Introduction
Female genital mutilation (FGM) is a serious problem affecting many women in different parts of the world. This traditional malpractice entails the complete or partial removal of the female genitalia. Health professionals and experts have undertaken numerous studies to understand FGM and behaviors associated with it. Individuals who have gone through this cut tend to exhibit psychological, social, and mental behaviors that tend to impact their future experiences and overall life outcomes (Elduma, 2018). In the African setting, FGM is pursued as a unique cultural practice intended to deliver positive medical health outcomes. Unfortunately, most of the completed studies have identified the behavior as inappropriate and incapable of delivering any known benefit to the victim.
While different racial groups and tribes in African promote FGM, the Sudanese living in South Sudan and Sudan are identifiable as the best population for this analysis. Most of the members of this community identify FGM as an important health practice aimed at supporting the people’s cultural attributes. For instance, some investigations have indicated that FGM among the Sudanese is identified as an important heritage or behavior (Elduma, 2018). The society acknowledges that those who embrace FGM in the region would grow in a decent or proper manner. The community goes further to encourage men who want to marry to identify women who have undergone FGM. According to Lugiai et al. (2021), most of the Sudanese are convinced that FGM is an important health behavior that helps keep female sexuality monitored or controlled.
The appreciation and promotion of FGM remains a questionable health behavior among members of this population. The government of Sudan has gone further to implement progressive policies and law to deal with the health predicament. For instance, the country passed the National Child Act (2009) with the aim of criminalizing the process of FGM. This move was a response to the failed attempts of the previous legislation to deal with this health misbehavior. Unfortunately, the 2009 law failed to deliver the needed outcomes within a decade. In 2020, the Sudanese government introduced a new policy in 2020 with the aim of making FGM a criminal offense that was punishable under the law (O’Neill and Pallitto, 2021). Despite these attempts, FGM still remains a public health concern in this country. Young girls below the age of 16 remain at risk of going through this malpractice (O’Neill and Pallitto, 2021). These issues explain why there is a need for an effective health plan and intervention to influence this behavior in Sudan.
Novel Health Promotion Intervention
In Sudan, FGM remains a problematic behavior that affects the experiences and health outcomes of women and young girls. Members of this country promote a number of socio-cultural factors that have encouraged more people to pursue the idea. As described above, FGM appears to be one of the requirements for women who would want to get married or grow up to become prosperous members of the society (Elduma, 2018). This knowledge could explain why FGM has remained common among the Sudanese. In the past, the government has attempted to implement policy initiatives and laws to help deal with FGM. Unfortunately, such efforts have failed to deliver the much needed outcomes. Despite the ban on FGM, over 60 percent of young women continue to experience the predicaments associated with it (O’Neill and Pallitto, 2021). These realities explain why a novel health intervention would be recommendable for this African population.
The current situation calls for a multidisciplinary health intervention plan that seeks to promote the most acceptable health practices among the Sudanese. This novel approach needs to begin by appreciating that FGM is a systemic malpractice that is deeply engraved in the people’s cultural and social ideologies (Dawson et al., 2015). This understanding means that it cannot be possible to get rid of FGM completely within a short period (Sabahelzain et al., 2019). This knowledge should encourage the participants to consider evidence-based approaches that would deliver short-term gains in the fight against FGM. The approach should also be implemented depending on the nature of the existing challenges and gaps in the current fight against this critical health behavior.
In the recent past, scholars have unearthed some of the challenges that make hard societies to overcome the burden of FGM. For example, Sabahelzain et al. (2019) completed a detailed literature analysis that revealed that most of the midwives involved in the fight against FGM lacked adequate technical skills. They also displayed reduced cultural competencies while trying to deliver desirable results. In most of the cases, the people’s social and cultural attributes were so strong such that they were unwilling to abandon practicing FGM (Dawson et al., 2015). These complexities meant that it was impossible for more women to get rid of FGM. Those who had gone through the cut were also keen to support the behavior. Sabahelzain et al. (2019) observed that such victims had been brainwashed to acknowledge that FGM was an important cultural practice that defined their places in the society. Such insights were critical and capable of guiding future scholars to design superior or more inclusive health promotions programs.
