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What Makes People Abandon Female Genital
Mutilation/Cutting?
Experiences from Senegal and Burkina Faso
Nafissatou J. DiopInternational Day of Zero Tolerance for Female Genital Cutting Washington D.C. February 6, 2007
Information Based on Several Studies
Senegal
Breakthrough in Senegal, 1998
Evaluation of a community based program 2000-2004
Evaluation of the long term impact of the Tostan program, 2006
Burkina
Testing a community based program 2000-2004
Is Female Genital Cutting declining in Burkina Faso? An assessment of the evidence 2004-2006
Outline of the Presentation
Current statistics of FGC in Burkina and Senegal
The mental map: What is still there?
Observation: Change - people are abandonning the practice.Why?
- Tostan intervention in Senegal- CNLPE interventions in Burkina Faso
Perceptions of innovation - not cutting girls
Conclusion
What are the Statistics on FGM/C in Burkina Faso?
Prevalence of FGM/C Among Women Aged 15-49
Since 19961996 (INSD) : 66% 1999 (DHS) : 72%2000 (Ouéd D.) : 85%2001 (Sangli G.) : 75.5%2001 (Ouéd I.) : 76.4%2002 (Kaboré Y.) : 76.9%2003 (EDS): 77%
TAPOA
COMOE
SO UM
HOUET
PONI
TUY
SENO
KO SSI
GOURMA
SISSILI
ZIRO
OUDALAN
GNAGNA
BAM
YAGHA
BALE
BANWA
YATEN GA
SO URO U
BOULGOU
IOBA
SA NMATENGA
MOUHOUN
SA NGUIE
KO MPIEN GAKENEDOU GOU
BAZEGA
NAYALA
NAMENTENGA
PASSO RE
LOROUM
NAHOURI
KO ULPELOG O
LERABA
KO MANDJARI
BOULKIEMD EKA DIOGO
GANZOURGOU
NOUMBIEL
ZOUNDWEOGO
OUBRITENGA
BOUG OURIBA
KO URITENG A
ZONDOMA
KO URWEO GO
Adm46Données manquantes16 - 5050 - 6061 - 98
N
EW
S
PASSOREPASSORE
BoulkiemdBoulkiemdéé
BazégaBazéga
SanguiéSanguié
4 provinces have a prevalence of less than
50%
Prevalence among women 15-49 years old by province
Sources:SangliKaboré YimianINSDKaboré Idrissa
Prevalence Among Daughters 0-10 years old
Surveys Year
0-10 years 15-49 years
% %
INSD 1996 36,4 (1204) 66,4 (1654)
PEBC
PEBC
2001
2003
6 (556)
2,6 (690)
70,4 (608)
71 (720)
Ouédraogo D. 2000 15,6 (940) 85,1 (879)
Sangli 2001 9,8 (1215) 75,5 (1632)
Ouedraogo I. 2001 12 (1018)) 76,4 (1861)
Kabore 2002 18,7 (nd) 76,9 (3150)
Selected studies
What are the Statistics on FGM/Cin Senegal?
Prevalence rate of FGM/C28 % national rate among mothers; 20% among daughters DHS 2005
Proportion of girls aged 0 - 10 years not cut following a Tostan intervention
46
6064
48 48
0
20
40
60
80
100
Baseline(n=589)
Participant(n=358)
Nonparticipant
(n=189)
Baseline(n=222)
Endline(n=199)
Endline
Intervention areaComparaison
No reported cases of FGC in the villages
«In this village FGC is condemned by the population. Tostan conducted education activities so we learned the harsh trials for health » Religious leader, Kolda
Disappearance of traditional excisors
«The excisor who was doing it died. Her daughter didn’t take it over » Woman not participating in the program, Diabougou
In villages where Tostan worked
Where Are We With the Reasons to Continue the
Practice?
Why the Practice of FGC Continues: The Mental Map
WHO. 1999. What works what doesn’t work.
A. Psychosexual and Social Reasons
Social acceptability Less Control of women’s sexuality
Chastity and virginity YesMarriagibility Less The honor of the family Yes, but modern stigma is
unmarried pregnancy (no longer uncut woman) Hygienic and esthetism No Religious requirement Marginal
If We Follow the Mental Map
B. Community enforcement mechanismsFear of punishment by God or supernatural forces NoDivorce and refusal to marry uncut girls Marginal
No clear opposition to mariage Cultural mix particularly in cities Migration and exposition to western world
Obligation to cut a wife that comes from a non-practicing community No
Poems and songs glorifying FGC and humiliating non cut girls Disappeared
If We Follow the Mental Map
People are Abandonning the
Practice
Why?
CNLPE Strategy
CNLPE is a government body; 13 institutions (Army, Health, Social,Defense, Communication, Justice, ….)
