Female Genital Mutilation/cutting Research Articles

URGENCY TO RE-EVALUATE FEMALE GENITAL MUTILATION PRACTICE AMONG MUSLIM COMMUNITIES IN INDONESIA

This article discusses the long-lasting problem of the Indonesian practice of Female Genital Mutilation/Cutting (FGM/C) among Muslim communities. With the purpose to identify the religious and medical rationalization of the FGM/C practice and if it needs to be re-evaluated. The data collection in this study was carried out through a literature study from various secondary sources. This article concludes that Indonesia's religious basis for FGM/C practice that is mandated by MUI in 2008 is full of loopholes. The rationalization and ambiguous regulations made by Permenkes No.6/2014 also create more confusion among civilians and healthcare practitioners that cause medicalization practice for FGM/C. In addition to the way of Indonesia's national and international policy that prone to the realization of international commitments and SDGs 2030. Therefore Indonesia's government needs to pay more attention to FGM/C problems as it can affect the development of Indonesia to achieve its national and international commitment.

Female Genital Mutilation/Cutting (FGM/C) for The Harmony of Sexual Relationship by Islamic Law Perspective

The practice of female circumcision or FGM/C (Female Genitalia Mutilation/Cutting) in Indonesia is stated as a purification process by removing najis or dirt in female genital area and it is useful for controlling women's sexual desires so that they are far from evil. Based on this motivation, FGM/C makes women increasingly subordinated by placing the assumption of infertility and being responsible for the satisfaction of sexual relations with their partners. Apart from tradition, this phenomenon is also based on the strong influence of Islamic religious doctrine which generally makes parents feel compelled to fulfill it. Through a qualitative approach with descriptive-analytical methods, this research will compile and explain the data that has been obtained to be analyzed and drawn conclusions. The results of this study indicate that there is no concrete evidence that correlates female circumcision with sexual harmony, female circumcision is purely a tradition and not an Islamic teaching.

Relationship between Females' Knowledge and Attitude and Intention of Female Genital Mutilation

Background: The terms female genital cutting (FGC) and female genital mutilation/cutting (FGM/C) are often used among practicing communities and individuals. These concepts emphasize the significance of adopting nonjudgmental vocabulary when working with practitioners. When discussing the matter in practice communities, terms like excision or genital cutting are also acceptable. Aim: The present study was carried find to estimate relationship between level of knowledge, attitude and intentions of females toward the practice of FGM. Subject & Methods: Descriptive Cross-sectional study carried out in family health centers (FHCs) in different sitting at Beni-Suef Governorate on a convenient sample. Structured Interviewing Questionnaire sheet which includes three sections: (I): Females' Knowledge of females regarding FGM/C, (II): Attitudes of females regarding FGM/C. (III): Intention to practice FGM/C. Results: About 76.9% of females know that FGM/C practice is illegal and 61.7% did not know that there is a punishment for parents seeking FGM/C, and 70.4% did not know that prison is the type of punishment for parents in Egyptian law. Only 25.7% of females had good knowledge regarding FGM/C, 35.5% had an unfavorable attitude towards. About 79.4% of females who experienced FGM/C had the intention to mutilate their daughters in the future. Almost all females with unfavorable attitudes towards FGM/C (78.7%) had the intention to practice FGM/C in the future, followed by 17.6% of females with neutral attitudes and only 3.7% of females with a favorable attitude. Conclusion: The highest proportion of females did not know that there is a punishment for parents seeking FGM/C, and most of them did not know that prison is the type of punishment for parents in Egyptian law and did not know that there is a punishment for physicians performing FGM/C in Egyptian law as well. The proportion of females who had the intention to practice FGM/C increased with the decrease in the level of knowledge. Recommendations: Enhancement of females' knowledge and negative attitude toward Female Genital Mutilation should be established by educational programs.

