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Table 5 Health professionals’ attitudes towards FGMC

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

Reference Country Beliefs about the reasons for performing FGM/C Support for and intentions for performing FGM/C Beliefs and attitudes about the law and educational needs
Publications from African Countries
 Ashimi et al. 2014 [21] Nigeria 53 % - prevent promiscuity 4 % would support FGM/C NRa
28 % - preserve virginity 4 % would perform FGM/C
16 % - socio-cultural acceptance 4 % of respondents (all women) would allow daughters to undergo FGM/C
10 % - religious reasons
8 % - medically beneficial
 Kaplan et al. 2013 [22] Gambia 54 % - mandatory religious practice 43 % - were supportive of the continuation of FGM/C practice NR
48 % - cultural practice 47 % - intended to subject their daughters to FGM/C
14 % - preserve virginity 43 % - medicalising FGMC would make the practice safer
1 % - it does not violate human rights 73 % - Health care workers have a role in eliminating FGMC
55 % – FGM/C cannot be eliminated in The Gambia
78 % - men should be involved in the debate about FGM/C
13 % - girls that have not undergone FGM/C should be discriminated against
 Ali et al. 2012 [23] Sudan 51.2 % - cultural 19 % - all forms of FGM/C are harmful NR
26 % - religious 76 % - only some forms are harmful
23 % - economic 5 % - all forms are not harmful
 Dike et al. 2012 [24] Nigeria 51 % - prevent promiscuity 100 % would NOT have their daughters undergo FGM/C To stop FGM/C:
47 % - appearance of external genitalia   81 % - Public enlightenment needed
27 % - tradition   25 % - Counselling of parents
11 % - initiation into womanhood   7 % - punishing any person who aids or abets the practice
7 % - spiritual satisfaction
 Rasheed et al. 2011 [25] Egypt 100 % - senior physicians believed FGM/C prescribed by religion Nurses: NR
97 % - young physicians believed FGM/C prescribed by religion 88 % - supported the practice of FGM/C
88 % - nurses believe it is a traditional practice 48 % - would have their daughters undergo FGM/C
28 % - had their daughters undergo FGM/C
Young Physicians:
34 % - supported the practice of FGM/C
Senior physicians:
15 % - supported the practice
 Refaat 2009 [26] Egypt 82 % - do NOT approve of the practice 18 % - supported practice; reasons for continuing practice included: 91 % - FGM/C and complications should be taught at medical school
Those practising in the Upper Egypt area, those from rural areas and those with a diploma (rather than PhD or Fellowship) were more likely to approve the practice of FGM/C • Convinced of benefit 40 % believed that physicians are the most appropriate to perform FGM/C
• Profit 35 % did NOT approve of the law banning FGM/C
• Harm reduction
82 % - did NOT approve of the practice for the following reasons:  
18 % - supported practice for religious or customary reasons 75 % - reduced sexual pleasure
64 % – pain
61 % - bad habit
52 % - not religious practice
49 % - causes health problems
48 % - against women’s dignity
 Mostafa et al. 2006 [27] Egypt 51 % - NO medical reason for performing FGM/C 43 % - unethical for a health professional to damage a healthy body 50 % - medicalization is the first step to prevention of the practice
45 % - FGM/C is a violation of human rights 65 % - FGM/C is NOT a health issue 23 % - believed that the law is enough for prevention
34 % - FGM/C is essential part of culture 32 % - would subject their future daughters to this practice 53 % - believe that laws must go hand in hand with community education
24 % - FGM/C prevents external genitalia from growing 58 % - would NOT object if family members were to subject their daughters to FGM/C
20 % FGM/C ensures a girl’s virginity 73 % - FGM/C should be medicalised
49 % - prevents promiscuity 91 % - medicalization favourable because it reduces pain; carried out under hygienic conditions and with anaesthetic
30 % - FGM/C is a religious obligation
86 % - believed that FGMC is practiced only by Muslims
 Onuh et al. 2006 [28] Nigeria 9 % - decreases promiscuity 4 % - will have their own daughters undergo FGMC 92 % - FGM/C should be legislated against
10 % - makes genitalia more attractive 3 % - FGM/C is a good practice
Other reasons: − cultural; financial; patient safeguarding from “traditional circumcisers” 3 % - will encourage FGM/C
24 % - some forms of FGM/C are not harmful
Publications from “Western Countries”
 Purchase et al. 2013 [30] UK 76 % - cultural reasons NR NR
16 % - religious reasons
 Relph et al. 2013 [31] UK 100 % - cultural reasons 9 % - FGM/C should be medicalized to reduce complications 87 % - would warn social services of a child in danger of FGM/C
18 % - would support a woman’s request for re-infibulation after birth if this was legal in the UK
 Moeed et al. 2012 [20] Australia and New Zealand NR 21 % - O&G specialists believed that in the women and girls with FGMC seen by them, the FGM/C was probably done in Australia (but they did not provide number estimates) NR
42 % of the FGM/C workers believed that the women and children with FGMC probably had the procedure performed in Australia/NZ
26 % of FGMC/C workers believed that children were being taken out of Australia to attend family celebrations and to have FGM/C done overseas
 Kaplan-Marcusan et al. 2009 [33] Spain 50 % - traditional reasons NR 2001 -1 % said ignore the problem
16 % - religious reasons   48 % - educate
32 % - educate and report
19 % - report to authorities
2004 – None said ignore
49 % - educate and report
27 % - educate
24 % - report to authorities
 Leye 2008 [34] Belgium NR 86 % - FGM/C is a form of violence against women 21 % - believed that FGM/C performed by a medical practitioner would reduce harm
61 % - FGM/C is a violation of human rights 48 % - wanted more clarity around ethico-legal issues
7 % - FGM/C should be respected because of cultural and religious beliefs
77 % - considered re-infubulation as a form of FGM/C
19 % - would re-infibulate if requested by the woman
47 % - a symbolic incision was a good alternative to FGM/C
15 % - Genital piercings and vaginal cosmetic surgery considered a type of FGM/C
  1. aNR = Not reported