Abandoning Female Genital Mutilation/Cutting: An In-depth Look at Promising Practices

This 63-page publication presents findings from surveys, questionnaires, and in-country interviews about three interventions promoting the abandonment of female genital mutilation/cutting (FGM/C). The goal of this publication is to provide information on these abandonment interventions based on four criteria set forth by the project's collaborating partners: positive tangible impact; potential for replication; fostering of effective partnerships; and demonstrated sustainability. The researchers found that each of the projects outlined below had a positive impact in encouraging community awareness and abandonment of FGC.

The Navrongo FGM Experiment
According to the document, in addition to developing strategies to accelerate the abandonment of the practice, this project used rigorous scientific analysis to test which strategies work best: Is education alone enough? Does livelihood training have a greater impact? Could a combination of both activities be the most effective way to bring about changes in FGM attitudes and behaviour? Communities were engaged and mobilised through an approach known locally as Alagube, a Nankam term "connoting the process by which people solve a common problem by pooling their individual and community social resources." According to the paper, one year of the Alagube and FGM education strategy was associated with a 93% decrease in the risk of FGM, and one year of the combined Alagube, education, and livelihood strategy was associated with a 94% decrease in the risk of FGM, compared to that in the control group. Navrongo believes that its findings underscore that culturally sensitive, community-led interventions can reduce FGM. Although the impact of the livelihood and development strategy was not found to be statistically significant, in their final evaluation researchers stated: "It is entirely possible that a combination of livelihood and education methods could have a more sustainable impact in the long run than a less intensive community educational approach."

IntraHealth International: A Five-Dimensional Approach for the Eradication of Female Genital Cutting (FGC) in Ethiopia
The document states that this project used an extensive range of activities and a multi-faceted approach to changing FGC knowledge and behaviour. Although bridging knowledge gaps, especially among different groups in the community, is a key component of the approach, it also includes generating dialogue, empowering women and communities to advocate against FGC, involving influential religious and political leaders, and creating networks of anti-FGC groups from the grassroots to the national level. According to the evaluation, more than 4,200 community members, both men and women, gained "five-dimensional knowledge" through the project's training, information, education, and communication (IEC) materials, and community mobilisation activities. The publication says that the project resulted in the Ethiopian parliament making FGC punishable by law in July 2004 and a consensus by 83 prominent national and religious leaders in June 2004 to unanimously criminalise and ban clitoridectomy, excision, and infibulations. Over the project period more than 4,200 community members gained knowledge via the project's workshops, training events, community mobilisation activities, public declarations, and/or IEC interventions and materials.

Tostan: The Community Empowerment Program
Along with FGC, the Tostan programme, in which democracy and human rights education provide a foundation for community development, also addresses hygiene, health, literacy, and management skills over the course of 2 to 3 years. A Population Council/FRONTIERS evaluation carried out in 2002-2003 found that Tostan's programme had a significant effect on knowledge about human rights and gender-based violence. An evaluation of Tostan in the Matam and St. Louis Regions of Senegal credited the programme with the abandonment of FGC and child marriage by 70 villages in November 2005 through the Public Declaration of Sedo Abass. Outcomes include positive results in health, education, and the environment. For example, during the Tostan programme, 13,459 vaccinations occurred, 1,300 women went for antenatal consultations, and 2,326 children obtained birth registration papers.

According to the authors, Navrongo's evaluation was the most scientifically rigorous. Navrongo researchers offer the following lessons pertaining to evaluation:

• A multi-phased approach is useful and should include: a diagnostic phase to understand and assess the level of FGM and its underlying rationale; a pilot phase in which the community is involved through participatory learning techniques in the planning of intervention strategies; and an experimental phase, where interventions are introduced to randomly selected communities over time.
• Inconsistent or inaccurate reporting by girls (or their mothers) on whether they had been cut can be an impediment to an accurate evaluation of effectiveness.

The evaluation concludes that it is imperative that researchers continue in their efforts to measure impact. As stated by Ian Askew in his article on methodological issues in measuring FGM/C, "concerted behaviour change efforts to encourage abandonment of the practice need to be informed by empirical evidence, and to be evaluated using strong research designs. A better understanding of research methods and operations research in particular, can contribute to this end."