New guidelines on improving care for female genital mutilation issued by UN health agency

A woman holds a knife used in Female Genital Mutilation/Cutting (FGM/C). Photo: UNICEF/Catherine Ntabadde

16 May 2016 – The United Nations World Health Organization (WHO) today released new guidelines aimed at helping health workers provide better care to the more than 200 million girls and women worldwide living with female genital mutilation.

“Health workers have a crucial role in helping address this global health issue. They must know how to recognize and tackle health complications of [female genital mutilation] FGM,” said Flavia Bustreo, WHO Assistant Director General, in a press release.

“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,” she added.

WHO underscored that health workers are often unaware of the many negative health consequences of female genital mutilation and many remain inadequately trained to recognize and treat them properly. As a result, many women may suffer needlessly from physical and mental health consequences due to the procedure.

The guidelines build on and contribute to international efforts to stop female genital mutilation, underlining the recognition that action must be taken across sectors to stop the practice and help those who are living with its consequences.

The recommendations focus on preventing and treating obstetric complications; treatment for depression and anxiety disorders; attention to female sexual health such as counselling; and the provision of information and education.

The guidelines also warn against the so called “medicalization” of the practice – for example, when parents ask health providers to conduct it because they think it will be less harmful.

“It is critical that health workers do not themselves unwittingly perpetuate this harmful practice,” said Lale Say, WHO Coordinator, Department of Reproductive Health and Research at WHO.

Global strategy to stop health-care providers from performing FGM

In 2010, WHO published a Global strategy to stop health-care providers from performing female genital mutilation in collaboration with the UN Population Fund (UNFPA) and UN Children’s Fund (UNICEF) Joint Programme on Female Genital Mutilation/Cutting and other partners.

One fundamental measure to prevent medicalization of the practice is the creation of protocols, manuals and guidelines for health providers, WHO said. These include what to do when faced with requests from parents or family members to perform female genital mutilation on girls, or requests from women to perform re-infibulation after delivery.

The agency noted that the new guidelines also highlight the need for more research to improve evidence-based practice, so that health workers can better manage the complications arising from FGM, and the health community is better informed about the associated health risks, which also can contribute to effectively work towards the elimination of the harmful practice.

In particular, recommendations include: de-infibulation 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; and information and education for all women and girls who have undergone female genital mutilation, and health education and information on de-infibulation, where appropriate, for both health-care providers and for women and girls.

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