Abstract
With increased migration, female genital mutilation (FGM) also referred to as female circumcision or female genital cutting is no longer restricted to Africa, the Middle East, and Asia. The European Parliament estimates that up to half a million women living in the EU have been subjected to FGM, with a further 180,000 at risk. Aware of the limited success of campaigns addressing FGM, the World Health Organization recommended a behavioural change approach be implemented in order to end FGM. To date, however, little progress has been made in adopting a behaviour change approach in strategies aimed at ending FGM. Based on research undertaken as part of the EU's Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE), this paper argues that behaviour change has not been implemented due to a lack of understanding relating to the application of the two broad categories of behaviour change approach: individualistic decision-theoretic and community-change game-theoretic approaches, and how they may be integrated to aid our understanding and the development of future intervention strategies. We therefore discuss how these can be integrated and implemented using community-based participatory action research methods with affected communities.
Highlights
Female genital mutilation (FGM), sometimes called female circumcision or female genital cutting, is a deep rooted traditional practice that adversely affects the health and well-being of millions of girls and women
In addition to those coming to the EU who have already been subjected to FGM, there is anecdotal evidence supported by criminal prosecutions, in France and Sweden, that suggests that FGM is conducted in the EU [6,7,8,9]
In this paper we argue that because of the social aspects characteristically associated with FGM, including gender norms, power relations, and the level of social capital associated with the practice, it is fundamentally important that behaviour change approaches adopt a holistic approach, rather than focusing on the individual or group dynamics of attitude and behaviour change
Summary
Female genital mutilation (FGM), sometimes called female circumcision or female genital cutting, is a deep rooted traditional practice that adversely affects the health and well-being of millions of girls and women. According to the UNCHR, nearly 20,000 women from FGM practising countries applied for asylum to the EU in 2011 with an estimated 8,809 female applicants aged 14–64 likely to be affected by FGM [5] In addition to those coming to the EU who have already been subjected to FGM, there is anecdotal evidence supported by criminal prosecutions, in France and Sweden, that suggests that FGM is conducted in the EU [6,7,8,9]. The results of this part of the research were applied to a grounded health behaviour change approach in line with WHO’s [16, page 2] call for the reorientation of anti-FGM communication strategies “from awareness raising to behaviour-change intervention approaches”. In order to provide context for arguing for the applicability of a more holistic behaviour change approach, we introduce the four traditional approaches to ending FGM
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