Hello Everyone. We are glad to have you join our Tweet Conference today. We hope to have you participate in this conference till we #endcuttinggirls  in this generation.

The aim of this conference is to ensure that the right message about this practice, FGM, is available to everyone and also a means to mobilise everyone to advocate for the elimination of FGM

In today’s edition of the conference, we will discuss ENHANCING HEALTH WORKERS KNOWLEDGE OF FGM THROUGH PRE-SERVICE AND IN SERVICE TRAINING

Also note that the conference will explain basic facts about FGM, explain the importance of health workers in this campaign and the need for their knowledge base to be improved.

This section will run for 1 Hour and 45 minutes. You can start rolling in your questions from 06:45 pm. Ensure you include the hashtag  so we can track your questions.

Globally, it has been recorded that more than 200 million girls and women have undergone either one or more form of FGM in their lifetime with another 3.6 million at the risk of being cut annually.

Female Genital Mutilation (FGM) is a culturally entrenched practice that is associated with socioeconomic repercussions on girls/women, families and communities. And as such, it is known to be harmful and constitutes a form of violence and human rights violation of the child; girls and women

According to WHO in 1997, FGM entails all all procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons..

The practice which has 4 defined types is known to predate Islam and Christianity. It has no basis in religion yet has been religiously driven over the course of time.

The practice of FGM has continued for years because of various reasons and chief amongst that is the ability of advocates of the practice to always evolve with time and provide suitable explanation for the practice

According to a baseline survey conducted by UNICEF in 2015, respondents who have knowledge of FGM maintained that mothers and grandmothers are the major drivers of the practice

It was also found out that the major people supplying the services are Traditional Birth Attendants (TBAs), matriarchs of a particular family (based on her age and experience), etc. In some unusual cases, barbers are contracted to do the cutting

After the early days of advocacy to stop the cutting of the girl with focus on the health risks, many drivers of the practice moved swiftly to engage medical workers to save the day. Hence, the medicalization of FGM

This means #FGM is now performed by health care professionals in hospitals, clinics, homes or neutral places using surgical tools, anaesthetics and antiseptics in the hope of mitigating the immediate complications of FGM

In 2015, Prof Jaldesa and Guyo W described medicalization of FGM as the new threat as they concluded that “with increasing awareness of the adverse health consequences and greater access to health care services, health workers have become involved in performing FGM

“Data indicates that the prevalence of FGM medicalization is increasing, especially among mothers with secondary education” (Tweet 18 &19 sourced from Africa Coordinating Centre for Abandonment of FGM)

Medicalization also involves reinfinulation of deinfibulated external genitalia on women with FGM type iii following delivery and related gynecologic procedures by doctors or nurses/midwives

It has been supported and perpetuated mainly through supposedly justification, namely, harm reduction from immediate complications, fulfilment of cultural requirement among many others

It must be noted also that FGM is a means of adding to health workers’ streams of income even when the practice is outlawed.

The dangers associated with FGM are physical, psychological, social and sexual harms on women and by extension, on men. These dangers are immediate, short and long term in nature

With these associated dangers, it is believed that the medicalization of FGM is a bigger problem as the health sector has critical role to play in the global campaign to eliminate FGM

This also means that health workers must have needed knowledge to be a part of the multi-disciplinary approach aimed at eliminating female genital mutilation in this generation

As health workers are largely a unit of professionals from diverse educational and cultural background, their roles and availability at different service delivery points make them perfect advocates to

This would fit in directly into the outcomes of the global Joint Programme of the United Nation where Girls and women receive appropriate, quality and systemic services for FGM prevention, protection and care.

Hence, the need to adequately equip them with pre requisite knowledge through Pre-Service and In-Service trainings.

The Pre-Service Training for Health Workers refers to the education and training provided to health workers in training, before they actually undertake any service to end user.

While In-Service Training for Health Workers is the form of training they get from experience, capacity building and all forms of ‘on-the-job’ training to increase their efficiency and quality of services they provide

To #endcuttinggirls, it has been established that all health workers, regardless of cadre, will play vital roles. Hence, the preponderance of enhancing and monitoring of their (health workers) trainings (Pre and In Service)

To ensure that health workers are indeed empowered with the right knowledge, the regulatory bodies responsible for training of health workers must include #FGM related topics in their training modules

It is through this that health practitioners at all levels will be able to face head-on any form of issue arising from their workplace

With the appropriate knowledge on health risks, legal potholes and human rights violated by the practice of #FGM, a health worker is prepared to navigate around parents seeking to cut their girl child when such health worker is deployed to a service point

This approach will  drastically reduce the incidence of medicalized cutting, and also help the health worker to educate and counsel such parents, accordingly.

It also means that the health worker is equipped to collect and collate data, interpret and use when needed before making it available to policy makers who can use such to design programmes that will help to #endcuttinggirls

With health workers who have the required knowledge of #FGM prior to deployment to service delivery points, the legal documents that outlaw the practice can now be fully used as health workers are now collaborators and are aware of the demands of the law

As collaborators, health workers are also duly aware that their guiding rules would change to punish health workers who engage in the practice of cutting the Girl Child within or without a health facility

Knowing that the efforts to #endFGM is a continuous one, new information are constantly made available to health workers to meet the new challenges that might arise at their various centres

It is to the end that the In-Service Training of health workers is of great importance and must be invested in to ensure that health workers don’t lose sight of the goal.

The In-Service training directly prepares the health workers to respond to issues that may affect survivors directly

When survivors come into facilities for any form of help, the health workers are available to render such help as demanded. This might not necessarily be health related; could be counselling

With the usual confidence reposed in health workers, survivors would find it easier to discuss issues that bother them with health workers they are familiar with.

This will also reduce the possibility of a survivor getting wrong counsel or a parent getting tricked into cutting her girl-child for the economic gain of the adviser. It must be said that the In-Service training doesn’t have to take the structure of a formal class as health workers can learn more about #FGM through interaction with the community and stakeholders, in particular

This suggests that a health worker would learn more about cultural and religious reasons that drive the practice in her community through local engagements and relationships built.

Such interactions will help the health worker become a trusted ally in the community engagements that will drive the social norm change that will lead to the elimination of female genital mutilation

By and large, as collaborators in the campaign to #endFGM, health workers must be supplied with the information they need through constant in service training to keep ahead of their community. They must not be left alone with the assumption that ‘as health workers, they will know what to do’ as this will not only be dangerous for the cause, it might put their end users at risk.

As a group of people, while we continue to find ways to end medicalization of #FGM and elimination of the practice, we must continue to single out health workers who have shunned the practice for the deserved accolades

In this campaign, everyone is important and we urge you all to join this train to  in this generation.

For pre-service and in-service training of Health Professionals, we recommend two documents from World Health Organisation, “Guidelines on the management of health complications from FGM (WHO 2016) and “Care of women and girls living with FGM: a clinical handbook. Geneva: (WHO 2018)” .

To learn of the works my team and I have been able to do with the support of @UNICEF_Nigeria, kindly visit www.endcuttinggirls.org

You can connect with us on Twitter and Instagram through @endcuttinggirls and Endcuttinggirls Nigeria on Facebook and YouTube. You can also search  on all these platforms to learn more.

Thank you one and all.

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