Female genital mutilation/cutting incidence, diagnostic capacities, and obstetric outcomes among migrant women: a single-center retrospective analysis in a 10-year birth cohort in Austria

IntroductionPractical experience in the care of women with female genital mutilation/cutting (FGM/C) is uncommon in Austria. However, affected women require specialized gynecological and obstetric care. In our region, there is currently neither an official counseling center nor specially trained medical personnel to address the special needs of women after FGM/C. The aim of this study was to determine the potential need for obstetric care for women who have undergone FGM/C in our region.MethodsWe retrospectively reviewed women presenting for delivery at the LKH University Hospital Graz from 1.1.2010 until 31.12.2020 regarding the place of birth and/or the nationality of the mother to filter out women from a country with known FGM/C prevalence according to the UNICEF Global Database. Data on the documentation of FGM/C as well as demographic maternal data and peripartal parameters were gathered. Periods before and after the European refugee crisis in 2015 were compared.ResultsDuring the study period, a total of 35,628 deliveries took place at our hospital. 856 (2.4%) deliveries of 539 women were included due to nationality or birthplace in a country with known FGM/C prevalence. We found only 17/539 (3.2%) documented FGM/C cases. The estimated FGM/C prevalence among those patients was, however, 208/539 (38,6%). Women affected by FGM/C in our collective were most frequently from Nigeria, Egypt, Iraq, Ghana, and Somalia. No statistically significant increase in deliveries during the study period in the overall study cohort was observed, with the exception of deliveries of Somali women (p = 0.000).DiscussionThe discrepancy between documented and expected FGM/C rates (3,2% vs. 38,6%) in our collective suggests that most cases of FGM/C go undetected among women delivering in Austria. These data show the great need for special training for obstetricians and targeted contact points for affected women.

Health outcomes and female genital mutilation/cutting: how much is due to the cutting itself?

While Female Genital Mutilation/Cutting (FGM/C) continues to garner global attention, FGM/C-affected migrant communities, who are often racialized minorities in the U.S., face additional challenges which may impact their physical and mental health and well-being. It has been proposed that an overly narrow focus on the female genitalia or FGM/C status alone, while ignoring the wider social experiences and perceptions of affected migrant women, will result in incomplete or misleading conclusions about the relationship between FGM/C and migrant women’s health. A cross-sectional study was conducted across two waves of Somali and Somali Bantu women living in the United States, (n = 879 [wave 1], n = 654 [wave 2]). Socio-demographics, self-reported FGM/C status, perceived psychological distress, and self-reported FGM/C-related health morbidity was examined against self-reported experiences of everyday discrimination and perceived psychosocial support. In statistical models including age and educational attainment as potentially confounding socio-demographic variables, as well as self-reported FGM/C status, self-reported discrimination, and perceived psychosocial support, self-reported discrimination was the variable most strongly associated with poor physical health and psychological distress (i.e., FGM/C-related health morbidity and psychological distress), with greater perceived psychosocial support negatively associated with psychological distress, when controlling for all the other variables in the model. FGM/C status was not significantly associated with either outcome. Discrimination, more frequently reported among ‘No FGM/C’ (i.e., genitally intact or unmodified) women, was most frequently perceived as linked to religion and ethnicity. Our findings are consistent with views that discrimination drives negative outcomes. In this population, discrimination may include the ‘quadruple jeopardy’ of intersecting relationships among gender, race, religion, and migration status. We find that self-reported experiences of discrimination—and not FGM/C status per se—is associated with adverse physical and mental health consequences in our sample drawn from Somali migrant communities living in the United States, and that social support may help to mitigate these consequences. Our findings thus reinforce calls to better contextualize the relationship between FGM/C and measures of health and well-being among Somali women in the United States (regardless of their FGM/C status), taking psychosocial factors more centrally into account.Clinical Trials.Gov ID no. NCT03249649, Study ID no. 5252. Public website: https://clinicaltrials.gov/ct2/show/NCT03249649

Advancing Efforts and Strategies to Stop Female Genital Mutilation/Cutting (Fgm/C) in South-East Nigeria: A Qualitative Approach

This study focused on advancing efforts and strategies to stop Female Genital Mutilation/Cutting (FGM/C) in South-East Nigeria using a qualitative approach. The specific objectives included: to find out efforts made towards eliminating FGM/C in South-East Nigeria; and to identify how the practice of FGM/C can be eradicated in South-East Nigeria. The study was anchored on the social norms theory and it is purely qualitative. A combination of purposive sampling, cluster sampling and simple random sampling techniques was adopted to select respondents for this study. A total of 54 interviews were conducted across 9 qualitative population categories in 6 communities in South-East Nigeria. The QDA Miner software was used to analyze the data. The findings showed that a number of efforts have been made to stop FGM/C in South-East Nigeria which include lecture/campaigns/sensitization, health worker education of community members, punishing the offenders and skeletal involvement of men in FGM/C-eradication campaigns. Again, FGM/C can be eradicated in South-East Nigeria especially through the intensification of such culturally specific/grassroots oriented strategies already existent in the communities such as community sensitization/education, community sanctioning and male-targeted FGM/C-eradication campaigns. It was concluded that it is only the strategies that are culturally specific/grassroots oriented that can bring about FGM/C-eradication but must not be fluidly applied. It was therefore recommended that Government and Non-Governmental Organizations should intensify the already existing sensitization efforts towards the eradication of FGM/C in South-East communities.

