Tag Archives: Cultural competency

Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. Competence implies the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities.

Reconciling female genital circumcision with universal human rights

Dev World Bioeth. 2017 Sep 18. doi: 10.1111/dewb.12173. [Epub ahead of print]

Reconciling female genital circumcision with universal human rights

Gordon JS


One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision (FGC), which is prevalent in many African countries and the Middle East as well as in some Asian and Western countries. It is commonly assumed that FGC, in all its versions, constitutes a gross violation of the universal human rights of health, physical integrity, and individual autonomy and hence should be abolished. This article, however, suggests a mediating approach according to which one form of FGC, the removal of the clitoris foreskin, can be made compatible with the high demands of universal human rights. The argument presupposes the idea that human rights are not absolutist by nature but can be framed in a meaningful, culturally sensitive way. It proposes important limiting conditions that must be met for the practice of FGC to be considered in accordance with the human rights agenda.

This article can be accessed in this LINK

Educating about female genital mutilation.

Educ Prim Care. 2016 Oct 28:1-4. [Epub ahead of print]

Educating about female genital mutilation.

Holmes V, Farrington R, Mulongo P

Female genital mutilation (FGM) is illegal in the UK but nevertheless practised in some immigrant communities. Effective educational approaches are required to inform policy and to direct resources, often in the voluntary sector. The opinions in this article arise from discussions with professionals and members of FGM-practising communities. We highlight the importance of sharing experiences and expertise across health and social care professionals as well as working in partnership with culturally sensitive Non-Governmental Organisations. Enlisting the support of men and religious leaders is crucial to breaking down barriers in male-dominated communities and dispelling myths about FGM being a ‘requirement’ of faith.

This article can be accessed in this LINK

Australian midwives’ perspectives on managing obstetric care of women living with female genital circumcision/mutilation

Health Care Women Int. 2016 Jul 22:1-14. [Epub ahead of print]

Australian midwives’ perspectives on managing obstetric care of women living with female genital circumcision/mutilation

Ogunsiji O


Female genital mutilation (FGM) or female circumcision is a global health issue with increasing international migration of affected women and girls to countries unfamiliar with the practice. Western health care providers are unfamiliar with FGM, and managing obstetric care presents challenges to midwives who are in the forefront of care provision for the women. The participants in this Heideggerian qualitative interpretive study elucidated the strategies they used in overcoming the particular physical, emotional, and gynecological health issues with which mutilated women present. Ongoing emphases on women-centered, culturally competent maternity care are germane to optimal maternity care of circumcised women.

[Genital mutilation of women. A new challenge for the health service]. [Article in Norwegian]

Tidsskr Nor Laegeforen. 1993 Sep 10;113(21):2704-7.
[Genital mutilation of women. A new challenge for the health service]. [Article in Norwegian]
Sundby J, Austveg B
Female circumcision, or genital mutilation is practised around the world. Because of war, conflicts and poverty, many women from cultures involving this practice now enter European communities. Some of them demand circumcision for their children. Genital mutilation of women has serious health effects, and in our societies there is a strong demand for its eradication. The cultural reasons for genital mutilation are varied, but it is not a compulsory part of the Islamic faith. Health workers in Norway may lack knowledge on how to handle these women when they meet them in their daily work. Sometimes unnecessary interventions are performed, sometimes ignorance may cause traumatic experiences for both patient and doctor. This article describes some of the social and cultural background for continued exposure to female mutilation, the health effects and some suggestions for interventions.
There is no LINK to see this article online

Nursing Care of Women Who Have Undergone Genital Cutting

Nurs Womens Health. 2015 Oct;19(5):445-9. doi: 10.1111/1751-486X.12237.

Nursing Care of Women Who Have Undergone Genital Cutting

Tilley DS


Female genital cutting (FGC), commonly called female genital mutilation, affects
millions of women but is poorly understood by many health care providers. FGC
procedures intentionally alter the female genital organs for nonmedical reasons
and include partial or total removal of female genital organs. These procedures,
which have no medical value, are usually done between birth and puberty. Health
consequences vary in severity but can be devastating. Women who have experienced
FGC may be reluctant to seek health care or to disclose their condition to
providers. Suggestions for culturally competent care of women who have
experienced FGC are outlined, focusing on understanding the cultural beliefs and
values of women who have undergone these procedures and providing informed and
sensitive care.

This article can be accessed in this LINK

An explorative study of Sudanese midwives’ motives, perceptions and experiences of re-infibulation after birth

Midwifery. 2004, 20(4); 299–311.

