Among cut women aged 15-19, percent who had it performed by a medical practitioner Among cut women aged 15-19, percent who had it performed by a medical practitioner Definition: Among women aged 15-19 who have undergone female genital cutting (FGC), the percent of women who had the procedure done by a health professional. Two basic categories are used: Traditional practitioners, which can include a traditional circumciser, traditional birth attendant (TBA), or other person Health professionals, which can include a doctor, nurse, or school-trained midwife (as opposed to a TBA who has gone through a short training program). It is important to use locally adapted wording to identify traditional practitioners. This indicator is calculated as: (The number of cut women aged 15-19 who state that a health professional performed their procedure / All cut women aged 15-19 in the survey) x 100 Data Requirement(s): Report, by women surveyed, of type of practitioner who performed the procedure. Data should be disaggregated by age, region, ethnicity and religion. Data Source(s): A population-based survey (e.g., DHS’s female genital cutting (FGC) module) Purpose: This indicator is based on the theory of harm-reduction which supports the belief that when the procedure is performed by a trained health professional, some of the immediate risks may be reduced. If the procedure was performed by another type of practitioner, the likelihood of infection and other medical complications is high. Some have argued that medicalization is a useful or necessary first step towards total abandonment of FGC, however the evidence to support this is scarce. Issue(s): There are many negative effects that can follow an FGC procedure. Some of these effects depend on how the procedure itself was performed. For example, the chance of infection would be greatly reduced if performed within a clinical environment, and if anesthesia were used within this environment, pain during the procedure would also be reduced. However, having the procedure performed by a health professional does not guarantee the procedure will be less severe or the conditions sanitary. Furthermore, it may do little to ameliorate the psychological effects of cutting, which have been widely reported in the literature. Since FGC is located within the social context of patriarchal social control over women and their sexuality, some researchers consider that having the procedure done by a health professional represents progress in the wrong direction: rather than working towards the eventual elimination of the practice altogether, moving it within the clinical context lends credibility to the practice and wrongly legitimizes it as being medically sound or beneficial for girls and women’s health. It can further institutionalize FGC as medical personnel often hold power, authority, and respect in society (WHO et al., 2008). Having a trained health provider perform the procedure is inconsequential to the fact that FGC performed under any circumstances violates girls’ and women’s right to life, right to physical integrity, and right to health. Furthermore, it violates the fundamental medical ethic to ‘Do no harm’. Thus, medical licensing authorities and professional associations have joined the UN organizations in condemning actions to medicalize FGC. The International Federation of Gynecology and Obstetrics (FIGO) passed a resolution in 1994 at its General Assembly opposing the performance of FGC by obstetricians and gynecologists, including a recommendation to “oppose any attempt to medicalize the procedure or to allow its performance, under any circumstances, in health establishments or by health professionals” (WHO et al., 2008). Indeed, health providers in areas where FGC is practiced are often enlisted as allies in the effort to eradicate it. As health providers become engaged in these efforts, their awareness increases not only of the health consequences of FGC, but also of the broader human rights of choice and bodily integrity (Mohamud, 2002). An additional consideration for this indicator is that if women were very young when they had the cutting performed, they may not remember or know who did it and what their qualifications were. One alternative would be asking women whether or not the cutting was performed in a health facility. For this and the other reasons given, this indicator should be interpreted with caution. Keywords: access, female genital cutting (FGC), adolescent, violence References: Bloom S. “Violence Against Women and Girls: A Compendium of Monitoring and Evaluation Indicators.” USAID, IGWG, and MEASURE Evaluation, 2008. Eliminating female genital mutilation: an interagency statement. UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCHR, UNHCR, UNICEF, UNIFEM, WHO, 2008. Mohamud A., Ringheim K Bloodworth S., and Gryboski K. Girls at Risk: Community Approaches to End Female Genital Mutilation and Treating Women Injured by the Practice. Reproductive Health and Rights – Reaching the Hardly Reached, 2002. Related content Sexual and Gender-Based Violence Adolescent and Youth Sexual and Reproductive Health Access to Sexual and Reproductive Health Services Filed under: access, adolescent, Family Planning, female genital cutting, FP, FP/RH, Indicators, Reproductive Health, RH, violence