Canadian medical student knowledge and attitudes toward female genital mutilation.

Despite female genital mutilation/cutting (FGM/C) practices being an illegal form of gender-based violence in Canada, this practice impacts many Canadians. Lack of education and training among Canadian health-care providers has resulted in systematic barriers to care. Awareness and FGM/C-related education among Canadian health-care providers must be urgently assessed. Canadian medical students were recruited to complete an anonymous survey via E-mails distributed through their schools' student organization between January and March 2021. We evaluated student understanding of FGM/C, attitudes toward medicalization and legislation, and prior clinical experience using multiple choice, Likert scale, and open-response questions. Respondents (n = 135) performed poorly on knowledge assessment questions (mean percent correct <50%). Only 10.4% of respondents indicated knowing how to involve appropriate authorities when necessary, and most never evaluate FGM/C in patient history (86.7%) or clinical examination (57.1%). Subgroup analysis revealed that prior education significantly improved knowledge scores and influenced students' behaviors and attitudes. About 92.2% of respondents supported the integration of FGM/C curricula in undergraduate medical education. This study reveals that Canadian medical students have a poor understanding of FGM/C and are not prepared to identify affected patients or intervene when necessary. These results provide rationale for the implementation of FGM/C-learning modules in undergraduate medicine.

Genital Mutilation in India - An Evil Practice

Female Genital Mutilation commonly known as FGM/C has in recent times been an eye opener for the Ministry of Women and Child Development and set the system in motion. FGM/C is practised mostly by the Dawoodi Bohra community with one million members in India. khatna, khafz, and khafd, the procedure is performed on six- or seven-year-old girls and involves the total or partial removal of the clitoral hood. Female genital mutilation/ cutting (FGM/C) involves the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons, and said practice has no health benefits for girls as well as for women.

Circumcising daughters in Nigeria: To what extent does education influence mothers' FGM/C continuation attitudes?

Education has been adjudged as an important behavioural change intervention and a key player in combating Female Genital Mutilation/Cutting (FGM/C). An assumed pathway is that it influences FGM/C attitudes. However, empirical evidence that explores this assumption is scarce. Hence, our study examines whether the associative effect of FGM/C continuation attitudes on circumcision of daughters is influenced by the level of a mother's education in Nigeria. We extracted data from the 2018 Nigeria Demographic and Health Survey (NDHS). The study focused on youngest daughters that were born in the last five years preceding the survey. A sample of 5,039 children with complete data on variables of interest to the study were analysed. The main outcome variable for this study is "circumcision among youngest daughters". The key explanatory variables were maternal "FGM/C continuation attitudes" and "education". At 95% confidence interval, we conducted a two-level logistic regression modelling and introduced interaction between the key independent variables. In the study's sample, the prevalence of FGM/C was 34%. It was lower for daughters whose mothers had higher education (12%) and believe FGM/C should discontinue (11.1%). Results from the multivariate analysis show statistically significant odds of circumcision for a daughter whose mother has had higher education and believes FGM/C should discontinue (OR-0.28, 95%CI: 0.08-0.98). For women who believe FGM/C should discontinue, the probability of daughter's circumcision reduced by 40% if the mother has attained higher education. Among those who believe FGM/C should continue, the probability of daughter's circumcision worsened if the mother had attained higher education (64%), however, this result was influenced by mothers' experience of circumcision. Education influences FGM/C attitudes, nonetheless, women's cutting experience can be a conduit for which the practice persists. Promoting female education should be accompanied by strong political commitment towards enforcing laws on FGM/C practice.

