Prevention of female genital mutilation and management of its complications: XXI Factors influencing health status and contact with health services Other
Conditions
Interventions
The intervention package that will be scaled up will consist of two levels, as implemented and tested in a previous phase. The level one component will involve provision of the following resource mate
WHO clinical guidelines on management of health complications of FGM
WHO clinical handbook, which includes chapters on how to detect and manage FGM-related complications, how to communicate sensitively and how to provide care for specific populations
posters opposing FGM medicalization and promoting comprehensive care for women and girls affected by FGM
and job aids to guide provision of care. In-country research partners will distribute these materials to all study sites after baseline data collection and sensitize staff on how to utilize them.
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Sponsors
World Health Organization
Eligibility
Sex/Gender
All
Age
15 Years to 80 Years
Inclusion criteria
Inclusion criteria: Health workers: Adult health workers aged 18 years and over at study facilities who provide routine antenatal care (ANC) or immunization services Clients: 1. For ANC clients, participants will include pregnant women aged 15 -49 years receiving routine ANC services. 2. For immunization clients, participants will include mothers or family members bringing infants for routine immunization services. 3. The clients should be seeking services from one of the health workers who is participating in the study.
Exclusion criteria
Exclusion criteria: Health workers: 1. Not based at a particular study site, but are present on a substitute basis for a short time period 2. Who will retire in the subsequent nine months Clients: 1. Women whose primary clinic visit is not related to ANC or childhood immunization or who are less than 15 years old 2. Clients seeking immunization services for someone other than an infant or young child
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Health workers’ knowledge, attitudes, clinical management practices, and provision of FGM prevention counselling among health workers will be measured using a standardized instrument measuring these concepts adapted from a previous study, at baseline, month 3 and month 9. Knowledge is assessed in Q1 – Q3 of the HCP questionnaire, attitudes are assessed in Q6 – Q21 of the HCP questionnaire, clinical management practices are assessed in Q22 – Q29 of the HCP questionnaire, and FGM prevention counselling will be assessed in Q6 - Q12 in the client EXT questionnaire. 2. Reduced intentions to have FGM performed on their daughters among clients will be measured among health service users based on responses to a question inquiring about respondents’ intentions if they (hypothetically) had a daughter who was the age at which girls are traditionally subjected to FGM (Q17 in the client EXT questionnaire) at three time points (baseline, month 3 and month 9) | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. The validity of health care providers’ knowledge, attitudes, and practices (KAP) measurement tool measured using the KAP measurement component of the questionnaire in the health workers standardized questionnaire (Q1 – Q3, Q6 – Q21, Q22 – Q29 in the HCP questionnaire), correlation analysis will be conducted to check for problematic variables (e.g., those that correlate too highly). Principal factor estimation and oblimin rotation techniques will be used to investigate latent variables. Item response techniques will be used to test the items in the latent KAP domains and items intended to measure those domains. 2. The assessment of the reach, fidelity, feasibility, and costs of implementing FGM prevention and care services at scale within ANC and immunization services will be undertaken using the following methods: 2.1. The reach of FGM prevention and care services will be measured during the in-depth interviews with health facility clients and district health managers at month 9 using an in-depth interview guide. 2.2. Fidelity of implementation will be measured as the proportion of clients reporting correct responses on Q5 – Q12 in the EXT questionnaire at baseline, month 3 and month 9, as well as responses on IDIs with clients and district managers. 2.3. Feasibility of implementation will be measured in Q30 – Q31 in the HCP questionnaire at baseline, month 3 and month 9; Q6 – Q10 in the facility checklist (CHK) at baseline, month 3 and month 9; In-depth interviews with clients and district health managers at month 9. 3. Costs of implementation will be measured in HCP Q31 at month 9, which inquires about the time to implement the intervention, combined with budgetary information. 4. Barriers and facilitators to scale-up and sustainability will be measured at month 9 during in-depth interviews with clients and district health managers; responses on the facility checklist Q3 – 17 at month 9, and patient satisfaction as measured in Q13 of the EXT at baseline, month | — |
Countries
Guinea, Kenya
Contacts
Public ContactChristina Pallitto
Outcome results
None listed