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Female genital mutilation as an issue of gender disparity in the 21st century: Leveraging opportunities to reverse current trends.
Ethiopian Medical Journal. 2016 Jul; 54(3):107-108.Add to my documents.
Obstetrics and Gynecology. 2016 Nov; 128(5):958-963.Female genital mutilation comprises all procedures that involve partial or total removal of the external female genitalia or injury to the female genital organs for nonmedical reasons. Health care providers for women and girls living with female genital mutilation have reported difficulties in recognizing, classifying, and recording female genital mutilation, which can adversely affect treatment of complications and discussions of the prevention of the practice in future generations. According to the World Health Organization, female genital mutilation is classified into four types, subdivided into subtypes. An agreed-upon classification of female genital mutilation is important for clinical practice, management, recording, and reporting, as well as for research on prevalence, trends, and consequences of female genital mutilation. We provide a visual reference and learning tool for health care professionals. The tool can be consulted by caregivers when unsure on the type of female genital mutilation diagnosed and used for training and surveys for monitoring the prevalence of female genital mutilation types and subtypes.
African Journal of Reproductive Health. 2008 Apr; 12(1):7-11.Add to my documents.
[Geneva, Switzerland], World Health Assembly, 2008 May 24. 3 p. (WHA61.16; A61/VR/8)This document presents the text of the Sixty-first World Health Assembly agenda item on female genital mutilation.
Eliminating female genital mutilation: an interagency statement. OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO.
Geneva, Switzerland, World Health Organization [WHO], 2008. 41 p.The term 'female genital mutilation' (also called 'female genital cutting' and 'female genital mutilation/cutting') refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. Between 100 and 140 million girls and women in the world are estimated to have undergone such procedures, and 3 million girls are estimated to be at risk of undergoing the procedures every year. Female genital mutilation has been reported to occur in all parts of the world, but it is most prevalent in: the western, eastern, and north-eastern regions of Africa, some countries in Asia and the Middle East and among certain immigrant communities in North America and Europe. Female genital mutilation has no known health benefits. On the contrary, it is known to be harmful to girls and women in many ways. First and foremost, it is painful and traumatic. The removal of or damage to healthy, normal genital tissue interferes with the natural functioning of the body and causes several immediate and long-term health consequences. For example, babies born to women who have undergone female genital mutilation suffer a higher rate of neonatal death compared with babies born to women who have not undergone the procedure. (excerpt)
Coordinated strategy to abandon female genital mutilation / cutting in one generation: a human rights-based approach to programming. Leveraging social dynamics for collective change.
New York, New York, UNICEF, 2007.  p. (Technical Note)The coordinated strategy presented in this technical note describes a human rights-based approach to female genital mutilation/cutting (FGM/C) programming. The note aims to provide guidance to programmers who are supporting large-scale abandonment of FGM/C in Egypt, Sudan and countries in sub-Saharan Africa. To provide a more comprehensive understanding of FGM/C as a social convention, this coordinated strategy includes an in-depth examination of the research documented by the UNICEF Innocenti Research Centre in 'Changing a Harmful Social Convention: Female genital mutilation/cutting', Innocenti Digest. Its focus is limited to the social dynamics of the practice at the community level, and it applies game theory, the science of interdependent decision-making, to the social dynamics of FGM/C. This strategy does not cover everything that occurs at the community level, but rather, looks at the practice from the perspective of a particular type of social convention described by Thomas C. Schelling in The Strategy of Conflict. It introduces an innovative approach to FGM/C programming that is intended to bring about lasting social change. (excerpt)
New York, New York, UNICEF, 2005 Nov.  p.FGM/C is a fundamental violation of human rights. In the absence of any perceived medical necessity, it subjects girls and women to health risks and has life-threatening consequences. Among those rights violated are the right to the highest attainable standard of health and to bodily integrity. Furthermore, it could be argued that girls (under 18) cannot be said to give informed consent to such a potentially damaging practice as FGM/C. FGM/C is, further, an extreme example of discrimination based on sex. The Convention on the Elimination of All Forms of Discrimination against Women defines discrimination as "any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field." Used as a way to control women's sexuality, FGM/C is a main manifestation of gender inequality and discrimination "related to the historical suppression and subjugation of women," denying girls and women the full enjoyment of their rights and liberties. (excerpt)
