as in individual countries, strong movements are in action to eliminate GBV/VAW. FIGO has been and continues to be at the forefront of the battle for equality, with initiatives that cover many aspects of this, including the imperative to involve men, who—in the majority of cases—are the perpetrators. Since men are often the root of the problem, they must also be at the forefront of the battle to eradicate it. GBV/VAW comprises many facets, including selective female abortion, infanticide, femicide, honor killing, female genital mutilation, and child marriage. These deeply rooted forms of violence continue to perpetuate gender inequalities, remain major obstacles to health and societal progress, and violate the most basic human rights. Synopsis: Violence against women must be eradicated. To this end, strong movements are in action at the global international level as well as in individual countries. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion International migration from source countries has meant that clinicians in high income countries, that is, receiving countries, are increasingly caring for affected women affected by female genital mutilation/cutting (FGM/C). The aim of the present study was to assess the prevalence of FGM/C among women at childbirth, and its association with pregnancy outcomes.This was an observational study using data from a cross‐sectional population‐based study from the French National Perinatal Survey of 2021 (ENP) conducted in all maternity units in mainland France and including all women delivering a live birth during 1 week in March 2021 (N = 10 928). We estimated the FGM/C prevalence using (i) the diagnosed cases and (ii) the indirect prevalence estimated by UNICEF in each source country. We compared population characteristics and perinatal outcomes between women diagnosed with FGM/C and two groups: (i) women originating in source countries and diagnosed as without FGM/C and (ii) all women without diagnosis of FGM/C whatever the country of birth.Diagnosed prevalence of FGM/C was 95% (95% CI: 0.78–1.14] and the indirect computed estimation prevalence was estimated at 1.53% (95% CI: 1.31–1.77) in 113 and 183 women, respectively. Labor and delivery outcomes were globally similar in women with FGM/C and the other two groups. Only episiotomy was more frequently performed in women with FGM/C than in the other two groups.In receiving countries, obstetric outcomes of women with FGM/C can be similar to those of other women, which does not preclude need of further research and training to provide the most appropriate care, including enhanced attention to diagnosis. [ABSTRACT FROM AUTHOR]

The Middle East region has a long history of resistance, activism, and advocacy movements in health, most recently as part of the 2011 region‐wide Arab Spring. Despite this storied history, however, movements of resistance, activism, and advocacy in health in the region are rarely unpacked, examined, or documented. This historical and contextual analysis aims to examine the long‐standing confiscated health rights and subsequent experiences of resistance, activism, and advocacy in health in populations in Palestine, Lebanon, Egypt, and Iraq. Promoting a health equity and health rights‐based approach is key to achieving Universal Health Coverage and health‐related Sustainable Development Goals, particularly in contexts that experience fragile socioeconomic and humanitarian conditions and political instability such as many countries in the Middle East. Marginalized populations, including Palestinians living under Israeli occupation, Lebanese Lesbian, Gay, Bisexual, and Transgender+ (LGBT) communities, Egyptian women and girls affected by Female Genital Mutilation, and Iraqi refugees and Internally Displaced Persons, have been severely impacted by decades of oppression, conflict, and displacement. These populations have faced various forms of discrimination, neglect, and violence that have hindered their access to quality healthcare and basic health rights. Rather than relying on government efforts, local and international movements to advocate for and protect the health rights of these populations are key. Innovative approaches, strategic dialogue and collective actions are prerequisites for promoting resistance, activism, and advocacy in health in all country's systems structure. This analysis highlights the important of this social public health issue in the most turbulent region and provides evidence to guide all countries to realize equitable human rights for health for all populations. [ABSTRACT FROM AUTHOR]

This editorial explores the need for a collaborative and holistic approach to studying genital cutting and modification practices. It challenges stereotypes and dominant discourses surrounding female genital cutting and male circumcision, emphasizing the importance of critical evaluation and breaking down conventional boundaries. The text discusses various forms of genital cutting, including female genital cutting, male circumcision, and intersex surgeries, highlighting their complexity and diversity. It raises concerns about the selective ban on female genital cutting and examines the role of medical and non-medical factors in these practices. The text calls for a more nuanced understanding of these practices and the development of theories that can accommodate diverse perspectives and experiences. [Extracted from the article]

To evaluate the quality of Electronic Health Record (EHR) documentation practices of Female Genital Cutting (FGC) by medical providers. A retrospective chart review study of 99 patient encounter notes within the University of Minnesota health system (inclusive of 40 hospitals and clinics) was conducted. Extracted data included but was not limited to patient demographics, reason for patient visit, ICD code used in note, and provider description of FGC anatomy. Data was entered into REDCAP and categorized according to descriptive statistics. Out of 99 encounters, 45% used the unspecified code for FGC. The most common reason for patient visits was sexual pain, though many notes contained several reasons for the visit regarding reproductive, urological, or sexual concerns. 56% of visits discussed deinfibulation. 11 different terms for FGC were used, with "female circumcision" being the most common. 14 different terms for deinfibulation were found within 64 notes. 42% of encounters included a description of introitus size in the anatomical description, and only 38% of these provided a metric measurement. This study found significant variation in the quality of FGC documentation practices. Medical providers often used the unspecified FGC code, subjective and/or seemingly inaccurate descriptions of FGC/anatomy, and several different terms for both FGC and deinfibulation. Clearly, more education is needed in clinical training programs to (1) identify FGC type, (2) use the corresponding ICD code, and (3) use specific, objective descriptions (including presence/absence of structures and infibulation status). [ABSTRACT FROM AUTHOR]

Since the onset of the Somali civil war in the late 1980s, more than 2 million Somalis have been internally displaced or crossed international borders to seek haven. Yet, research on diasporic Somali women's intergenerational communication about marriage, sex, and female genital cutting (FGC) remains scant. This paper draws from data we collected from 15 women over the age of 45 who were part of a much larger project on refugee women and sexual health and well-being. The analysis centers on how Somali women across the generations recalibrate definitions of family. We analyze the new roles that sisters, aunts, and grandmothers occupy in the lives of younger women, as family dispersal often results in the absence of biological mothers. In the new settlement, the findings showcase both continuity and change in how sex, marriage, and female genital cutting (FGC) are discussed among female family members. Our findings support not only the dynamic nature of family roles that women occupy across generations but also the malleability of cultural practices as families navigate changing cultural, legal, and social norms in their new settlements. [ABSTRACT FROM AUTHOR]

