Tag Archives: health policy

Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.

Tackling female genital mutilation in the UK.

BMJ. 2013 Dec 4;347:f7150. doi: 10.1136/bmj.f7150.FREE

Tackling female genital mutilation in the UK.

Creighton SM, Liao LM.


As a result of the diaspora of communities that practise female genital mutilation, many more women are now living with genital mutilation in the United Kingdom, and many more girls are at risk. The campaign to end the practice in the UK has been spearheaded by committed and experienced activists (www.forwarduk.org.uk, http://www.equalitynow.org with wide institutional endorsement),1 as reflected in recent intercollegiate recommendations for dealing with the problem.2

The document results from collaboration between the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of Nursing, Equality Now, and the Unite union. It merges key points from several existing guidelines3 4 5 6 into a single paper that reiterates the core message: female genital mutilation is a form of child abuse. It points to the importance of data collection and sharing between relevant agencies for effective action. It stipulates appropriate professional care for girls and young women affected by the practice. For the recommendations to be implemented (we hope urgently), a strategic implementation plan with a tight time frame is …

This article can be accessed in this LINK.

Female genital mutilation: a hidden epidemic (statement from the European Academy of Paediatrics).

Eur J Pediatr. 2013 Aug 28. [Epub ahead of print]

Female genital mutilation: a hidden epidemic (statement from the European Academy of Paediatrics).

Sauer PJ, Neubauer D.

Beatrix Children Hospital/UMCG, PO BOX 30.001, 9700 RB, Groningen, The Netherlands, p.j.j.sauer@umcg.nl.


Female genital mutilation or female circumcision is frequently performed worldwide. It is estimated by the World Health Organisation that worldwide, 100-140 million girls and women currently have to live with the consequences of female genital mutilation. The article argues that the tradition is one of the causes, while another four possible reasons for undergoing such cruel mutilation of young girls exist. Today, there exists a classification of at least four different ways of such mutilation which has no health benefits, and it harms girls and women in many ways. Long-term consequences like recurrent urinary tract infections, dysmenorrhea, sexual problems, infertility and complications both for the mother and infant at delivery are mentioned. Female genital mutilation is a violation of the fundamental human rights, as well as a savage breach of the integrity and personality. Conclusion: The European Academy of Paediatrics advises its members to initiate appropriate counselling for parents and female adolescents regarding the risk of female genital mutilation and strongly condemns female genital mutilation and councils its members not to perform such procedures.

This article can be accessed in this LINK

BMA backs police campaign against female genital mutilation.

BMJ. 2007 Jul 21;335(7611):116.FREE

BMA backs police campaign against female genital mutilation.

Moszynski P.


A crackdown on female genital mutilation has been launched by London’s Metropolitan Police in an attempt to protect the estimated 6500 girls it believes undergo the procedure each year in the United Kingdom.

The BMA backed campaign, dubbed Operation Azure, has been launched at the start of the summer holidays, because that is the time when girls from certain ethnic groups—mainly African communities—are thought to be most at risk. The extended holiday period allows time to recover from the physical effects of the operation. Most girls are sent abroad, but female genital mutilation is also thought to be conducted in the UK, although no one has ever been prosecuted.

A £20 000 (€30 000; $40 000) reward has been offered in an attempt to break the wall of silence surrounding the issue. The Metropolitan …

This article can be accessed for free in this LINK

US paediatricians withdraw guidance on female genital cutting after criticisms.

BMJ. 2010 Jun 1;340:c2922. doi: 10.1136/bmj.c2922.

US paediatricians withdraw guidance on female genital cutting after criticisms.

Kmietowicz Z.


The American Academy of Pediatrics has retracted its 2010 policy statement on female genital cutting after criticism and confirmed its opposition to all forms of mutilation, however minor.

Last month the UK Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health voiced concerns about the guidance, which suggested that doctors …

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Virginity testing in South Africa: re-traditioning the postcolony.

Cult Health Sex. 2006 Jan-Feb;8(1):17-30.

Virginity testing in South Africa: re-traditioning the postcolony.

Vincent L.

Department of Political and International Studies, Rhodes University, South Africa. L.Vincent@ru.ac.za


Umhlanga is a ceremony celebrating virginity. In South Africa, it is practiced, among others, by the Zulu ethnic group who live mainly in the province of KwaZulu Natal. After falling into relative disuse in the Zulu community, the practice of virginity testing made a comeback some 10 years ago at around the time of the country’s first democratic election and coinciding with the period when the HIV pandemic began to take hold. In July 2005 the South African Parliament passed a new Children’s Bill which will prohibit virginity testing of children. The Bill has been met with outrage and public protest on the part of Zulu citizens. Traditional circumcision rites are also addressed in the new bill but are not banned. Instead, male children are given the right to refuse to participate in traditional initiation ceremonies which include circumcision. This paper asks why the practice of virginity testing is regarded as so troubling to the new democratic order that the state has chosen to take the heavy-handed route of banning it. The paper further asks why the state’s approach to traditional male circumcision has been so different to its approach to virginity testing. Finally, the paper asks what these two challenging cases in the country’s new democracy tell us about the nature of liberal democratic citizenship in South Africa 10 years after apartheid’s formal demise.