The proposed health promotion intervention seeks to educate more Sudanese about FGM, its dangers, and the problems associated with the current notions about it. Using the findings of Sabahelzain et al. (2019), this novel strategy would begin by providing adequate competencies to most of the midwives practicing in the country. The primary focus would be to equip them with adequate social and cultural skills that could help them to interact with the Sudanese in a professional manner. This initiative will ensure that they are prepared for key questions and views that might emerge from the process (Dawson et al., 2015). The consideration of the established clinical guidelines and campaign procedures would help to develop the best campaign that can help deliver the much needed outcomes.
The next idea would be to consider the power of a multidisciplinary team. In different African societies, most of the initiatives aimed at addressing FGM have put midwives at the center of the campaigns. While these professionals are usually the frontline providers of critical services, there is a need to collaborate with community workers, psychotherapists, traditional or community leaders, social workers, government agencies. This reasonable novel approach might not have been tried in the Sudanese society. The inclusion of most of these experts will make it possible for the beneficiaries to understand the unique realities of FGM.
These professionals would also help members of the selected community to appreciate the fact that FGM is a dangerous behavior that is associated with numerous problems. For instance, Sabahelzain et al. (2019) acknowledges that young women or girls who undergo the cut would record negative health outcomes. Some of them are long-term in nature and capable of disorienting their future life experiences. The best examples include tissue damage, increased risk for sexually transmitted diseases, cysts, and scarring. In most cases, most of the women who have gone through the malpractice would have painful menstruations. They can also experience difficulties when engaging in sexual intercourse or urinating (O’Neill and Pallitto, 2021). These observations explain why scholars in the fields of sociology and health have not identified any positive medical or emotional gain associated with FGM.
Upon the establishment of the proposed team, it would be easier to offer additional technical knowledge and guidelines for meeting the demands of more women. The involved leaders of the intervention would provide additional insights for allowing the participants to learn more about the cultural issues and views associated with the intended beneficiaries (Elduma, 2018). The professionals would liaise with the community leaders to learn more about the gaps and barriers towards effective implementation of the novel promotion (Njue et al., 2019). The involvement of policy experts and government leaders would help link the misbehavior to the established policies. These efforts would become powerful guiding principles for empowering the professionals and ensuring that the focus on the best outcomes. Some of these participants will go further to outline some of the challenges they might have encountered in the past while trying to tackle the problem of FGM. The emerging insights will form the basis for launching the promotion and ensuring that sustainable results are eventually recorded.
The inclusion of local organizations and non-governmental agencies in Sudan will help make the process successful. Such an approach is evidence-based since these stakeholders understand the issues affecting the people and how they analyze or address them (Elduma, 2018). These institutions will provide additional insights regarding the complexity of FGM and some of the best procedures for tackling it among members of the selected African community. According to Njue et al. (2019), a multifaceted approach remains a valid and tested approach for pursuing positive health behaviors. The model should include all key players, stakeholders, and professionals who have a clear understanding of the problem. In another study, Dawson et al. (2015) revealed that cultural competency formed the foundational strategy whenever planning to address challenges that were entrenched in people’s cultural and social practices. Thesetheoretical arguments explain why the participants and leaders should focus on cultural competences and a multidisciplinary approach to support the delivery of desirable outcomes.