This article on the case of R v Noor (2024) discusses the second successful UK prosecution under the Female Genital Mutilation Act 2003, marking a significant legal precedent in addressing female genital mutilation. It underscores the critical role of midwives in detecting, reporting and caring for victims, highlighting the intersection of healthcare, law and ethics in combating this practice. By examining the case of Amina Noor, who took a child abroad for female genital mutilation, the article elucidates the legal ramifications of such acts. It stresses the importance of midwifery awareness, education and collaboration with legal entities to protect women and girls. The article advocates for continuous professional development, the use of legal tools such as female genital mutilation protection orders and a Commissioner to prevent female genital mutilation, emphasising the collective responsibility of healthcare professionals in eradicating this harmful practice and safeguarding vulnerable individuals. [ABSTRACT FROM AUTHOR]

Female genital mutilation (FGM/C) is the partial or total removal of external female genitalia for non-medical reasons and is recognized as a human rights violation. It is practiced in various ethnic groups around the world and is an expression of gender inequality. FGM/C is most prevalent in sub-Saharan Africa but has also spread to migrant communities in Europe, North America, and Australia. Spain has criminalized FGM/C and has implemented prevention measures in primary healthcare settings. However, there is a need to improve detection and address the physical and psychological consequences of FGM/C. An intersectional approach that considers the cultural, social, and structural factors influencing migrant women's choices is necessary to eliminate this harmful practice. [Extracted from the article]

The unique health-related traditions, perceptions, and communication patterns of Ethiopian immigrants are challenging to Israeli healthcare providers who are trained in western medicine. The aim of this review was to conduct a survey of traditions, beliefs, and symptom reporting by Ethiopian immigrants and culturally oriented interventions to improve the care of Ethiopian immigrants. We used the keywords "Ethiopian immigrants Israel" and "Ethiopian Jews." Of 418 articles initially retrieved, 35 satisfied the inclusion and exclusion criteria. We described health-related traditions and their possible complications. Possession syndrome was frequently misdiagnosed as a neurological or psychiatric disorder. The medical staff was unfamiliar with these health and illness beliefs, somatization patterns, and the communication style of Ethiopian immigrants. There were successful interventions that involved liaisons from the Ethiopian community and community-based educational activities. Medical professionals working with African immigrants worldwide can use the Israeli experience to develop effective, culturally oriented interventions to optimize the health care for these immigrants. [ABSTRACT FROM AUTHOR]

Introduction: The morbidity and mortality associated with Female Genital Mutilation (FGM) have been clearly documented. Controlling and eventually eradication this practice is very important. Despite a loud call from the WHO and other international organisations, there are extensive nationalities and societies from both developed and developing countries still practising FGM. Understanding the current magnitude and associated factors in Tanzania may bring more light for possible interventions intended to control FGM. This study is timely for this aim. Objective: To determine the prevalence of female genital mutilation and its associated factors among adolescent girls and young women in Tanzania. Methods: Secondary data analysis was conducted on data from the 2022 Tanzanian Demographic and Health Survey. The weighted sample included in this study was 2965 adolescent girls and young women aged 15–24 years. Data analysis was performed using Stata 18.0 software. The strength of the association was assessed using the adjusted odds ratio (aOR) along with its corresponding 95% confidence interval (CI). Results: The overall prevalence of FGM among adolescent girls and young women in Tanzania was 4.9% (95% CI = 3.37, 6.97). The prevalence varied significantly across the zones, ranging from < 1% in both Zanzibar and Southern zones to 19.7% in the Northern zone. Moreover, the results revealed that factors associated with FGM were rural areas (aOR = 2.09, 95% CI = 1.80, 5.44); no education (aOR = 11.59, 95% CI = 4.97, 27.03); poor (aOR = 2.41, 95% CI = 1.20, 4.83); unskilled manuals (aOR = 3.76, 95% CI = 1.97, 7.15); continued FGM (aOR = 3.86, 95% CI = 1.62, 9.18); FGM required by religion (aOR = 8.5, 95% CI = 3.15, 22.96) and watching television at least once a week (aOR = 0.20, 95% CI = 0.70, 1.56) among adolescents and young women in Tanzania. Conclusion: Female genital mutilation among adolescent girls and young women aged 15–24 years in Tanzania has decreased slightly between 2015/16 and 2022 from 5.9% to 4.9% respectively. This was mostly associated with education level, place of residence, occupation, wealth index, mass media exposure, attitudes towards FGM. More tailored programs focusing on high prevalence zones targeting adolescent girls and young women are needed to end female genital mutilation by 2030. [ABSTRACT FROM AUTHOR]

Background: Due to its economic burden and change of focus, there is no gainsaying of the potential impacts of the COVID-19 pandemic on the progress of several female genital mutilation (FGM) interventions across the various countries. However, the magnitude of the potential changes in likelihood and prevalence should be more accurately explored and quantified using a statistically robust comparative study. In this study, we examined the differences in the likelihood and prevalence of FGM among 15-49 years old women before and after the pandemic in Nigeria. Methods: We used advanced Bayesian hierarchical models to analyse post-COVID-19 datasets provided by the Multiple Indicator Cluster Surveys (MICS 2021) and pre-COVID-19 data from the Demographic and Health Surveys (DHS 2018). Results: Results indicated that although there was an overall decline in FGM prevalence nationally, heterogeneities exist at state level and at individual-/community-level characteristics. There was a 6.9% increase in prevalence among women who would like FGM to continue within the community. FGM prevalence increased by 18.9% in Nasarawa, while in Kaduna there was nearly 40% decrease. Conclusions: Results show that FGM is still a social norm issue in Nigeria and that it may have been exacerbated by the COVID-19 pandemic. The methods, data and outputs from this study would serve to provide accurate statistical evidence required by policymakers for complete eradication of FGM. [ABSTRACT FROM AUTHOR]

