Female Genital Mutilation (FGM) is illegal in the UK and is a significant problem with over 137,000 women and girls living with consequences of FGM in the UK, while over 60,000 girls under 15 remain at risk of FGM.
Women who have undergone FGM experience many barriers to accessing appropriate care in the UK. Likewise, health professionals lack confidence, knowledge and experience in addressing FGM-related issues exacerbated by fragmented service provision.
The project is based on a partnership between researchers, clinicians and community representatives. It seeks to inform the development of new models of FGM-related health service delivery and staff training through synthesis of qualitative evidence regarding the views and experiences of service provision and quality of care from the perspectives of:
- women and girls who have undergone FGM
- health professionals
Two qualitative reviews will be undertaken. Both are registered with PROSPERO.
Project information
Project Duration: March 1 2017- March 31 2018
Funding body: National Institute of Health Research (NIHR), Health Services and Delivery Programme
Project Number: 15/137/04
Principal Investigator: Dr Catrin Evans
Meet the Team
Co-Investigators
- Dr Catrin Evans – Principal Investigator, Associate Professor, School of Health Sciences, University of Nottingham
- Dr Ritah Tweheyo – Project Research Fellow
- Professor Gina Higginbottom MBE – Professor of Ethnicity and Community Health, School of Health Sciences, University of Nottingham
- Dr Julie McGarry - Associate Professor, School of Health Sciences, University of Nottingham
- Jeanette Eldridge – Senior Research Librarian, Faculty of Medicine and Health Sciences, University of Nottingham
- Dr Carol McCormick – Independent Consultant, Former FGM Specialist (Consultant) Midwife
- Valentine Nkoyo – Activist, Director Mojatu Foundation, Founder of Nottingham Community FGM Steering Group and FGM Survivors Club
Advisory Group
- Professor Jim Thornton, Professor of Obstetrics & Gynaecology, School of Medicine, University of Nottingham
- Dr Helen Denness, Public Health Consultant, Lead for Integrated Commissioning of FGM Services, Nottingham City
- Kinsi Clarke, Nottingham & Nottinghamshire Refugee Forum, Founding Member of Nottingham FGM Survivors Club
- Dr Comfort Momoh MBE, FGM and Public Health/Midwife Specialist, Guy's and St Thomas' NHS Foundation Trust
- Dr Phoebe Abe, GP & FGM Expert
Review 1: To explore the experiences of FGM-related healthcare across the life course for women and girls who have undergone FGM
Objectives:
From the perspective of women and girls who have undergone FGM: -
- to illuminate factors that influence FGM-related healthcare seeking and access to health services across the lifecourse
- to explore how quality of care is perceived and experienced in different healthcare settings and with different groups of healthcare professionals
- to characterise and explain elements of service provision considered important for the provision of acceptable and appropriate healthcare
- to describe factors perceived to influence open discussion and communication around FGM (including prevention) with health professionals
Review 2: To explore the views on, and experiences of, all cadres of health professionals in providing care for women/girls who have undergone FGM
Objectives:
From the perspective of health professionals:
- to explore how quality of care for women/girls who have undergone FGM is perceived in different healthcare settings and amongst different professional groups
- to characterise and explain elements of service provision considered important for the provision of high quality care to women/girls who have undergone FGM
- to illuminate factors perceived to facilitate or hinder appropriate provision of care for women and girls who have undergone FGM
- to identify processes and practices perceived to influence open discussion and communication around FGM (including prevention) with women/girls from affected communities
Research Design
The systematic reviews will be syntheses of qualitative research evidence, conducted using a thematic synthesis approach, and will follow the guidance set out by the Cochrane Qualitative and Implementation Methods Group. The overall design for each review will be the same and will be reported as per ENTREQ Guidelines. A final project report will critically compare and consider the findings of each review and bring these together to identify key recommendations for policy and practice.
Potential Impact
There are limited intervention studies around FGM and as per the MRC complex interventions guidance, a first step in developing new interventions or evaluation measures is to conduct a systematic review of the evidence. The proposed qualitative systematic reviews will, therefore, yield essential insights for future research and intervention development in this area.
Review results will be integrated in a final report:
- to make recommendations for NHS training, service development and improvement,
- to pinpoint key dimensions of quality of care that can be operationalised for use in future service improvement evaluations or patient reported outcome measures
- to identify areas where further research is required