Countries with Highest Prevalence of Female Genital Mutilation, 2004-15

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Female Genital Mutilation/Cutting: Risk Management and Strategies for Social Workers and Health Care Professionals

Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries.

Countries grouped according to prevalence, types I, II, and III and laws against FGM/C

Categories	Prevalence of girls and women of reproductive age who report having been cut, and Type of FGC/M	Countries	Countries with laws against FGM/C
1. Very high prevalence countries, almost universal	Over 80% of girls and women of reproductive age reported having been cut, 30% Type III	Somalia (98%), Guinea (96%), Djibouti (93%), Egypt (91%). Eritrea (89%), Mali (89%), Sierra Leone (88%), Sudan (88%).	Djibouti, Egypt. Eritrea, Guinea, Somalia, Sudan.
2. Moderately high prevalence countries	Between 51% and 80% of girls and women cut, predominantly Types I and II	Gambia (76%), Burkina Faso (76%), Ethiopia (74%), Mauritania (69%), Liberia (66%).	Burkina Faso, Ethiopia, Mauritania.
3. Moderately low prevalence countries	Between 26% and 50% of girls and women cut, predominantly Types I and II	Guinea Bissau (50%), Chad (44%), Cote D’Ivoire (38%), Kenya (27%), Nigeria (27%), Senegal (26%).	Chad, Cote D’Ivoire, Kenya, Senegal, Guinea Bissau, Nigeria.
4. Low prevalence	Between 10 and 25%, predominantly Types I and II	Central African Republic (24%), Yemen (23%), United Republic of Tanzania (15%), Benin (13%).	Central African Republic, Benin, United Republic of Tanzania.
5. Very low prevalence	Below 10%	Iraq (8%), Ghana (4%), Togo (4%), Niger (2%), Cameroon (1%), Uganda (1%).	Ghana, Niger, Togo.

Notes: Data from UNICEF 2013,4 and Macfarlane and Dorkenoo.15

Abbreviation: FGM/C, female genital mutilation/cutting.

Full article at:   http://goo.gl/h2My9U

By:  Susan Costello

School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia

Correspondence: Susan Costello, School of Global, Urban and Social Studies, RMIT University, 360 Swanston Street, Melbourne 3001, VIC, Australia, Email ua.ude.timr@olletsoc.nasus

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Prevalence & Correlates of Intimate Partner Violence among Family Planning Clients in Conakry, Guinea

BACKGROUND:

Intimate partner violence (IPV) is a global public health problem that affects women's physical, mental, sexual and reproductive health. Very little data on IPV experience and FP use is available in resource-poor settings, such as in West Africa. The aim of this study was to describe the prevalence, patterns and correlates of IPV among clients of an adult Family Planning clinic in Conakry, Guinea.

METHODS:

The study data was collected for four months (March to June 2014) from women's family planning charts and from an IPV screening form at the Adult Family Planning and Reproductive Health Clinic of "Association Guinéenne pour le Bien-Etre Familial", a non-profit organization in Conakry, Guinea. 232 women out of 245 women who attended the clinic for services during the study period were screened for IPV and were included in this study.

RESULTS:

Of the 232 women screened, 213 (92 %) experienced IPV in one form or another at some point in their lifetime. 169 women reported psychological violence (79.3 %), 145 reported sexual violence (68.1 %) and 103 reported physical violence (48.4 %). Nearly a quarter of women reported joint occurrence of the three forms of violence(24 %).Half of the IPV positive women were current users of family planning (51.2 %) and of these, 77.9 % preferred injectable contraceptives. The odds of experiencing IPV was higher in women with secondary or vocational level of education than those with higher level of education (AOR: 8.4; 95 % CI 1.2-58.5). Women residing in other communes of Conakry (AOR: 5.6; 95 % CI 1.4-22.9) and those preferring injectable FP methods (AOR: 4.5; 95 % CI 1.2-16.8) were more likely to experience lifetime IPV.