Having outlined the best approach for tackling FGM among the Sudanese, it would be appropriate to consider the power of social media use. In the recent past, more people have been relying on the use of different handheld devices and social media platforms to communicate and share ideas. The increasing uptake of Twitter and Facebook in Sudan presents a new opportunity for launching the proposed health promotion plan more effectively. Lugiai et al. (2021) reveal that a good social media campaign needs to integrate two platforms if positive results are to be realized. For this present case, Twitter and Facebook are capable of providing the much needed outcomes. Since the websites share data and links, the pioneers will be able to provide timely updates about the gains of the campaign. The leaders will only upload one update every day to elicit discussions and ensure that more people would remain engaged (Lugiai et al., 2021). Such approaches will increase chances of making the program successful.
To increase the possible success of this novel health promotion campaign, the online model would have to be merged with community-based education. The professionals will organize campaigns and traverse the county engaging and teaching most of the citizens about FGM. Community leaders, politicians, and health experts will help shed more light about FGM and the dangers associated with it. The promoters would need to remain respectful while using culturally competent tactics. For instance, they would respect the power distances and family hierarchies the individuals associate with (Lugiai et al., 2021). They will listen attentively and show maximum respect to these people’s cultural and psychological attributes. They will then include some of the victims of FGM to offer their revelations and experiences from FGM.
Community or traditional leaders involved in the health promotion will educate the beneficiaries about the problems of FGM and why there is a need to deal with them. Such a novel combination would be evidence-based, integrative, and capable of supporting the delivery of meaningful results. The participating government officials would sensitize the people about the practices being promoted elsewhere across the globe (Dawson et al., 2015). The beneficiaries would appreciate that FGM is a malpractice that does no longer have a place in the lives of the Sudanese. The continued replication of the proposed campaigns in different regions across the country will increase the chances of achieving the intended goals.
Implications
In Sudan, FGM remains a common problem affecting many women and young girls. Unfortunately, majority of the people in this country appreciate and support the practice as an integral part of their cultural manifestation. In a study by Elduma (2018), it emerged that FGM was promoted in different African societies because it was seen as the best strategy for ensuring that women remained faithful in their marriages (Njue et al., 2019). Men were also observed to identify and marry women who had undergone FGM. These complicated scenarios could explain some of the goals and outcomes expected from the case of the Sudanese population. The involved teams should be aware of these issues and consider the best approaches to ensure that desirable results are eventually recorded.
Based on previous research findings and recommendations, the implemented novel health promotion is evidence-based and tackles FGM from different perspectives. Specifically, the involvement of several professionals makes it possible to improve the overall level of cultural competencies (Elduma, 2018). When implemented in a timely manner, chances are high that the level of FGM could reduce from 60 to around 20 percent within the five years. This possible outcome would only be possible if the approach could become a norm in the country. The professionals would also need to allow all medical facilities, religiousorganizations, and community health centers to push the idea forward.
This targeted outcome means that most of the beneficiaries would be in a position to record positive health experiences. For instance, more young girls would no longer be compelled to have their external genitalia mutilated. Such beneficiaries would no longer have to be married at a tender age, thereby getting adequate time to continue pursuing their educational goals. Those who are older would be able to record positive health gains. For instance, they would record reduced cases of pain during menstrual period or when having sexual intercourse (World Health Organization, 1998). More young girls in the selected country would become more confident and improve their self-esteem (Sabahelzain et al., 2019). The wider community would start to promote additional procedures and practices that could help address FGM in the future.
Through the use of social media platforms, more women would be targeted and consider the best approaches to support the idea. The new technologies are timely and capable of meeting the needs of more people than ever before. The model will increase chances of attracting more partners and stakeholders to become part of the solution. The use of different social media platforms will allow the leaders to identify emerging opportunities and resources for implementing the health promotion strategy more efficiently (O’Neill and Pallitto, 2021). These efforts will make it easier for the planners to customize the intended messages and ensure that they focus on a paradigm shift in the Sudanese community. The involvement of all key stakeholders will increase the chances of recording permanent and sustainable behaviors that are opposed to FGM.
