DigiHealth Institute, Neu-Ulm University of Applied Science, Neu-Ulm, Germany.
Faculty of Social Science, Katholische Stiftungshochschule München/ Catholic University of Applied Science, Preysingstrasse 95, 81667, Munich, Germany.
BMC Womens Health. 2024 Jun 14;24(1):338. doi: 10.1186/s12905-024-03154-4.
Worldwide, at least 230 million girls and women are affected by female genital mutilation/ cutting (FGM/C). FGM/C violates human rights and can cause irreparable harm and even lead to death. In 2022, more than 100,000 survivors of FGM/C lived in Germany, and more than 17,000 girls were considered at risk. Due to the increasing number, there is a need to improve the skills of professionals not only to treat FGM/C but also to prevent it, aiming to maintain or improve women's physical and mental health. However, previous studies mostly focused on health care providers, even though other professionals such as social workers, play an important role in the provision of sexual and reproductive health (SRH) care and are often the first point of contact. Therefore, the study's main objective was to understand challenges perceived by social workers in pregnancy counselling centres in the provision of good quality of SRH care for girls and women suffering from or endangered by FGM/C.
A quantitative self-administered cross-sectional online survey was sent by e-mail in 2021 to all pregnancy counselling centers in the German federal state of Bavaria.
Among the 141 participants, 82% reported no or insufficient FGM/C knowledge and barriers to provide the best quality of care. The main findings were language obstacles (82.7%), perceived client's fear or shame (67.9%) and cultural difficulties (45.7%). Furthermore, participants also reported a lack of competence on the professional side (29.6%). Importantly, most participants (129 of 141; 92%) expressed interest in training.
Providing comprehensive good quality sexual and reproductive health care to women and girls affected from or endangered by FGM/C is challenging. The study revealed the importance of strengthening the skills of social workers and suggested the following strategies: (1) enhancing FGM/C knowledge and skills (including specialized competences e.g., in mental health) by improving training and information material for the target group, (2) improving referral pathways and addressing deficits in the existing care system (e.g. with health or legal institutions), and (3) developing trusting relationships with cultural (or traditional) mediators to build strong community networks.
全世界至少有 2.3 亿女童和妇女受到女性生殖器切割/切割（FGM/C）的影响。FGM/C 侵犯了人权，会造成不可挽回的伤害，甚至导致死亡。2022 年，德国有超过 10 万名 FGM/C 的幸存者，超过 1.7 万名女孩被认为有风险。由于人数不断增加，不仅需要提高专业人员治疗 FGM/C 的技能，还需要预防它，目的是维护或改善妇女的身心健康。然而，之前的研究主要集中在医疗保健提供者身上，尽管其他专业人员，如社会工作者，在提供性和生殖健康（SRH）护理方面发挥着重要作用，并且往往是第一个接触点。因此，该研究的主要目的是了解在为遭受或面临 FGM/C 风险的女孩和妇女提供良好的 SRH 护理方面，妊娠咨询中心的社会工作者所面临的挑战。
2021 年，通过电子邮件向德国巴伐利亚州的所有妊娠咨询中心发送了一份定量的自我管理的横断面在线调查。
在 141 名参与者中，82%的人报告称对 FGM/C 知识了解不足或存在障碍，无法提供最佳护理质量。主要发现是语言障碍（82.7%）、感知到的客户的恐惧或羞耻（67.9%）和文化困难（45.7%）。此外，参与者还报告了专业方面的能力不足（29.6%）。重要的是，大多数参与者（141 名中的 129 名；92%）表示有兴趣接受培训。
为遭受或面临 FGM/C 风险的妇女和女孩提供全面的良好的性和生殖健康护理具有挑战性。该研究揭示了加强社会工作者技能的重要性，并提出了以下策略：（1）通过改进针对目标群体的培训和信息材料，增强 FGM/C 知识和技能（包括专门技能，如心理健康）；（2）改善转诊途径，并解决现有护理系统中的缺陷（例如与卫生或法律机构）；（3）与文化（或传统）调解人建立信任关系，建立强大的社区网络。
