Cations for women’s health, with women who have undergone FGM more likely than others to have adverse obstetric outcomes. FGM has no health benefits and harms girls and women both physically and mentally. These impacts occur at the time of the procedure as well at adulthood, particularly motherhood. All forms of FGM have psychological effects, particularly related to female2 sexuality and sexual relationships. The UN regards FGM as a violation of female reproductive rights [12, 13], and thus the ending of FGM is of relevance to all health professionals. Understanding the issues associated with preventing FGM is particularly relevant to health professionals who work with FGM affected and at risk women and girls, since they are in a position to communicate directly with affected community members and may also be linked with organisations which engage in prevention as well as obstetric and gynaecological treatment of FGM complications. The WHO, United Nations (UN), Unicef, and other antiFGM organisations have adopted various strategies in order to raise awareness and work towards ending FGM. Such efforts have centred around four main approaches. These include bodily and sexual integrity; human rights; legislative; and the health approach. Thirty years on since the WHO called for the ending of FGM, there is conflicting evidence as to whether these approaches have led to a reduction in the practice [14, 15]. In 1999, aware of the limited success to date in eliminating FGM, the WHO recommended a behavioural change approach be implemented in order to move closer to the elimination of FGM [16]. In 2002, the Frontiers in Reproductive Health and Population Council (FRHPC) produced a review of FGM interventions and called for research to be informed by behaviour change theory (BCT) [17]. They suggested that few evaluations of interventions assess their impact on important outcomes including “knowledge, beliefs, attitudes, and CV205-502 hydrochloride web behaviors” concerning FGM and that BCT is needed to establish how interventions work [17, page 1]. Despite the numerous calls for more targeted behaviour change approaches to the issue of FGM, little progress has been made in implementing and/or evaluating behaviour change approaches [2]. This paper is based on research undertaken as part of the EU’s Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE). One of the aims of this 12-month project was to work with FGM affected communities and nongovernmental organisations implementing FGM elimination interventions to understand the barriers to the ending of FGM and to assess the appropriateness of NGO intervention materials and awareness raising activities. The project used a community-based participatory action research approach to try to understand why FGM intervention programmes have not delivered an end to FGM in the EU. The results of this part of the research were then applied to a grounded health behaviour change approach in line with WHO’s [16, page 2] call for the reorientation of anti-FGM communication strategies “from awareness raising to behaviour-change intervention approaches”. order BX795 REPLACE produced a toolkit designed to introduce behaviour change approaches to those working to end FGM amongst affected communities in the EU [18]. This was achieved by integrating social cognitive and community level behaviour change intervention strategies. In this paper we argue that because of the social aspects characteris.Cations for women’s health, with women who have undergone FGM more likely than others to have adverse obstetric outcomes. FGM has no health benefits and harms girls and women both physically and mentally. These impacts occur at the time of the procedure as well at adulthood, particularly motherhood. All forms of FGM have psychological effects, particularly related to female2 sexuality and sexual relationships. The UN regards FGM as a violation of female reproductive rights [12, 13], and thus the ending of FGM is of relevance to all health professionals. Understanding the issues associated with preventing FGM is particularly relevant to health professionals who work with FGM affected and at risk women and girls, since they are in a position to communicate directly with affected community members and may also be linked with organisations which engage in prevention as well as obstetric and gynaecological treatment of FGM complications. The WHO, United Nations (UN), Unicef, and other antiFGM organisations have adopted various strategies in order to raise awareness and work towards ending FGM. Such efforts have centred around four main approaches. These include bodily and sexual integrity; human rights; legislative; and the health approach. Thirty years on since the WHO called for the ending of FGM, there is conflicting evidence as to whether these approaches have led to a reduction in the practice [14, 15]. In 1999, aware of the limited success to date in eliminating FGM, the WHO recommended a behavioural change approach be implemented in order to move closer to the elimination of FGM [16]. In 2002, the Frontiers in Reproductive Health and Population Council (FRHPC) produced a review of FGM interventions and called for research to be informed by behaviour change theory (BCT) [17]. They suggested that few evaluations of interventions assess their impact on important outcomes including “knowledge, beliefs, attitudes, and behaviors” concerning FGM and that BCT is needed to establish how interventions work [17, page 1]. Despite the numerous calls for more targeted behaviour change approaches to the issue of FGM, little progress has been made in implementing and/or evaluating behaviour change approaches [2]. This paper is based on research undertaken as part of the EU’s Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE). One of the aims of this 12-month project was to work with FGM affected communities and nongovernmental organisations implementing FGM elimination interventions to understand the barriers to the ending of FGM and to assess the appropriateness of NGO intervention materials and awareness raising activities. The project used a community-based participatory action research approach to try to understand why FGM intervention programmes have not delivered an end to FGM in the EU. The results of this part of the research were then applied to a grounded health behaviour change approach in line with WHO’s [16, page 2] call for the reorientation of anti-FGM communication strategies “from awareness raising to behaviour-change intervention approaches”. REPLACE produced a toolkit designed to introduce behaviour change approaches to those working to end FGM amongst affected communities in the EU [18]. This was achieved by integrating social cognitive and community level behaviour change intervention strategies. In this paper we argue that because of the social aspects characteris.
