A Research Agenda to Strengthen Evidence Generation and Utilisation to Accelerate the Elimination of Female Genital Mutilation

Authored by: Dennis Matanda and Esther Lwanga-Walgwe

Categories: Global Public Health, Human Rights
Sub-Categories: Economic Participation, Human Development, Sexual and Reproductive Health
Region: No Region
Year: 2022
Citation: Matanda, Dennis and Esther Lwanga-Walgwe. "A Research Agenda to Strengthen Evidence Generation and Utilisation to Accelerate the Elimination of Female Genital Mutilation." United Nations Population Fund. August 2022.

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Executive Summary

The World Health Organisation (WHO) has classified female genital mutilation (FGM) into four broad categories: FGM Type I, also called clitoridectomy (partial or total removal of the clitoral glans and/or the prepuce); FGM Type II, also called excision (partial or total removal of the clitoral glans and labia minora, with or without excision of the labia majora); FGM Type III, also called infibulation (narrowing of the vaginal orifice by cutting and bringing together the labia minora and/or the labia majora to create a type of seal, with or without excision of the clitoris; in most instances, the cut edges of the labia are stitched together); and FGM Type IV, which includes all other harmful procedures to the female genitalia for non-medical purposes, such as pricking, piercing, incising, scraping and cauterisation (Office of the High Commissioner for Human Rights [OHCHR] et al 2008).

More than 200 million girls and women alive today have undergone FGM in 31 countries with nationally representative data in Africa, the Middle East and Asia (UNICEF 2020). This is most likely an under-representation as FGM may be present in more than 90 countries globally (Cappa, Van Baelen, and Leye 2019). While girls are one third less likely today to undergo the harmful practice than 30 years ago, rapid population growth in some of the world’s poorest countries where FGM persists threatens to roll back progress (United Nations Population Fund (UNFPA) 2019; UNICEF 2020). In 2020 alone, an estimated 4.1 million girls were at risk of undergoing FGM, with the number of girls each year projected to rise to 4.6 million by 2030 (UNFPA 2019; UNICEF 2020). Without concerted and accelerated actions, an estimated 68 million more girls will have undergone FGM by 2030 (UNFPA, 2019).

The emergence of the COVID-19 pandemic in 2020 is also likely to have a huge impact on efforts towards achieving zero new cases of FGM by 2030, as envisaged in the Sustainable Development Goals (SDGs). Measures to contain the spread of COVID-19, such as restrictions on movement and social distancing, have directly affected the implementation of FGM interventions. Closure of schools, local and national lockdowns leading to girls spending more time at home and increased economic hardship are potentially exacerbating the problem (Orchid Project 2020). Previous projections suggested that scaling up FGM prevention programmes could reduce new cases by 5.3 million between 2020 and 2030 (UNFPA 2020). However, due to COVID-19 and the scaling down of FGM programmes, achievement of this milestone could be challenging. It is estimated that 2 million additional FGM cases that would otherwise have been averted could occur over the next decade as a result of the pandemic (UNFPA 2020). The need to accelerate progress towards FGM elimination is therefore even more pertinent in the context of the COVID-19 pandemic.

To achieve this, UNICEF and UNFPA in collaboration with the Population Council, Kenya conducted a global review of evidence on the effectiveness of FGM interventions designed to prevent or respond to FGM, spanning over a decade. Subsequently, an experts’ meeting was convened with researchers, programme staff and policymakers to prioritise research questions geared towards acceleration in achieving the SDG on gender equality, particularly target 5.3 on the elimination of FGM. Based on the evidence review and prioritization by experts, a global research agenda for the FGM sector was developed.