Background: Half of the world's children experience violence every year, but the meaning of violence is not universally agreed. We may therefore risk failing to measure, and address, the acts that matter most to children and adolescents. In this paper, we describe and synthesise evidence on how children and adolescents in sub-Saharan Africa conceptualise different behavioural acts which are deemed violence in childhood under WHO and UN CRC definitions. Methods and findings: We conducted a systematic review of qualitative studies. We searched PsychINFO, CINAHL, Embase, Global Health, Medline and ERIC for all publications released prior to March 2023. 30 papers met inclusion criteria. We synthesised primary data from children and adolescents and drew upon theoretical and contextual interpretations of authors of included studies. Only 12 of more than 45 sub-Saharan African countries were represented with relevant research. Of the 30 included papers, 25 came from three countries: South Africa, Uganda and Ghana. Only 10 of 30 papers reported data from young children (pre-adolescence), and 18 of 30 papers primarily focused on sexual violence. 14 studies used child friendly and/or participatory methods. From this limited evidence, we identified six overarching themes in how children and adolescents conceptualised their experiences of acts internationally recognised as violence: 1) adults abusing or neglecting responsibility; 2) sexual violence from peers, family and community members; 3) violence in established intimate relationships; 4) emotional violence surrounding sex from peers and community members; 5) fighting and beating between peers; 6) street and community dangers. No studies meeting our inclusion criteria specifically examined children or adolescents' conceptualisations of homophobic or transphobic violence; violence against children with disabilities; boys' experiences of sexual violence from male perpetrators; trafficking, modern slavery or conflict; child labour; or female genital mutilation. We found that three dimensions were important in how children and adolescents constructed conceptualisations of violence: their age, relationship to the perpetrator, and the physical location of acts they had experienced. These dimensions were interrelated and gendered. Conclusion: The current limited evidence base suggests children and adolescents' conceptualisations of violence overlapped with, but were also distinct from, the WHO and UNCRC definitions of violence. Currently international survey tools focus on measuring types and frequencies of particular acts and neglect to focus on children's understandings of those acts. Relationship to perpetrator, age of child, physical location are all important in how children conceptualise their experiences of acts internationally recognised as violence, and therefore might be important for their health and social outcomes. Those developing measures should account for these dimensions when developing items for testing. [ABSTRACT FROM AUTHOR]

This article analyses the discursive construction of what has become known as 'Female Genital Mutilation' (FGM) in colonial-era debates in the UK Houses of Parliament. The author shows how, in order to bring the topic into the realm of political legitimacy and to be heard in an institution that had only recently allowed women to stand for office, (White) women MPs emphasised their superiority to the African cultures they were talking about. They fought for inclusion as parliamentarians by re-articulating and aligning themselves with Whitely virtues, positioning themselves as noble, respectable and civilised in contrast to the 'evil', 'abhorrent' and 'barbaric' natives. By delineating the moral distance between themselves and non-White men and women, and by (re)stating female parity as the measure of civilisation, they asserted their own right to full inclusion in the nation-state, using the master's tools to trouble the master's house. Ultimately, they gained ground for feminism through the re-articulation of racism. Through historicising and deconstructing the narrative as iterated in the seat of government in colonial times, the author furthers the tentative moves towards decolonising the global campaign against FGM. The article sheds light on the coloniality in the present-day hegemonic narrative of 'Female Genital Mutilation' and questions whether there might be less harmful ways to articulate opposition to the practice. [ABSTRACT FROM AUTHOR]

Objective: Obstetric anal sphincter injuries (OASIS) are severe complications to vaginal births with potential long‐term consequences. Maternal origin has been proposed to affect the overall risk, but the association and underlying explanation are uncertain. The objective was to assess the association between maternal country of birth and OASIS. Methods: A Swedish nationwide cohort study including singleton term vaginal births during 2005–2016. Data were extracted from the Swedish Medical Birth Registry and Statistics Sweden. Modified Poisson regression analyses were performed to obtain crude and adjusted risk ratios (RRs). Adjustments were made in four cumulative steps. Sub‐analyses were performed to investigate the risk of OASIS associated with female genital circumcision (FGC). Results: In all, 988 804 births were included. The rate of OASIS in Swedish‐born women was 3.5%. Women from East/Southeast Asia had an increased risk of OASIS (adjusted RR [aRR] 1.71, 95% confidence interval [CI] 1.60–1.83), as did women born in Sub‐Saharan Africa (aRR 1.60, 95% CI 1.49–1.72). The risk remained significantly increased also after adjustment for maternal height. By contrast, women from South/Central America had a decreased risk of OASIS (aRR 0.65, 95% CI 0.56–0.76). FGC was associated with an increased risk of OASIS (aRR 3.05, 95% CI 2.60–3.58). Episiotomy appeared to have an overall protective effect (aRR 0.95, 95% CI 0.92–0.98), but not significantly more protective among women with female genital mutilation. Conclusions: Country of birth plays an important role in the risk of OASIS. Women from East/Southeast Asia and Sub‐Saharan Africa are at significantly increased risk as compared with Swedish‐born women, whereas women from South/Central America are at lower risk. FGC is also a significant risk factor for OASIS. Synopsis: Maternal country of birth plays an important role in the risk of sphincter injuries. Female genital circumcision is associated with increased risk of sphincter injuries. [ABSTRACT FROM AUTHOR]

The practice of female circumcision is widely recognised across many regions, notwithstanding the ongoing debate and controversy surrounding it. Similarly, in Indonesia, this contentious issue encompasses various concerns regarding religion, tradition, law, and human rights, including women's rights, gender dynamics, as well as reproductive health and sexuality. This article concentrates on Gorontalo, Indonesia, examining the discussion on female circumcision, especially investigating its link to the sacredness of religious rituals and traditions, as well as the impact of power dynamics that sustain this traditional practice as a seemingly natural phenomenon. Through Michel Foucault's theory of normalization in power discourse, it dissects the factors sustaining this controversial tradition. Research methods included field observations and literature studies. The findings elucidate that female circumcision in Gorontalo not only elucidates aspects of religion and tradition but also unveils the power relations underpinning the perpetuation of this practice within the sociocultural fabric of Gorontalo society. [ABSTRACT FROM AUTHOR]

By taking these five steps, physicians can start changing a culture of medicine that prizes stoic perfectionism and stigmatizes asking for help. [ABSTRACT FROM AUTHOR]

