powerpoint presentation · tanzania 2010. none. primary. secondary + prevalence among women by...
TRANSCRIPT
http://www.thedailybeast.com/articles/2015/02/06/female-genital-mutilation-skyrockets-in-the-u-s.html
Feldman-Jacobs & Clifton, 2010
http://www.cosmeticsurg.net/procedures/labiaplasty/
Overview
UNICEF, 2013
Trends
UNICEF, 2013
Feldman-Clifton & Jacobs, 2014
Female Genital Mutilation/Cutting, by Residence
81
93
81
69
39
23
37
8
9296
8778
48
28 2617
Sierra Leone2010
Djibouti 2006 Mali 2006 Burkina Faso2010
Guinea-Bissau 2006
Senegal2010-11
Nigeria 2008 Tanzania2010
Urban Rural
Prevalence Among Urban and Rural AreasPercent
Sources: ICF International, Demographic and Health Surveys; UNICEF, Multiple Indicator Cluster Surveys.
Female Genital Mutilation/Cutting, Within Countries
1 1
13
27
1
27
9298
75
97
87
98
26 27
38
74
58
72
Senegal 2010-11 Kenya 2008-09 Côte d'Ivoire 2012 Ethiopia 2005 Liberia 2007 Mauritania 2007
Lowest Region Highest Region National
Percent
Sources: ICF International, Demographic and Health Surveys; UNICEF, Multiple Indicator Cluster Surveys.
Female Genital Mutilation/Cutting, by Education
4751
7781
54 54
85
28
95
20
42
27
71
80
35
26
86
24
85
17
31
16
6471
21 19
84
20
74
3
Chad 2010 Côted'Ivoire
2012
Ethiopia2005
Gambia2005-06
Guinea-Bissau2006
Kenya2008-09
Mali 2006 Senegal2010-11
SierraLeone 2010
Tanzania2010
None Primary Secondary +
Prevalence Among Women by Level of EducationPercent
Sources: ICF International, Demographic and Health Surveys; UNICEF, Multiple Indicator Cluster Surveys.
Female Genital Mutilation/Cutting, by Wealth
15
55
40
25
95
73 75
26
94 94
17
37
29
17
95
75
86
46
82
93
5
23
15
6
7871
64
24
86
76
Poorest Fifth Middle Fifth Richest Fifth
Prevalence by Wealth QuintilePercent
Sources: ICF International, Demographic and Health Surveys; UNICEF, Multiple Indicator Cluster Surveys.
MotivationUNICEF, 2013
Complications
19941995199920002001200620122013
19941995199920002001200620122013
19941995199920002001200620122013
19941996199920002001200620122013
19941996199920002001200620122013
19941995199920002001200620122013
19941995199920002001200620122013
19941995199920002001200620122013
19941995199920002001200620122013
The Public Policy Advisory Network on Female Genital Surgeries in Africa, 2012
19941995199920002001200620122013
The Public Policy Advisory Network on Female Genital Surgeries in Africa, 2012
19941995199920002001200620122013
Ban on “vacation cutting”
Zong & Batalova, 2016
Sub-Saharan African immigration to the US 1980-2013
Gambino et al., 2014
“The Population Reference Bureau estimates that behind California, New York has the highest number of women and girls at risk of undergoing FGM, whether at home or abroad. Of the estimated 506,795 at-risk women and girls in the U.S. – a figure based on ties to countries with a high prevalence of FGM – nearly 10 percent (48,000 live in New York State…”
Allen, 2015, para 7
“The Population Reference Bureau estimates that behind California, New York has the highest number of women and girls at risk of undergoing FGM, whether at home or abroad. Of the estimated 506,795 at-risk women and girls in the U.S. – a figure based on ties to countries with a high prevalence of FGM – nearly 10 percent (48,000 live in New York State…”
Allen, 2015, para 7
27%
36%
Number of women and girls in the US born in FGC-practicing countries or born to women from FGC practicing countries
0
100
200
300
400
500
600
1990 2004 2012
Thou
sand
s
Total< 18 yo
28%
Goldberg, H. , Stupp, P., Okoroh, E., Besera, G., Goodman, D., Danel, I. (2016). Female Genital Mutilation/Cutting in the United States: Updated Estimates of Women and Girls at Risk, 2012. Public Health Reports, 131, 1-8
“At risk’’
C/S PPH Severelacerations
Low Apgar/ Fetal distress
Poor fetalgrowth
Perinatal death
Salim et al., 2012
Vangen et al., 2000
Vangen et al., 2002
DeSilva, 1989
Essen et al., 2000
Essen et al., 2002b
Essen et al., 2002a
Flynn et al., 2009
Johnson et al., 2005
Small et al., 2008 oppositeWuest, 2009
Yoong et al., 2005 = =
Chibber et al., 2011
Correa-Velez, 2012
Malin, 2009 opposite
Client
Distrustful Ashamed/angry/ignored/disrespectedFearful of providers, cesarean sectionsDo not feel heardFrustrated by communication challenges
Providers
Poorly trained, limited experienceUnaware of client perspectives
Frustrated by communication challenges
Brown et al., 2010
Essen et al., 2002; Vangen et al., 2002; Chibbers et al., 2011
Perinatal deaths
Essen et al., 2002; Vangen et al., 2002; Chibbers et al., 2011
Perinatal deaths
Poor communication
27%
36%
Number of women and girls in the US born in FGC-practicing countries or born to women from FGC practicing countries
0
100
200
300
400
500
600
1990 2004 2012
Thou
sand
s
Total< 18 yo
28%
Goldberg, H. , Stupp, P., Okoroh, E., Besera, G., Goodman, D., Danel, I. (2016). Female Genital Mutilation/Cutting in the United States: Updated Estimates of Women and Girls at Risk, 2012. Public Health Reports, 131, 1-8
27%
36%
Number of women and girls in the US born in FGC-practicing countries or born to women from FGC practicing countries
0
100
200
300
400
500
600
1990 2004 2012
Thou
sand
s
Total< 18 yo
28%
Goldberg, H. , Stupp, P., Okoroh, E., Besera, G., Goodman, D., Danel, I. (2016). Female Genital Mutilation/Cutting in the United States: Updated Estimates of Women and Girls at Risk, 2012. Public Health Reports, 131, 1-8
Does accuracy matter?
What are the costs of the extraterritoriality clause?
Federal Interest (again)
OWH call center & in-serviceCDC expert meeting & researchOWH Listening SessionDOJ RoundtablesGAO Inquiry
http://www.acf.gov/hhsgrantsforecast/index.cfm?switch=grant.view&gff_grants_forecastInfoID=73169
FGC ECHO
“It is not DOJ’s practice to comment on hypothetical situations, and federal prosecutors throughout the US exercise prosecutorial discretion every day when applying federal statutes. I would just remind you that subsection (c) eliminates consideration of a person’s belief or custom as a reason for performing FGM/C, which includes infibulation”.
O’Conner, K. (email, 2015)
Some women who have just given birth will request immediate refibulation…should be strongly discouraged. The woman many only feel comfortable being infibulated; her request should be respected…Reinfibulation is NOT included as a federal crime, so it may be performed…
Nour, 2015