Female genital mutilation (FGM) is defined as any procedure involving the alteration or excision of external female genitalia for no medical reason. Somaliland has among the highest prevalence rates of FGM globally. In this article we describe how the Civil Society Organisation (CSO) ‘Network against female genital mutilation in Somaliland’ (NAFIS) has approached the challenge to reduce the high FGM prevalence. From its start in 2006, NAFIS has developed a multifaceted program to reach the overall goal: the elimination of all forms of FGM in Somaliland. Alone among the group of CSOs in the network, NAFIS introduced in its activities medical care and counselling for women who suffer from the consequences of FGM. From 2011 and onwards, thousands of women have been relieved of their FGM-related health complications and participated in counselling sessions at project centres. Shortly after this visit they have been invited to participate in community group meetings to share their experiences with other women who also have received FGM care and counselling, and other community members. The aim of the article is to describe this model of work - combining FGM care and counselling with community dialogues. The article is basically descriptive, using the authors’ own observations and encounters with project clients and staff over eight years. We have also used findings from three Master's theses on aspects of the process, and from other small scale studies to highlight people’s understanding, experiences and opinions in a context of an on-going health intervention. A lesson learnt from NAFIS project is that it has helped to open up communicative spaces in community dialogues where experiences are shared and understanding created of the harm caused by FGM, without the habitual stigma and shame. We discuss this process in a context of behavioural change theories. A major challenge during the process has been to involve men in the project’s FGM information and counselling activities. The role of nurses/midwives, being the first to meet women with FGM complications, is also discussed and the need emphasised to strengthen capacity of this category of health workers. One type of FGM gaining in usage is the poorly defined sunna, the health risks of which are unclear.
{"title":"Female genital mutilation (FGM) in Somaliland – why is change so slow?","authors":"A. Johansson, Abdirahman Osman Gaas, A. Warsame","doi":"10.36368/shaj.v1i1.254","DOIUrl":"https://doi.org/10.36368/shaj.v1i1.254","url":null,"abstract":"Female genital mutilation (FGM) is defined as any procedure involving the alteration or excision of external female genitalia for no medical reason. Somaliland has among the highest prevalence rates of FGM globally. In this article we describe how the Civil Society Organisation (CSO) ‘Network against female genital mutilation in Somaliland’ (NAFIS) has approached the challenge to reduce the high FGM prevalence. From its start in 2006, NAFIS has developed a multifaceted program to reach the overall goal: the elimination of all forms of FGM in Somaliland. Alone among the group of CSOs in the network, NAFIS introduced in its activities medical care and counselling for women who suffer from the consequences of FGM. From 2011 and onwards, thousands of women have been relieved of their FGM-related health complications and participated in counselling sessions at project centres. Shortly after this visit they have been invited to participate in community group meetings to share their experiences with other women who also have received FGM care and counselling, and other community members. The aim of the article is to describe this model of work - combining FGM care and counselling with community dialogues. The article is basically descriptive, using the authors’ own observations and encounters with project clients and staff over eight years. We have also used findings from three Master's theses on aspects of the process, and from other small scale studies to highlight people’s understanding, experiences and opinions in a context of an on-going health intervention. A lesson learnt from NAFIS project is that it has helped to open up communicative spaces in community dialogues where experiences are shared and understanding created of the harm caused by FGM, without the habitual stigma and shame. We discuss this process in a context of behavioural change theories. A major challenge during the process has been to involve men in the project’s FGM information and counselling activities. The role of nurses/midwives, being the first to meet women with FGM complications, is also discussed and the need emphasised to strengthen capacity of this category of health workers. One type of FGM gaining in usage is the poorly defined sunna, the health risks of which are unclear.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131487353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Warsame, Ali Abdulrahman Osman, A. Hassan, A. Abdulle, Abdikarim Muse, A. Hassan, Mohamed Abdullahi Ali, F. Yusuf, J. Amran
Case management – rapid diagnosis and prompt administration of artemisinin-based combination therapy (ACT) – is a fundamental pillar of recommended malaria interventions in Somalia. Unfortunately, the emergence and spread of drug resistant falciparum parasites continues to pose a considerable threat to effective case management. With technical and financial support from WHO, the efficacy of recommended ACTs has been regularly monitored in sentinel sites since 2003. These studies provided evidence that supported the adoption of artesunate-sulfadoxine/pyrimethamine as first-line treatment in 2005 and artemether-lumefantrine as second-line treatment in 2011. Efficacy studies conducted between 2011 and 2015 showed high artesunate-sulfadoxine/pyrimethamine treatment failure rates of 12.3% - 22.2%, above the threshold (10%) for a change of treatment policy as recommended by WHO. This was also associated with high prevalence of quadruple and quintuple mutations in the dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes, which are associated with sulfadoxine/pyrimethamine resistance. Based on these findings, national malaria treatment guidelines were updated in 2016, with artesunate-sulfadoxine/pyrimethamine replaced by artemether-lumefantrine as first-line treatment and dihydroartemisinin-piperaquine recommended as second-line treatment. Subsequent efficacy studies in 2016 and 2017 confirmed that both the current first- and second-line treatments remain highly efficacious (cure rate above 97%). Technical and financial support from WHO has been instrumental in generating evidence that informs malaria treatment policy and should therefore continue to ensure that effective treatments are available to malaria patients in the country.
{"title":"Current guidelines for malaria treatment in Somalia: evidence-based recommendations","authors":"M. Warsame, Ali Abdulrahman Osman, A. Hassan, A. Abdulle, Abdikarim Muse, A. Hassan, Mohamed Abdullahi Ali, F. Yusuf, J. Amran","doi":"10.36368/shaj.v1i1.249","DOIUrl":"https://doi.org/10.36368/shaj.v1i1.249","url":null,"abstract":"Case management – rapid diagnosis and prompt administration of artemisinin-based combination therapy (ACT) – is a fundamental pillar of recommended malaria interventions in Somalia. Unfortunately, the emergence and spread of drug resistant falciparum parasites continues to pose a considerable threat to effective case management. With technical and financial support from WHO, the efficacy of recommended ACTs has been regularly monitored in sentinel sites since 2003. These studies provided evidence that supported the adoption of artesunate-sulfadoxine/pyrimethamine as first-line treatment in 2005 and artemether-lumefantrine as second-line treatment in 2011. Efficacy studies conducted between 2011 and 2015 showed high artesunate-sulfadoxine/pyrimethamine treatment failure rates of 12.3% - 22.2%, above the threshold (10%) for a change of treatment policy as recommended by WHO. This was also associated with high prevalence of quadruple and quintuple mutations in the dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes, which are associated with sulfadoxine/pyrimethamine resistance. Based on these findings, national malaria treatment guidelines were updated in 2016, with artesunate-sulfadoxine/pyrimethamine replaced by artemether-lumefantrine as first-line treatment and dihydroartemisinin-piperaquine recommended as second-line treatment. Subsequent efficacy studies in 2016 and 2017 confirmed that both the current first- and second-line treatments remain highly efficacious (cure rate above 97%). Technical and financial support from WHO has been instrumental in generating evidence that informs malaria treatment policy and should therefore continue to ensure that effective treatments are available to malaria patients in the country.","PeriodicalId":338064,"journal":{"name":"Somali Health Action Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129210446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：