&Scedil;eyma Zehra Altunkurek,1 Eylül Ye&scedil;ilyurt,2 Samira Hassan Mohamed3 1Department of Public Health Nursing, University of Health Sciences, Gulhane Faculty of Nursing, Ankara, Türkiye; 2Department of Public Health Nursing, Ufuk University School of Nursing, Ankara, Türkiye; 3Department of Nursing, University of Health Sciences, Somalia Mogadishu Recep Tayyip Erdo&gbreve;an Faculty of Health Sciences, Mogadishu, SomaliaCorrespondence: Samira Hassan Mohamed, Email samirahsn1992@gmail.comPurpose: The aim of this study was to compare the menstrual symptoms and dysmenorrhea in university students who underwent Female genital mutilation/cutting (FGM/C), in Mogadishu, Somalia, and students who did not undergo FGM/C in Ankara, Türkiye.Methods: A comparative cross-sectional study design was used.Results: Among the participants with FGM/C, 88.5% were Type 1 and the age at FGM/C was 8 years. The pain severity was 6.20± 2.54 in women with FGM/C and was higher than that of those without FGM/C (5.97± 2.32), but no significant difference was found. Among those who had FGM/C, 66% had a menstrual duration of 3– 5 days, while 52.0.% of those who did not have FGM/C had a menstrual duration of 6– 8 days (p< 0.05). While 85.1% of those without FGM/C had a menstrual cycle of 21– 35 days, 35% of those with FGM/C had a menstrual cycle of less than 20 days (p< 0.05). It was found that 95% of those who have undergone female circumcision and 90.2% of those who have not had dysmenorrhea (p< 0.05). Painkillers were always used by 28% of women with FGM/C and 26.3% of women without FGM/C (p< 0.05). The total MSS score of those who have not had FGM/C was 3.34± 0.72 and the score of those who have had FGM/C was 2.91± 0.74 (p< 0.05). The negative effects sub-dimension score was found to be higher in the non-FGM/C group with 3.20± 0.75, while the coping methods sub-dimension score was higher in the FGM/C group with 2.91± 1.13 (p< 0.05).Conclusion: FGM/C is still common in Somalia. Our study results showed that having FGM/C may cause differences in dysmenorrhea and menstrual symptoms. Efforts to increase students’ effective coping with menstrual symptoms and dysmenorrhea are thought to be useful.Keywords: female genital mutilation, menstrual symptoms, university students, Somalia, Turkey

Abstract Introduction The morbidity and mortality associated with Female Genital Mutilation (FGM) have been clearly documented. Controlling and eventually eradication this practice is very important. Despite a loud call from the WHO and other international organisations, there are extensive nationalities and societies from both developed and developing countries still practising FGM. Understanding the current magnitude and associated factors in Tanzania may bring more light for possible interventions intended to control FGM. This study is timely for this aim. Objective To determine the prevalence of female genital mutilation and its associated factors among adolescent girls and young women in Tanzania. Methods Secondary data analysis was conducted on data from the 2022 Tanzanian Demographic and Health Survey. The weighted sample included in this study was 2965 adolescent girls and young women aged 15–24 years. Data analysis was performed using Stata 18.0 software. The strength of the association was assessed using the adjusted odds ratio (aOR) along with its corresponding 95% confidence interval (CI). Results The overall prevalence of FGM among adolescent girls and young women in Tanzania was 4.9% (95% CI = 3.37, 6.97). The prevalence varied significantly across the zones, ranging from

This study explores the complex nature of female genital mutilation/cutting (FGM/C) by juxtaposing the mental and sexual health of women who had undergone FGM/C as part of initiation/membership into a traditional women's society (TWS) with those who were also cut but not initiated into a TWS. While considerable differences emerged between TWS members and nonmembers, there was no evidence that TWS membership was protective against the physical and psychological trauma typically ascribed to FGM/C. In fact, the pattern of results would tend to suggest the opposite. Possible explanations for and implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Abstract Background Female genital mutilation (FGM) is defined as all procedures involving partial or total removal of the external female genitalia, or other injuries to them for non-medical reasons. Due to migration, healthcare providers in high-income countries need to better understand the consequences of FGM. The aim of this study was to elucidate women’s experiences of FGM, with particular focus on perceived health consequences and experiences of healthcare received in Sweden. Methods A qualitative study was performed through face-to-face, semi-structured interviews with eight women who had experienced FGM in childhood, prior to immigration to Sweden. The transcribed narratives were analyzed using content analysis. Results Three main categories were identified : “Living with FGM”, “Living with lifelong health consequences” and “Encounters with healthcare providers”. The participants highlighted the motives behind FGM and their mothers’ ambivalence in the decision process. Although the majority of participants had undergone FGM type 3, the most severe type of FGM, the lifelong health consequences were diverse. Poor knowledge about FGM, insulting attitude, and lack of sensitive care were experienced when seeking healthcare in Sweden. Conclusions Our findings indicate that FGM is a complex matter causing a diversity in perceived health consequences in women affected. Increased knowledge and awareness about FGM among healthcare providers in Sweden is of utmost importance. Further, this subject needs to be addressed in the healthcare encounter in a professional way.

This paper examines the practice of female genital mutilation (FGM) among the Dawoodi Bohra community in Pakistan. FGM, a non-therapeutic alteration of the female genitalia, is examined through the lenses of religion, culture and health. The Dawoodi Bohra, predominantly based in Karachi, practice FGM as a religious and cultural rite, linking it to notions of purity and social acceptance. Despite global efforts to outlaw and eradicate FGM, it persists, underpinned by deeply held beliefs and the insular nature of the community. The physical and psychological effects of FGM are profound, leading to immediate and long-term complications such as severe pain, infection and psychological trauma. This paper discusses the impact of these practices on women’s health and rights, while critiquing the lack of an effective legal framework in Pakistan to combat FGM. In addressing this issue, the paper contributes to the broader discourse on gender-based violence and the rights of women and children in patriarchal societies.

Abstract Background The practice of female genital mutilation (FGM) is a health and social problem. Millions of girls and women have undergone FGM or will soon, and more information is needed to effectively reduce the practice. The aim of this research is to provide an overview of the FGM trendlines, the inequality of its prevalence, and the economic burden. The findings shed light on 30-year trends and the impact of the pandemic on planned efforts to reduce FGM which helps with public health interventions. Methods Temporal trend analysis, and graphical analysis were used to assess the change and inequality over the last 30 years. We included 27 countries in which FGM is prevalent. We calculated the extra economic burden of delayed interventions to reduce FGM like COVID-19. Results For the 27 countries analyzed for temporal trendlines, 13 countries showed no change over time while 14 had decreasing trends. Among the 14, nine countries, Uganda, Togo, Ghana, Benin, Kenya, Nigeria, Central African Republic, Chad, and Ethiopia had high year-decrease (CAGR − 1.01 and − 10.26) while five, Côte d’Ivoire, Egypt, Gambia, Djibouti, and Mali had low year-decrease (CAGR>-1 and

