Twelfth Forum on Dissemination of Research and Studies on Female Genital Mutilation Convenes

Mapping and Capacity Assessment of Civil Society Organizations (CSOs) and National NGOs Working on Maternal and child health fields/FGM-2017
*Background* : Lack of the coordination bodies and mechanism has weakened the collective action and voice by Sudanese local civil society actors. In addition, lack of adequate and sustainable resources made civil society prone to staff drain and enduring surviving elements. Thus, MCH Directorate FMOHdecided to engage in buildinga strong network of CSO/NNGO partners. Noteworthy, networking is very advantageous for both government and CSOs/NNGOs; it helps CSOs/NNGOs to impact communities beyond the immediate range of their projects. Hence, the overall objective for this study was to strengthen partnerships, coordination and capacity of CSOs and NNGOs.
*Methods** : mapping was conducted in ten (10) SFFGC states namely; Khartoum, River Nile, Northern, Red Sea, Kassala, El-Gadaref, Sennar, Jazzera, North Kordofan and South Darfur. A research team had been assigned and used a participatory method for mapping of all NGOs working in MCH through key informants interviews, desk review and verification onsite visits within the period between 15th February till 22nd March 2017 followed by data compilation and analysis using SPSS version 21.
*Result:* A total of one hundred seventy nine (179) CSOs\NNGOs were identified through the desk review and contact with HAC and department of NGOs in some SMOH at the 10 states. Out of these, one hundred and nine (109) were mapped and only eighty two (82/109) were assessed based on the eligibility criteria. Of those, fifty per cent have good capacity, 41.5 per cent with some capacity and 8.5 per cent with little capacity. The state’s net capacity scored good for five out of the 10 targeted states (South Darfur, Northern, Kassala, Sennar and Al-Gadaref states). CSO/NNGO’s capacity mainly suffers from financial constraints.Althoughtheyappeared to be in a safe position in respect tohuman resources, almost 77 per cent of CSOs/NNGOs lacked expertise. Advocacy was the strongest dimension of mapped CSO/NNGOs.
*Conclusion** : CSOs/NNGOs appear to be responding to communities’ needs, such as endeavoring to ease poverty and in some states work to resolve conflict. Also, some CSOs/NNGOs are engaging in environmental protection and women’s empowerment. Most of the CSOs/NNGOs assessed strive to build constituencies, often due to lack of resources. Financial capacity considered to be one of the weakest dimensions of CSO/NNGO sustainability. Advocacy appears to be the strongest dimensions. This study recommends increasing financial resource and providing technical assistance through immediate training on articulation of operational policies.CSOs/NNGOs should be supported to form an anti-FGM/C CSO support group/professional association to continually diffuse best practices and enhance internal network, partnerships and cooperation across programs.
*Medicalization of FGM in Sudan: Negotiating Between Medical Ethics/Knowledge and Perceived Socio-Cultural Obligations by Community Midwives in Sudan?*
*Introduction* : Social and economic motivations buttressed by patriarchy have been linked to perpetuation of Female Genital Mutilation (FGM) in several African countries including Sudan.  However, over the years, we have seen an increase in medicalization of FGM—Health workers participating in performing FGM. In Sudan in particular majority of FGM cases are performed by trained community midwives (CMWs). The reasons (or drivers) of this situation need to be understood to inform policy and programming related to de-medicalization of FGM.
*Methods* : An implementation research study is currently being undertaken in five states in Sudan to understand the drivers of medicalization of FGM as well as knowledge attitudes and practices of CMWs in relation to FGM and management of its complications. The study is using a mixed methods employing both qualitative and quantitative research. The main methods of data collection include focus group discussions and in-depth interviews and semi-structured questionnaires particularly for the KAP study targeting community midwives. In addition, FGDs have also been conducted targeting adult women and men in the community. For this article we present preliminary findings from the qualitative component of the study. Thematic analysis has been employed to analyse the data.
Preliminary results: Results suggest that medicalization is primarily driven by the demand motivated by social norms and the supply motivated by economic gains tending towards commercialization of FGM among the community midwives. Medicalization is also influenced by limited understanding among some of the CMWs of the depth of the health and social consequences of FGM. FGM guarantees CMWs power and influence over sexuality, reproduction and being gate keepers of the institution of marriage especially in communities where FGM is perceived as a major factor in marriageability of a girl/woman. Competition between CMWsand traditional birth attendants is also apparent. Although CMWs have started to appreciate the health consequences of FGMas members of the community, they also feel that they have a social and moral obligation to perform FGM in order to save marriages, preventdivorce, and facilitate marriages in communities where FGM is perceived as a prerequisite for marriage.
Results show that training about complications related to FGM and emphasizing medical ethics including taking oath not to perform FGM was perceived to be effective butneeds to be complimented by social norm change interventions among CMWs as well as exploring alternative livelihood options for CMWs. Results reveal that some CMWs of particularly the relatively young and more literate are exercising their agency by employing strategies to say no to requests from communities to perform FGM by trying out different options.
*Conclusion : Medicalization of FGM is driven by socio-cultural and socio-economic motivations as well as limited knowledge of the immediate and long term health, sexual and psychosocial complications associated with FGM. CMWs are constantly negotiating between allegiance to medical ethics and knowledge on one hand and their socio-cultural obligations as well as economic interests. Efforts to empower CMWs with knowledge on FGM and its health complications are beginning to yield results especially among the young CMWs but these alone are not sufficient. There is need to be strengthening the integration of social norm change interventions in the pre and in-service trainings for CMWs and supporting alternative livelihood options. In addition, as the supply side is being addressed, it is important to deepen efforts to address the demand side for FGM at the community level

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