Joachim Osur Technical Director

Reproductive, Maternal and Child Health Amref Health Africa

Kevin O’Neill

Director of Programmes Amref Health Africa in Canada

CAN-MNCH Symposium, Montreal, QC, Canada November 4, 2015

Alternative Rites of Passage: Working to Eliminate Female Genital Mutilation in Africa

Amref Health Africa: Who Are We?

• An indigenous African health development organization founded in 1957

• Improves health of Africans by partnering with and empowering communities, and strengthening health systems.

• Vision: Lasting health change in Africa.

• Formerly the African Medical and Research Foundation (AMREF)

• Headquarters in Nairobi, Kenya

Key Facts on FGM/C (Source: WHO)

• Female genital mutilation/cutting (FGM/C) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons.

• Mostly carried out on young girls sometime between infancy and age 15.

• Possible health consequences: acute and chronic

FGM/C: A Violation of Human Rights

• 1993: FGM/C classified as a form of violence against women; and the issue of violence against women acknowledged to fall under the purview of international human rights law.

• 2012: UN General Assembly resolution on elimination of FGM/C

• Today: 24 of the 29 countries where FGM/C is concentrated have enacted decrees or legislation related to FGM/C

FGM/C in Kenya and Among the Maasai

• Criminalized in 2001; legislation strengthened in 2010

• Practiced in varying degrees by ~30 of Kenya’s 40+ ethnic groups: Kisii – 97%; Maasai – 89%; Kalenjin – 62%; Taita and Taveta – 59%; Meru/Embu groups – 54%; Kikuyu – 43%; Kamba –33%; Miji Kenda/Swahili – 12%

• Among the Maasai:

– Takes place between 7-15 years

– Executed by community circumcizers

– Part of an age old rite of passage

How did we gain Trust with the Maasai?

More info: http://bit.ly/1hUsw2L

Effectively involving the community in decision making on health via models such as the ‘BOMA’ Health Delivery Model: An innovative approach to delivering MNCH services to Semi-Nomadic communities in hard-to-reach regions

• Community-led and community-driven cultural alternative to FGM/C

• Amref Health Africa facilitates the change process; the community takes the lead

• Long term presence (before ARP is introduced)

• Embedded in a broader Sexual and Reproductive Health Rights (SRHR) framework

Amref’s Alternative Rites of Passage (ARP) Model

ARP Model: The process

• Analysis of the community • Educating peer educators • Establish fora for different target groups • Enable discussions between different groups • Exchange visits to other communities • Establish a Village Committee • Prepare the alternative ritual: content, selection

of girls, consent of the parents • Three-day training on SRHR for participating girls • Blessing by the elders • Organize follow-up for the girls • Advocacy

Key Strategies:

Supporting communities to own, take leadership of ARP and support girls’ education

Key Strategies:

Advocacy: Engaging National and County Leadership to Publicly Support ARP

Key Strategies:

Use of role models and ARP champions from the community

Key Strategies:

Increasing Male Involvement in Community Anti-FGM/C Campaigns

Key Strategies:

Youth Participation: Supporting and mentoring youth to denounce FGM/C and champion ARP

Key Strategies:

Influencing the Influencers: Engaging, supporting and partnering with key cultural figures (cultural elders, TBAs, morans, etc.) to denounce FGM/C and promote ARP for girls

Key Strategies:

Use of community dialogue and symbolism

Key Strategies:

Use of cultural examples of social change

ARP Success To Date

• 7,631+ girls have undergone an Alternative Rites of Passage since 2007 – including 2,634 in 2014 alone

• Publically denounced FGM/C and promoting ARP for girls: – 817 morans – 85 TBAs – 400 cultural elders – 246 religious leaders

• Adopted ARP and scaling it up as a best practice: – 9 CBOs – 2 NGOs – 10 schools

• County-level Anti-FGM/C bills being drafted by 3 County Assemblies

What’s Next?

Intensify in the Counties where we are, by continuing to build the capacity of change agents

Reach new areas by developing a scale-up tool to guide other CSOs and providing support

Strengthening our ARP advocacy voice. Together with communities, create stronger and better coordinated partnerships, collaborations and alliances.

Continue to innovate to tackle the unintended consequences of our success.

Lessons Learned

Build partnerships and trust at all levels Multi-generational participation is key, and communities are

at the core Don’t just inform: inspire Build a base: Embed FGM/C interventions in broader SRHR

spectrum. Change agents will start and sustain the multiplier effect:

Embrace and celebrate the community heroes Celebrate small victories Re-package/re-position the anti-FGM/C campaign message Measure, reflect, share and innovate.

T: 416-961-6981 E: info@amrefcanada.org I: www.amrefcanada.org Tw: @amrefcanada

“As the chief of this area I am living by example. My daughters have not been

circumcised. I have declared that we shall never circumcise girls again in this area.”

- Chief Sakaya