Background
Methods
Definitions
Inclusion criteria
Design
Participants
Outcomes
Exclusion criteria
-
Publications reporting patient or community knowledge or attitudes
-
Publications that used qualitative study designs
-
Publications reporting on genital cosmetic procedures
-
Foreign language publications
Quality assessment
Data extraction and analysis
Results
Reference | Country | Study design and method | Domains assessed | Sample | N | Response rate | ||
---|---|---|---|---|---|---|---|---|
Attitudes | Knowledge | Practice | ||||||
Publications from African Countries | ||||||||
Ashimi et al. 2014 [21] | Nigeria | Cross-sectional; self- administered survey | Yes | Yes | No | Nurses | 350 | 84 % |
Kaplan et al. 2013 [22] | Gambia | Cross-sectional; survey administered face to face | Yes | Yes | Yes | Nurses, community nurses and midwives | 468 | NR |
Ali et al. 2012 [23] | Sudan | Survey administered via face to face interview | Yes | Yes | Yes | Midwives (~63 % of midwives were illiterate)
| 157 | NR |
Dike et al. 2012 [24] | Nigeria | Cross-sectional survey | Yes | Yes | No | Student nurses and midwives | 269 | 95.7 % |
Rasheed et al. 2011 [25] | Egypt | Cross sectional; self- administered survey | Yes | No | Yes |
aNurses; junior and senior physicians | ||
Refaat 2009 [26] | Egypt | Cross-sectional Survey | Yes | Yes | Yes |
aPhysicians | 193 | 68 % |
Mostafa et al. 2006 [27] | Egypt | Random sample; Survey | Yes | Yes | No | 5th year medical students | 330 | 90.3 % |
Onuh et al. 2006 [28] | Nigeria | Cross-sectional; Survey | Yes | Yes | Yes | Nurses practising in a hospital | 182 | 94.3 % |
Publications from “Western Countries” | ||||||||
Caroppo et al. 2014 [29] | Italy | Purposive sample; Self-administered survey | No | Yes | Yes | Physicians, social workers, psychologists, “health assistants” working in an asylum seeker centre | 41 | 100 % |
Purchase et al. 2013 [30] | UK | Cross-sectional; survey | No | Yes | No | Obstetricians and Gynaecologists | 607 | 20.1 % |
Relph et al. 2013 [31] | UK | Cross-sectional; Survey | Yes | Yes | No | Health care professionals | 79 | 92.9 % |
Moeed et al. 2012 [20] | Australia and New Zealand | Cross- sectional; Survey | No | Yes | Yes | Obstetricians and Gynaecologists and trainees | 564 | 18.5 % |
FGM/C workers | 34 | 91.9 % | ||||||
Hess et al. 2010 [32] | USA | Randomised Survey | Yes | Yes | Yes | Nurse-midwives | 243 | 40.3 % |
Kaplan-Marcusan et al. 2009 [33] | Spain | Cross-sectional; Survey at two time points (2001 and 2004) | Yes | Yes | Yes |
bPrimary health care professionals | 280 (2001) | 80 % (2001) |
296 (2004) | 62 % (2004) | |||||||
Leye 2008 [34] | Belgium | Cross-sectional; Survey | Yes | Yes | Yes | Gynaecologists and trainees | 333 | 46 % |
Zaidi et al. 2007 [35] | UK | Cross-sectional; Survey | No | Yes | Yes | Labour ward staff | 45 | 100 % |
Tamaddon et al. 2006 [36] | Sweden | Cross-sectional; Survey | No | Yes | Yes |
bHealth professionals | 796 | 28 % |
Jager et al. 2002 [37] | Switzerland | Cross-sectional; Survey | No | Yes | Yes | Obstetricians and gynaecologists | 454 | 39.1 % |
Quality assessment
Reference | Representativeness | Survey validity | Score out of 8 | ||||||
---|---|---|---|---|---|---|---|---|---|
Profession of respondents described | Age or years of practice | Gender | Setting | Sampling procedure | Response rate reported | Pre-test | Expert review | ||
Publications from African Countries | |||||||||
Ashimi et al. 2014 [21] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No | 7 |
Kaplan et al. 2013 [22] | Yes | Yes | Yes | Yes | No | No | Yes | Yes | 7 |
Ali et al. 2012 [23] | Yes | Yes | Noa
| Yes | No | No | No | No | 3 |
Dike et al. 2012 [24] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No | 7 |
Rasheed et al. 2011 [25] | Yes | No | No | Yes | No | Yes | No | No | 3 |
Refaat 2009 [26] | Yes | Yes | Yes | No | Yes | Yes | No | No | 5 |
Mostafa et al. 2006 [27] | Yes | Yes | Yes | Yes | Yes | Yes | No | No | 6 |
Onuh et al. 2006 [28] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No | 7 |
