G56(P) Female genital mutilation: knowledge, training and experience of healthcare professionals at a london hospital

Abstract

The World Health Organisation defines female genital mutilation (FGM) as “procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” Since 1985 it has been a criminal offence in the UK to perform FGM, or to assist a girl in performing FGM on herself. This study was based at a district general hospital in London with a high prevalence of patients originating from countries where FGM is practiced. We aimed to assess healthcare professionals’ knowledge and confidence in managing FGM, as this underpins their ability to respond adequately to the medical needs of patients with FGM and safeguard girls and young women from the practice. A confidential survey was distributed within the hospital from January–March 2014. 157 healthcare professionals responded. 35% were midwives (n = 51), 45% medical doctors (N = 71), 19% nursing (N = 30), 3% other (N = 5). 100% of respondents stated they knew what FGM was and 71.4% felt they would benefit from further training on the subject. Only 21% of respondents stated that they would feel comfortable discussing FGM with patients. Most healthcare professionals had not read any guidelines relating to FGM (65.3%). Midwives were more likely to have read guidelines compared with any other profession (p = 0.001). Interestingly, 73% felt there were barriers that prevent healthcare professionals from speaking to patients about FGM. On a scale of 1–5 (1 = not important at all, to 5 = very important), lack of knowledge of FGM was rated as the most important barrier with a mean rating of 4.3 out of 5, followed by a language barrier (rating = 4.1) and fear of appearing culturally insensitive (rating = 3.9). We have identified what are perceived by healthcare professionals to be the most significant barriers to discussing FGM with patients. We suggest that future training should particularly focus on overcoming these barriers. One potential approach would be specialised communication training provided by people who are already familiar with working with women who have suffered FGM. These barriers should be addressed if we are to identify and protect all girls and young women who are potential or actual victims of FGM.