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Open Access Research article

Knowledge, attitudes and practices of female genital mutilation/cutting among health care professionals in The Gambia: a multiethnic study

Adriana Kaplan123*, Suiberto Hechavarría456, Mariola Bernal2 and Isabelle Bonhoure2

Author Affiliations

1 Chair of Social Knowledge Transfer/Parc de Recerca UAB - Santander, Department of Social and Cultural Anthropology, Universitat Autònoma de Barcelona, Barcelona, Spain

2 Interdisciplinary Group for the Prevention and Study of Harmful Traditional Practices (IGPS/HTP), Department of Social and Cultural Anthropology, Universitat Autònoma de Barcelona, Barcelona, Spain

3 NGO Wassu Gambia Kafo, Fajara F Section, Banjul, The Gambia

4 Cuban Medical Mission in The Gambia, Banjul, The Gambia

5 Community-based Medical Programme, Ministry of Health and Social Welfare, Banjul, The Gambia

6 Facultad de Ciencias Médicas Manuel Fajardo, Universidad Médica de La Habana, Havana, Cuba

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BMC Public Health 2013, 13:851  doi:10.1186/1471-2458-13-851

Published: 16 September 2013

Abstract

Background

Female genital mutilation/cutting (FGM/C) is a harmful traditional practice with severe consequences for the health and well-being of girls and women. Health care professionals (HCPs) are therefore expected to be aware of how to identify and manage these consequences in order to ensure that those affected by the practice receive quality health care. Moreover, their integration and legitimacy within the communities allow them to play a key role in the prevention of the practice. Nevertheless, the perception of HCPs on FGM/C has been barely explored in African contexts. This study seeks to contribute to this field of knowledge by examining the knowledge, attitudes, and practices regarding FGM/C among HCPs working in rural settings in The Gambia.

Methods

A cross-sectional descriptive study was designed through a quantitative methodology, following a multiethnic approach. A pre-tested questionnaire with open and closed-ended questions was created. Forty medical students from the Community-based Medical Programme were trained to administer the questionnaire, face to face, at village health facilities in rural areas of The Gambia. A final sample of 468 HCPs included all nurse cadres and midwives.

Results

A significant proportion of Gambian HCPs working in rural areas embraced the continuation of FGM/C (42.5%), intended to subject their own daughters to it (47.2%), and reported having already performed it during their medical practice (7.6%). However, their knowledge, attitudes, and practices were shaped by sex and ethnic identity. Women showed less approval for continuation of FGM/C and higher endorsement of the proposed strategies to prevent it than men. However, it was among ethnic groups that differences were more substantial. HCPs belonging to traditionally practicing groups were more favourable to the perpetuation and medicalisation of FGM/C, suggesting that ethnicity prevails over professional identity.

Conclusions

These findings demonstrate an urgent need to build HCP’s capacities for FGM/C-related complications, through strategies adapted to their specific characteristics in terms of sex and ethnicity. A culturally and gender sensitive training programme might contribute to social change, promoting the abandonment of FGM/C, avoiding medicalisation, and ensuring accurate management of its health consequences.

Keywords:
Female genital mutilation/cutting; The Gambia; Health care professionals; Knowledge, Attitudes and practices (KAP); Sexual and reproductive health; Africa