Publications from “Western Countries” | |||||||||
Caroppo et al. 2014 [29] | Yes | No | Yes | Yes | Yes | Yes | No | No | 5 |
Purchase et al. 2013 [30] | Yes | Yes | No | Yes | Yes | Yes | No | No | 5 |
Relph et al. 2013 [31] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No | 7 |
Moeed et al. 2012 [20] | Yes | No | No | No | Yes | Yes | No | No | 3 |
Hess et al. 2010 [32] | Yes | Yes | Yes | Yes | Yes | Yes | No | Yes | 7 |
Kaplan-Marcusan et al. 2009 [33] | Yes | Yes | Yes | Yes | Yes | Yes | No | No | 6 |
Leye 2008 [34] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | 8 |
Zaidi et al. 2007 [35] | Yes | No | No | Yes | Yes | Yes | No | Yes | 5 |
Tamaddon et al. 2006 [36] | Yes | No | No | Yes | Yes | Yes | No | Yes | 5 |
Jager et al. 2002 [37] | Yes | No | No | Yes | Yes | Yes | No | No | 4 |
Reference | Country | Had seen patients with FGMC | Managed women or girls with FGMC/FGMC complications; used prevention measures | Has performed FGMC or has been asked to perform FGMC | Clinical Guidelines/Clinical Education to support practice |
---|---|---|---|---|---|
Publications from African Countries | |||||
Kaplan et al. 2013 [22] | Gambia | 41 % - had seen a girl with complications of FGM/C | 41% - had seen a girl with complications of FGM/C | 8 % - had performed FGM/C | NRa
|
69 % - FGM/C is practiced in my family/household | |||||
Ali et al. 2012 [23] | Sudan | NR | NR | 81 % had performed FGM/C during their career | NR |
Each of these midwives had performed 5–88 FGM/C procedures in the previous year | |||||
Rasheed et al. 2011 [25] | Egypt | NR | NR | None of the nurses had performed FGM/C | NR |
Refaat 2009 [26] | Egypt | NR | NR | 19 % - performed FGM/C | NR |
34 % of those who perform FGM/C reported complications among patients | |||||
Onuh et al. 2006 [28] | Nigeria | NR | NR | 7 % - currently practice FGM/C | NR |
14 % have practiced FGM/C in the past | |||||
58 % - will perform FGM/C in the future if compelled to do so | |||||
Publications from “Western Countries” | |||||
Caroppo et al. 2014 [29] | Italy | 71 % - never met or assisted a woman with FGM/C despite working in an asylum seeker facility | 76 % - stated they would refer the woman for care elsewhere, with many different options provided | 34 % were aware of guidelines/procedures for the management of women with FGM/C | |
Purchase et al. 2013 [30] | UK | 87 % - had been involved in the care of a girl/woman with FGM/C | 3 midwives had been asked to perform FGM/C in a child or to re-infibulate after delivery | 26 % - had sufficient training in FGMC | |
20 % - had seen >10 cases | 31 % - reported that the hospital/trust had screening for FGM/C procedures | ||||
21 % - there was an FGM/C specialist (obstetrician or midwife) at the hospital trust | |||||
40 % - had training in de-infibulation | |||||
Relph et al. 2013 [31] | UK | 59 % had been involved in the care of a woman with FGM/C | NR | NR | NR |
Moeed et al. 2012 [20] | Australia and New Zealand | 76 % see women from African countries and from the Middle East | 47 % had seen at least one woman or girl with complications related to FGMC – “most commonly” urinary problems; problems in labour and dyspareunia | 21 % - of O&G specialists asked to re-infibulate after birth | NR |
75 % saw at least one woman with FGM/C in the last 5 years | “A few” reported psychosexual complications | 12 % - of those who had been asked had done so: | |||
Most saw 1–5 women with FGMC in the last 5 years | 38 % of the FGM/C workers had heard of re-suturing taking place; one respondent indicated that re-suturing had taken place >50 times | ||||
2 (0.5 %) respondents had been asked to perform FGM/C on a baby, young girl or woman | |||||
One was asked on 1–5 occasions; the other 6–10 occasions | |||||
1 % of the O&G specialists had convincing evidence that the procedure was done in Australia or NZ | |||||
10 % of the FGM/C workers were aware of convincing evidence that the procedure was being performed in Australia or NZ | |||||