This article can be purchased in this LINK

Female genital mutilation: Australian law, policy and practical challenges for doctors.

Med J Aust. 2011 Feb 7;194(3):139-41.

Female genital mutilation: Australian law, policy and practical challenges for doctors.

Mathews B.

Faculty of Law, Queensland University of Technology, Brisbane, QLD, Australia.b.mathews@qut.edu.au


The issue of whether medical practitioners should perform “ritual nicks” as a method of meeting demand for female genital mutilation (FGM) has recently been debated in the United States and Australia. Due to increasing numbers of people arriving and settling in Australia from African nations in which FGM is customary, demand for FGM in Australia is present and may be increasing.

Australian law clearly prohibits performance of any type of FGM. FGM is also prohibited by the most recent policy of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). For legal, medical and social reasons, the RANZCOG policy is sound, and medical practitioners should not administer FGM in any form. Development of an evidence base regarding incidence of and attitudes towards FGM, and the need for post-FGM treatment, would help inform sound policy and practical responses. Strategies adopted in African nations to abolish FGM may assist in refining educational and supportive efforts.

This article can be accessed in this LINK

Why are current efforts to eliminate female circumcision in Ethiopia misplaced?

Cult Health Sex. 2012 Oct 2. [Epub ahead of print]

Why are current efforts to eliminate female circumcision in Ethiopia misplaced?

Boyden J.


This paper discusses the eradication challenges of female circumcision in Ethiopia. It argues that despite an overall decline in the practice nationally, eradication efforts have caused significant quandaries for girls and their families. The most common justification by far for its continuance is that circumcision confirms a girl’s social place by proving her readiness for marriage and adulthood and thereby ensures her protection against material want. Hence, intervention has often resulted in the transformation, rather than the elimination, of the practice, the exchange of one type of risk for another, or even increased risk to girls. In discussing policy, the paper argues that there has been a misapplication of the risk concept in the promotion of change in Ethiopia. It calls for risk definitions and interventions that are more holistic, correspond more closely with children’s social realities and take into account the phenomenological dimensions of experience.

This article can be purchased in this LINK

Female genital mutilation and its prevention: a challenge for paediatricians.

Eur J Pediatr. 2009 Jan;168(1):27-33. Epub 2008 Apr 25.

Female genital mutilation and its prevention: a challenge for paediatricians.

Jaeger F, Caflisch M, Hohlfeld P.

Service de Pédiatrie, Hôpital de Pourtalès, Rue de la Maladière 45, 2000, Neuchâtel, Switzerland. f.jaeger@gmx.ch


Female genital mutilation (FGM) is defined as an injury of the external female genitalia for cultural or non-therapeutic reasons. FGM is mainly performed in sub-Saharan and Eastern Africa. The western health care systems are confronted with migrants from this cultural background. The aim is to offer information on how to approach this subject. The degree of FGM can vary from excision of the prepuce and clitoris to infibulation. Infections, urinary retention, pain, lesions of neighbouring organs, bleeding, psychological trauma and even death are possible acute complications. The different long-term complications include the risk of reduced fertility and difficulties during labour, which are key arguments against FGM in the migrant community. Paediatricians often have questions on how to approach the subject. With an open, neutral approach and basic knowledge, discussions with parents are constructive. Talking about the newborn, delivery or traditions may be a good starting point. Once they feel accepted, they speak surprisingly openly. FGM is performed out of love for their daughters. We have to be aware of their arguments and fears, but we should also stress the parents’ responsibility in taking a health risk for their daughters. It is important to know the family’s opinion on FGM. Some may need support, especially against community pressure. As FGM is often performed on newborns or at 4-9 years of age, paediatricians should have an active role in the prevention of FGM, especially as they have repeated close contact with those concerned and medical consequences are the main arguments against FGM.

This article can be accessed in this LINK

A step forward for opponents of female genital mutilation in Egypt

Lancet. 1997 jan;349(9045)129 – 130

A step forward for opponents of female genital mutilation in Egypt

Abd El Hadi A


In July, 1996, a decree by the Egyptian Minister of Health, Dr Ismail Sallam, prohibited physicians from performing female genital mutilation in private or public health facilities. Despite the decree’s short-comings, opponents of such mutilation view it as an important step. The decree reverses the decision of the previous Minister of Health who, in 1994, overturned a 35-year ban and permitted female genital mutilation to be done in public hospitals.

The fight against female genital mutilation is not new in Egypt. Activists have raised the issue since the late 1970s, and the main focus has been the health hazards associated with female genital mutilation. However, in 1994, with the establishment of the Task Force Against Female Genital Mutilation, such opposition coalesced into a national movement, which has brought a new human rights perspective to the debate. One activist said “Whether or not female genital mutilation leads to infection, shock, or death, it is a violation of women’s bodily integrity and their reproductive and sexual rights. It is a human rights violation even if it is done in hospitals under anaesthesia and in aseptic conditions”…

This article can be purchased in this LINK