Health care providers' and mothers' perceptions about the medicalization of female genital mutilation or cutting in Egypt: a cross-sectional qualitative study

Background

Female genital mutilation/cutting (FGM/C) is a traditional harmful practice that has been prevalent in Egypt for many years. The medicalization of FGM/C has been increasing significantly in Egypt making it the country with the highest rate of medicalization. In this qualitative study, we explored the drivers and motives behind why healthcare professionals perform FGM/C and why mothers rely on them to perform the practice on their daughters.

Methods

The study drew on a “mystery client” approach, coupled with in-depth interviews (IDIs) and focus group discussions (FGDs) with health care providers (i.e. physicians and nurses) and mothers. It was conducted in three geographic areas in Egypt: Cairo, Assiut and Al Gharbeya.

Results

Study findings suggest that parents who seek medicalized cutting often do so to minimize health risks while conforming to social expectations. Thus, the factors that support FGM/C overlap with the factors that support medicalization. For many mothers and healthcare providers, adherence to community customs and traditions was the most important motive to practice FGM/C. Also, the social construction of girls’ well-being and bodily beauty makes FGM/C a perceived necessity which lays the ground for stigmatization against uncut girls. Finally, the language around FGM/C is being reframed by many healthcare providers as a cosmetic surgery. Such reframing may be one way for providers to overcome the law against FGM/C and market the operation to the clients.

Conclusion

These contradictions and contestations highlighted in this study among mothers and healthcare providers suggest that legal, moral and social norms that underpin FGM/C practice are not harmonized and would thus lead to a further rise in the medicalization of FGM/C. This also highlights the critical role that health providers can play in efforts to drive the abandonment of FGM/C in Egypt.

Electronic supplementary material

The online version of this article (10.1186/s12914-019-0202-x) contains supplementary material, which is available to authorized users.

Knowledge and attitude towards sexual and reproductive health rights and associated factors among Adet Tana Haik College students, Northwest Ethiopia: a cross-sectional study

OBJECTIVE

Sexual and reproductive health rights are the rights of all people regardless of their age, sex and other characteristics to make choices about their own sexuality and reproductive issues. However, little is known about the knowledge and attitude towards SRH rights in Ethiopia. Therefore, this study aimed to assess knowledge and attitude towards SRH rights and associated factors among Adet Tana Haik college students in northwest Ethiopia.

RESULTS

Overall, about 59.6% students were knowledgeable and more than half (53.4%) had favorable attitude towards SRH rights. In this study, students attending third-year class (AOR = 2.20;95% CI 1.29, 3.33), discussion with parents (AOR = 3.35;95% CI 1.61, 6.96), respondent's mothers attended secondary/above school (AOR = 3.01; 95% CI 1.28, 7.13), participation in RH clubs (AOR = 1.72; 95% CI 1.09, 2.70) and favorable attitude towards SRH rights (AOR = 2.41; 95% CI 1.56, 3.74) were significantly associated with knowledge of participants. On the other hand, knowledge of students (AOR = 2.33; 95% CI 1.36, 7.07), participation in RH clubs (AOR = 1.41;95% CI 1.09, 2.20) and discussion with parents (AOR = 2.50; 95% CI 1.15, 5.47) were the predictors for the attitude of students towards SRH rights. Hence, strengthening women's education, encouraging discussions with parents and participation in RH clubs may improve the knowledge and attitude of students towards SRH rights.