Hess et al. 2010 [32] | USA | 43 % - of certified nurse- midwives had seen women with FGM/C in their practice | Problems associated with FGMC not discussed consistently | NR | |
20 % discussed circumcision of daughters, nieces, grand- daughters “Often” or “Always” | |||||
78 % never discussed infertility | |||||
Kaplan-Marcusan et al. 2009 [33] | Spain | 2001 | NR | 91 % of paediatricians had an interest in FGM/C | NR |
6 % - of all HP surveyed had seen cases in practice | 42 % of paediatricians were aware of guidelines and protocols | ||||
7 % - of paediatricians saw FGM/C | |||||
2004 | |||||
16 % - had seen FGMC in practice | |||||
19 % – of paediatricians saw FGM/C | |||||
FGM/C was seen by females more often than males | |||||
Leye 2008 [34] | Belgium | 58 % had seen women or girls with FGM/C in their practice | Consulted regarding complications: | 2 % [6] respondents had been asked to perform FGM/C in Belgium | |
Most common forms: | 1 % - acute complications | 4 % [13] had been asked whether FGMC could be performed in Belgium | 51 % wanted guidelines on FGM/C | ||
56 – infibulation | 1 % - fertility problems | 9.5 % [31] gynaecologists had heard that FGM/C had been performed in Belgium | 45 % sought more information about FGM/C after seeing patients with FGM/C | ||
40 – Excision | 2 % - psychological problems | ||||
3 – sunnab
| 4 % - fistulae | ||||
7 patients , 14 years old | 15 % - pregnancy and delivery problems | ||||
23 patients 15–18 years old | 18 % - chronic pain | ||||
The rest were 19 years or older | 19 % - urinary tract infections | ||||
Patients were from: Somalia, Ethiopia, and other including Nigeria, Egypt, Mali, Senegal | 41 % - sexual dysfunction | ||||
35 % - of those looking after pregnant women tried to persuade the mother not to perform FGMC if the child was a daughter | |||||
65 % - said they would not do any prevention | |||||
Zaidi et al. 2007 [35] | UK | 80 % had seen women with FGM/C in their practice | NR | NR | NR |
Tamaddon et al. 2006 [36] | Sweden | 60 % had seen at least one patient with FGM/C | 39 % - had seen patients with long-term complications of FGM/C | 5 % - had been asked about performing FGM/C in Sweden; 4 of these were paediatricians | NR |
1 % - had seen patients with complications due to recently performed FGC | 10 % - had been asked to perform reinfibulation after birth | ||||
2 of these 7 were paediatricians, 4 midwives, 1 gyneacologist | |||||
Jager et al. 2002 [37] | Switzerland | 51 % - had seen women with FGM/C in their practice in Switzerland | NR | 21 % - had been asked to re-infibulated after birth | FGM/C is not included in the undergraduate medical curriculum |
73 % - from the French-speaking region of Switzerland had seen women with FGM/C in their practice | 2 gyneacologists have been asked to perform FGM/C in young girls | There is no reporting system for FGM/C | |||
4 gyneacologists were asked where FGMC could be performed in Switzerland | |||||
12 gyneacologists said that they knew of FGM/C being performed in Switzerland |
Reference | Country | Knowledge of FGM/C ; FGM/C types ; high risk groups | Knowledge about complications | Knowledge about legislation / clinical guidelines |
---|---|---|---|---|
Publications from African Countries | ||||
Ashimi et al. 2014 [21] | Nigeria | 91 % - had heard of FGM/C | 77 % - haemorrhage | NRa
|
40 % - did not know any of the 4 types | 73 % - transmission of infectious disease (HIV, hepatitis and tetanus) | |||
49 % identified “Angurya and Gishiri”b as forms of FGM/C | 63 % - sexual dysfunction | |||
54 % - difficult birth | ||||
48 % - epidermal cysts | ||||
Kaplan et al. 2013 [22] | Gambia | NR | 53 % - haemorrhage | NR |
59 % - transmission of infectious disease | ||||
46 % - difficult birth | ||||
25 % - sexual dysfunction | ||||
21 % - affects health and welfare of women and girls | ||||
Ali et al. 2012 [23] | Sudan | 7 % - identified all 4 types correctly | 46 % - transmission of infectious disease (HIV) | 25.5 % - FGM/C is illegal |
