BMJ Open
Volume 7, Issue 8, 2017

Baseline data from a planned RCT on attitudes to female genital cutting after migration: When are interventions justified? (Article) (Open Access)

Wahlberg A.* , Johnsdotter S. , Selling K.E. , Källestål C. , Essén B.
  • a Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
  • b Faculty of Health and Society, Malmö University, Malmö, Sweden
  • c Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
  • d Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
  • e Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden

Abstract

Objectives To present the primary outcomes from a baseline study on attitudes towards female genital cutting (FGC) after migration. Design Baseline data from a planned cluster randomised, controlled trial. Face-to-face interviews were used to collect questionnaire data in 2015. Based on our hypothesis that established Somalis could be used as facilitators of change among those newly arrived, data were stratified into years of residency in Sweden. Setting Sweden. Participants 372 Somali men and women, 206 newly arrived (0-4 years), 166 established (>4 years). Primary outcome measures Whether FGC is acceptable, preferred for daughter and should continue, specified on anatomical extent. Results The support for anatomical change of girls and women's genitals ranged from 0% to 2% among established and from 4% to 8% among newly arrived. Among those supporting no anatomical change, 75%-83% among established and 53%-67% among newly arrived opposed all forms of FGC, with the remaining supporting pricking of the skin with no removal of tissue. Among newly arrived, 37% stated that pricking was acceptable, 39% said they wanted their daughter to be pricked and 26% reported they wanted pricking to continue being practised. Those who had lived in Sweden ≤ 2 years had highest odds of supporting FGC; thereafter, the opposition towards FGC increased over time after migration. Conclusion A majority of Somali immigrants, including those newly arrived, opposed all forms of FGC with increased opposition over time after migration. The majority of proponents of FGC supported pricking. We argue that it would have been unethical to proceed with the intervention as it, with this baseline, would have been difficult to detect a change in attitudes given that a majority opposed all forms of FGC together with the evidence that a strong attitude change is already happening. Therefore, we decided not to implement the planned intervention. Trial registration number Trial registration number NCT02335697;Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Author Keywords

Migration Female genital mutilation intervention Sweden Pricking Somalis

Index Keywords

immigrant genital system girl skin culture human middle aged controlled study randomized controlled trial Somali (citizen) skin ethnology interview Young Adult Sweden Humans attitude Adolescent female genital system male female questionnaire Circumcision, Female female genital mutilation Genitalia, Female major clinical study adult migration Somalia Emigration and Immigration registration Child

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85027398849&doi=10.1136%2fbmjopen-2017-017506&partnerID=40&md5=480daf111adbd1d8978a7c1c456c1040

DOI: 10.1136/bmjopen-2017-017506
ISSN: 20446055
Cited by: 4
Original Language: English