期刊论文详细信息
BMC Public Health
Knowledge, attitudes and practices of female genital mutilation/cutting among health care professionals in The Gambia: a multiethnic study
Isabelle Bonhoure3  Mariola Bernal3  Suiberto Hechavarría1  Adriana Kaplan2 
[1] Facultad de Ciencias Médicas Manuel Fajardo, Universidad Médica de La Habana, Havana, Cuba;NGO Wassu Gambia Kafo, Fajara F Section, Banjul, The Gambia;Interdisciplinary Group for the Prevention and Study of Harmful Traditional Practices (IGPS/HTP), Department of Social and Cultural Anthropology, Universitat Autònoma de Barcelona, Barcelona, Spain
关键词: Africa;    Sexual and reproductive health;    Knowledge, Attitudes and practices (KAP);    Health care professionals;    The Gambia;    Female genital mutilation/cutting;   
Others  :  1161781
DOI  :  10.1186/1471-2458-13-851
 received in 2012-10-24, accepted in 2013-09-10,  发布年份 2013
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【 摘 要 】

Background

Female genital mutilation/cutting (FGM/C) is a harmful traditional practice with severe consequences for the health and well-being of girls and women. Health care professionals (HCPs) are therefore expected to be aware of how to identify and manage these consequences in order to ensure that those affected by the practice receive quality health care. Moreover, their integration and legitimacy within the communities allow them to play a key role in the prevention of the practice. Nevertheless, the perception of HCPs on FGM/C has been barely explored in African contexts. This study seeks to contribute to this field of knowledge by examining the knowledge, attitudes, and practices regarding FGM/C among HCPs working in rural settings in The Gambia.

Methods

A cross-sectional descriptive study was designed through a quantitative methodology, following a multiethnic approach. A pre-tested questionnaire with open and closed-ended questions was created. Forty medical students from the Community-based Medical Programme were trained to administer the questionnaire, face to face, at village health facilities in rural areas of The Gambia. A final sample of 468 HCPs included all nurse cadres and midwives.

Results

A significant proportion of Gambian HCPs working in rural areas embraced the continuation of FGM/C (42.5%), intended to subject their own daughters to it (47.2%), and reported having already performed it during their medical practice (7.6%). However, their knowledge, attitudes, and practices were shaped by sex and ethnic identity. Women showed less approval for continuation of FGM/C and higher endorsement of the proposed strategies to prevent it than men. However, it was among ethnic groups that differences were more substantial. HCPs belonging to traditionally practicing groups were more favourable to the perpetuation and medicalisation of FGM/C, suggesting that ethnicity prevails over professional identity.

Conclusions

These findings demonstrate an urgent need to build HCP’s capacities for FGM/C-related complications, through strategies adapted to their specific characteristics in terms of sex and ethnicity. A culturally and gender sensitive training programme might contribute to social change, promoting the abandonment of FGM/C, avoiding medicalisation, and ensuring accurate management of its health consequences.

