.Considers fgm/c to be a mandatory religious practice (a). in the gambia, the impact of fgm/c was assessed through a recent clinical study conducted by the authors of the present study, where we found that one out of three girls and women suffered injuries as a consequence of this practice . fula and mandinka hcps prioritised the fact that fgm/c is mandatory by islam (58. other given reasons include the fact that fgm/c is a rite of passage (34. in the short-term, fgm/c might lead to shock, haemorrhage, infections, and psychological consequences, while in the long-term, it can cause chronic pain, infections, keloids, fibrosis, primary infertility, an increase in delivery complications, and psychological sequela/trauma [2–7]. this has mostly been explored among western hcps working in hospitals and primary health care centres located in receptor countries of african migrants, such as spain, the uk, switzerland, sweden, belgium, australia, and the usa [21–28], indicating knowledge gaps concerning the health and legal issues of fgm/c. additionally, more men than women considered that fgm/c has no consequences (3. findings show a concerning rate of support towards fgm/c among gambian hcps, as well as a tendency for medicalisation. attitudes towards those who do not undergo fgm/c were found in 12. male and female hcps receive the same training at health schools, but by the time that this study was conducted, fgm/c was not included in their academic curriculum.-sex analysis showed that female and male hcps also had similar opinions on the main three reasons given for fgm/c to be performed, although there were some nuances. assessment of hcps’ knowledge on fgm/c was performed by exploring the reasons given for the practice to be performed, as well as through acknowledging hcps’ awareness of its health consequences. to the world health organisation (who) , female genital mutilation/cutting (fgm/c) includes all procedures involving partial or total removal of the external female genitalia, or injury to the female genital organs, for non-therapeutic reasons. a considerable percentage of hcps were able to recognise the negative impact of fgm/c on the health of girls and women. this study seeks to contribute to this field of knowledge by examining the knowledge, attitudes, and practices regarding fgm/c among hcps working in rural settings in the gambia. therefore, it is understandable that wolof and serer hcps were found to be the most prominent groups considering the deep cultural roots of tradition as the major reason for the perpetuation of fgm/c. study showed that a considerable proportion of gambian hcps working in rural areas embraced the continuation of fgm/c..Do you think hcp workers have a role to play in eliminating fgm/c? a lot more hcps might have been exposed to fgm/c health consequences without being able to connect the complications with this practice.
this interpretation is supported by previous studies that have shown an association of fgm/c practices with low education levels [37, 38]. when asked if hcps have a role to play in eliminating fgm/c, 73. mandinka respondents were also less eager regarding the idea of having hcps playing a role in eliminating fgm/c. regard to fula and mandinka hcps, the mandatory requirement according to religion primarily encourages and legitimises the continuation of fgm/c. additionally, more men than women considered that fgm/c has no consequences (3. this was reported by male and female hcps, showing that, in a medical setting, fgm/c is no longer reserved only to women..As a health care provider, have you ever carried out fgm/c on a girl? ali’s study , conducted among midwives in eastern sudan, showed that they did not consider the practice of fgm/c to be harmful and insisted on continuing it for cultural reasons.% of hcps reported that fgm/c is practiced in their family/household. fgm/c is considered as a critical component of the process of socialisation and essential in the distinction between sexes as necessary opposites in the community, and it is linked with the two fundamental values that shape african life: sense of community and sex complementarity . male and female hcps receive the same training at health schools, but by the time that this study was conducted, fgm/c was not included in their academic curriculum. attitudes towards the continuation of fgm/c, possible strategies for preventing it (including the role that can be played by hcps and islamic leaders), its medicalisation, the discrimination of girls who do not undergo fgm/c, and the involvement of men in the debate were examined. the who estimates that 140 million women and girls in the world have been victims of some form of fgm/c, and that each year, 3 million girls are subjected to, or at risk of being subjected to, this harmful traditional practice. limited access to quality health care services, which is reflected by gambia’s high rates of childa and maternalb mortality [18–20], affects the well-being of those experiencing fgm/c-related complications.% of girls and women have been subjected to fgm/c, which is neither prohibited nor punished by law. strategies to prevent the practice, mandinka, djola, and fula hcps were less eager for the idea of religious leaders preaching against fgm/c, with this strategy finding the strongest support among wolof (71. they also intended to carry on with this practice by subjecting their own daughters to fgm/c, with some of them reporting to have already performed it during their medical practice. were designed to measure the attitude of hcps towards the practice of fgm/c as follows: the feasibility of its elimination; different strategies to prevent fgm/c (including the role that can be played by islamic leaders and by hcps themselves); medicalisation; discrimination towards those who do not undergo fgm/c; and the involvement of men in the debate. study aimed to examine the kap of fgm/c of gambian hcps working in rural settings.
