Percent of sevice delivery points providing medical and psychological services and referrals for women/girls with FGC complications
The number and percent of health facilities providing medical and psychological services and referrals for services for women and girls with complications from female genital cutting (FGC).
Surveys or reviews of client records from primary health care sites provided by supervisors or evaluators on types of services provided.
It is recommended that data are collected using a census-based approach (i.e., from all primary care sites in the target area). For validation purposes, the data collector may choose to conduct brief follow-up interviews with a subset of clients. Where the data are available, the indicator can be disaggregated by province and district, urban/rural location, type of facility (public, private, community-based), and client characteristics (age, ethnicity, religion, etc.).
If targeting and/or linking to inequity, classify service delivery points by location (poor/not poor) and disaggregate by location.
Client records, surveys, and interviews from primary care sites, staff, and clients.
This indicator measures the coverage and components of care provided by health facilities providing medical and psychological services and referrals for women and girls with FGC complications. Those who have undergone the practice present with unique physical and emotional issues. The experience can be extremely painful and traumatic and those who have been cut may suffer anxiety, depression, and post-traumatic stress disorder. Physically, common complications are (Jones, Diop, Askew and Kaboré, 1999):
- Shock (from severe pain and/or hemorrhage)
- Infection (wound infection, including tetanus, and urinary tract and vaginal infections)
- Keloids (scar formation)
- Stenosis (thickening or narrowing of the vagina due to scarring)
- Vaginal synechia (labial adhesion)
- Vaginal obstruction (which can lead to obstructed labor)
- Vesicovaginal fistula (opening between the bladder and the vagina)
- Rectovaginal fistula (opening between the rectum and the vagina)
- Urinary incontinence.
Because most international effort has been directed toward eradication of FGC, less attention has been placed on serving the neglected health needs of the estimated 100 to 140 million women who have been subjected to the practice (Muhamed et al, 2002). Meeting the physical and mental health needs of women who have been cut is a critical component in providing comprehensive reproductive health care.
While the indicator measures coverage of health services for women and girls with FGC complications, it does not evaluate the quality and outcomes of the care. Lack of accuracy and quality control in record keeping can impact the validity of this indicator.
access, female genital cutting (FGC), quality, violence, safe motherhood (SM)
Mohamud A., Ringheim K, Bloodworth S., and Gryboski K. Girls at Risk: Community Approaches to End Female Genital Mutilation and Treating Women Injured by the Practice. Reproductive Health and Rights – Reaching the Hardly Reached, 2002.
Jones H., Diop N., Askew I., and Kaboré I. Female Genital Cutting Practices in Burkina Faso and Mali and Their Negative Health Outcomes. Studies in Family Planning, 1999:30(3), 219-230.
PATH. Female Genital Mutilation-The Facts. Compiled by Reymond L., Mohamud A., and Ali N.
Available at: http://www.path.org/files/FGM-The-Facts.htm