Female genital mutilation/cutting : changes and trends in knowledge, attitudes, and practices among health care professionals in The Gambia

Abstract

Altres ajuts: The completion of this study has been made possible thanks to the work of Wassu Gambia Kafo personnel, with special regards to the training and research team members, who offered their expertise and professionalism. We would also like to thank the HCPs who agreed to participate in the research and the close collaboration of the Gambian health and academic institutions, whose collaboration was fundamental for its development. Likewise, we acknowledge Diputación Foral de Álava/Arabako Foru Aldundia, "La Caixa" Foundation and the Catalan Agency for Development Cooperation (ACCD) for having the confidence and providing the financial support that has made this study possible.

Female genital mutilation/cutting (FGM/C) is a harmful traditional practice that affects two out of three girls in The Gambia, seriously threatening their life and well-being with severe health consequences. By tracking the reference values established in former research conducted between 2009 and 2011, the objectives of this study are to explore trends and to measure and assess changes in knowledge, attitudes, and practices regarding FGM/C among health care professionals (HCPs) in The Gambia. A cross-sectional descriptive study was designed to collect and analyze data from an overall stratified sample consisting of 1,288 HCPs including health professionals and students throughout the six regions of The Gambia. Data were collected by the implementation of a self-administered written knowledge, attitudes, and practices questionnaire between 2012 and 2014. The results of this study showed that 76.4% of HCPs are eager to abandon FGM/C, and 71.6% of them regard it as a harmful practice with negative consequences on life and health. HCPs reported more knowledge and favorable attitudes towards FGM/C abandonment, being better able to identify the practice, more aware of its health complications, and more concerned in their essential role as social agents of change. However, 25.4% of HCPs still embraced the continuation of the practice, 24.4% expressed intention of subjecting their own daughters to it, and 10.5% declared to have performed it within their professional praxis. Findings confirm progress in knowledge and attitudes regarding FGM/C among HCPs, who are better skilled to understand and manage the consequences. Nevertheless, discrepancies between information, intention, and behavior unveil resistance in practice and proves that FGM/C medicalization is increasing. Thus, there is an urgent need to support HCPs in the integration of FGM/C preventive interventions within the public health system, to address arguments favoring medicalization, and to use data to design appropriate strategies.