International Journal of Gynecology and Obstetrics. 2006; 92:5-9.The April 2005 edition of Population Reports provides a detailed summary of the different contraceptive choices that are currently available. The report focuses on effective, less costly, easier to deliver contraceptive innovations that have fewer side effects. While some of the new contraceptives discussed are already available in some countries, others are on the brink of introduction. Some of the new methods covered include vaginal rings, transdermal patches, spray-on contraceptives and new implants. Two new variations on fertility awareness-based methods -- the Standard Days Method and the Two-Day method -- are described. The Standard Days Method is reported to be as effective as barrier methods for women with regular cycles between 26 and 32 days long. The Two-Day method can be used by women with cycles of any length regardless of regularity. It however produces best results in couples who can avoid unprotected intercourse for about 10--15 days per cycle. (excerpt)
Florence, Italy, UNICEF, Innocenti Research Centre, 2005.  p. (Innocenti Digest)This Innocenti Digest is intended to serve as a practical tool to bring about positive change for girls and women. It: analyses the most current data to illustrate the geographic distribution of FGM/C and outlines key trends; identifies the principal ways in which FGM/C violates a girl’s or woman’s human rights, including the serious physical, psychological and social implications of this harmful practice; examines the factors that contribute to perpetuating FGM/C; and outlines effective and complementary action at the community, national and international levels to support the abandonment of FGM/C. On the basis of analysis conducted, there is good reason to be optimistic that, with the appropriate support, FGM/C can be ended in many practicing communities within a single generation. (excerpt)
Progress in Reproductive Health Research. 2005; (67):6.In many parts of the world, certain sexual practices, such as dry sex, douching, and warming and stretching of the labia, are common. However, the epidemiological impact, and the social and cultural meanings of these practices, are not well understood. With the emergence of the HIV pandemic, there has been renewed interest in the role these practices might play in facilitating transmission of HIV, as well as in their potential impact on the effectiveness and acceptability of new products such as microbicides. In addition, it is increasingly recognized that such practices could also compromise the efficacy of some contraceptive methods. Recent studies of rituals associated with sexual initiation in sub-Saharan Africa indicate a greater prevalence of such practices than had previously been documented. However, there is a need for more in-depth research on sexual practices, to explore the full context of both belief and practice, particularly in the context of HIV. (excerpt)
Population 2005. 2002 Mar-Apr; 4(1):1, 8-10.Significant legal and policy provisions and improved access to information have helped women and adolescents in many countries to become aware of their reproductive rights and make informed choices about childbearing. This has resulted in more people in the world using family planning today than ever before. Yet, millions of women still become pregnant before they expect to and have more children than they want, the United Nations says in a report. "Today’s adolescents have far more choices than their parents had. Access to basic education, especially for girls, offers new opportunities for work, careers, and higher education," according to the World Population Monitoring report prepared by the UN Population Division. Education also enables young people to obtain the necessary information to make "responsible and informed choices and decisions regarding their sexual and reproductive health needs," says the report presented at the 35th session of the United Nations Commission on Population and Development in New York in the first week of April. (excerpt)
Report of the Global Action Against Female Genital Mutilation First Inter-Agency Working Group Meeting, Doral Inn Hotel, Lexington Avenue, New York, New York, 3-4 November 1994.
[Unpublished] 1994. , 22,  p.The Global Action Against Female Genital Mutilation (GAAFGM) Project facilitates the Inter-Agency Working Group which held its first meeting in November 1994 in New York City. Participants were representatives from UN agencies, multilateral and bilateral donor agencies, private foundations, research and technical assistance organizations, and associates from Burkina Faso, Egypt, Ethiopia, Kenya, and Nigeria. After the welcoming remarks, the director of the Reproductive Rights Project at Columbia University presented a paper entitled "Linking Health and Human Rights: Applying Evolving Concepts to FGM." The director of the GAAFGM Project then reviewed its policy and objectives. GAAFGM Project activities revolve around advocacy and policy, the information clearing house, epidemiological and behavior research, skill and counseling training, development of media messages, and fund-raising and subgranting. The director also presented basic facts about FGM. In-country experiences presented included Egypt, Ethiopia, Kenya, and Nigeria. The Special Projects Director of Population Action International presented a paper entitled "Funding and Technical Assistance: Past Experiences and Future Opportunities, Challenges, Successes and Pitfalls in Funding for FGM." The director of the Program for Appropriate Technology in Health (PATH) shared PATH's experience of providing technical assistance in Nigeria and Kenya. The next topic discussed was developing policies and programs on FGM within international agencies, the examples being UNICEF and USAID. The report of this first meeting of the Inter-Agency Working Group provides summaries of FGM-related work of selected agencies (e.g., UNFPA and the Danish Development Aid Agency). At the conclusion of the meeting, participants decided on the next steps for the Inter-Agency Working Group. Based on the meeting's evaluations, GAAFGM learned what steps it needs to take next.
