School of Public Health, Department of Health Policy & Management, University of Maryland, College Park, Maryland, USA.
Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Trop Med Int Health. 2022 May;27(5):468-478. doi: 10.1111/tmi.13749. Epub 2022 Apr 3.
Female Genital Mutilation and Cutting (FGM/C) is an act of gender-based violence (GBV) and a global public health issue with well-documented adverse outcomes. With the rise in global migration, there is an increasing prevalence of FGM/C among Arab diaspora living in the West and Global South. What remains unclear is how to reduce the practice. This study was designed to identify interventions exerting an effect on reducing the practice of FGM/C.
A systematic review of peer-reviewed articles was conducted on interventions targeting individuals and/or the broader community to prevent FGM/C within the Arab League and its diaspora, up to December 2021. Databases searched included PubMed, Medline, Web of Science, PsycINFO, EMBASE, CINAHL, BIOSIS, ASSIA and Scopus. Quality assessment used the Mixed Methods Appraisal Tool (MMAT) 2018.
Twelve of 896 studies met the inclusion criteria. Eight interventions relied entirely on education with short-term gains but unchanged practices. Three interventions used social marketing and mixed media. Only one study took a multi-sectoral approach.
At a macro level, opportunities to reduce or to end the practice of FGM/C exist through legislation, policy, a public health approach grounded in gender equality and human rights. Using multi-sectoral actions that consider the social context and challenge social norms at macro, meso and micro levels appears more effective than individual-level interventions. Promoting advocacy and developing supportive environments to reduce GBV, enhance gender equality and empower communities is crucial for interventions to succeed and achieve the Sustainable Development Goal target of FGM/C abandonment by 2030.
女性外阴残割和切割（FGM/C）是一种基于性别的暴力（GBV）行为，也是一个具有充分记录的不良后果的全球公共卫生问题。随着全球移民的增加，在西方和全球南方生活的阿拉伯侨民中，FGM/C 的流行率不断上升。目前尚不清楚如何减少这种做法。本研究旨在确定对减少 FGM/C 实践有影响的干预措施。
对针对个人和/或更广泛社区的干预措施进行了系统的文献回顾，以预防阿拉伯联盟及其侨民中的 FGM/C，截至 2021 年 12 月。搜索的数据库包括 PubMed、Medline、Web of Science、PsycINFO、EMBASE、CINAHL、BIOSIS、ASSIA 和 Scopus。使用混合方法评估工具（MMAT）2018 进行质量评估。
在 896 项研究中，有 12 项符合纳入标准。八项干预措施完全依赖于教育，取得了短期收益，但做法没有改变。三项干预措施使用社会营销和混合媒体。只有一项研究采取了多部门方法。
在宏观层面上，通过立法、政策、基于性别平等和人权的公共卫生方法，有机会减少或结束 FGM/C 的实践。采用多部门行动，考虑社会背景并在宏观、中观和微观层面挑战社会规范，似乎比个人层面的干预措施更有效。促进宣传和制定支持性环境，以减少性别暴力，增强性别平等和增强社区能力，对于干预措施的成功和实现到 2030 年放弃 FGM/C 的可持续发展目标至关重要。
