Health impacts of female genital mutilation/cutting: A synthesis of the evidence

The goal of this review was to inform the development of a comprehensive set of training guidelines and materials for frontline health care providers so they can manage the care of women and girls who have undergone FGM/C prevent the practice at the community level and accelerate abandonment of FGM/C practices. An analysis of existing systematic reviews meta-analyses and published studies on health impacts associated with FGM/C and their specific interventions was conducted. A content analysis of 44 reference materials related to FGM/C was conducted using an updated data abstraction form that included 17 review criteria. Descriptive statistics were applied to the generated data to understand the components of the analysed documents. A review and validation of the outcomes and interventions were carried out by medical experts on the ACCAF team. The health impacts associated with FGM/C that require interventions have been broadly categorised into: immediate genito-urinary gynecological obstetric sexual and psycho-social consequences. An analysis of existing training and research reference materials on FGM/C management showed major strength in epidemiology but scored marginally on physical gynecological and obstetric complications. In addition the reference materials scored poorly on the sexual and psycho-social impacts of FGM/C. Curative and preventive interventional approaches are recommended in the review for the various health consequences. Specifically capacity building for health care providers to respond to women exposed to FGM/C in both health care facility and community settings should be prioritized. In addition strengthening the health care systems by anchoring FGM/C interventions to existing programs and socio-community structures especially in high prevalence areas and by establishing supervisory mechanisms protocols documentation and referral systems where expert care is lacking among other interventions will greatly help the response to the needs of cut women and girls while reventing new FGM/C cases. (excerpt)