New WHO guidelines to improve care for millions living with female genital mutilation

Posted by Kimberley Meijers on June 16, 2016 at 4:59 pm

Health-care providers across the world need to be prepared to provide care to girls and women who have undergone female genital mutilation (FGM). Many are unaware of the potential negative health consequences of FGM and are often inadequately trained to recognize and treat these properly. As a result, girls and women can suffer needlessly from the negative physical and mental health consequences of this harmful practice.

No health benefits, only harm

Female genital mutilation (FGM) comprises all procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons. Procedures can cause death, severe bleeding, problems urinating, and later cysts, infections, complications in childbirth and increased risk of newborn deaths. FGM has no health benefits and causes only harm. The practice is a grave violation of the human rights of girls and women.

International migration has now made the practice a global health issue with particularly high prevalence in 30 countries in Africa and in a few countries in Asia and the Middle East.

Informing health workers

“Health workers have a crucial role in helping address this global health issue. They must know how to recognize and tackle health complications of FGM,” says Dr Flavia Bustreo, WHO Assistant Director General.

The new publication, WHO guidelines on the management of health complications from female genital equips health-care providers with key recommendations, grouped into four main areas:

  • deinfibulation (1) to prevent and treat obstetric complications, as well as to facilitate childbirth, and prevent and treat problems with the urinary tract system;
  • mental health including cognitive behavioural therapy and psychological support to treat depression and anxiety disorders;
  • female sexual health covering sexual counselling to prevent or treat female sexual dysfunction;
  • information and education for all women and girls who have undergone female genital mutilation, and health education and information on deinfibulation, where appropriate, for both health-care providers and for women and girls.

Dr Bustreo adds: “Access to the right information and good training can help prevent new cases and ensure that the millions of women who have undergone FGM get the help they need.”

Stop medicalization of FGM

The guidelines also warn against the “medicalization” of FGM – when health-providers themselves perform female genital mutilation. Performing FGM violates the human rights of girls and women, and goes against the Hippocratic Oath of ‘Do no harm’.

“It is critical that health workers do not themselves unwittingly perpetuate this harmful practice” comments Dr Lale Say, Coordinator of the Adolescents and at-risk populations team in the WHO Department of Reproductive Health and Research.

Prevention and care

Since 1997, there have been growing international efforts to stop FGM. This includes through research, work within communities, revised legal frameworks and growing political support to end FGM, as well as international monitoring bodies and resolutions that condemn the practice. In 2007, UNFPA and UNICEF initiated the Joint Programme on Female Genital Mutilation/Cutting to accelerate the abandonment of the practice.

These guidelines build and contribute to these efforts, and underline not only the importance of ending FGM, but also the need to help health workers improve care for girls and women to prevent and manage the consequences of this harmful practice.

A global goal

More research and better quality data are needed to improve evidence-based care, so that health professionals can better manage the complications arising from female genital mutilation. This is also crucial to achieve one of the targets of the Sustainable Development Goals – to eliminate FGM by 2030.