[Unpublished] 1986. 6 p. (WHO/CDD/CMT/86.1)This article presents an overview of current therapeutic practice as recommended by the World Health Organization (WHO) Diarrheal Disease Control Program. The recommendations apply solely to acute diarrheal disease in infants and children. Therapy for such cases is primarily concerned with the prevention or correction of dehydration, the maintenance of nutrition, and the treatment of dysentery. The various approaches to treatment considered are: 1) oral rehydration, which is highly effective for combating dehydration and its serious consequences, but does not diminish the amount or duration of diarrhea; 2) antimotility drugs, none of which are recommended for use in infants and children because the benefits are modest and they may cause serious side effects, such as nausea and vomiting; 3) antisecretory drugs, only a few of which have been properly studied in clinical trials, virtually all of which have important side effects, a low therapeutic index, and/or only modest efficacy. Consequently, none can at present be recommended for the treatment of acute infectious diarrhea in infants and children. 4) aciduric bacteria, on which conclusive evidence is still lacking; 5) adsorbents: kaolin and charcoal have been proposed as antidiarrheal agents in view of their ability to bind and inactivate bacterial toxins, but the results of clinical studies have been disappointing. 6) improved Oral Rehydration Salts (ORS): this may turn out to be the most effective and safest antidiarrheal drug. 7) antibiotics and antiparasitic drugs for a few infectious diarrheas (e.g., cholera). Antibiotics can significantly diminish the severity and duration of diarrhea and shorten the duration of excretion of the pathogen. No antibiotic or chemotherapeutic agent has proven value fort the routine treatment of acute diarrhea; their use is inappropriate and possibly dangerous. It is concluded that oral that oral rehydration is the only cost-effective method of treating diarrhea among infants and children.The Inter-African Committee's (IAC) work against harmful traditional practices is mainly directed against female circumcision. Progress towards this aim is achieved mostly through the efforts of th non governmental organizations (NGO) Working Group on Traditional Practices Affecting the Health of Women and Children and the IAC. In 1984 the NGO Working Group organized a seminar in Dakar on such harmful traditional practices in Africa. The IAC was created to follow up the implementation of the recommendations of the Dakar seminar. The IAC has endeavored to strengthen local activities by creating national committees in Benin, Djibouti, Egypt, Ethiopia, Gambia, Ghana, Kenya, Liberia, Mali, Nigeria, Senegal, Sierra Leone, Somalia, Sudan and Togo. IAC activities in each country are briefly described In addition, the IAC has created an anatomical model, flannelgraphs, and slides to provide adequate educational material for the training of medical staff in teaching hospitals and to make village women aware of the harmful effects of female circumcision. The IAC held 2 African workshops at the Nairobi UN Decade for Women Conference. The African participants recognized the need for international solidarity to fight female circumcision and showed a far more definite and positive difference in their attitude towards the harmful practice than was demonstrated at the Copenhagen Conference/ Forum of 1980. At the United Nations level, female circumcision is receiving serious consideration. A special Working Group has been set up to examine the phenomenon. Finally, this article includes a statement by a sheikh from the Al Azhar University in Cairo about Islam's attitude to female circumcision.
New York, New York, UNICEF, 1996. , 54 p.This document contains the UN's 1996 assessment that ranks the nations of the world according to their achievements in specific areas of human well-being. The introductory comments by the Executive Director of the UN Children's Fund notes that the ratios between national wealth and social progress are not static and depend upon such factors as history and culture, political stability, the accountability of governments, and the sense of realism and honesty adopted as a country faces its problems. Past successes teach the importance of avoiding complacency in working toward progress in eliminating avoidable human suffering. The six commentaries then cover the major topics of 1) maternal mortality (female genital mutilation), 2) nutrition, 3) health (progress in immunization), 4) education (with data on the number of girls out of school), 5) the Convention on the Rights of the Child (national performance gaps and action to date), and 6) the industrial world (child poverty in rich nations and levels of youth illiteracy, tobacco use, suicide, pregnancy, and injury deaths). The report also includes statistical tables that illustrate 1) social indicators for less populous countries, 2) progress in meeting 1995 goals, 3) statistical profiles, and 4) information on the age of the data.
