Where education, law and health meet: a public health approach to ending female genital mutilation
Female genital mutilation (FGM) still occurs around the world. It a procedure in which the female genitalia are altered, damaged or removed without medical indication. Preventing FGM is axiomatically better than prosecuting perpetrators. Prevention saves a child from having FGM performed on them (“being cut”). Prosecution of a case means that a child has already been cut. Against the background of a tight legal framework in the United Kingdom (UK), our research has found that whilst that law has been necessary it may very well be the case that in the UK there is now a limit to the effectiveness of legal responses to tackling FGM. We have considered whether more resources should be put into health education as part of a combined public health strategy aimed at protecting women and girls.
Performing FGM is prohibited in the United Kingdom by the Female Genital Mutilation Act 2003. Within the schedule of the Act provision is made for the granting of FGM Protection Orders (FGMPOs) to protect women and girls from FGM. A mandatory reporting duty requires regulated health and social care professionals and teachers in England and Wales to report known cases of FGM in under 18-year-olds to the police. There has been no comprehensive evaluation of the introduction of FGMPOs and their effectiveness in protecting women and girls.
The public health adage of ‘prevention is better than cure’ is even more apparent in FGM, in which there is no complete physical cure once performed. Through our research we have been considering the potential for a combined approach to preventing FGM through law, health and education. Using an educational project as an example, the improving efficacy of upstream public health interventions over time has been demonstrated. Arguing that the use of law may have reached its outer limits in the ability to prevent FGM and that various sectors work in silos rather than together, it is suggested that a combined health and law approach through bespoke education is the way to reach the United Nations’ ‘Sustainable Development Goals to eradicate FGM’. Further, a recommendation is made for a full evaluation of the introduction of FGMPOs by a national FGM Commissioner.
Team: Professor Andrew Rowland, Dr Joseph Home, Professor Felicity Gerry (external), Dr Charlotte Proudman (external)