545 % - identified type 1 correctly | 64 % - sexual dysfunction | 74.5 % - FGM/C is legal | ||
29 % - infertility | ||||
Dike et al. 2012 [24] | Nigeria | NR | 86 % - haemorrhage | 100 % - FGM/C is banned in some states |
84 % - transmission of infectious disease (HIV) | 96 % - FGM/C is a crime against humanity | |||
27 % - difficult birth | ||||
7 % - sexual dysfunction | ||||
Rasheed et al. 2011 [25] | Egypt | NR | 66 % - knew about complications of FGM/C | NR |
Refaat 2009 [26] | Egypt | 76 % - know the type usually performed in Egypt (type II) | 75 % - haemorrhage | NR |
70 % - sexual dysfunction | ||||
64 % - shock | ||||
63 % - genital disfigurement | ||||
14 % - NO complications (if done by a physician or gynaecologist) | ||||
Mostafa et al. 2006 [27] | Egypt | 52 % - correctly identified type I | 62 % - aware that FGMC can cause complications including: | 17 % - knew Egyptian law which states that FGM/C cannot be performed by a non-physician |
30 % - identified type II | 48 % - short-term physical | 28 % - reported that FGM/C violates the medical ethical principles of “do no harm” and “no not kill” | ||
5 % - identified type III | 39 % - long term physical | |||
62 % - psychosocial complications | ||||
59 % - sexual dysfunction | ||||
Onuh et al. 2006 [28] | Nigeria | 100 % - identified at least one type of FGMC | 98 % - haemorrhage | NR |
38 % - identified Type I and Type II ONLY as FGM/C | 81 % - transmission of infectious disease | |||
7 % - identified all 4 types correctly | 54 % - transmission of HIV | |||
80 % - difficult birth | ||||
55 % - scars and keloid formation | ||||
21 % - infertility | ||||
59 % - sexual dysfunction | ||||
Publications from “Western Countries” | ||||
Caroppo et al. 2014 [29] | Italy | 9 % - knew that there are different types of FGM/C depending on the woman’s country of origin | 5 % - knew how to manage a woman with FGMC | 44 % - knew that Italy has a law prohibiting FGMC practice |
Purchase et al. 2013 [30] | UK | NR | 92 % - identified each of the long term complications | 94 % - FGM/C always illegal in the UK |
75 % - HIV/hepatitis risk | 79 % - were aware of the FGM/C Act | |||
74 % - pelvic infection | 84 % - knew to contact a child protection officer if they thought a child was at risk | |||
10 % - associated psychiatric syndromes | ||||
To prevent complications during labour: | ||||
74 % - knew that defibulation should take place pre-conception | ||||
31 % - knew that defibulation is recommended at ~ 20 weeks pregnancy | ||||
52 % - unaware of referral pathways | ||||
Relph et al. 2013 [31] | UK | 100 % - aware of the practice of FGM/C | 76 % - haemorrahge | 72 % - aware of UK legislation on FGM/C |
58 % - knew there are 4 types of FGM/C | 32 % - knew that defibulation should be performed before pregnancy to avoid complications | 89 % - family/religious figure performing FGM/C in UK is illegal | ||
93 % of senior doctors | 77 % - UK doctor performing FGM/C in UK is illegal | |||
50 % of junior doctors | 67 % - reinfibulation after delivery is illegal | |||
40 % - confident in diagnosing FGM/C | 78 % - sending a child abroad for FGM/C is illegal | |||
Hess et al. 2010 [32] | USA | 18 % - knew that both Muslim and Christian women may have FGM/C | 71 % - of nurse midwives who did not have direct experience with FGMC knew about FGMC complications , compared with 89 % of those who had direct experience | 56 % - knew that it is illegal to perform FGM/C in girls and young women aged <18 years |
39 % - knew FGM/C is NOT required by either religion | Over a half of respondents did not know that circumcised women avoid health care due to stigma and legal implications | |||
Nurse midwives with direct practice experience of FGM/C scored better on a knowledge test | ||||
Kaplan-Marcusan et al. 2009 [33] | Spain | 97 % knew what FGM/C is | NR | 20 % - aware of protocols or guidelines |
Able to identify the 4 types: | 42 % - of paediatricians aware of protocols or guidelines | |||
41 % - of all professionals | ||||
68 % - of O&G | ||||