Hepatitis C virus (HCV) infection remains a major cause of liver related morbidity and mortality worldwide. Epidemiologic data on seroprevalence, viremia prevalence and risk factors remain limited in sub-Saharan Africa. In Ghana, HCV-related deaths are estimated to have increased since 2015. Risk factors associated with HCV infection in Ghana are not well described. The aim of this study was to determine the prevalence of, and risk factors associated with hepatitis C virus infection in the Upper East Region located in the northern part of Ghana. A community-based cross-sectional study was conducted in 9 communities in the Upper East region of Ghana. A total of 1,769 participants aged ≥12 years were screened for HCV antibody (anti-HCV) using rapid diagnostic testing (RDT). Seventy-four participants undertook HCV RNA testing after a positive anti-HCV result. Multivariate logistic regression was used to determine risk factors associated with HCV seropositivity. The anti-HCV prevalence was 8.4%, with 149 out of 1,769 testing anti-HCV positive. Mean age (±SD) of seropositive persons was 45.4 (±16.3) years. The highest anti-HCV seroprevalence was amongst persons aged 60 years and above. Forty-four out of 74 (59.5%) seropositive cases had viremic infection and the estimated viremic prevalence in the screened population was 5.0%. Predictors of HCV seropositivity were age (OR 1.03 95% CI 1.01–1.04), history of female genital mutilation or circumcision (OR 1.63 95% CI 1.04–2.55), sexual activity (OR 2.57 95% CI 1.38–4.79), positive maternal HCV status (OR 10.38 95% CI 4.13–26.05) and positive HIV status (OR 4.03 95% CI 1.35–12.05). In conclusion, the Upper East Region demonstrates a high Hepatitis C antibody prevalence. Almost 60% of individuals have viremic infection, however the cost of RNA testing is a barrier to virological diagnosis. There is a need to educate the population about HCV-associated risk factors to reduce HCV transmission and burden of disease. [ABSTRACT FROM AUTHOR]

Background Objectives Search strategy Selection criteria Data collection and analysis Main results Conclusions Female genital mutilation (FGM) is a global public health concern. However, reconstructive surgery remains unavailable in many countries.This scoping review, guided by Joanna Briggs Institute (JBI) principles, explores indications, referral routes, eligibility, care pathways and clinical outcomes of reconstructive surgery for FGM.Medical Subject Headings (MeSH) terms and subject headings were searched in EMBASE, MEDLINE, SCOPUS, Web of Science and publicly available trial registers.Any primary experimental and quasi‐experimental study addressing reconstructive surgery for FGM, and its impact on women, published before June 2023.After removing duplicates from the search results, titles and abstracts were screened and data were extracted. Disagreements were resolved through panel discussion. The Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) flow diagram depicts the search results and inclusion process.A total of 40 studies were included. Multidisciplinary teams were involved in 40% (16/40) of the studies, and psychosexual counselling was offered in 37.5% (15/40) of studies. Clitoral reconstruction using Foldes’ technique was predominant (95%, 38/40). A total of 7274 women underwent some form of reconstruction. Post‐surgery improvement was reported in 94% of the cases (6858/7274). The complication rate was 3% (207/7722 women with reconstruction).Further research and clinical trials are needed. Although the outcomes suggest improved sexual function and quality of life post‐surgery, the evidence remains limited. Advocating surgical reconstruction for survivors of FGM is vital for addressing health disparities and potential cost‐effectiveness. [ABSTRACT FROM AUTHOR]

Background: As global immigration from countries with a high prevalence of female genital mutilation and cutting (FGM/C) has grown in the United States (US), there is need for pediatricians to have adequate training to care for these patients. The objective of this study is to determine the level of knowledge and attitudes of child abuse pediatricians (CAPs) towards FGM/C in the US. Methods: This cross-sectional study distributed a peer-reviewed survey to US CAPs—members of the Helfer Society—to assess their attitudes, knowledge, clinical practice, and education about FGM/C. Data was analyzed using descriptive statistics, Kruskal–Wallis tests, and Fisher's exact test. Results: Most of the 65 respondents were aware that FGM/C is illegal (92%) and agreed that it violated human rights (99%). Individuals reporting previous training related to FGM/C were significantly more likely to correctly identify World Health Organization types of FGM/C (p < 0.05) and report confidence in doing so (p < 0.05). Only 21% of respondents felt comfortable discussing FGM/C with parents from countries with a high prevalence of FGM/C. Sixty-three percent were not aware of the federal law, and 74% were not aware of their own state's laws about FGM/C. Conclusions: US CAPs have high rates of training related to FGM/C; however, they need additional training to increase confidence and ability to identify FGM/C. FGM/C remains a topic that CAPs find difficult to discuss with families. With culturally sensitive training, CAPs have the opportunity to help manage and prevent the practice by serving as educators and experts for general pediatricians. [ABSTRACT FROM AUTHOR]

Background: Worldwide, at least 230 million girls and women are affected by female genital mutilation/ cutting (FGM/C). FGM/C violates human rights and can cause irreparable harm and even lead to death. In 2022, more than 100,000 survivors of FGM/C lived in Germany, and more than 17,000 girls were considered at risk. Due to the increasing number, there is a need to improve the skills of professionals not only to treat FGM/C but also to prevent it, aiming to maintain or improve women's physical and mental health. However, previous studies mostly focused on health care providers, even though other professionals such as social workers, play an important role in the provision of sexual and reproductive health (SRH) care and are often the first point of contact. Therefore, the study's main objective was to understand challenges perceived by social workers in pregnancy counselling centres in the provision of good quality of SRH care for girls and women suffering from or endangered by FGM/C. Methods: A quantitative self-administered cross-sectional online survey was sent by e-mail in 2021 to all pregnancy counselling centers in the German federal state of Bavaria. Results: Among the 141 participants, 82% reported no or insufficient FGM/C knowledge and barriers to provide the best quality of care. The main findings were language obstacles (82.7%), perceived client's fear or shame (67.9%) and cultural difficulties (45.7%). Furthermore, participants also reported a lack of competence on the professional side (29.6%). Importantly, most participants (129 of 141; 92%) expressed interest in training. Conclusion: Providing comprehensive good quality sexual and reproductive health care to women and girls affected from or endangered by FGM/C is challenging. The study revealed the importance of strengthening the skills of social workers and suggested the following strategies: (1) enhancing FGM/C knowledge and skills (including specialized competences e.g., in mental health) by improving training and information material for the target group, (2) improving referral pathways and addressing deficits in the existing care system (e.g. with health or legal institutions), and (3) developing trusting relationships with cultural (or traditional) mediators to build strong community networks. [ABSTRACT FROM AUTHOR]