【 授权许可】

   
2013 Kaplan et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]World Health Organization: [http://whqlibdoc.who.int/publications/2008/9789241596442_eng.pdf] webciteEliminating female genital mutilation: an interagency statement. OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM. Geneva: WHO; 2008.
  • [2]Dare FO, Oboro VO, Fadiora SO, Orji EO, Sule-Odu AO, Olabode TO: Female genital mutilation: an analysis of 522 cases in South-Western Nigeria. Int J Gynecol Obstet 2004, 24(3):281-283.
  • [3]Behrendt A, Moritz S: Posttraumatic stress disorder and memory problems after female genital mutilation. Am J Psychiatry 2005, 162:1000-1002.
  • [4]Alsibiani SA, Rouzi AA: Sexual function in women with female genital mutilation. Fertil Steril 2010, 93(3):722-724.
  • [5]Morison L, Scherf C, Ekpo G, Paine K, West B, Coleman R, Walraven G: The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey. Trop Med Int Health 2001, 6:643-653.
  • [6]World Health Organization Study Group on Female Genital Mutilation and Obstetric Outcome: Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries. Lancet 2006, 367(925):1835-1841.
  • [7]Chibber R, El-Saleh E, El Harmi J: Female circumcision: obstetrical and psychological sequelae continues unabated in the 21st century. J Matern Fetal Neonatal Med 2011, 24(6):833-836.
  • [8]Kaplan A, Hechavarría S, Martín M, Bonhoure I: Health consequences of female genital mutilation/cutting in the Gambia, evidence into action. Reprod Health 2011, 8:26. BioMed Central Full Text
  • [9]Gage AJ, Van Rossem R: Attitudes toward the discontinuation of female genital cutting among men and women in Guinea. Int J Gynecol Obstet 2006, 92(1):92-96.
  • [10]United Nations Children’s Fund: [http://www.unicef-irc.org/publications/pdf/fgm_insight_eng.pdf] webciteThe dynamics of social change towards the abandonment of female genital mutilation/cutting in five African countries. Innocenti digest. Florence. UNICEF Innocenti Research Centre; 2010.
  • [11]Reveyrand O: Tradition, modernité et tendances culturelles des femmes de. Casamance (Senegal): Etude effectuée en milieu peul, manding et diola. Doctoral thesis, Université de Bordeaux; 1982.
  • [12]Red Activas: [http:/ / www.redactivas.org/ media/ uploads/ triptico_eficacia_de_la_ayuda_para_ mejorar_la_sdsr__el_caso_de_gambia. pdf] webciteEficacia de la ayuda para mejorar la salud y los derechos sexuales y reproductivos. El Caso de Gambia; 2012.
  • [13]Gambia Bureau of Statistics (GBoS): The Gambia multiple indicator cluster survey 2010 report. Banjul: UNICEF The Gambia; 2011.
  • [14]Ahmadu F: Rite and wrongs: an insider/outsider reflects on power and excision. In Female “circumcision” in Africa: culture, controversy and change. Edited by Shell-Duncan B, Hernlund Y. London: Rienner publishers; 2000.
  • [15]Hernlund Y: Cutting without ritual and ritual without cutting: female circumcision and the Re-ritualization of initiation in The Gambia. In Female “circumcision” in Africa: culture, controversy and change. Edited by Shell-Duncan B, Hernlund Y. London: Rienner publishers; 2000.
  • [16]Kaplan A: From Senegambia to Catalonia: acculturation and social integration process. Fundación La Caixa, Barcelona: X Award Dr. Rogeli Duocastella in Social Sciences; 1998. Spanish
  • [17]Kaplan A: Learning about motherhood and reproductive health as a global adult education strategy: the case of rural African migrant women in Europe. Stratégies éducatives, familles et dynamiques démographiques CICRED. Paris; 1999. Not published
  • [18]Cham M, Sundby J, Vangen S: Maternal mortality in the rural Gambia, a qualitative study on access to emrgency obstetric care. Reprod Health 2005, 2:3. BioMed Central Full Text
  • [19]Cham M, Sundby J, Vangen S: Availabilty and quality of emergency obstetric car in Gambia’s main referral hospital: wpmen user’s testimonies. Reprod Health 2009, 6:5. BioMed Central Full Text
