7. Seeking respectful care: A qualitative evidence synthesis of the healthcare experiences of women who have undergone FGM/C

Abstract

High levels of migration mean that healthcare systems in 'destination' countries are being challenged to respond to the needs of communities practising FGM/C. This paper reports a systematic review of qualitative evidence (funded by the UK National Institute of Health Research) to explore the experiences, needs, barriers and facilitators to seeking and obtaining FGM-related healthcare in high income (OECD) countries, from the perspectives of women and girls who have undergone FGM/C. Twelve databases and grey literature sources were searched. Papers were screened, selected and quality appraised by two independent reviewers using the JBI QARI tool. Data was extracted using a JBI tool. Synthesis involved inductive thematic analysis of study findings. 59 papers from 14 different countries were included (50% published within the last 8 years). There were 19 descriptive themes summarised into 6 analytical themes relating to: access; communication; cultural dissonance/integrity; disempowering vs. positive care encounters; and voicing healthcare needs. The themes illuminate significant challenges to obtaining timely and holistic care, and highlight different ways in which women may experience care as disrespectful and disempowering. Key elements of 'good care' are identified. Service provision and provider training can be improved by understanding women's needs and experiences.