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 |