This review critically examines the socio-cultural and religious landscape of female genital mutilation (FGM) in Somalia, where the practice remains pervasive despite global condemnation and human rights infringements. With the highest FGM rates globally, Somalia's scenario underscores the complexities of eradicating practices deeply embedded in societal fabric. The purpose of this review is to understand prevailing attitudes towards FGM among various Somali stakeholders and to recalibrate intervention strategies accordingly, with an emphasis on harm reduction as a pragmatic initial approach towards a long-term eradication goal. The review employs a thematic synthesis of qualitative studies to discern Somali communities’ awareness of FGM health risks, ongoing support for the practice, and resistance to its abandonment. It reveals a perceptual shift towards Sunna, a less extreme FGM form, influenced by religious considerations and health awareness, yet still infringing on women's rights. The contentious role of medicalization as a harm-reduction tactic is also discussed, which, while safer, may perpetuate the practice. Overall, the review underscores the necessity for culturally sensitive, community-driven interventions that advocate for collective action against FGM. These interventions should integrate educational efforts, legal frameworks, and redefinition of FGM's socio-cultural importance, aiming for a gradual yet definitive end to the practice.
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