An explorative study of Sudanese midwives’ motives, perceptions and experiences of re-infibulation after birth

Berggren V, Abdel Salam G, Bergström S, Johansson E, Edberg A


Objective: to explore Sudanese midwives’ motives for and perceptions and experiences of re-infibulation after birth and to elucidate its context and determinants. Design: triangulation of methods, using observational techniques and open-ended interviews. Setting and participants: two government hospitals in Khartoum/Omdurman, Sudan, for the observations and in-depth interviews with 17 midwives. Findings: midwives are among the major stakeholders in the performance of primary female genital cutting (FGC) as well as re-infibulation. Focusing on re-infibulation after birth, midwives were trying to satisfy differing, and sometimes contradictory, perspectives. The practice of re-infibulation (El Adel) represented a considerable source of income for the midwives. The midwives integrated the practice of re-infibulation into a greater whole of doing well for the woman, through an endeavour to increase her value by helping her to maintain her marriage as well as striving for beautification and completion. They were also trying to meet socio-cultural requests, dealing with pressure from the family while balancing on the edge of the law. Key conclusions and implications for practice: the findings confirm that midwives are important stakeholders in perpetuating re-infibulation, and indicate that the motives are more complex than being only economic. The constant balancing between demands from others puts the midwives in a difficult position. Midwives’ potential role to influence views in the preventative work against FGC and re-infibulation should be acknowledged in further abolition efforts.

This article can be accessed online

Female genital mutilation: Knowledge, attitude and practices of Flemish midwives

Midwifery. 2014 Dec 8. pii: S0266-6138(14)00294-0. doi: 10.1016/j.midw.2014.11.012. [Epub ahead of print]

Female genital mutilation: Knowledge, attitude and practices of Flemish midwives.

Cappon S, L’Ecluse C, Clays E, Tency I, Leye E


BACKGROUND: health professionals in Belgium are confronted with female genital mutilation (FGM). To date, no survey to assess knowledge, attitudes and practices on FGM was conducted among midwives in the Northern region of Belgium. OBJECTIVE: the objective of this study was to assess the knowledge, attitude and practices of Flemish midwives regarding female genital mutilation (FGM). DESIGN: we used a quantitative design, using KAP study (semi-structured questionnaire). SETTING: labour wards, maternity wards and maternal intensive care units (MIC) in 56 hospitals in Flemish region of Belgium. PARTICIPANTS: 820 midwives, actively working in labour wards, maternity wards and maternal intensive care units (MIC). FINDINGS: 820 valid questionnaires (40.9%) were returned. More than 15% of the respondents were recently confronted with FGM. They were mostly faced with the psychological and sexual complications caused by FGM. Few respondents were aware of existing guidelines regarding FGM in their hospitals (3.5%). The results also showed that only 20.2% was aware of the exact content of the law. The majority of midwives condemned the harmful traditional practice: FGM was experienced as a form of violence against women or a violation of human rights. Only 25.9% declared that FGM forms a part of their midwifery program. The vast majority of respondents (92.5%) indicated a need for more information on the subject. KEY CONCLUSIONS: this study indicated that midwives in Flanders are confronted with FGM and its complications and highlighted the gaps in the knowledge of Flemish midwives regarding FGM. This may interfere with the provision of adequate care and prevention of FGM for the new-born daughter. IMPLICATIONS FOR PRACTICE: there is an important need for appropriate training of (student)midwives concerning FGM as well as for the development and dissemination of clear guidelines in Flemish hospitals.

This article can be accessed in this LINK

Female Circumcision: Perceptions of Clients and Caregivers

Journal of American College Health,1985, 33(5), 193-197

Female Circumcision: Perceptions of Clients and Caregivers

Shaw E


Female circumcision is a custom which continues to be widespread in many parts of the word, yet very little is known about the practice by health care providers in the United States. Student health services in colleges and universities with large populations of international students need to be prepared to meet the health needs of this group of women. This paper discusses basic information about the practice of female circumcision. It summarizes data from a descriptive study conducted to identify specific needs and concerns of a group of 12 circumcised women who have used the western medical system while living in the United States. It also discusses the results of a follow-up study based on a questionnaire sent to 95 student health centers in the United States that had a foreign student population base of more than 500. Responses to the questionnaire identified the problems and concerns that student health providers encountered while caring for circumcised women. Suggestions for improved care are included from the perspective of both the client and the student health service personnel.

This article can be accessed in this LINK

Medical complications of female genital mutilation

Journal of American College Health. 2001, 49(6):275-280.

Medical complications of female genital mutilation

Epstein D, Graham P, & Rimsza M


More than 130 million women are subjected to genital mutilation. Despite increasing efforts to reduce the practice, there are many obstacles to eliminating this 2,000-year-old practice, which is based on strong cultural traditions. As college health clinicians provide care to more international students from countries where female genital mutilation is performed, increased awareness and knowledge of the procedure will enable clinicians to understand and manage its complications. We report a case of obstructive uropathy resulting in hydronephrosis secondary to female genital mutilation and review the medical literature regarding this and other complications of genital mutilation “surgery.”

This article can be accessed in this LINK