55 % - of paediatricians | ||||
38 % - general medicine | ||||
79 % - said they knew high risk countries | ||||
22 % - actually able to identify the high risk countries | ||||
Leye 2008 [34] | Belgium | NR | NR | 46 % - knew that FGM/C was illegal in Belgium |
24 % - knew which types of FGM/C were included under the law | ||||
1 % (4 respondents) - knew of guidelines and information about FGM/C in their hospital | ||||
Zaidi et al. 2007 [35] | UK | 98 % - knew what FGMC was | 84 % - knew of complications associated with FGMC | 40 % - knew the details of the UK FGM/C Act |
42 % - knew that there were different types of FGMC | 70 % - knew that the best time for defibulation was before pregnancy (if FGMC diagnosed before pregnancy) | |||
4 % - correctly classified the 4 types | 80 % - knew that defibulation should be done during pregnancy if diagnosed during pregnancy | |||
84 % - knew the high risk groups | 54 % - knew that an anterior episiotomy should be performed if the woman is in the 2nd stage of labour | |||
58 % - were NOT aware that women at risk should be identified during antenatal visits | ||||
Tamaddon et al. 2006 [36] | Sweden | 28 % - said they had adequate knowledge about FGM/C | NR | NR |
20 % - of paediatricians said they had adequate knowledge about FGM/C | ||||
Jager et al. 2002 [37] | Switzerland | NR | NR | Representatives from the Departments of Health in each Canton, did not know of any guidelines on FGM/C in their Canton |
Reference | Country | Beliefs about the reasons for performing FGM/C | Support for and intentions for performing FGM/C | Beliefs and attitudes about the law and educational needs |
---|---|---|---|---|
Publications from African Countries | ||||
Ashimi et al. 2014 [21] | Nigeria | 53 % - prevent promiscuity | 4 % would support FGM/C | NRa
|
28 % - preserve virginity | 4 % would perform FGM/C | |||
16 % - socio-cultural acceptance | 4 % of respondents (all women) would allow daughters to undergo FGM/C | |||
10 % - religious reasons | ||||
8 % - medically beneficial | ||||
Kaplan et al. 2013 [22] | Gambia | 54 % - mandatory religious practice | 43 % - were supportive of the continuation of FGM/C practice | NR |
48 % - cultural practice | 47 % - intended to subject their daughters to FGM/C | |||
14 % - preserve virginity | 43 % - medicalising FGMC would make the practice safer | |||
1 % - it does not violate human rights | 73 % - Health care workers have a role in eliminating FGMC | |||
55 % – FGM/C cannot be eliminated in The Gambia | ||||
78 % - men should be involved in the debate about FGM/C | ||||
13 % - girls that have not undergone FGM/C should be discriminated against | ||||
Ali et al. 2012 [23] | Sudan | 51.2 % - cultural | 19 % - all forms of FGM/C are harmful | NR |
26 % - religious | 76 % - only some forms are harmful | |||
23 % - economic | 5 % - all forms are not harmful | |||
Dike et al. 2012 [24] | Nigeria | 51 % - prevent promiscuity | 100 % would NOT have their daughters undergo FGM/C | To stop FGM/C: |
47 % - appearance of external genitalia | 81 % - Public enlightenment needed | |||
27 % - tradition | 25 % - Counselling of parents | |||
11 % - initiation into womanhood | 7 % - punishing any person who aids or abets the practice | |||
7 % - spiritual satisfaction | ||||
Rasheed et al. 2011 [25] | Egypt | 100 % - senior physicians believed FGM/C prescribed by religion | Nurses: | NR |
97 % - young physicians believed FGM/C prescribed by religion | 88 % - supported the practice of FGM/C | |||
88 % - nurses believe it is a traditional practice | 48 % - would have their daughters undergo FGM/C | |||
28 % - had their daughters undergo FGM/C | ||||
Young Physicians: | ||||
34 % - supported the practice of FGM/C | ||||
Senior physicians: | ||||
15 % - supported the practice | ||||
Refaat 2009 [26] | Egypt | 82 % - do NOT approve of the practice | 18 % - supported practice; reasons for continuing practice included: | 91 % - FGM/C and complications should be taught at medical school |