Introduction: Despite the commitment of the Swedish government to ensuring equal access to Sexual Reproductive Health and Rights services for all citizens, shortcomings persist among the migrant population. In cases where healthcare providers lack sufficient knowledge or hold misconceptions and biases about these contentious issues, it can lead to the delivery of suboptimal care. Therefore, the objective of this study was to assess the level of knowledge of Swedish healthcare providers on global and Swedish migrant Sexual Reproductive Health and Rights. Methods: A national cross-sectional study was conducted using a questionnaire consisting of seven questions related to global and Swedish migrant Sexual Reproductive Health and Rights. The questionnaire was distributed among midwives, nurses, gynecologists and obstetricians, and hospital social workers (N = 731). The analysis was guided by the Factfulness framework developed by Hans Rosling to identify disparities between healthcare providers' viewpoints and evidence-based knowledge. Results: There was an overall lack of knowledge among the health care providers on these issues. The highest correct responses were on the question on abandonment of female genital cutting/mutilation after migration (74%). The findings indicated that healthcare providers originating from Sweden, physicians, those with fewer years of clinical experience, and exhibiting more migrant-friendly attitudes, demonstrated a higher level of knowledge regarding global and Swedish migrant Sexual and Reproductive Health and Rights. Conclusion: This study demonstrates that healthcare providers lacked knowledge of global and Swedish migrant Sexual Reproductive Health and Rights, which was almost uniformly distributed, except among those with more comprehensive and recent education. Contrary to expectations, healthcare professionals did not primarily rely on their education and experiences but were influenced by their personal values and opinions. The study underscores the importance of upgrading knowledge in Sexual Reproductive Health and Rights and encourages policymakers, professionals, and students to base their opinions on well-founded facts, particularly in the context of a diverse and globalized society. [ABSTRACT FROM AUTHOR]

This paper explores FGM-safeguarding in the UK through a decolonial lens. Based on an analysis of the development of law and policy relating to 'Female Genital Mutilation' in the UK alongside data collected in focus groups with people of ethnic Somali heritage living in Bristol, we argue that the current legislation and policies, as well as their delivery, are steeped in colonial Othering. We demonstrate that legislative and policy approaches operate through a gendered and generational binary in which non-White mothers are othered as migrants (regardless of citizenship status) for whom anachronistic culture is deemed determinative, whilst their daughters are claimed as British. In this construction, 'FGM' operates as the symbolic marker that designates un/belonging: the uncircumcised girl is rescuable and claimed as 'one of us', whilst the circumcised mother is considered a mutilated political subject for whom belonging is foreclosed. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This case study critically examines the long-term detrimental effects of female genital mutilation (FGM), specifically focusing on the development of clitoral epidermoid inclusion cysts. The study illuminates the oftenoverlooked post-mutilation complications that extend beyond immediate physical trauma, encompassing significant anatomical alterations with potential psychosocial implications. As a direct consequence of FGM, clitoral epidermoid inclusion cysts represent a physical manifestation of such prolonged complications, contributing to discomfort, potential sexual dysfunction, and an overall decline in quality of life. In an unusual case, a 38-year-old African woman presented with a painful clitoral tumor intermittently draining for three years. The study underscores the urgent need for comprehensive preventive measures, early diagnosis, and effective management strategies in affected populations to mitigate the enduring consequences of this harmful practice. : [ABSTRACT FROM AUTHOR]

Feminist criticism emphasizes the position of women within society. The novel Alati Ta'ud al Salalim (She who counts the staircases) was authored by the Omani author Hoda Hamed. In her novel, she takes a critical approach to women's position in society critically in her novel, addressingconcepts like social class inequality among women, cultural challenges they face, and masculine dominance. The present study aims to investigate this novel based on four gynocriticism models that Elaine Showalter has proposed: biological, linguistic, psychoanalytic, and cultural. The objective of this study is to provide an answer to the following inquiry: "how does the writer reflect women's components in her novel?" She has brought up concerns regarding childbirth, female circumcision, and pregnancy, considering the biological model. In terms of the psychoanalytic model, she has made reference to bipolar disorder, obsessions, compulsions, and sleep. Hamed has produced an exemplary and enlightening piece by utilizing noticeable linguistic characteristics, including vocabulary and Arabic dialect, to address women's concerns and cultural challenges, like women trafficking and physical abuse. According to the findings of the research, she has effectively identified women who are concerned with the social and cultural issues of women. Furthermore, its feministic nature is confirmed by the high frequency with which the components of Showalter's model appear in the novel under study. The narrative places such an emphasis on the cultural dimension of women that fundamental and profound cultural concerns are overshadowed by biological and psychoanalytic issues. [ABSTRACT FROM AUTHOR]

Background: The Women's Health Needs Study (WHNS) collected information on the health characteristics, needs, and experiences, including female genital mutilation (FGM) experiences, attitudes, and beliefs, of women aged 18 to 49 years who were born, or whose mothers were born, in a country where FGM is prevalent living in the US. The purpose of this paper is to describe the WHNS design, methods, strengths and limitations, as well as select demographic and health-related characteristics of participants. Methods: We conducted a cross-sectional survey from November 2020 –June 2021 in four US metropolitan areas, using a hybrid venue-based sampling (VBS) and respondent-driven sampling (RDS) approach to identify women for recruitment. Results: Of 1,132 participants, 395 were recruited via VBS and 737 RDS. Most were born, or their mothers were born, in either a West African country (Burkina Faso, Guinea, Mali, Mauritania, Sierra Leone, The Gambia) (39.0%) or Ethiopia (30.7%). More than a third were aged 30–39 years (37.5%) with a majority who immigrated at ages ≥13 years (86.6%) and had lived in the United States for ≥5 years (68.9%). Medicaid was the top health insurer (52.5%), followed by private health insurance (30.5%); 17% of participants had no insurance. Nearly half of women reported 1–2 healthcare visits within the past 12 months (47.7%). One in seven did not get needed health care due to cost (14.8%). Over half have ever used contraception (52.1%) to delay or avoid pregnancy and 76.9% had their last pelvic and/or Papanicolaou (pap) exam within the past 3 years. More than half experienced FGM (55.0%). Nearly all women believed that FGM should be stopped (92.0%). Conclusion: The VBS/RDS approach enabled recruitment of a diverse study population. WHNS advances research related to the health characteristics, needs, and experiences of women living in the US from countries where FGM is prevalent. [ABSTRACT FROM AUTHOR]