An Insider–Outsider Approach to Understanding the Prevalence of Female Genital Mutilation in Pusiga in the Upper East Region of Ghana

Female Genital Mutilation/Cutting (FGM/C) as a form of gender-related violence continues to thrive within communities and across borders, with (under)reported prevalence among communities in the diaspora. Reports of FGM/C among communities in the diaspora speak to the socio-cultural and religious factors which promote its prevalence. Successful interventions offer alternatives such as rites of passage to the socio-cultural-religious prospects offered by FGM/C to practicing communities. This suggests the need for a critical approach to research methods that engage intimately with the worldview of communities practicing FGM/C while inferring implications for designing health-promotion interventions in specific contexts. This paper draws on the insider and outsider approach to positionality to assess the factors accounting for the prevalence of FGM/C in Pusiga (3.8% nationally and 27.8% in Pusiga) in the Upper East Region of Ghana while inferring lessons for designing health promotion interventions. Applying a phenomenological qualitative design guided by focus groups and interviews, we draw on the insider approach to present a contextually and culturally sensitive report of five survivors, five non-survivors, and ten religious leaders on factors that account for the prevalence of FGM/C. Next, we assume an outsider approach to infer implications based on participants’ perspectives for designing health promotion interventions to curb FGM/C. The findings suggest shifting from socio-cultural-religious factors to economic undertones underpinning FGM/C. Inter-generational differences also vary attitudes toward FGM/C. We recommend a systematic approach to health promotion that addresses FGM/C’s deep socio-cultural and economic, religious underpinnings of FGM/C in Pusiga. The insider–outsider continuum in feminist research provides a powerful approach to producing knowledge on contextual factors that account for FGM/C in particular settings.

My Body, My Culture: Understanding Body Image Concerns Among West African Immigrant Women.

Few studies have focused on the impact of body image disturbance on mental health among African immigrant women, particularly as it pertains to female genital mutilation/cutting (FGM/C). This study surveyed 231 West African immigrant women in New York city with and without FGM/C experience and investigated each group's level of body image disturbance and its relation to mental health (i.e., well-being, psychological distress, and PTSD). Body image concerns of FGM/C-experienced women were centered on genital disturbance, whereas the concerns of non-FGM/C women were mostly weight-related. Regression analysis revealed that greater genital image disturbance in FGM/C-experienced group and body image disturbance in non-FGM/C group significantly related to lower well-being and higher psychological distress and PTSD, with stronger relationships appearing in FGM/C-experienced group. This study brings to the fore West African immigrant women's body-related concerns and its potential impact to mental health in the context of acculturation, and suggests the importance of culturally informed interventions for African immigrant women who face body image concerns.

Attitude and intention of migrant populations in the Netherlands regarding female genital mutilation/cutting

BackgroundDue to migration, the practice female genital mutilation/cutting (FGM/C) has become an issue of concern in high-resource countries such as the Netherlands. It was therefore of utmost importance to explore the attitude and intention of migrant populations in the Netherlands towards FGM/C, which may be leveraged to promote its elimination. Therefore, the aim of the present study was to explore the attitude and intention of migrant populations in the Netherlands regarding FGM/C.MethodsA qualitative study design was employed using Theory of Planned Behaviour (TPB) as a framework for the analysis. Data were collected using focus-group discussions (FGDs) and individual interviews. The FGDs and individual interviews were audio-recorded and transcribed verbatim. The main topics of the interviews were based on the constructs of TPB (attitude, subjective norms, perceived behavioral control and intention). Thus, concerning the development of categories, we opted for a hybrid form using a deductive as well as an inductive approach.ResultsA total of 55 participants, 15 men and 40 women (9 born in the Netherlands) participated in the study. The findings showed that as a result of migration and regardless of country of origin and gender, many participants have changed their attitudes towards the abandonment of FGM/C. None of the participants intended to have FGM/C performed on their daughters. Generally, the social pressure to perform FGM/C seems to be lower in the Netherlands when compared to the country of origin. Most participants felt confident in their ability to resist social pressure. However, some participants feared that they might succumb to social pressure or feared that their daughters would undergo FGM/C without their consent.ConclusionThis study aimed to explore the attitude and intention of migration populations in the Netherlands regarding FGM/C. Our findings showed that the study participants had no intention to perform FGM/C on their daughters. As a consequence of acculturation process, interest in the practice of FGM/C could wane following migration. Nonetheless, some pressure to perform FGM/C still exists after migration. Newly arrived migrants and those more vulnerable to social pressure, may benefit from educational interventions that increases knowledge and awareness about various aspects of the practice, with an emphasis on empowering those individuals in facing social pressure.