Those practising in the Upper Egypt area, those from rural areas and those with a diploma (rather than PhD or Fellowship) were more likely to approve the practice of FGM/C | • Convinced of benefit | 40 % believed that physicians are the most appropriate to perform FGM/C | ||
• Profit | 35 % did NOT approve of the law banning FGM/C | |||
• Harm reduction | ||||
82 % - did NOT approve of the practice for the following reasons: | ||||
18 % - supported practice for religious or customary reasons | 75 % - reduced sexual pleasure | |||
64 % – pain | ||||
61 % - bad habit | ||||
52 % - not religious practice | ||||
49 % - causes health problems | ||||
48 % - against women’s dignity | ||||
Mostafa et al. 2006 [27] | Egypt | 51 % - NO medical reason for performing FGM/C | 43 % - unethical for a health professional to damage a healthy body | 50 % - medicalization is the first step to prevention of the practice |
45 % - FGM/C is a violation of human rights | 65 % - FGM/C is NOT a health issue | 23 % - believed that the law is enough for prevention | ||
34 % - FGM/C is essential part of culture | 32 % - would subject their future daughters to this practice | 53 % - believe that laws must go hand in hand with community education | ||
24 % - FGM/C prevents external genitalia from growing | 58 % - would NOT object if family members were to subject their daughters to FGM/C | |||
20 % FGM/C ensures a girl’s virginity | 73 % - FGM/C should be medicalised | |||
49 % - prevents promiscuity | 91 % - medicalization favourable because it reduces pain; carried out under hygienic conditions and with anaesthetic | |||
30 % - FGM/C is a religious obligation | ||||
86 % - believed that FGMC is practiced only by Muslims | ||||
Onuh et al. 2006 [28] | Nigeria | 9 % - decreases promiscuity | 4 % - will have their own daughters undergo FGMC | 92 % - FGM/C should be legislated against |
10 % - makes genitalia more attractive | 3 % - FGM/C is a good practice | |||
Other reasons: − cultural; financial; patient safeguarding from “traditional circumcisers” | 3 % - will encourage FGM/C | |||
24 % - some forms of FGM/C are not harmful | ||||
Publications from “Western Countries” | ||||
Purchase et al. 2013 [30] | UK | 76 % - cultural reasons | NR | NR |
16 % - religious reasons | ||||
Relph et al. 2013 [31] | UK | 100 % - cultural reasons | 9 % - FGM/C should be medicalized to reduce complications | 87 % - would warn social services of a child in danger of FGM/C |
18 % - would support a woman’s request for re-infibulation after birth if this was legal in the UK | ||||
Moeed et al. 2012 [20] | Australia and New Zealand | NR | 21 % - O&G specialists believed that in the women and girls with FGMC seen by them, the FGM/C was probably done in Australia (but they did not provide number estimates) | NR |
42 % of the FGM/C workers believed that the women and children with FGMC probably had the procedure performed in Australia/NZ | ||||
26 % of FGMC/C workers believed that children were being taken out of Australia to attend family celebrations and to have FGM/C done overseas | ||||
Kaplan-Marcusan et al. 2009 [33] | Spain | 50 % - traditional reasons | NR | 2001 -1 % said ignore the problem |
16 % - religious reasons | 48 % - educate | |||
32 % - educate and report | ||||
19 % - report to authorities | ||||
2004 – None said ignore | ||||
49 % - educate and report | ||||
27 % - educate | ||||
24 % - report to authorities | ||||
Leye 2008 [34] | Belgium | NR | 86 % - FGM/C is a form of violence against women | 21 % - believed that FGM/C performed by a medical practitioner would reduce harm |
61 % - FGM/C is a violation of human rights | 48 % - wanted more clarity around ethico-legal issues | |||
7 % - FGM/C should be respected because of cultural and religious beliefs | ||||
77 % - considered re-infubulation as a form of FGM/C | ||||
19 % - would re-infibulate if requested by the woman | ||||
47 % - a symbolic incision was a good alternative to FGM/C | ||||
15 % - Genital piercings and vaginal cosmetic surgery considered a type of FGM/C |