NAIROBI, 18 November 2010 (IRIN) - Narrow approaches which focus on individuals or appear to attack deep-seated customs are less successful at reducing female genital mutilation/cutting (FGM/C) than those that aim for community-driven change that addresses the complex social dynamics associated with the practice, according to a new study by the UN Children's Fund (UNICEF).

"Families will and are abandoning FGM/C when the right conditions are in place - conditions that include the involvement of community and religious leaders, legislative reform and [ensure] that any discussion surrounding FGM/C is framed in a way that reinforces the positive aspects of local culture and builds community trust by implementing development projects that address local needs," James Elder, spokesman for UNICEF's Innocenti Research Centre, which conducted the study, told IRIN via email.

The report looks at highly promising approaches being used to support social change around FGM/C and how these strategies are being implemented in Egypt, Ethiopia, Kenya, Senegal and Sudan. An estimated three million African girls and women risk FGM/C annually.

In northern Sudan, for instance, where FGM/C prevalence is about 89 percent, community, state and national efforts to end FGM/C have included human rights education, introducing development activities to communities and a national media campaign to elevate the status of being "uncut", and changing attitudes towards the practice. The country also has national and state policies to protect the rights of women and children, and efforts are under way to criminalize FGM/C.

The country's `Saleema' (Arabic for "whole" or "undamaged") Campaign has helped reinforce positive social values which favour the well-being of children by leading with discussions about parental care and family pride and gently easing into more direct messages about FGM/C.

Narrow approaches, limited success

According to Zeinab Ahmed, a child protection specialist with UNICEF Kenya based in the northeastern town of Garissa, narrow approaches to ending the practice have met with little success.

"Some of the interventions that have had limited impact are alternative rites of passage focusing on individual girls - girls belong to communities, and dealing with a girl as an individual has limitations if she then goes back into a community that still strongly believes in FGM/C. It's important to involve parents, aunts, uncles, elders - the whole community," she said.

According to the UNICEF report, a 2001 evaluation of alternative rites of passage - which involve substitute coming-of-age ceremonies that preserve local customs but eliminate FGM/C - concluded that they have limited effect unless accompanied by a process of participatory education that engages the whole community.

"Similarly, rescue centres for girls do not deal with the roots of the problem, and they are not sustainable... Can they really house all the girls who run away from FGM and early marriage? Why not approach this by changing how the community thinks about FGM," she added.

Ahmed noted that it was important to tailor responses to suit the various communities involved in FGM. "For example, the alternative rites of passage have worked well in Maasai communities, but among Somali communities, the approach needs to address both cultural and religious aspects of FGM, so community dialogue is the method used," she said.

Complex social dynamics

"Among the Somali, it has been important to gently draw out the community to discuss issues around FGM... We might start, for instance, by discussing pregnancy and labour and the reasons why childbirth is so difficult for them, which eventually comes to a discussion of FGM."

Northeastern Kenya is dominated by ethnic Somalis, who practice infibulation - the removal of the external genitalia before sealing and leaving a small opening for menstrual blood and urine - almost universally. This method makes sex and childbirth particularly difficult.

It was important, she added, for the government to take leadership of FGM/C by enforcing existing laws and funding sustainable programming. She emphasized the need to speak to communities in their own languages through well respected community members acting as "facilitators of change".

"The media has been very effective in creating debate on FGM; FM stations in local languages, featuring experts - gynaecologists, children's officers, education experts, religious leaders - on panels discussing the issue promote healthy and lively discussion of FGM," Ahmed said. "Women and girls are able to call in anonymously and say how FGM has negatively affected them. After all, it is the shoe wearer who knows where it pinches."

According to the report, while several countries have laws in place prohibiting FGM/C, legislation alone was insufficient to end the practice, which is closely tied to social identity and acceptance.

"Religion, tradition and culture are often cited by families as reasons for cutting their daughters," said UNICEF's Elder. "Many communities, for example, assume that FGM/C is mandated by religious doctrine, despite the fact that no major religion requires it."

"In some cutting communities, a woman can't be married without being cut," Ahmed said. "In Africa, marriage is the ultimate security, and in these communities, it doesn't matter if you have 10 PhDs... If you're not cut you are not recognized for your achievements and getting married is usually a huge challenge."

Ahmed said part of the approach to ending FGM/C among the Somalis in northeastern Kenya involved debunking the idea that Islam demanded the practice, as well as de-linking the practice from ideas about promiscuity and chastity.

Elder noted that ending FGM/C was a good way to eradicate other practices that lowered the value of women in their communities.

"Evidence from the report suggests that the approach used to support the abandonment of FGM/C can also promote and contribute to the abandonment of other harmful practices, such as forced and child marriage," he said.

Subtle attitude shifts

The report noted that although prevalence rates are still high in Egypt, Ethiopia and Sudan, there has been a significant change in attitudes about FGM/C in all three countries, indicating that individuals are questioning the merits of these practices.

According to Ahmed, there has been a similar shift in attitude among Kenya's Somali population.

"We are seeing an attitude shift - for example, some Somali communities are moving from infibulation to the pricking or nicking of the clitoris," she said. "A small percentage have discreetly left the practice altogether. However, no form of FGM should be condoned."