CONCLUSIONS:

IPV is prevalent among family planning clients in Conakry, Guinea where nine out of ten women screened in the AGBEF adult clinic reported having experienced one or another type of IPV. A holistic approach that includes promotion of women's rights and gender equality, existence of laws and policies is needed to prevent and respond to IPV, effective implementation of policies and laws, and access to quality IPV services in Guinea and countries with higher rates of IPV.

Below:  Venn diagram illustrating overlaps between lifetime experiences of psychological, physical and sexual violence reported by FP clients in Conakry, Guinea, March to June 2014

Full article at:   http://goo.gl/Mq1M02

By:  Alexandre Delamou, Ghazaleh Samandari, Bienvenu Salim Camara, Pernamou Traore, Fatoumata Guilinty Diallo, Sita Millimono, Defa Wane, Maimouna Toliver, Kira Laffe, and Fabio Verani

Centre National de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea

Department of Public Health, Faculty of Medicine, University of Conakry, Conakry, Guinea

EngenderHealth, New York, USA

Association Guinéenne pour le Bien-Etre Familial, Conakry, Guinea

Ministry of Health, Conakry, Guinea

EngenderHealth, Conakry, Guinea

Alexandre Delamou, Email: moc.liamg@uomaleda.

BMC Res Notes. 2015; 8: 814.

Published online 2015 Dec 23. doi:  10.1186/s13104-015-1811-7

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Rapid Assessment of Ebola-Related Implications for Reproductive, Maternal, Newborn and Child Health Service Delivery and Utilization in Guinea

Below:  Median number of outpatient visits in hospitals

Introduction: Since March 2014, Guinea has been in the midst of the largest, longest, and deadliest outbreak of Ebola Virus Disease ever recorded. Due to sub-optimal health conditions prior to the outbreak, Guinean women and children may have been especially vulnerable to worsening health care conditions. A rapid assessment was conducted to better understand how the delivery and utilization of routine RMNCH services may have been affected by the extraordinary strain placed on the health system and its client population by the Ebola outbreak in Guinea.

Methods: Data were collected January-February 2015 in a convenience sample of public and private facilities in areas of the country that were Ebola active, calm and inactive. Monthly data on a number of RMNCH services were collected by facility record abstraction for the period from October 1, 2013 through December 31, 2014. Structured interviews were also held with facility directors and RMNCH service providers.

Results: Data on RMNCH services from forty five public facilities were obtained. A statistically significant decline of 31% was seen in outpatient visits between October-December 2013 (before the Ebola outbreak) and October-December 2014 (the advanced stage of the Ebola outbreak). Service declines appeared to be greater in hospitals compared to health centers. Child health services were more affected by the Ebola epidemic than other assessed health areas. For example, the number of children under five seen for diarrhea and Acute Respiratory Infection (ARI) showed a large decrease over the one-year period in both hospitals (60% for diarrhea and 58% for ARI) and health centers (25% and 23%, respectively). Results also suggest that the negative effects on service availability (such as reduced hours, closures, and service suspensions) are likely to be regional and/or facility-specific. Providers reported a number of improved infection control behaviors as a result of the Ebola outbreak, including more frequent hand-washing and the use of disinfectants. Nevertheless, 30% of interviewed staff had not received any training on Ebola infection control.  

Discussion: Although there may be differences in RMNCH service delivery and availability in selected versus non-selected facilities, a large number of indicators were assessed in order to provide needed information on the effects of the Ebola crisis on routine RMNCH service delivery and uptake in Guinea. This information is an important and timely contribution to ongoing efforts to understand and respond to the adverse effects of the Ebola crisis on essential RMNCH services in Guinea.

Via: http://ht.ly/RUnI7

By: Janine Barden-O'Fallon,* Mamadou Alimou Barry,* Paul Brodish, and Jack Hazerjian

MEASURE Evaluation, Carolina Population Center, University of North Carolina at Chapel Hill,