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Baseline data from a planned RCT on attitudes to female genital cutting after migration: when are interventions justified?
  1. Anna Wahlberg1,
  2. Sara Johnsdotter2,
  3. Katarina Ekholm Selling1,
  4. Carina Källestål1,
  5. Birgitta Essén1
  1. 1 Department of Women’s and Children’s Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
  2. 2 Faculty of Health and Society, Malmö University, Malmö, Sweden
  1. Correspondence to Dr Anna Wahlberg; anna.wahlberg{at}kbh.uu.se

Abstract

Objectives To present the primary outcomes from a baseline study on attitudes towards female genital cutting (FGC) after migration.

Design Baseline data from a planned cluster randomised, controlled trial. Face-to-face interviews were used to collect questionnaire data in 2015. Based on our hypothesis that established Somalis could be used as facilitators of change among those newly arrived, data were stratified into years of residency in Sweden.

Setting Sweden.

Participants 372 Somali men and women, 206 newly arrived (0–4 years), 166 established (>4 years).

Primary outcome measures Whether FGC is acceptable, preferred for daughter and should continue, specified on anatomical extent.

Results The support for anatomical change of girls and women’s genitals ranged from 0% to 2% among established and from 4% to 8% among newly arrived. Among those supporting no anatomical change, 75%–83% among established and 53%–67% among newly arrived opposed all forms of FGC, with the remaining supporting pricking of the skin with no removal of tissue. Among newly arrived, 37% stated that pricking was acceptable, 39% said they wanted their daughter to be pricked and 26% reported they wanted pricking to continue being practised. Those who had lived in Sweden ≤ 2 years had highest odds of supporting FGC; thereafter, the opposition towards FGC increased over time after migration.

Conclusion A majority of Somali immigrants, including those newly arrived, opposed all forms of FGC with increased opposition over time after migration. The majority of proponents of FGC supported pricking. We argue that it would have been unethical to proceed with the intervention as it, with this baseline, would have been difficult to detect a change in attitudes given that a majority opposed all forms of FGC together with the evidence that a strong attitude change is already happening. Therefore, we decided not to implement the planned intervention.

Trial registration number Trial registration number NCT02335697;Pre-results.

  • female genital mutilation
  • pricking
  • migration
  • Somalis
  • Sweden
  • intervention

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors BE had the original idea for the study and designed it together with AW, KES, SJ and CK. Data collection was monitored by AW. The analysis of the data, interpretation of the findings and manuscript writing were done by AW together with all co-authors.

  • Funding This work was supported by the Swedish Research Council for Health, Working Life and Welfare (2013-2095, 2015-00771), the Swedish Research Council (2015-03546), the County Administrative Board Uppsala (801-2478-15) and the Sven Jerring Foundation.

  • Competing interests None declared.

  • Patient consent NA. The participants in this study gave their verbal informed consent.

  • Ethics approval The study was approved by the Regional Ethical Review Board of Uppsala, Sweden (2014/274).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Researchers can apply to obtain raw data from the corresponding author at anna.wahlberg@kbh.uu.se.