Skip to main content

Advertisement

Table 4 Health professionals’ reported knowledge about FGMC

From: Female genital mutilation and cutting: a systematic literature review of health professionals’ knowledge, attitudes and clinical practice

Reference Country Knowledge of FGM/C ; FGM/C types ; high risk groups Knowledge about complications Knowledge about legislation / clinical guidelines
Publications from African Countries
 Ashimi et al. 2014 [21] Nigeria 91 % - had heard of FGM/C 77 % - haemorrhage NRa
40 % - did not know any of the 4 types 73 % - transmission of infectious disease (HIV, hepatitis and tetanus)
49 % identified “Angurya and Gishiri”b as forms of FGM/C 63 % - sexual dysfunction
54 % - difficult birth
48 % - epidermal cysts
 Kaplan et al. 2013 [22] Gambia NR 53 % - haemorrhage NR
59 % - transmission of infectious disease
46 % - difficult birth
25 % - sexual dysfunction
21 % - affects health and welfare of women and girls
 Ali et al. 2012 [23] Sudan 7 % - identified all 4 types correctly 46 % - transmission of infectious disease (HIV) 25.5 % - FGM/C is illegal
545 % - identified type 1 correctly 64 % - sexual dysfunction 74.5 % - FGM/C is legal
29 % - infertility
 Dike et al. 2012 [24] Nigeria NR 86 % - haemorrhage 100 % - FGM/C is banned in some states
84 % - transmission of infectious disease (HIV) 96 % - FGM/C is a crime against humanity
27 % - difficult birth
7 % - sexual dysfunction
 Rasheed et al. 2011 [25] Egypt NR 66 % - knew about complications of FGM/C NR
 Refaat 2009 [26] Egypt 76 % - know the type usually performed in Egypt (type II) 75 % - haemorrhage NR
70 % - sexual dysfunction
64 % - shock
63 % - genital disfigurement
14 % - NO complications (if done by a physician or gynaecologist)
 Mostafa et al. 2006 [27] Egypt 52 % - correctly identified type I 62 % - aware that FGMC can cause complications including: 17 % - knew Egyptian law which states that FGM/C cannot be performed by a non-physician
30 % - identified type II 48 % - short-term physical 28 % - reported that FGM/C violates the medical ethical principles of “do no harm” and “no not kill”
5 % - identified type III 39 % - long term physical
62 % - psychosocial complications
59 % - sexual dysfunction
 Onuh et al. 2006 [28] Nigeria 100 % - identified at least one type of FGMC 98 % - haemorrhage NR
38 % - identified Type I and Type II ONLY as FGM/C 81 % - transmission of infectious disease
7 % - identified all 4 types correctly 54 % - transmission of HIV
80 % - difficult birth
55 % - scars and keloid formation
21 % - infertility
59 % - sexual dysfunction
Publications from “Western Countries”
 Caroppo et al. 2014 [29] Italy 9 % - knew that there are different types of FGM/C depending on the woman’s country of origin 5 % - knew how to manage a woman with FGMC 44 % - knew that Italy has a law prohibiting FGMC practice
 Purchase et al. 2013 [30] UK NR 92 % - identified each of the long term complications 94 % - FGM/C always illegal in the UK
75 % - HIV/hepatitis risk 79 % - were aware of the FGM/C Act
74 % - pelvic infection 84 % - knew to contact a child protection officer if they thought a child was at risk
10 % - associated psychiatric syndromes
To prevent complications during labour:
74 % - knew that defibulation should take place pre-conception
31 % - knew that defibulation is recommended at ~ 20 weeks pregnancy
52 % - unaware of referral pathways
 Relph et al. 2013 [31] UK 100 % - aware of the practice of FGM/C 76 % - haemorrahge 72 % - aware of UK legislation on FGM/C
58 % - knew there are 4 types of FGM/C 32 % - knew that defibulation should be performed before pregnancy to avoid complications 89 % - family/religious figure performing FGM/C in UK is illegal
93 % of senior doctors   77 % - UK doctor performing FGM/C in UK is illegal
50 % of junior doctors 67 % - reinfibulation after delivery is illegal
40 % - confident in diagnosing FGM/C 78 % - sending a child abroad for FGM/C is illegal
 Hess et al. 2010 [32] USA 18 % - knew that both Muslim and Christian women may have FGM/C 71 % - of nurse midwives who did not have direct experience with FGMC knew about FGMC complications , compared with 89 % of those who had direct experience 56 % - knew that it is illegal to perform FGM/C in girls and young women aged <18 years
39 % - knew FGM/C is NOT required by either religion Over a half of respondents did not know that circumcised women avoid health care due to stigma and legal implications
Nurse midwives with direct practice experience of FGM/C scored better on a knowledge test
 Kaplan-Marcusan et al. 2009 [33] Spain 97 % knew what FGM/C is NR 20 % - aware of protocols or guidelines
Able to identify the 4 types:   42 % - of paediatricians aware of protocols or guidelines
41 % - of all professionals
68 % - of O&G
55 % - of paediatricians
38 % - general medicine
79 % - said they knew high risk countries
22 % - actually able to identify the high risk countries
 Leye 2008 [34] Belgium NR NR 46 % - knew that FGM/C was illegal in Belgium
24 % - knew which types of FGM/C were included under the law
1 % (4 respondents) - knew of guidelines and information about FGM/C in their hospital
 Zaidi et al. 2007 [35] UK 98 % - knew what FGMC was 84 % - knew of complications associated with FGMC 40 % - knew the details of the UK FGM/C Act
42 % - knew that there were different types of FGMC 70 % - knew that the best time for defibulation was before pregnancy (if FGMC diagnosed before pregnancy)
4 % - correctly classified the 4 types 80 % - knew that defibulation should be done during pregnancy if diagnosed during pregnancy
84 % - knew the high risk groups 54 % - knew that an anterior episiotomy should be performed if the woman is in the 2nd stage of labour
58 % - were NOT aware that women at risk should be identified during antenatal visits
 Tamaddon et al. 2006 [36] Sweden 28 % - said they had adequate knowledge about FGM/C NR NR
20 % - of paediatricians said they had adequate knowledge about FGM/C
 Jager et al. 2002 [37] Switzerland NR NR Representatives from the Departments of Health in each Canton, did not know of any guidelines on FGM/C in their Canton
  1. aNR = Not reported b Angurya: is a form of FGMC type 4 that involves the scraping of tissue around the vaginal opening. Gishiri: is a form of FGMC type 4 where a long knife is inserted into the vagina and backward cuts from the vagina's anterior wall into the perineum are made