Eliminating Female Genital Mutilation: An Interagency Statement

This 48-page report, published by the World Health Organization, is a call to all states, international and national organisations, civil society, and communities to uphold the rights of girls and women. It also calls on those bodies and communities to develop, strengthen, and support specific and concrete actions directed towards ending female genital mutilation (FGM). According to the statement, while there are positive signs, prevalence in many areas remains high, and there is an urgent need to intensify, expand, and improve efforts if FGM is to be eliminated within one generation. To reach this goal, increased resources, coordination, and cooperation are needed to bring about positive social change.

The statement argues that, although much effort has been made to counteract FGM (and, in some countries, the practice has declined), in many areas prevalence remains high. Drawing on experience from interventions in many countries, this statement describes the elements needed - both for working towards complete abandonment of FGM and for caring for those who have suffered from its consequences. Experience over the past two or three decades has shown that there are no quick or easy solutions. The elimination of FGM requires a strong foundation that can support successful behaviour change and address the core values and enforcement mechanisms that support the practice.

According to the report, lessons learned from other initiatives indicate that actions and interventions must be multisectoral, sustained, and community-led. The abandonment of FGM on a large scale results from a process of positive social change. It requires a significant number of families within a community to make a collective, coordinated choice to abandon the practice so that no single girl or family is disadvantaged by the decision. Programmes that include "empowering" education and debate, public pledges, and organised diffusion have been shown to bring about the necessary consensus for sustained abandonment of FGM. The activities encourage communities to raise problems and define solutions - themselves regarding a variety of concerns, including sensitive ones such as FGM - without feeling coerced or judged. Different methods can be used to create a space for open and reflective dialogue, including intercultural dialogue that investigates cultural variations within and between communities as well as aspects of cultural change. Such methods have been shown to be particularly effective when they raise and stimulate discussion on human rights principles.

The report argues that national-level actions are also a part of FGM abandonment, as social change within communities can be hindered or enhanced by activities at the national level. The report looks at the role that various actors need to play, including media, governments, local parliamentarians, professional, religious and non-governmental organisations, traditional and religious leaders and circumcisers, and health care providers. The media can play a crucial role - both in bringing correct information to households and in informing people about positive social change that may be taking place in communities. This is particularly important when discussion of FGM is considered taboo. Information activities should be designed for local needs and concerns and should provide information on a wide range of issues, including child and women's rights, facts on female sexual organs and functions, consequences of FGM, and ways individuals and communities can combat the practice.

In addition, the report states that training and capacity building is needed. Training must be comprehensive in terms of the range of people trained and the range of topics covered. Continued research is also needed, particularly on: the dynamics of social and cultural change that lead to abandonment; the prevalence of immediate health complications; girls' experiences of the practice; and psychological consequences of FGM. Capacity building is also needed on: care procedures for girls and women; birth care procedures that might reduce the harmful consequences of the practice for mothers and babies; the impact of legal measures to prevent FGM; and the medicalisation of the practice.

The report calls on various actors to play their role in eradicating FGM. For example, the authors argue that professional organisations such as medical associations and nursing councils can promote ethical guidelines in medical training and in practice. Associations for teachers, lawyers, social workers, and others can also contribute towards eliminating FGM within their respective fields through activities such as lobbying, advocacy, and conducting appropriate training activities. Health care providers can play a key role in preventing FGM and in supporting and informing patients and communities about the benefits of eliminating it.

The report concludes that application of existing knowledge through a common, coordinated approach that promotes positive social change at community, national, and international levels could lead to FGM being abandoned within a generation, with some of the main achievements obtained by 2015, in line with the Millennium Development Goals.