Work consisting of a set of directions or principles to assist the health care practitioner with patient care decisions about appropriate diagnostic, therapeutic, or other clinical procedures for specific clinical circumstances. Practice guidelines may be developed by government agencies at any level, institutions, organizations such as professional societies or governing boards, or by the convening of expert panels. They can provide a foundation for assessing and evaluating the quality and effectiveness of health care in terms of measuring improved health, reduction of variation in services or procedures performed, and reduction of variation in outcomes of health care delivered.
A survey on knowledge of female genital mutilation guidelines.
Purchase TC, Lamoudi M, Colman S, Allen S, Latthe P, Jolly K.
College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
The increase in immigration from countries with a high prevalence of female genital mutilation (FGM) has highlighted the need for knowledge and sensitivity in this area of healthcare in high-resource countries. We have surveyed with an online questionnaire 607 members, fellows and trainees of the Royal College of Obstetricians and Gynaecologists (RCOG) on knowledge about the RCOG guidelines for FGM. Completed training and more practical experience with women affected by FGM significantly increased knowledge. Many respondents were not aware of specialist services locally (22.9%) or how to access them (52.3%). Some areas of insufficient knowledge were identified, in particular in relation to psychiatric morbidity, HIV, hepatitis B and pelvic infection. More specialized training efforts might improve this aspect.
Health Care in Europe for Women with Genital Mutilation
Els Leye, Richard A. Powell, Gerda Nienhuis, Patricia Claeys & Marleen Temmerman
The increasing number of immigrants from African countries practicing female genital mutilation (FGM) has raised concern in Europe. Health care professionals have developed three main responses: (1) technical guidelines for clinical management; (2) codes of conduct on quality of care; and (3) specialised health services for medical and psychological care and counselling. Much remains to be done, however, to ensure adequate care in Europe: (1) medico-legal/ethical discussions; (2) development of protocols to assist in making informed decisions; and (3) development of guidelines on counselling, communication strategies, and referral procedures. All agencies working in the field of FGM should be interlinked at the national level, in which members of the affected communities should be included. At the European level, a coordinated approach between all agencies should be developed.
Lakartidningen. 2005 May 23-29;102(21):1637-8, 1640, 1642-3.
[Genital mutilation of children is an offence. Do health services have a sufficient knowledge to see the problem?]. [Article in Swedish]
Holmgren H, Almroth L, Berggren V, Bergström S.
Barn- och ungdomskliniken, Centralsjukhuset, Kristianstad.
There are contradicting opinions whether female genital cutting (FGC) takes place in Sweden. The results from several studies indicate, however, that FGC is practiced on girls residing in Sweden. Almost no research has been done on girls on how they are affected by FGC. Thus there is no scientifically based knowledge on signs and symptoms in girls related to the practice, which can lead to cases passing unnoticed. Many health professionals feel they have poor knowledge about FGC. It is important to teach about FGC at medical and nursing schools and to make guidelines based on paediatric aspects of FGC.
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.