Decision-Making Process in Female Genital Mutilation: A Systematic Review.

S.M Yasir Arafat,Angi Alradie-Mohamed,Russell Kabir

doi:10.3390/ijerph17103362

Abstract

Female genital mutilation/cutting “FGM/C” is a deep-rooted damaging practice. Despite the growing efforts to end this practice, the current trends of its decline are not enough to overcome the population’s underlying growth. The aim of this research is to investigate the FGM/C household decision-making process and identify the main household decision-makers. A review of peer-reviewed articles was conducted by searching PubMed, JSTOR, Ovid MEDLINE, Ovid EMBASE, EBSCO, and CINAHL Plus via systematic search using keywords. The found publications were screen using inclusion and exclusion criteria in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After critical appraisal, seventeen articles were included in this review. The data extracted from the articles regarding FGM/C household-decision making process and decision-makers were analyzed using narrative analysis. FGM/C decision-making process varies from a region to another; however, it generally involves more than one individual, and each one has different power over the decision. Fathers, mothers, and grandmothers are the main decision-makers. It was shown from this review that opening the dialogue regarding FGM/C between sexes may lead to a productive decision-making process. The participation of fathers in the decision-making may free the mothers from the social-pressure and responsibility of carrying on traditions and create a more favorable environment to stop FGM/C practice.

Highlights

Female genital mutilation or female circumcision/cutting (FGM/C) is one of the most ancient deep-rooted damaging practices worldwide
The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) (1997) [3], classify it to four major types: “clitoridectomy” or Type I which involves the excision of the clitoral prepuce “the hood” or/and excision of all/ part of the clitoris, Type II is the excision of the clitoris with excision of part or all of the
The review included 17 studies from 11 different countries; 13 of the studies were conducted in the African countries of Ethiopia, Sudan, Somaliland, Sierra Leone, Guinea, Gambia, and Senegal; two studies were conducted in Mideastern country Kurdistan regions in Iraqi; two studies were carried among immigrant communities, one in the United States of America, and the other in Canada

Summary

Introduction

Female genital mutilation or female circumcision/cutting (FGM/C) is one of the most ancient deep-rooted damaging practices worldwide It is defined by the World Health Organization (WHO) as “all procedures involving partial or total removal of the external female genitalia or other injuries to the female genital organs for non-medical reasons” [1]. It causes lifelong suffering for women and girls and creates health inequality without having any health benefits, by leading to life-lasting physical, mental and sexual problems among females who are exposed to the practice (severe pains, bleeding, death, kidney failure, infertility, difficulties during childbirth, fetal distress, death of the newborn, and/or maternal death) [2].The psychological consequences of FGM/C include behavior disturbances and loss of trust among girls and long-term consequences among women (depression, anxiety, feeling of incompleteness, and the inability to express their fears) [3]. Gebremariam, Assefa and Weldegebreal 2016 [27]

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