Unfortunately, a number of difficulties could emerge during and after the implementation of the suggested health promotion intervention. For instance, the uptake of social media platforms remains high in the selected country due to the forces of globalization and availability of handheld devices. However, Internet access remains a major problem in the selected country. This gap means that the use of social media might not deliver most of the anticipated goals. Language barrier could also be a critical challenge whereby some of the professionals might be unable to comprehend the demands or expectations of some of the community members (Njue et al., 2019). The inclusion of experts who are familiar with the cultural attributes and social norms of the people could help increasing of launching theprogram successfully and eventually delivering positive results.
Additionally, Sudan lacks efficient strategies and platforms for pursuing policy issues. The government has not instituted proper mechanisms to mitigate the problem of FGM in most of the regions. This problem appears to be more pronounced in rural settings whereby poor infrastructure and ineffective coordination of government services remain the norm. These gaps appear to be systemic and capable of disorienting the overall success of the intended campaign. The managerial procedures in most of the underserved regions in the country make it impossible for campaigners to launch their programs successfully. This challenge is also associated with the government’s inability to address the challenges of corruption that have created an enabling environment for FGM to thrive (Dawson et al., 2015). Most of the beneficiaries of the malpractice tend to issue bribes to government officers to ensure that the status quo remains. These issues should encourage the participants to focus on the best ways to ensure that desirable results are recorded from the health intervention program.
Despite the nature of these obstacles, the proposed multidisciplinary approach is founded on theory and past evidence. The relevant authorities and government agencies need to be involved and provide the relevant incentives to push the agenda forward. Past successes and challenges need to inform the best strategies for addressing FGM in Sudan. The professionals will have to apply their cultural competencies and focus on the best approaches to record sustainable results. When done correctly, chances are high that the outlined short-term or immediate objectives would eventually deliver the much needed long-term goals (Njue et al., 2019). The support of the government and the use of the established legislation would increase chances of launching the campaign more effectively and eventually help address the problematic issue of FGM in this society.
Conclusion
Sudan is one of the countries in the African continent whereby FGM remains a problematic issue. This malpractice exists as a cultural behavior that results in public health predicaments. Members of the Sudanese society pursue FGM since they believe that it allows women to remain faithful and respectable in their respective communities. The analysis described above has revealed that FGM results in permanent scars, interferes with women’s sexual experiences, and increases chances of getting infections. These health concerns are directly linked to financial burden and make it impossible for most of the affected victims to achieve their goals in life. The proposed novel health promotion intervention is evidence-based and revolves around the inclusion of different professionals and experts. Such an approach is capable of delivering meaningful results and helping more people in the selected community to start appreciating the dangers of FGM. These aspects will trigger a paradigm shift in the country and increase chances of dealing with the health problem for once and for all in the near future. The most important thing is for all stakeholders to collaborate and replicate the intervention across the country.
Reference List
Dawson, A. et al. (2015) ‘Evidence to inform education, training and supportive work environments for midwives involved in the care of women with female genital mutilation: a review of global experience’, Midwifery, 31(1), pp. 229-238.
Elduma, A.H. (2018) ‘Female genital mutilation in Sudan’, Open Access Macedonian Journal of Medical Sciences, 6(2), pp. 1-5.
Lugiai, M. et al. (2021) ‘Female genital mutilation in Sudan: is a new era starting?’, Sexuality & Culture, 25(1), pp. 1540-1545.
Njue, C. et al. (2019) ‘Preventing female genital mutilation in high income countries: a systematic review of the evidence’, Reproductive Health, 16(1), pp. 113-132.
O’Neill, S. and Pallitto, C. (2021) ‘The consequences of female genital mutilation on psycho-social well-being: a systematic review of qualitative research’, Qualitative Health Research, 31(9), pp. 1738-1750.
Sabahelzain, M.M. et al. (2019) ‘Decision-making in the practice of female genital mutilation or cutting in Sudan: a cross-sectional study’, Global Health Research and Policy, 4(5), pp. 1-8.
World Health Organization (1998) Female genital mutilation: an overview. Geneva: WHO.