医疗保健提供者和母亲对埃及女性生殖器切割/割礼医学化的看法：一项横断面定性研究。
Health care providers' and mothers' perceptions about the medicalization of female genital mutilation or cutting in Egypt: a cross-sectional qualitative study.
机构信息
Assiut University, Assiut, Egypt.
Population Council, Cairo, Egypt.
出版信息
BMC Int Health Hum Rights. 2019 Aug 27;19(1):26. doi: 10.1186/s12914-019-0202-x.
BACKGROUND
Female genital mutilation/cutting (FGM/C) is a traditional harmful practice that has been prevalent in Egypt for many years. The medicalization of FGM/C has been increasing significantly in Egypt making it the country with the highest rate of medicalization. In this qualitative study, we explored the drivers and motives behind why healthcare professionals perform FGM/C and why mothers rely on them to perform the practice on their daughters.
METHODS
The study drew on a "mystery client" approach, coupled with in-depth interviews (IDIs) and focus group discussions (FGDs) with health care providers (i.e. physicians and nurses) and mothers. It was conducted in three geographic areas in Egypt: Cairo, Assiut and Al Gharbeya.
RESULTS
Study findings suggest that parents who seek medicalized cutting often do so to minimize health risks while conforming to social expectations. Thus, the factors that support FGM/C overlap with the factors that support medicalization. For many mothers and healthcare providers, adherence to community customs and traditions was the most important motive to practice FGM/C. Also, the social construction of girls' well-being and bodily beauty makes FGM/C a perceived necessity which lays the ground for stigmatization against uncut girls. Finally, the language around FGM/C is being reframed by many healthcare providers as a cosmetic surgery. Such reframing may be one way for providers to overcome the law against FGM/C and market the operation to the clients.
CONCLUSION
These contradictions and contestations highlighted in this study among mothers and healthcare providers suggest that legal, moral and social norms that underpin FGM/C practice are not harmonized and would thus lead to a further rise in the medicalization of FGM/C. This also highlights the critical role that health providers can play in efforts to drive the abandonment of FGM/C in Egypt.
背景
女性生殖器切割是一种传统的有害习俗，在埃及已经流行了多年。女性生殖器切割的医学化在埃及显著增加，使其成为医学化程度最高的国家。在这项定性研究中，我们探讨了医疗保健专业人员进行女性生殖器切割的驱动因素和动机，以及母亲为何依赖他们为女儿实施这种做法。
方法
该研究采用了“神秘客户”方法，结合了与医疗保健提供者（即医生和护士）和母亲的深入访谈（IDIs）和焦点小组讨论（FGDs）。它在埃及的三个地理区域进行：开罗、阿西尤特和盖勒尤卜。
结果
研究结果表明，寻求医学切割的父母通常这样做是为了降低健康风险，同时符合社会期望。因此，支持女性生殖器切割的因素与支持医学化的因素重叠。对许多母亲和医疗保健提供者来说，遵守社区习俗和传统是实施女性生殖器切割的最重要动机。此外，女孩幸福和身体美的社会建构使女性生殖器切割成为一种被认为是必要的做法，为未切割的女孩带来了污名化。最后，许多医疗保健提供者正在重新构建女性生殖器切割的语言，将其视为一种整容手术。这种重新构建可能是提供者克服反对女性生殖器切割的法律并向客户推销手术的一种方式。
结论
本研究中母亲和医疗保健提供者之间存在的这些矛盾和争议表明，支撑女性生殖器切割实践的法律、道德和社会规范并不协调，因此会导致女性生殖器切割的医学化进一步增加。这也凸显了医疗保健提供者在推动埃及放弃女性生殖器切割方面可以发挥的关键作用。
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