New York, New York, UNFPA, . 74 p.United Nations Population Fund (UNFPA) program activities during 1996 were strengthened by the implementation of a new resource allocation approach based on progress in achieving the goals established at the 1994 International Conference on Population and Development (ICPD). In 1996, the 27 Group A countries (those most in need of assistance to reach ICPD goals) received 73.7% of total allocations. In terms of program areas, reproductive health activities received 71% of total allocations, population and development strategies accounted for another 18%, and advocacy was allotted 11%. The country programming process was accompanied by management reviews to streamline operations and strengthen program delivery, to improve the coordination of activities under the Fund's decentralized programming approach, and to compile a comprehensive set of guidelines and policies covering areas such as programs, administration, procurement, personnel, staff development, and financial issues. Total contributions in 1996 reached a new high of US $302.5 million, pledged by 95 governments, while total income generated through multi-bilateral arrangements was $18.3 million. Program priorities included reproductive health (including family planning and sexual health), adolescent reproductive health, female genital mutilation, HIV/AIDS, population and development strategies, advocacy, and women's empowerment and gender issues.
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES. 1991; 626:1-10.WHO defines reproductive health as people having the ability to reproduce, to regulate fertility, and to practice and enjoy sexual relationships. It also means safe pregnancy, child birth, contraceptives, and sex. Procreation should include a successful outcome as indicated by infant and child survival, growth, and healthy development. 60-80 million infertile couples live in the world. Core infertility, i.e., unpreventable and untreatable infertility, ranges from 3% to 5%. Sexually transmitted diseases, aseptic abortion, or puerperal infection are common causes of acquired infertility. Sub-Saharan Africa has the highest prevalence of acquired infertility. In 1983, the world contraceptive use rate stood at 51% with the developed countries having the highest rate (70%) and Africa the lowest rate (14%). About 40 countries in Africa and the Arabian Peninsula practice female circumcision. The percent of low birth weight infants is greater in developing countries than in developed countries (17% vs. 6.8%). Intrauterine growth retardation is responsible for most low birth weight infants in developing countries while in developed countries it is premature birth. About 15 million infants and children die each year. Maternal mortality risk is highest in developing countries especially those in Africa (1:21) and lowest in developed countries (1:9850). Sexually transmitted diseases continue to be a major problem in the world especially in developing countries. Chlamydia afflicts 50 million people each year. The proportion of women with AIDS is growing so that between the 1980s and 1990s it will grow between 25% and 50%. More available contraceptive choices enhance safety in fertility regulation. Socioeconomic conditions that determine reproductive health are poverty, literacy, and women's status. Sexual behavior, reproductive behavior, breast feeding, and smoking are life style determinants of reproductive health. Availability, utilization, and efficiency of health care services and level of medical knowledge also determine women's reproductive health.
JOURNAL OF NURSE-MIDWIFERY. 1989 Nov-Dec; 34(6):355-8.a nurse-midwife born and trained Belgium recounts her decision to be a nurse-wife and her experience in the Third World. Her 1st international position was at a obstetric/gynecologic (OB/GYN) ward in a hospital in Mogadishu, Somalia operated by Europeans. The foreigners here were still behaving as colonialists. All OB/GYN clients had undergone circumcision before reaching puberty. These genital mutilations caused them problems, such as infections and multiple episiotomies. Many pregnant women never received prenatal care. She learned prevention would have eased the suffering of many OB/GYN clients. This led her to a maternal-child health care project in Baltimore, Maryland, USA. This experience reinforced what she had learned in Somalia: women were not in charge and were victims of events beyond their control. Indeed this was especially true in Baltimore's slums than in Somalia. Then she earned her masters degree in public health at Johns Hopkins University. She later tool an assignment with a WHO community health development project in Haiti, the poorest country in the western hemisphere. By the end of the 1st year, health personnel had switched focus from curative care to preventive care, such as mass immunization campaigns. Since the early 1970s, Haiti did not train professional midwives. Yet schools for nurse midwives existed in virtually every other country. Under the auspices of WHO, she later went to Algeria to train nurse midwives at the Institute of Public Health. She has worked in a total of 32 countries. Later she worked at family planning clinic in Brooklyn and taught foreign midwives in New York City. Since 1979, she has worked on short term technical assistance projects, especially family planning projects, in developing countries. She pointed out the advantages and disadvantages of short term consultancies.