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Combating female genital mutilation: an agenda for the next decade.

World Health Stat Q. 1996;49(2):142-7.

Combating female genital mutilation: an agenda for the next decade. 

Dorkenoo E.

Family and Reproductive Health Programme, WHO, Geneva, Switzerland.

Female genital mutilation (FGM)-sometimes locally referred to as “female circumcision”-is a deeply rooted traditional practice that adversely affects the  health of girls and women. At present it is estimated that over 120 million girls and women have undergone some form of genital mutilation and that 2 million girls per year are at risk. Most of the girls and women affected live in 28 African countries where the prevalence of female genital mutilation is estimated to range from 5% to 98%. The elimination of female genital mutilation will not only improve women’s and children’s health; it will also promote gender equity and women’s empowerment in the communities where the practice persists. To achieve change will require more planning, and more sustained programmes for its elimination. The political will of governments is essential in order to eliminate this harmful traditional practice and concerted efforts from all concerned are required.  PIP: It is estimated that more than 120 million females have undergone female genital mutilation (FGM) and that 2 million more girls are at risk of mutilation  each year. In response to this enormous health problem, the World Health Organization (WHO) convened a Technical Working Group Meeting on the subject in July 1995. The working group defined FGM as “the removal of part or all of the external female genitalia and/or injury to the female genital organs for cultural or other nontherapeutic reasons.” The working group also provided four classifications for different types of FGM. FGM is usually performed by traditional practitioners (the WHO is opposed to the medicalization of this procedure) on girls and young women of any age (but the average age is decreasing). The origins of FGM are unknown, and a variety of reasons are forwarded in its defense. The health complications are known, however, and include the immediate complications of hemorrhage, severe pain, fractured bones,  possible HIV transmission, and shock; longterm complications such as keloid scar  formation, painful intercourse, chronic infection, and problems in pregnancy and  childbirth; and psychological problems associated with sexual dysfunction caused  by painful intercourse, the loss of trust in care-givers, and depression. Human rights instruments exist that oblige states to eliminate such harmful procedures, but gaps exist in information about types and prevalence of FGM. Because FGM involves human rights and health issues, a multidisciplinary approach will be necessary for its eradication. An action agenda calls for adoption of clear national policies, establishment of interagency coalitions, research, community outreach, and training of health workers.

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