% for fgm/c, which increases almost up to universal rates in some regions, only 40.% of the respondents viewed medicalisation as a way of encouraging fgm/c and 40.% of male hcps considered that men should participate in the debate surrounding fgm/c, suggests their willingness to do so.% of hcps admitting to having performed fgm/c in girls.%) considered that men should be concerned about the debate on fgm/c. a considerable decrease was observed between the rates of reported practice of fgm/c in the family/household of hcps and the intention of future practice on their daughters. findings illustrate the importance of further exploring the kap of hcps in other countries where fgm/c is practiced to develop accurate and culturally sensitive methodologies for designing efficient training programmes. however, fgm/c is also found in europe, australia, and the usa, to where migrants brought their culture. practices concerning fgm/c were assessed by investigating if fgm/c was performed in the hcps’ family/household, if they intended to subject their own daughters to fgm/c, and if they had ever performed fgm/c during their medical practice.% of hcps reported that fgm/c is practiced in their family/household. more women than men carried out fgm/c during their medical practice (7. a culturally and gender sensitive training programme might contribute to social change, promoting the abandonment of fgm/c, avoiding medicalisation, and ensuring accurate management of its health consequences. fgm/c is recognised internationally as a violation of the human rights of girls and women, constituting an extreme form of gender discrimination with documented health consequences. therefore, a plausible explanation for the increased awareness revealed by women is that they, by knowing how fgm/c is performed, are also able to realise how it changes female genitalia. we found that women exhibited a more discriminatory attitude towards girls who had not undergone fgm/c and were more aware than men of the powerful force that lies beneath its tradition, when considering its deep cultural roots as the main reason for its perpetuation. the complexity of the fgm/c issue is evident from the contradictory positions assumed by the women in this study, and these must be recognised and addressed. other given reasons include the fact that fgm/c is a rite of passage (34..Do you think that girls that have not undergone fgm/c should be discriminated? all types of fgm/c have consequences that undermine the health and well-being of newborns, girls, and women, exposing a situation that deserves attention in the world’s sexual and reproductive public health agenda.
% of hcps confirming to have performed fgm/c on girls.% of all hcps had seen a girl with fgm/c-related complications raises concern, taking into consideration that an estimated 76.  showed that medical knowledge on fgm/c was limited in nurses and their tendency was to support its continuation. women showed less approval for continuation of fgm/c and higher endorsement of the proposed strategies to prevent it than men. answers of gambian hcp about consequences on health of fgm/c. prevalence rates of fgm/c are significantly different between ethnic groups. however, although a new line of research on how men perceive and relate to fgm/c has already been initiated, men’s kap towards this “female” practice have scarcely been addressed..Do you think hcp workers have a role to play in eliminating fgm/c? the medical students attended 1 week of training on fgm/c and social research skills (including data collection, entry and analysis, as well as proposal development) by a team consisting of a medical anthropologist, a biostatistician, and a medical doctor. regard to men, fgm/c appears to be viewed from a moral perspective. study showed that a considerable proportion of gambian hcps working in rural areas embraced the continuation of fgm/c. in this sense, fgm/c grants women a special value, by attesting their femininity and making them worth inclusion in their social network. identity also confines the intention expressed by hcps to have fgm/c performed on their own daughters. genital mutilation/cutting (fgm/c) is a harmful traditional practice with severe consequences for the health and well-being of girls and women. in line with the most recent studies conducted in the gambia [13, 33, 36], our findings showed that fgm/c is not homogeneously practiced. when asked if they consider fgm/c to be mandatory by religion, 40. strategies to prevent the practice, mandinka, djola, and fula hcps were less eager for the idea of religious leaders preaching against fgm/c, with this strategy finding the strongest support among wolof (71. a culturally and gender sensitive training programme might contribute to social change, promoting the abandonment of fgm/c, avoiding medicalisation, and ensuring accurate management of its health consequences. an inverse relationship was found between hcps’ reported rates of intention to subject their daughters to fgm/c and rates of exposure to fgm/c health consequences.
this was confirmed in a recent encounter for policy dialogue between religious leaders and international organisations working towards the prevention of fgm/c, organised by the gambian women’s bureau, and attended by one of the authors, in september 2012.% of gambian girls and women have been subjected to this practice, and that in some regions, fgm/c prevalence rates are almost universal (99% in basse, upper river region). this might explain the highest resistance of female hcps to the inclusion of men in the debate on fgm/c. significant proportion of gambian hcps working in rural areas embraced the continuation of fgm/c (42. in many societies, fgm/c has become the physical proof that confirms that a girl has been initiated through a rite of passage to adulthood, confirming her femininity and ensuring that she has received all the necessary teachings to be worthy to belong in the community. we found that women exhibited a more discriminatory attitude towards girls who had not undergone fgm/c and were more aware than men of the powerful force that lies beneath its tradition, when considering its deep cultural roots as the main reason for its perpetuation. prevalence rates of fgm/c are significantly different between ethnic groups. fula and mandinka hcps prioritised the fact that fgm/c is mandatory by islam (58. knowledge on fgm/c health consequences (including exposure), reasons given for performing this practice, and its mandatory character in relation to religion, were examined. however, the fact that almost all hcps are aware of fgm/c health complications and that a substantial amount (42.%) believed that fgm/c should continue to be practiced, although this opinion was more commonly shared among traditionally practicing ethnic groups. women’s gender identity depends on this special value, women ensure its transmission in a ceremony that encloses the practice of fgm/c with secrets, and fgm/c becomes part of the “women’s world”. this may also be connected with the differences found regarding the awareness of the health consequences of fgm/c..Do you think that the practice of fgm/c can ever be eliminated in the gambia? therefore, it is crucial to reach an accurate understanding of the knowledge, attitudes and practices (kap) of hcps towards the practice of fgm/c to envision effective strategies for their involvement. these circumstances, health care professionals (hcps) play an important role in fgm/c. however, the fact that almost all hcps are aware of fgm/c health complications and that a substantial amount (42.% of all hcps had seen a girl with fgm/c-related complications raises concern, taking into consideration that an estimated 76.% of hcps confirming to have performed fgm/c on girls.