  • [20]Cole-Ceesay R, Cherian M, Sonko A, Shivute N, Cham M, Davis M, Fatty F, Wieteska S, Baro M, Watson D, Phillips B, Macdonald R, Hayden B, Southall D: Strengtheining the emergency healthcare system for mothers and children in The Gambia. Reprod Health 2010, 7:21. BioMed Central Full Text
  • [21]Kaplan-Marcusan A, Torán-Monserrat P, Moreno-Navarro J, Castany Fàbregas MJ, Muñoz-Ortiz L: Perception of primary health professionals about female genital mutilation: from healthcare to intercultural competence. BMC Health Serv Res 2009, 9:11. BioMed Central Full Text
  • [22]Simpson J, Robinson K, Creighton SM, Hodes D: Female genital mutilation: the role of health professionals in prevention, assessment, and management. Br Med J 2012, 14:344.
  • [23]Tamaddon L, Johnsdotter S, Liljestrand J, Essén B: Swedish health care providers’ experience and knowledge of female genital cutting. Health Care Women Int 2006, 27(8):709-722.
  • [24]Leye E, Ysebaert I, Deblonde J, Claeys P, Vermeulen G, Jacquemyn Y, Temmerman M: Female genital mutilation: knowledge, attitudes and practices of Flemish Gynaecologists. Eur J Contracept Reprod Health Care 2008, 13(2):182-190.
  • [25]Mathews B: Female genital mutilation: Australian law, policy and practical challenges for doctors. Med J Aust 2011, 7,194(3):139-141.
  • [26]Hess RF, Weinland J, Saalinger NM: Knowledge of female genital cutting and experience with women who are circumcised: a survey of nurse-midwives in the United States. J Midwifery Womens Health 2010, 55(1):46-54.
  • [27]Thierfelder C, Tanner M, Kessler Bodiang CM: Female genital mutilation in the context of migration: experience of African women with the Swiss health care system. Eur J Public Health 2005, 15(1):86-90.
  • [28]Zaidi N, Khalil A, Roberts C, Browne M: Knowledge of female genital mutilation among healthcare professionals. J Obstet Gynaecol 2007, 27(2):161-164.
  • [29]Onuh SO, Igberase GO, Umeora JO, Okogbenin SA, Otoide VO, Gharoro EP: Female genital mutilation: knowledge, attitude and practice among nurses. J Natl Med Assoc 2006, 98(3):409-414.
  • [30]Ragheb SS, Smith E, Mekhemer SA: Study of knowledge and attitudes of nurses in Alexandria towards female circumcision. Bull High Inst Publ Health 1978, 8(1):293-306.
  • [31]Mostafa SRA, El Zeiny NAM, Tayel SES, Moubarak EI: What do medical students in Alexandria know about female genital mutilation? East Mediterr Health J 2006, 12(S2):S78-S92.
  • [32]Ali AAA: Knowledge and attitudes of female genital mutilation among midwives in Eastern Sudan. Reprod Health 2012, 9:23. BioMed Central Full Text
  • [33]Kaplan A, Forbes M, Bonhoure I, Utzet M, Martín M, Maneh M, Ceesay H: Female genital mutilation/cutting (FGM/C) in the Gambia: long-term health consequences and complications during delivery and for the newborn. Mtl J Womens Health 2013, 5:323-331.
  • [34]Gambia Bureau of Statistics (GBoS): The Gambia atlas of 2003 population and housing census report. Banjul: Government of The Gambia; 2006.
  • [35]Shell-Duncan B, Wander K, Hernlund Y, Moreau A: Dynamics of change in the practice of female genital cutting in Senegambia: testing predictions of social convention theory. Soc Sci Med 2011, 73(8):1275-1283.
  • [36]World Health Organization: [http://whqlibdoc.who.int/hq/2010/WHO_RHR_10.9_eng.pdf] webciteGlobal strategy to stop health care providers from performing female genital mutilation. Geneva: UNAIDS, UNDP, UNFPA, UNHCR, UNICEF, UNIFEM, WHO, FIGO, ICN, IOM, MWIA, WMA; 2010.
  • [37]Simister J: Domestic violence and female genital mutilation in Kenya: effects of ethnicity and education. J Fam Violence 2010, 25(3):247-257.
  • [38]Afifi M: Women’s empowerment and the intention to continue the practice of female genital cutting in Egypt. Arch Iran Med 2009, 12(2):154-160.
  • [39]Gambia Bureau of Statistics (GBoS): The Gambia multiple indicator cluster survey 2006 report. Banjul: UNICEF The Gambia; 2006.
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