Female genital mutilation and social change.

Lancet. 2010 Nov 27;376(9755):1800.

Female genital mutilation and social change.

[No authors listed]

Erratum in Lancet. 2011 Jan 15;377(9761):208.

Changing social expectations is the key to ending the practice of female genital mutilation or cutting, according to a new report by UNICEF, The dynamics of social change: towards the abandonment of female genital mutilation/cutting in five African countries. Worldwide, up to 140 million girls and women are estimated to have undergone some form of genital mutilation—a recognised violation of human rights and a procedure complicated by severe haemorrhage, infection, and difficulties with delivery and sexual intercourse. Yet many parents, influenced by community expectations, believe that cutting secures social and economic security for their daughters. For them, the social harm of not cutting outweighs any physical, psychological, or even legal risk. It is “insufficient to simply provide individual families information of the harm of the practice” says author Francesca Moneti. While cutting is seen as the only possible social way to act, one of the first steps towards abandoning the practice is to promote the alternative, not cutting.
The report looked at how Kenya, Senegal, Sudan, Egypt, and Ethiopia have promoted the type of social change needed for communities to abandon the practice. Although the national prevalence of genital mutilation remains high in Egypt (91%) and Sudan (89%), as a result of community-driven change all five countries have reported a decrease in the percentage of women who think the practice should continue. Successful approaches include reinforcing the positive aspects of local culture rather than demonising traditional practices, using the media to elevate the status of being uncut, human-rights education linked to local values and aspirations, and the development of linkages with neighbouring countries and countries of migration.
Efforts to end female genital mutilation started decades ago. The report’s insights represent an important step towards ending this and other practices that are damaging to women’s health. Whilst respecting the subtle message that understanding and changing social expectations takes time, governments and donors must act quickly and decisively to support what is working to end female genital mutilation. Communities ready to adopt the social expectation not to cut can then do so.