Tag Archives: Netherlands

“A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary?” A qualitative study into the perceptions of Somali women in the Netherlands about the prevention of cervical cancer

Int J Equity Health. 2015 Aug 21;14(1):68. doi: 10.1186/s12939-015-0198-3. FREE

“A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary?” A qualitative study into the perceptions of Somali women in the Netherlands about the prevention of cervical cancer.

Salad J, Verdonk P, de Boer F, Abma TA


INTRODUCTION: Participation in Human Papillomavirus (HPV) vaccination and Papanicolaou Screening (Pap smears) is low among ethnic minorities in the Netherlands and hardly any information is available about the cervical cancer prevention methods of Somali women living in the diaspora. This qualitative study, based on the Health Belief Model (HBM) and an intersectionality-based framework, explores the perceptions of Somali women living in the Netherlands regarding measures to prevent cervical cancer.

METHODS: Semi-structured interviews have been conducted with young Somali women aged 17-21 years (n = 14) and Somali mothers aged 30-46 years (n = 6). Two natural group discussions have been conducted with 12 and 14 Somali mothers aged 23-66 years. The collected data has been analyzed thematically for content.

RESULTS: In this study, we have identified perceived barriers to the use of preventive measures across three major themes: (1) Somali women and preventive healthcare; (2) Language, knowledge, and negotiating decisions; and (3) Sexual standards, culture, and religion. Many issues have been identified across these themes, e.g., distrust of the Dutch health care system or being embarrassed to get Pap smears due to Female Genital Mutilation (FGM) and having a Dutch, male practitioner; or a perceived low susceptibility to HPV and cancer because of the religious norms that prohibit sex before marriage.

CONCLUSIONS: Current measures in the Netherlands to prevent women from developing cervical cancer hardly reach Somali women because these women perceive these kinds of preventative measures as not personally relevant. Dutch education strategies about cervical cancer deviate from ways of exchanging information within the Somali community. Teachers can provide culturally sensitive information to young Somali women in schools. For Somali mothers, oral education (e.g., poetry or theater) about the Dutch health care system and men’s roles in HPV transmission may be useful. An intersectional approach, grounded in the HBM, is recommended to promote equal access to preventive health care for Somali women.

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Coping and chronic psychosocial consequences of female genital mutilation in the Netherlands.

Ethn Health. 2012 Dec;17(6):677-95. doi: 10.1080/13557858.2013.771148.

Coping and chronic psychosocial consequences of female genital mutilation in the Netherlands.

Vloeberghs E, van der Kwaak A, Knipscheer J, van den Muijsenbergh M.

Research & Development Department , PHAROS – Knowledge and Advisory Centre on Refugees’ and Migrants’ Health , Utrecht , The Netherlands.

Objective. The study presented in this article explored psychosocial and relational problems of African immigrant women in the Netherlands who underwent female genital mutilation/cutting (FGM/C), the causes they attribute to these problems – in particular, their opinions about the relationship between these problems and their circumcision – and the way they cope with these health complaints. Design. This mixed-methods study used standardised questionnaires as well as in-depth interviews among a purposive sample of 66 women who had migrated from Somalia, Sudan, Eritrea, Ethiopia or Sierra Leone to the Netherlands. Data were collected by ethnically similar female interviewers; interviews were coded and analysed by two independent researchers. Results. One in six respondents suffered from post-traumatic stress disorder (PTSD), and one-third reported symptoms related to depression or anxiety. The negative feelings caused by FGM/C became more prominent during childbirth or when suffering from physical problems. Migration to the Netherlands led to a shift in how women perceive FGM, making them more aware of the negative consequences of FGM. Many women felt ashamed to be examined by a physician and avoided visiting doctors who did not conceal their astonishment about the FGM. Conclusion. FGM/C had a lifelong impact on the majority of the women participating in the study, causing chronic mental and psychosocial problems. Migration made women who underwent FGM/C more aware of their condition. Three types of women could be distinguished according to their coping style: the adaptives, the disempowered and the traumatised. Health care providers should become more aware of their problems and more sensitive in addressing them.

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[Diagnostic image. A woman with a vulvar swelling]

Ned Tijdschr Geneeskd. 2009;153:A115.

[Diagnostic image. A woman with a vulvar swelling]. [Article in Dutch]

Lashley LE, Feitsma HA.

Leids Universitair Medisch Centrum, afd. Gynaecologie, Leiden, The Netherlands. lisalashley@hotmail.com

A 25-year-old woman presented with a tumour above the labia minora, due to an epidermal cyst.

There is no link to view this article online.

The lower prevalence of female genital mutilation in the Netherlands: a nationwide study in Dutch midwifery practices.

Int J Public Health. 2012 Apr;57(2):413-20.

The lower prevalence of female genital mutilation in the Netherlands: a nationwide study in Dutch midwifery practices.

Korfker DG, Reis R, Rijnders ME, Meijer-van Asperen S, Read L, Sanjuan M, Herschderfer K, Buitendijk SE.

TNO Innovation for Life, Leiden, The Netherlands. dineke.korfker@tno.nl


OBJECTIVES: To determine the prevalence of female genital mutilation (FGM) in women giving birth in 2008 in the Netherlands.

METHOD: A retrospective questionnaire study was conducted.The study covered all 513 midwifery practices in the Netherlands. The data were analysed with SPSS 17.0.

RESULTS: The response from midwifery practices was 93%(n = 478). They retrospectively reported 470 circumcised women in 2008 (0.32%). The expected prevalence in the Netherlands based on the estimated prevalence of FGM in the country of birth was 0.7%. It is likely that there was under reporting in midwifery practices since midwives do not always enquire about the subject and may not notice the milder types of FGM. Midwives who checked their records before answering our questionnaire reported a prevalence of 0.8%.

CONCLUSION: On the basis of this study, we can conclude that FGM is a serious clinical problem in Europe for migrant women from risk countries for FGM. These women should receive extra attention from obstetricians and midwives during childbirth, since almost half are mutilated and FGM involves a risk of complications during delivery for both women and children.

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Baaij M, Kagie MJ; Female circumcision; histories of 3 patients

Ned Tijdschr Geneeskd. 1999 Aug 21;143(34):1721-4.

[Female circumcision; histories of 3 patients]. [Article in Dutch]

Baaij M, Kagie MJ.

Medisch Centrum Haaglanden, locatie Westeinde, Den Haag.

Comment in Ned Tijdschr Geneeskd. 2000 Jan 8;144(2):95-6.


Three Somali women presented with problems of the infibulation they had undergone when they were girls. The first one was 22 years old and had problems with coition, the second one was 21 years old and had problems with parturition, the third one was 28 years old and had an epidermal cyst near the ventral commissure of the vulva. Infibulation is a form of female circumcision, in which the clitoris, labia minora and labia majora are removed and the ostium vaginae is reduced to less than a centimeter. In the Netherlands the Ministry of Health, Wellbeing and Sport and the Association of Obstetricians and Gynaecologists have declared themselves opponents to female genital mutilation carried out by Dutch physicians. The association decided also to not carry out reinfibulation, e.g. after parturition.

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Dutch government cracks down on female circumcision

Lancet. 2004 May;363(9420):1531

Dutch government cracks down on female circumcision

van Kolfschooten F


The Netherlands is taking measures to crack down on female genital mutilation (FGM) because of the practice’s severe physical and psychological effects. Last week, the Dutch cabinet set up a committee to develop a control system for the prevention and detection of FGM. The committee will also collect figures about the scale and varieties of female circumcision that are taking place and will estimate how many girls are at risk…

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