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Plan of action for the eradication of harmful traditional practices affecting the health of women and children in Africa.
[Unpublished] 1987. 14 p.The traditional and harmful practices such as early marriage and pregnancy, female circumcision, nutritional taboos, inadequate child spacing, and unprotected delivery continue to be the reality for women in many African nations. These harmful traditional practices frequently result in permanent physical, psychological, and emotional changes for women, at times even death, yet little progress has been realized in abolishing these practices. At the Regional Seminar of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children in Africa, held in Ethiopia during April 1987, guidelines were drawn by which national governments and local bodies along with international and regional organizations might take action to protect women from these unnecessary hazardous traditional practices. These guidelines constitute this "Plan of Action for the Eradication of Harmful Traditional Practices Affecting the Health of Women and Children in Africa." The plan should be implemented within a decade. These guidelines include both shortterm and longterm strategies. Actions to be taken in terms of the organizational machinery are outlined, covering both the national and regional levels and including special support and the use of the mass media. Guidelines are included for action to be taken in regard to childhood marriage and early pregnancy. These cover the areas of education -- both formal and nonformal -- measures to improve socioeconomic status and health, and enacting laws against childhood marriage and rape. In the area of female circumcision, the short term goal is to create awareness of the adverse medical, psychological, social and economic implications of female circumcision. The time frame for this goal is 24 months. The longterm goal is to eradicate female circumcision by 2000 and to restore dignity and respect to women and to raise their status in society. Also outlined are actions to be taken in terms of food prohibitions which affect mostly women and children, child spacing and delivery practices, and legislative and administrative measures. Women in the African region have a critical role to play both in the development of their countries and in the solution of problems arising from the practice of harmful traditions.
WHO CHRONICLE. 1986; 40(1):31-6.A traditional practice that has attracted considerable attention in the last decade is female circumcision, the adverse effects of which are undeniable. 70 million women are estimated to be circumcised, with several thousand new operations performed each day. It is a custom that continues to be widespread only in Africa north of the equator, though mild forms of female circumcision are reported from some Asian countries. In 1979 a Seminar on Traditional Practices that Affect the Health of Women and Children was held in the Sudan. It was 1 of the 1st interregional and international efforts to exchange information on female circumcision and other traditional practices, to study their implications, and to make specific recommendations on the approach to be taken by the health services. There are 3 main types of female circumcision: circumcision proper is the mildest but also the rarest form and involves the removal only of the clitoral prepuce; excision involves the amputation of the entire clitoris and all or part of the labia minora; and infibulation, also known as Pharaonic circumcision, involves the amputation of the clitoris, the whole of the labia minora, and at least the anterior 2/3 and often the whole of the medial part of the labia majora. Initial circumcision is carried out before a girl reaches puberty. The operation generally is the responsibility of the traditional midwife, who rarely uses even a local anesthetic. She is assisted by a number of women to hold the child down, and these frequently include the child's own relatives. Most of the adverse health consequences are associated with Pharaonic circumcision. Hemorrhage and shock from the acute pain are immediate dangers of the operation, and, because it is usually performed in unhygienic circumstances, the risks of infection and tetanus are considerable. Retention of urine is common. Cases have been reported in which infibulated unmarried girls have developed swollen bellies, owing to obstruction of the menstrual flow. Implantion dermoid cysts are a very common complication. Infections of the vagina, urinary tract, and pelvis occur often. A women who has been infibulated suffers great difficulty and pain during sexual intercourse, which can be excruciating if a neuroma has formed at the point of section of the dorsal nerve of the clitoris. Consummation of marriage often necessitates the opening up of the scar. During childbirth infibulation causes a variety of serious problems including prolonged labor and obstructed delivery, with increased risk of fetal brain damage and fetal loss. A variety of reasons are advanced by its adherents for continuing to support the practice of female circumcision, but the reasons are rationalizations, and none of the reasons bear close scrutiny. The campaigning against female circumcision is reviewed.