A mixed-method synthesis of knowledge, experiences and attitudes of health professionals to Female Genital Mutilation

Aim. To synthesize knowledge, attitudes and experiences of health professionals about Female Genital Mutilation. Background. Despite the World Health Organization campaigning to stop FGM, and it being illegal in many countries, the practice remains common in some countries and cultures. Migration has contributed to the growth of this practice in countries where it was not previously carried out. Design. Mixed-method synthesis. Data sources. Search of ten electronic databases: 2006–2014. Manual scanning of reference lists and summary feeds from international organizations such as WHO, UN and UNICEF. Review methods. Thematic synthesis comparing country of origin where the practice was common with country of residence where migrant women affected by the practice reside. 17 included descriptive, quantitative, qualitative studies and grey literature studies in English or Spanish. Results. Seven themes were developed: Ignorance of FGM practice and its consequences; Lack of adherence to FGM protocols and guidelines; Socially constructed acceptance of FGM; Ignorance of legislation and legal status of FGM; Condoning, sanctioning or supporting FGM; Lack of information and training; Nurses and Midwives as key to protecting and supporting girls and women. Conclusions. Although some nurses and midwives are in the forefront of eradicating FGM this is counterbalanced by health professionals (including nurses and midwives) who condone, sanction or support the practice with some calling for medicalization of FGM as a legitimate procedure. Girls at risk need better protection and women affected need more competent and cultural care from health professionals. Health and legal systems, professional regulation and governance, and professional training require strengthening to eradicate FGM, prevent the medicalization of FGM as an acceptable procedure, and to better manage the lifelong consequences for affected girls and women