Protecting the Lives of Women and Children: an Innovative Approach to Addressing the Problem of Female Genital Mutilation through Social Change, Public Health and Youth Development in a Fragile Region

The practice of Female Genital Mutilation (FGM) is a common traditional practice among the Afar communities of Eastern Ethiopia. FGM, as well as other harmful traditional practices, including early marriage, face branding with sharp tools and abduction, are common among the Afar communities of Eastern Ethiopia. This has been threatening the lives of women and children and remains very prevalent. The practice of FGM, although now illegal in Ethiopia, continues and has been sustained by deep-rooted cultural values and habits. Despite world wide publicity and attention, FGM has proved to be difficult to eradicate. The problems in Dawe district are exacerbated by poor health service coverage and high maternal and child mortality rates caused by a variety of health-related factors. The region is in general underdeveloped and remote from the major towns and cities. That FGM seriously violates women’s and girl’s sexual rights as well as being harmful to the health of any woman is now well-established fact. The traditional thinking in the Afar communities, however, forces women to want and undergo the practice without questioning. This situation is not unique to Dawe in Ethiopia: even after more than 25 years of effort to reduce FGM, there is still a limited understanding of the practice, and the success and fail-factors in the approaches used. Results of interventions are variable, and to some, are disappointing considering the large efforts dedicated to erasing this practice. Studies find that in certain communities, reported FGM numbers are still as high as 80-100% of all females (WHO, 2010). The Afar Women Support Project (AWSP), implemented by the Ethiopian NGO, ‘Action for Integrated Sustainable Development Association’ (AISDA), is assessed as a relevant case study in this paper. The AWSP received funding from the Dutch SK Foundation following an initial incubation of the project design in an educational program at the Maastricht School of Management (MSM). The design phase started with comprehensive problem identification leading to detailed planned in a combination of implementation strategies encompassing ‘hard’ medical training, including the provision of basic kits for improved child delivery services for Traditional Birth Attendants (TBAs), and ‘soft’ measures focused on achieving attitude change through integrated community development and mass mobilization using different communication strategies appropriate to the local setting. The project was launched immediately after the signing of an operational agreement with the main stakeholders of the regional state in consultation with Disaster Prevention, Preparedness and Food Security Programs Coordination Bureau (DPPFSPCB), Women, Children and Youth Affairs Bureau (WCYAB), Bureau of Health (BoH). Religious and clan leaders were involved as important stakeholders whose support and participation proved vital. A specific component was targeted at youth and schools where the future momentum for lasting change will come from. The project implementation approach was based on stakeholder participation throughout and undergirded by application of a rigorous project methodology – ‘Project Cycle Management.’ This paper critically examines the activities and results of the AWSP drawing conclusions from the wide-ranging project activities and distilling lessons for the future. Also, some recent relevant literature on FGM is traversed given the increasing attention to attitude and behavior change as key factors in overcoming health and education related problems in overcoming poverty. In this regard, it is argued that the AWSP’s activities and results provide an important contribution to the field, particularly concerning appropriate strategies to overcome deeply engrained, but harmful cultural norms and traditions.