CNLPE strategies consist of:
- Implementation of the law- Free telephone line for denunciation (SOS excision 80 00
11 12) - Capacity building and advocacy work - Education of communities on the risks of FGM/C
Health consequences Legal implications (arrested, condemned)
- Decentralized system of operating
Tostan Strategy
Comprehensive educational program for women on hygiene, human rights, women’s health and problem solving
Bring knowledge and awareness on health and life skills
Empower women through building confidence to participate and be pro-active
Tostan Strategy
Promote self development through the use of adapted educational materials
Participatory approach emphasizing peaceful strategies for social change
Create a mobilization movement by bringing together several villages for societal change: Public declaration of abandonment
How the Change is Perceived When We Look at the Theory of Diffusion
Diffusion Model
COMMUNICATION CHANNELS
KNOWLEDGE PERSUASION DECISION IMPLEMENTATION CONFIRMATION
Prior Conditions: Previous practice * Felt needs/problems * Innovativeness * Norms
CharacteristicCharacteristics ofs ofdecision-decision-makermakerSocioeconomiccharacteristicsPersonalityvariablesCommunication behavior
Perceived Perceived characteristicscharacteristicsof the innovationof the innovationRelative advantageCompatibilityComplexityTrialabilityObservability
Adoption Continued AdoptionLater Adoption
RejectionDiscontinuanceContinued Rejection
Rogers 1995.
Perceived Benefits of Not Cutting
The greater perceived relative advantage, the more rapid the rate of adoption and change
Sensibilisation , Education raise awareness. It contributes to change people perception of the practice
« In our community, this was an habit, we were doing it because it was a custom. People were laughing at those who were not cutting their daughter. But we understood, with the education campaigns that FGC do not bring any advantage to anybody. The bad consequences are important » (Mixed Focus Groups, Houét)
Recognize the complication of FGC or hear testimony of women on the subject is a major step for some people
Perceived Benefits of Not Cutting
People are recognizing a relative economic advantage of not cutting girl.
« If you take off the clitoris today, you will lost your hair by paying prescriptions and she can die (…) This is why abandon this practice has more advantage for us» (Focus adults men, Zoundwéogo)
« It is better to have an uncut woman to avoid problems. The day you will have a child, you will be a husband with a lot of problems, as the delivery will cost you more than for an uncut woman » (focus students Houet)
The implementation of the law
Contributed heavily in the abandonment of the practice in Burkina and plays the role of gatekeeper among communities that receive the Tostan program.
Perception of the people is that the law is very strict and it is necessary to obey.
« Yes it is because of the interdiction that I don’t want my daughter to be cut » (woman i favor of the practice of FGC, mossi, Ouaga-Kadiogo)
« Since the law has been voted, which coincide with the public declaration of Diabougou, this practice has ended. There is girls in this village that reached the age of marriage and who are uncut » leader, Keur simbara
Perceived Complexity for Practicing FGM/C
(Not practicing is simpler)
The community system of surveillance
« Everybody has abandoned, because if everybody abandon and I practice it, if they see me they are going to denunciate me » (Community Leader against the practice, 56, Oudalan)
« We discussed with the community to raise awarness. I know that if we caught someone practicing FGC, we will tell him/her « Don;t do it again
or I will denounce you » but this case hasn’t happened yet. » Woman leader, Diabougou
Perceived Complexity for Practicing FGM/C
(Not practicing is simpler)
Traditional leaders involvement in community activities provided stronger and more visible support to the abandonment« Here this is our chief. The chief told us that he doens’ want to here about FGC in his village in the short and long term, he doen’snt want to hear that a woman has been cut or want to cut someone …» (Focus adult women, Gourma)
The contact with other cultures create a confrontation of ideas and beliefs and support the decision« Because people travel, they are going everywhere, they bring back information on
FGC and its consequences. They explain it to the community and they abandon the practice because of what they saw » men leader, 70 ans,Korézéna, Oudalan)
« The world has changed, mentality have changed, all the girls are going to school now. There is a lot of mix up of people » Men, Malicounda
Perceived Compatibility of Not Cutting
The level of education contributes to the abandonment of the practice« My mother told me that this is because of my elder brother who is a teacher,
otherwise I would have been cut like her » (Girls non cut, 19 years old, Saouga, Oudalan)
Religious groups, particularly Christian, play a role in the abandonment «We were the first ones to abandon this practice. The pastor preached against and we
took it as a commandment. » (Male Community Leader, 37 years old, Bazèga)
Perceived Compatibility of Not Cutting
Reaching the Critical MassPeople that have abandoned the practice are important (large numbers;
started 6 or 7 years ago)There is a critical mass in terms of change of attitude But in terms of behavior change, 2 voices:
« The fear of denunciation and the change in the practice (family practice) make it difficult to know what is happening in your neighbor’s house »
« Communities highlight the fact that people have abandonned, but the number of cut women is still high and this hides the increase of the number of uncut girls. The critical mass will be reached with time ».
Health providers observe the abandonment: Girls received in consultation are not cut Young women that come to deliver are not cut
Commonalities:Factors Affecting Speed of Abandonment
Enabling environment: Policy (law), democracy (media)
Comprehensive, well structured, holistic intervention
Decentralized operating system, but a strong coordination mechanism
Long-term education of communities (constant; different channels)
Organized diffusion system
Involvement of leaders to become key actors
Responsibility of communities to maintain the surveillance system
But We Need to Support families/people that have abandoned cutting
- Pioneer women were stigmatized (Senegal); Need new messages to motivate, mechanism for rewards
Non cut girls are stigmatized with cultural changes
- Western dress, sexuality, sex outside of marriage, pregnancy, abortion - the older generation sees this behavior as a consequence of the abandoment of cutting and loss of accompanying education
Keep up commitment, include life skills education for young people and parent/child communication programs