Background: Female genital mutilation (FGM) is defined as all procedures involving partial or total removal of the external female genitalia, or other injuries to them for non-medical reasons. Due to migration, healthcare providers in high-income countries need to better understand the consequences of FGM. The aim of this study was to elucidate women's experiences of FGM, with particular focus on perceived health consequences and experiences of healthcare received in Sweden. Methods: A qualitative study was performed through face-to-face, semi-structured interviews with eight women who had experienced FGM in childhood, prior to immigration to Sweden. The transcribed narratives were analyzed using content analysis. Results: Three main categories were identified : "Living with FGM", "Living with lifelong health consequences" and "Encounters with healthcare providers". The participants highlighted the motives behind FGM and their mothers' ambivalence in the decision process. Although the majority of participants had undergone FGM type 3, the most severe type of FGM, the lifelong health consequences were diverse. Poor knowledge about FGM, insulting attitude, and lack of sensitive care were experienced when seeking healthcare in Sweden. Conclusions: Our findings indicate that FGM is a complex matter causing a diversity in perceived health consequences in women affected. Increased knowledge and awareness about FGM among healthcare providers in Sweden is of utmost importance. Further, this subject needs to be addressed in the healthcare encounter in a professional way. [ABSTRACT FROM AUTHOR]

Background: The practice of female genital mutilation is associated with harmful social norms promoting violence against girls and women. Various studies have been conducted to examine the prevalence of female genital mutilation and its associated factors. However, there has been limited studies conducted to assess the association between female genital mutilation and markers of women's autonomy, such as their ability to negotiate for safer sex. In this study, we examined the association between female genital mutilation and women's ability to negotiate for safer sex in sub-Saharan Africa (SSA). Methods: We pooled data from the most recent Demographic and Health Surveys (DHS) conducted from 2010 to 2020. Data from a sample of 50,337 currently married and cohabiting women from eleven sub-Saharan African countries were included in the study. A multilevel binary logistic regression analysis was used to examine the association between female genital mutilation and women's ability to refuse sex and ask their partners to use condom. Adjusted odds ratios (aORs) with a 95% confidence interval (CI) were used to present the findings of the logistic regression analysis. Statistical significance was set at p<0.05. Results: Female genital mutilation was performed on 56.1% of women included in our study. The highest and lowest prevalence of female genital mutilation were found among women from Guinea (96.3%) and Togo (6.9%), respectively. We found that women who had undergone female genital mutilation were less likely to refuse sex from their partners (aOR = 0.91, 95% CI = 0.86, 0.96) and ask their partners to use condoms (aOR = 0.82, 95% CI = 0.78, 0.86) compared to those who had not undergone female genital mutilation. Conclusion: Female genital mutilation hinders women's ability to negotiate for safer sex. It is necessary to implement health education and promotion interventions (e.g., decision making skills) that assist women who have experienced female genital mutilation to negotiate for safer sex. These interventions are crucial to enhance sexual health outcomes for these women. Further, strict enforcement of policies and laws aimed at eradicating the practice of female genital mutilation are encouraged to help contribute to the improvement of women's reproductive health. [ABSTRACT FROM AUTHOR]

Background: Obstetric fistula is a serious and debilitating problem resulting from tissue necrosis on the reproductive and urinary and/or lower gastrointestinal tract organs due to prolonged labor. Primary studies of the treatment of obstetric fistulae report significantly variable treatment outcomes following surgical repair. However, no systematic review and meta-analysis has yet estimated the pooled proportion and identified the determinants of successful obstetric fistula surgical repair. Objective: To estimate the proportion and identify the determinants of successful surgical repair of obstetric fistulae in low- and middle-income countries. Methods: The protocol was developed and registered at the International Prospective Register of Systematic Reviews (ID CRD42022323630). Searches of PubMed, Embase, CINAHL, Scopus databases, and gray literature sources were performed. All the accessed studies were selected with Covidence, and the quality of the studies was examined. Finally, the data were extracted using Excel and analyzed with R software. Results: This review included 79 studies out of 9337 following the screening process. The analysis reveals that 77.85% (95%CI: 75.14%; 80.56%) of surgical repairs in low and middle-income countries are successful. Women who attain primary education and above, are married, and have alive neonatal outcomes are more likely to have successful repair outcomes. In contrast, women with female genital mutilation, primiparity, a large fistula size, a fistula classification of II and above, urethral damage, vaginal scarring, a circumferential defect, multiple fistulae, prior repair and postoperative complications are less likely to have successful repair outcomes. Conclusion: The proportion of successful surgical repairs of obstetric fistula in low and middle-income countries remains suboptimal. Hence, stakeholders and policymakers must design and implement policies promoting women's education. In addition, fistula care providers need to reach and manage obstetric fistula cases early before complications, like vaginal fibrosis, occur. [ABSTRACT FROM AUTHOR]

Migratory flows require our country to reflect on the compatibility of some aditional practices which appear irreconcilable with the fundamental rights of the person protected by the Italian Constitution and with the principles established at an international level. Among these, Female Genital Mutilation (FGM) plays a leading role. A multidisciplinary therapeutic approach, framed in the guidelines of the World Health Organization and the international regulatory system, will allow the protection of women and the promotion of a preventive attitude free of prejudices and cultural resistance as well as the framing of FGM as a violation of human rights. This contribution therefore presents the main information on FGM, to address a type of person/patient who requires innovative and specific approccies for rehabilitation. [ABSTRACT FROM AUTHOR]

This study focused on female circumcision as a sacred practice among the Bugis-Makassar community, intertwined with various cultural and religious beliefs. It drew attention from both Islamic law and Bugis-Makassar cultural perspectives. The objective was to explore scholars' views on female circumcision and its connection to BugisMakassar culture through a qualitative descriptive approach. Data collection methods included observation, interviews, and documentation. The findings indicated that within the context of Islamic law, female circumcision can be interpreted based on hadith and Sunnah, with varying opinions among Islamic scholars regarding its status as obligatory, recommended, or permissible, while some even oppose it. Despite these differing views, in communities like Bugis-Makassar, female circumcision is seen as an important cultural and traditional heritage. This practice was often accompanied by traditional ceremonies and religious rituals involving family and community. However, there were varied approaches to female circumcision within the Bugis-Makassar society, where some maintain this tradition with pride. [ABSTRACT FROM AUTHOR]

