Girls' rights on the line: WHO's game-changing guidelines against female genital mutilation

In a significant move to combat the widespread practice of female genital mutilation (FGM), the World Health Organisation (WHO) has released new guidelines aimed at preventing this harmful custom and providing better care for survivors.

As the global community targets the abandonment of FGM by 2030, urgent measures are needed to address the concerning trend of the “medicalisation” of this traditional practice, which sees health workers performing these dangerous procedures.

According to research by the WHO, over 230 million girls and women alive today have undergone FGM in regions where the practice is prevalent, with more than 4 million girls at risk each year, many of whom are cut before they reach 15.

The ramifications of FGM extend beyond the immediate dangers; it poses numerous long-term health risks that can affect physical, mental and sexual well-being.

More importantly, it represents a gross violation of the rights of children, as it is often carried out without consent.

Dr Pascale Allotey, the WHO's director for sexual and reproductive health and research, stresses the essential part the health industry plays in ending FGM.

She states that "Female genital mutilation is a serious breach of girls’ rights and significantly jeopardises their health."

"The health sector has an essential role in preventing FGM – health workers must be agents for change rather than perpetrators of this harmful practice, and must also provide high-quality medical care for those suffering its effects.”

Alarmingly, health workers have increasingly become involved in FGM procedures, with estimates suggesting that one in four cases now occurs in healthcare settings.

According to WHO: "Some studies suggest it can even be more dangerous when performed by health workers, since it can result in deeper, more severe cuts. Its 'medicalisation" also risks unintentionally legitimising the practice and may thereby jeopardise broader efforts to abandon the practice."

In response to this alarming trend, the WHO's new guideline, titled "The prevention of female genital mutilation and clinical management of complications", outlines key strategies not only for the health sector but also for governments and communities. 

It promotes professional codes of conduct that explicitly prohibit health workers from performing FGM, suggesting that positive engagement and training are essential components in the battle against this practice.

Christina Pallitto, a WHO scientist who led the guideline's development, says that research shows that health workers can be influential opinion leaders in changing attitudes on FGM.

“Engaging doctors, nurses and midwives should be a key element in FGM prevention and response, as countries seek to end the practice and protect the health of women and girls.”

Beyond healthcare professionals, the guideline stresses the importance of community education, including raising awareness among men and boys about the detrimental effects of the practice.

While legal frameworks and policy enforcement are crucial, it is the community’s collective action that ultimately promotes the necessary attitudinal changes to protect girls’ rights.

The WHO's guidelines also extend to the provision of empathetic, high-quality medical care for FGM survivors.

Survivors often face a myriad of short and long-term health issues, necessitating varied healthcare services throughout their lives, from mental health support to management of obstetric risks and potential surgical repairs.

Despite the challenges, evidence from countries such as Burkina Faso, Sierra Leone and Ethiopia shows that it is indeed possible to reduce the prevalence of FGM through political commitment and community action.

Over the past 30 years, these nations have seen significant reductions in FGM cases among 15-19 year-olds, with declines of up to 50% in Burkina Faso alone.

WHO states: "Since 1990, the likelihood of a girl undergoing genital mutilation has decreased by threefold. However, it remains common in some 30 countries around the world, and an estimated 4 million girls each year are still at risk."