How Amref is working to end FGM by 2030
By ARP/WASH project implementation team, Amref Health Africa, Kenya.
Female Genital Mutilation/Cutting (FGM/C) is a harmful practice that involves partial or total removal of the external female genitalia and causes physical and psychological trauma. It is considered a violation of human rights by the World Health Organization (WHO). The practice results in severe bleeding, psychological trauma, permanent scarring and sometimes fistula during childbirth. It also leads to girls dropping out of school, early child marriage and teenage pregnancy. This not only affects the girl who has been through FGM, but her children, and the community.
Despite declining FGM/C prevalence rates overall in Kenya, it is still practiced in 22 of 47 counties, with Kajiado and Narok being two counties where the practice persists as a social norm. Communities with the highest prevalence rates include the Somali (94%), Samburu (86%), Kisii (84%) and Maasai populations (78%). The COVID-19 pandemic led to increased cases of FGM, teenage pregnancy, and child early and forced marriage, and the impact of the current drought crisis looks to follow the same trajectory.
Drought, climate change and FGM
Amref started the Community-Led Alternative Rite of Passage (CL-ARP) programme with Kajiado county’s Maasai community in 2009. This is a programme intervention which aims to support communities that practice FGM to respect the cultural practice of rite of passage to womanhood, without exposing girls to physical cutting. The programme has since been expanded to Samburu and Narok counties in Kenya, and parts of Tanzania, reaching 23,930 girls to date.
The Maasai community, the dominant group in the county, views FGM/C as a rite of passage and a means to increase the likelihood of marriage and therefore bringing in a dowry – usually in the form of cows. The devastating effects of prolonged drought, fuelled by the impacts of climate change, are therefore tragically undoing progress made in ending FGM/C. Girls are now more vulnerable to this harmful practice and early marriage; it is considered a way to support their families through these incredibly challenging times and to counter the family livestock losses due to drought.
Countering the challenges
With funding secured in the UK, Amref launched the ARPWASH II project in Kajiado, which combines the CL-ARP and Water, Sanitation and Hygiene (WASH) services to improve the Sexual Reproductive Health and Rights (SRHR) of adolescent girls and women. Over the last two years, the project has reached 3,000 individuals with safe WASH services, prevented 1,250 girls from undergoing FGM/C practices and child marriage, and trained 95 Community Health Workers on digital learning platform LEAP to monitor and track gender-based violence.
The CL-ARP model in Kenya and Tanzania
The CL-ARP approach is a comprehensive, community-led process that engages community members in structured dialogues on SRHR, menstrual hygiene management, WASH, and the importance of alternative rite of passage. To achieve a successful CL-ARP takes time and engagement with key community traditional, cultural, and elected leadership for a period of between 12-24 months. In this time, we work towards building the structures and support to ensure the cultural significance of the ARP is recognised and upheld by the community as a whole.
Throughout the programme, we use a combination of monitoring and evaluation strategies such as mobile tracking tools and regular follow-ups with the girls and their communities to measure success.
This success can be measured against several, layered outcomes; from community acceptance of uncut girls, the support and commitment from political leaders, fewer girls dropping out of school, male involvement and ownership of the process, to reduced or zero cases of FGM/C.
In particular, the tracking tool helps to collect data on the educational attainment, wellbeing, and experiences of the girls after participating in the ARP process. This data is analysed to assess the impact of the program and inform decisions for strengthening the CL-ARP approach. By keeping in constant contact with the girls and the community, Amref can quickly identify and address any challenges that may arise, ensuring that the girls are protected and enjoy a healthy life free from FGM/C up until the age of 24.
A community-led ARP will typically include the following activities, which are adapted to each community's specific and unique cultural context.
- Structured community dialogues to raise awareness and educate the community on the importance of ending FGM/C and the benefits of education for girls.
- Formation of Community Advisory Teams (CATs) made up of influential individuals within the community who will mobilize parents, protect uncut girls, and detect and respond to incidences of FGM/C and other forms of gender-based violence.
- Mobilization of parents and obtaining consent for girls to participate in sexual and reproductive health sessions and hygiene management activities.
- Fostering of peer support through school outreaches and providing safe spaces in schools for menstrual hygiene management.
- Engagement of boys and men to support and protect girls from FGM/C and promote a change in attitude towards women.
- Mobilization of community resources for the ARP ceremony.
- ARP participant training and candle-lighting ceremony, which is a 5-day programme focused on sexual and reproductive health, menstrual hygiene management, water safety, children's rights and life skills. The final candle-lighting ceremony symbolizes the rejection of harmful cultural practices and represents a bright future for girls. Tracking and support continue until the girls complete their education.
- CL-ARP ceremony with cultural blessing and certificates for girls, political leaders and stakeholders in attendance.
- ARP symposiums to monitor girls’ progress and provide support to prevent them from falling back into harmful cultural practices such as FGM/C and child marriage.
- Tracking of girls will be done up to age 24 until they complete their college or university education.
Focus on: Maparasha, Kenya
Two years ago, when Amref started to engage with the community in Maparasha, there was resistance to the idea of ending FGM/C. Traditional and political leaders in the community were afraid to openly address the topic as the community believed deeply in the practice. Religious leaders also did not initially accept to preach against FGM/C from the church platform.
Community engagement
While we continued a dialogue with community leaders, we adapted our approach to engage everyday people in the community. This village-by-village approach involved connecting with two key groups, namely community health workers (CHWs) and village elders to create anti-FGM champions to encourage conversations about child protection and SRHR at the grassroots. To build on the momentum, we ran a pre-ARP symposium, school outreach, and SRHR-talk radio shows to prepare parents, boys, and the wider community to safeguard the rights of girls during the long school holidays in December, which is a prime time for FGM to be performed.
#EndFGM community champions
By creating anti-FGM champions and involving the wider community, we began to see a shift in attitudes and behaviours. The final push to overcome the initial resilience was to arrange an exchange visit to Kilo, an ARP practicing community, to see how they successfully changed attitudes, behaviours, and social norms so that girls can make the transition to womanhood without undergoing FGM/C.
Meaningful engagement
Changing attitudes towards FGM will take time and requires meaningful engagement with communities and their specific needs, respecting their cultural heritage. There is no one-size-fits-all approach to ARPs, but with care and time, attitudes and practices can change, as demonstrated in Maparasha. In December 2022, two years after first engaging in the programme, the community held their first Alternative Rite of Passage ceremony.
Rhoda's story
Rhoda Kataro is one of the 400 girls that went through the CL-ARP in Maparasha in December 2022. In her powerful speech during the ceremony, Rhoda spoke on behalf of all 400 ARP girls and made a call to action to the leaders, mothers and fathers of the community, urging the community to invest in education for girls: "Brand me with education and I will show you what a resourceful person I can be," she said. "Please do not cut girls but instead give them education. I will show you what an empowered girl can do to her village."
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