Background: The practice of female genital mutilation (FGM) is a health and social problem. Millions of girls and women have undergone FGM or will soon, and more information is needed to effectively reduce the practice. The aim of this research is to provide an overview of the FGM trendlines, the inequality of its prevalence, and the economic burden. The findings shed light on 30-year trends and the impact of the pandemic on planned efforts to reduce FGM which helps with public health interventions. Methods: Temporal trend analysis, and graphical analysis were used to assess the change and inequality over the last 30 years. We included 27 countries in which FGM is prevalent. We calculated the extra economic burden of delayed interventions to reduce FGM like COVID-19. Results: For the 27 countries analyzed for temporal trendlines, 13 countries showed no change over time while 14 had decreasing trends. Among the 14, nine countries, Uganda, Togo, Ghana, Benin, Kenya, Nigeria, Central African Republic, Chad, and Ethiopia had high year-decrease (CAGR − 1.01 and − 10.26) while five, Côte d'Ivoire, Egypt, Gambia, Djibouti, and Mali had low year-decrease (CAGR>-1 and < 0). Among these five are the highest FGM prevalence similar distribution regardless the wealth quintiles or residence. There is an economic burden of delay or non-decline of FGM that could be averted. Conclusion: Findings indicate that some countries show a declining trend over time while others not. It can be observed that there is heterogeneity and homogeneity in the FGM prevalence within and between countries which may indicate inequality that deserves further investigation. There is considerable economic burden due to delays in the implementation of interventions to reduce or eliminate FGM. These insights can help in the preparation of public health interventions. [ABSTRACT FROM AUTHOR]

Objective: Female genital mutilation, which harms women physically and psychologically, also causes serious problems in sexual life that continue throughout life. This study aimed to determine the impact of female genital mutilation on sexual outcomes in Ibadan, Nigeria. Method: This is a cross-sectional descriptive study. A self-administered questionnaire was used to obtain data from 161 women who agreed to participate in the study. After the data were collected, the sample group was divided into two groups those with female genital mutilation (84) and those without (77), and they were compared in terms of sexual outcomes. Results: Type I (77.3%) and type II (22.7%) mutilations were found in women with female genital mutilation. It was determined that women with FGM experienced statistically significantly more pain and bleeding during vaginal penetration than uncircumcised women. At the same time, the orgasm rate was found to be statistically significantly lower in this group. Conclusions: Our study revealed that female genital mutilation and enlargement of the incision area negatively affect sexual health. [ABSTRACT FROM AUTHOR]

Even though the practice of female genital mutilation is not meant to hurt women, it nonetheless endangers their health. This necessitates research into the amount of understanding and cultural complications that prevent its eradication in Africa and Nigeria, particularly in rural communities where the practice is very prevalent. This study, therefore, examined cultural factors that promote the continued practice of female genital mutilation in the Attah community, Imo State. Social convention theory was used as the study's theoretical framework. The survey research method was adopted for this study. Using the multi-stage sampling method, 674 copies of the questionnaire were distributed to the study respondents for the quantitative data. However, only 539 copies of the questionnaire were retrieved. This represents the sample size of this study. For the qualitative data in the study, twelve (12) in-depth interviews were conducted among village and religious leaders. Statistical Package for Social Science (SPSS) was used to process this study's quantitative data, while descriptive and inferential statistics were analyzed. For the study's qualitative data, analysis was done using the content analysis method based on the study objectives. It was found that males are more likely to make decisions that influence the continued practice of Female Genital Mutilation in the Attah community than females. The study also found that cultural expectations for womanhood rite of passage, marriage prospects, and the belief that women with FGM are more likely to be less promiscuous are major factors that influence the continued practice of FGM in the Attah community. Consequently, to end female genital mutilation in the Attah community, there is a need to address those religious and cultural beliefs that negatively affect the control of the practice. [ABSTRACT FROM AUTHOR]

An editorial is presented on methodological contributions to global literature, with particular emphasis on uncovering research issues and building on existing theory, practice, and methods. Topics include diverse studies exploring chronic pain management, female genital mutilation, and emotional experiences of COVID-19 survivors, all contributing valuable insights to their respective fields and highlighting the importance of cross-cultural perspective.

Health and social service providers who immigrated from regions with high Female Genital Mutilation/Cutting (FGM/C) prevalence rates can provide unique insights on serving women with FGM/C experience. Specifically, we investigated African immigrant service providers' knowledge, experience, attitudes about FGM/C, and their recommendations on how to provide services to immigrants from sub-Saharan Africa who have experienced FGM/C. Derived from a larger study, interviews of 10 African service providers were selectively analyzed with a particular attention to cultural insights that could inform the framework in Western destination countries on how to serve women and girls with FGM/C experience. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Female circumcision (FC) affects the lives of millions of girls and women worldwide. This study assessed the demographic and socio-economic factors associated with female circumcision among women aged 15-49 in Maldives. Data for this study were extracted from the 2016-2017 Maldives Demographic and Health Survey, collected from a nationally representative probability sample of 7699 households interviewing women aged 15-49 years. The statistical analysis of this study focused on women aged 15-49 years who have heard about FC, excluding those who have never heard of FC (n = 5943). Analyses of data entailed descriptive statistics (frequencies and percentages) and estimation of logistic regression models to examine the roles that demographic, economic, and social factors play in the occurrence of FC in Maldives. The primary variable of interest (dependent variable) was the occurrence of FC. The factors included women's current age, age circumcised, highest education level, occupation, region, wealth quintile, and women's reported attitudes towards FC. Among all respondents, 17 % of the 5943 women who have heard of female circumcision reported having undergone the procedure. The findings revealed a significant difference in female circumcision by age, education, occupation, and attitudes towards FC. Furthermore, most circumcisions occurred before age 5 and were highest in Malé (capital city) and the island atolls in Maldives's South and North regions. The variables related to opinions were most strongly associated with female circumcision. Women who believed that their religion required FC or that the practice of FC should continue are more likely to be circumcised than women who do not hold this opinion. It was more than double. In addition, cross-tabulations of the opinion variables with age and region have found that the highest proportion of women who held these beliefs was in the age group 25-39 and lived in Malé. Therefore, we recommend further research and encouragement to enact policies and legislation that would eliminate the practice of female circumcision in Maldives. [ABSTRACT FROM AUTHOR]