Somalian women with female genital mutilation had increased risk of female sexual dysfunction: a cross-sectional observational study

Studies regarding the impact of female genital mutilation/cutting (FGM/C) on sexual function are scarce. This study is the first to explore the rate of female sexual dysfunction (FSD) among Somalian women who underwent FGM and its association with different FGM types. This study was carried out among women with a history of FGM who visited our clinic for a medical check-up. It relied on data including socio-demographic features, type of FGM determined by an examination, and the Female Sexual Function Index (FSFI) scores. Overall, 255 women were included. While 43.9% (n = 112) of the respondents had a history of Type 3 FGM, 32.2% had Type 2 (n = 82), and 23.9% had Type 1 (n = 61) FGM. Among all patients, 223 had FSD (87.6%). There was a significant association between the FGM type and FSD (p < 0.001). The mean total FSFI score for the patients with Type 1, 2, and 3 FGM was 22.5, 19.7, and 17.3, respectively, all indicating FSD. The FSD is prevalent among mutilated Somalian women. Patients with Type 3 FGM had the lowest mean total FSFI scores indicating that the impact on sexual function was correlated with the extent of tissue damage during FGM.

Contribution of between region and neighborhood variation of socioeconomic factors on the practice of female genital mutilation/cutting: a multilevel analysis of Tanzanian national surveys.

This study aimed to assess to what extent differences in socioeconomic factors between regions correlate to dramatic disparities in the prevalence of female genital mutilation/cutting (FGM/C) across Tanzania. The data from the 2004, 2010, and 2016 Tanzania Demographic Health Surveys were used in this analysis. The estimates from multilevel variance components for FGM/C were compared before and after adjusting for socioeconomic variables (residence, marital status, education, and wealth quintile) and age. The three-level structure of the sample sorted women into individual (level-1), neighborhood (level-2), and regional (level-3) categories. The pooled data included a total of 27587 women of reproductive age with a median age (IQR) of 29 (21-36) years. The random-effects results revealed that of the total age-adjusted variance in FGM/C, 76.7% was attributed to the between region and neighborhood differences. Despite the large between region variations, only 3.7% was explained by socioeconomic factors. Despite the large contribution of between region and neighborhood differences to variance in FGM/C prevalence, less of this variation was explained by socioeconomic factors. Therefore, it is possible that maternal and reproductive educational programs tailored to such neighborhood differences, beyond socioeconomic factors alone, could contribute to a radical shift in perspective for regions with high prevalence.

Female genital mutilation/cutting and birthing: Enhanced education and training is critical for health care providers

While the World Health Organization calls for a universal ban on female genital mutilation/cutting (FGM/C), 200 million women and girls around the world are affected by the ongoing practice [1]. Physicians in high-income countries will encounter patients with FGM/C more frequently. For example, in 2021, over half of the top ten countries of origin for […]

Acceptability of a Smartphone Application to Enhance Healthcare to Female Genital Mutilation Survivors in Liberia: A Qualitative Study.

In Liberia, female genital mutilation/cutting (FGM/C) is a legally allowed initiation ritual in the secret Sande society. Due to the secrecy, Liberian healthcare providers receive little education on FGM/C and its health consequences. As mobile learning approaches proved to efficiently increase providers’ knowledge and skills, a mobile application (‘app’) was designed to support self-learning, decision-making, and the follow-up of FGM/C survivors’ health. The ‘app’ was introduced in a capacity-building project in 2019 and evaluated through this qualitative study to assess healthcare provider’s needs and acceptance. We conducted 22 semi-structured interviews and eight focus group discussions with 42 adult healthcare providers in three Liberian counties. A thematic approach grounded in descriptive phenomenology guided data analysis and led to three main themes: the ‘app’, mobile learning and health education, and personal impression. Healthcare providers judge the ‘app’ useful to broaden their knowledge and skills, which might lead to better FGM/C detection and management. The ‘app’ might further facilitate patient and community education about the negative health consequences of FMG/C, possibly contributing to a reduction of FGM/C prevalence.

Female Genital Mutilation/Cutting and Breastfeeding Outcomes: The Modifying Effects of Healthcare Access and Women’s Attitudes to FGM/C

