Eradicating female genital mutilation and cutting in Tanzania: an observational study.

BACKGROUND Female genital mutilation and cutting (FGM/C) has long been practiced in various parts of the world. The practice is still prevalent in 29 countries on the African continent despite decades of campaigning to eradicate it. The approaches for eradication have been multi-pronged, including but not limited to, health risk campaigns teaching about the health consequences for the girls and the women, recruitment of change agents from within the communities and the enforcement of legal mechanisms. The purpose of this study was to analyse the impact of an 18 month long campaign to eradicate or reduce FGM/C in a rural predominantly Masai community. METHODS An observational study involving mixed methods, quantitative and qualitative was conducted in Arusha region, Tanzania. A household survey, key informant interviews, focus group discussions, school children's group discussions and project document reviews for both baseline and endline assessments were used. Same tools were used for both baseline and endline assessements. Comparison of baseline and endline findings and conclusions were drawn. RESULTS The prevalence of self reported FGM/C at endline was 69.2 %. However, physical obstetric examination of women in labour revealed a prevalence of over 95 % FGM/C among women in labour. Those in favour of FGM/C eradication were 88 %. Nearly a third of the 100 FGM practitioners had denounced the practice; they also formed a peer group that met regularly comparing baseline and endline. Knowledge about FGM/C health risks increased from 16 to 30 % (p < 0.001). The practice is currently done secretly to an uncertain extent. CONCLUSION This multifaceted educational campaign achieved moderate success in increasing knowledge of the health risks and changing attitudes despite a short period of intervention. However, its effectiveness in reducing FGM/C prevalence was uncertain.