The prevalence of female genital mutilation/cutting (FGM/C) in Nigeria is on the rise, although the practice has no known medical/health benefits. This study aims to assess FGM/C’s effect on breastfeeding outcomes and to identify the role of women’s attitudes and their access to healthcare services on these relationships. Associations between FGM/C and breastfeeding outcomes were measured using multi-logistic regression. About 32% of women underwent FGM/C, and 23% believed FGM/C should continue. Women exposed to FGM/C were less likely to initiate early breastfeeding (OR = 0.56, [95% CI = 0.47–0.66]) or to breastfeed exclusively (0.64, [0.57–0.73]). FGM/C acceptance reduced odds of early initiation of breastfeeding (0.57, [0.45–0.73]) (p for interaction &lt; 0.001) and exclusive breastfeeding (0.65, [0.59–0.78]) (p for interaction &lt; 0.001). Four or more antenatal care visits while pregnant modified the associations between FGM/C and early initiation (1.55, [1.26–1.90) (p for interaction &lt; 0.001) or exclusive breastfeeding (2.01, [1.73–2.330]) (p for interaction &lt; 0.001), respectively. FGM/C is associated with breastfeeding outcomes, but this association may be improved with healthcare access and attitudinal changes towards FGM/C. Targeted public health education interventions raising awareness about FGM/C and breastfeeding and policy changes increasing access to prenatal healthcare services in underserved areas are recommended.

Management of Female Genital Mutilation/Cutting-Related Obstetric Complications: A Training Evaluation.

Although female genital mutilation/cutting (FGM/C) is a prevalent practice in Liberia, healthcare workers lack the capacity to provide adequate care for FGM/C survivors. Therefore, Liberian nurses, physician assistants, midwives and trained traditional midwives were trained in sexual, obstetric and psychosocial care for FGM/C survivors in 2019. Through questionnaires, we assessed knowledge acquisition, trainee attitudes towards FGM/C care and acceptability to implement WHO-endorsed recommendations. The questionnaires were analyzed using descriptive statistics for quantitative data and an inductive approach for qualitative data. A total of 99 female and 34 male trainees participated. Most trainees perceived FGM/C as harmful to women’s health, as a violation of women’s rights and showed a willingness to change their clinical practice. While 82.8% (n = 74/90) perceived their role in advocating against FGM/C, 10.0% (n = 9/90) felt that they should train traditional circumcisers to practice FGM/C safely. The pre-training FGM/C knowledge test demonstrated higher scores among physician assistants (13.86 ± 3.02 points) than among nurses (12.11 ± 3.12 points) and midwives (11.75 ± 2.27 points). After the training, the mean test score increased by 1.69 points, from 12.18 (±2.91) points to 13.87 (±2.65) points. The trainings successfully increased theoretical knowledge of FGM/C-caused health effects and healthcare workers’ demonstrated willingness to implement evidence-based guidelines when providing care to FMG/C survivors.

What makes a woman? Understanding the reasons for and circumstances of female genital mutilation/cutting in Indonesia, Ethiopia and Kenya

This study presents the reasons for, and circumstances of, female genital mutilation/cutting (FGM/C) in Indonesia, Ethiopia and Kenya. Data were collected in 2016 and 2017 by means of a household survey conducted with young people (15–24 years) and through focus group discussions, in-depth interviews and key informant interviews with youth and community stakeholders. The study findings confirm previously documented reasons for FGM/C, noting that these reasons are interconnected, and are rooted in gender norms. These reasons drive the alterations of bodies to produce a ‘cultured’ body in the form of the ‘pure body’ among Sundanese and Sasak peoples in Indonesia, the ‘tame’ body among the Amhara people in Ethiopia and the ‘adult body’ among the Maasai people in Kenya. While health workers and parents are important decision-makers in each setting, young Maasai women are, at times, able to exercise their agency to decide whether to undergo FGM/C, owing to their older age at circumcision. Changing legal and social contexts in each setting have brought about changes in the practice of FGM/C such as increased medicalisation of the procedure in Indonesia. The clear links between the different drivers of FGM/C in each setting demonstrate the need for context-specific strategies and interventions to create long-lasting change.

Contending with Health Outcomes of Sanctioned Rituals: The Case of Puberty Rites

This paper explores the rites of passage rituals as the loci of health outcomes. It highlights how religiously sanctioned practices play a central role in healthcare in defiance of the perceived private and public dichotomy that dominates the modern secular mindset. Highlighted in the chapter are African rites of passage, specifically breast “ironing”, female genital mutilation/cutting (FGM/C), and child marriage. Drawing from findings of a survey of 50 respondents, the chapter illustrates how these practices exemplify how rituals invoke health concerns in Africa and amongst Africans in the diaspora. The elevation of scientific knowledge and the privatization and categorization of religious knowledge as non-scientific in the mid-19th century resulted in the separation of the cure for the physical body from the spiritual factors, thus eliciting statements like “medicine is secular” and “religion is sacred and private.” In reality, however, medicine and religion have been interwoven for centuries and ancient holistic paradigms of healthcare have been present in many cultures even as society has modernized.