I was just seven years old when I underwent female genital mutilation (FGM) while on holiday with my family in Djibouti. 

I almost died a few years later back in the UK when I was rushed to hospital with kidney failure, so I know only too well the physical and psychological consequences from this horrific violation of a girl’s rights, which range from infertility to fistula and traumatic stress disorder. FGM can also result in death.

An extreme form of violence against girls, the practice is caused by a toxic mix of factors including gender inequality, economic injustice and deep-rooted societal norms. It remains widespread, with 200 million survivors worldwide and 70 million girls at risk between now and 2030.

So how do we stop this pervasive abuse from happening?

In June 2021, Population Council, an international research group, published a desperately needed review of evidence, documenting which approaches are effective – and which have little or no impact. It is the most comprehensive review that I have seen, and backs many of the interventions and solutions that survivors have long called for. 

The research showed that health education and conversations with communities, parents and religious leaders can change attitudes about FGM – an important first step towards eradication – though less is known about how sustainable this change is over the long term. Using marketing or media outlets including community radio to change mindsets can also encourage a shift towards abandoning the practice.

The Population Council also found that the higher level of education of a mother, the less likely her daughter was to be cut. The ramifications of this are obvious: if we better fund education for girls, we can help to break the cycle for the next generation.

FGM bans accompanied by strong government leadership and proper training of the police, right down to the local level, should help in reducing FGM – but may take a long time to work.

Making sure that villages are FGM-free by using public declarations, where people hold up anti-FGM banners, may help to change mindsets – at least for a while. However, even though these types of community declarations are very commonly used by activists, we don’t really know if they stick or how effective they are in the long term.

Finally, better training for medical professionals has been shown to prevent FGM from happening, while also improving the health and well-being of those who have already undergone it and experience medical problems.

Whether some other commonly-adopted approaches work is less clear. Community efforts to convert or provide traditional practitioners with alternative sources of income have next to no impact, the Population Council found. Alternative rites of passage – for instance public ceremonies where milk is poured on a girls’ legs – have had limited success when done in insolation.

At The Five Foundation, The Global Partnership To End FGM, we wanted to build on this work, to see how the emerging evidence was being incorporated into initiatives. We surveyed roughly 50 of our partners on the ground, and the results were telling.

Almost all the respondents were from African countries where FGM is still prevalent, such as Kenya, Sierra Leone and Nigeria. Just over 70 per cent said they currently use what are called “community dialogues”, where intensive conversations take place with parents and religious leaders, but only 55 per cent use media or social marketing – even though these are proven to be effective tools.

Meanwhile around a third encourage alternative rites of passage, while 81 per cent agreed that legislation is essential. One particularly interesting finding was that 45 per cent of respondents still use alternative sources of income for cutters, even though this has been shown as ineffective.

While some groups are clearly highly responsive to the evidence of what works to end FGM, the findings show there can be a disparity between the type of work activists prioritise and what we know are the most effective approaches. This is partly due to of a lack of communication through the anti-FGM network, but also because groups are rarely supported to measure and track their own impact.

In other words: this isn’t just about understanding the evidence. For many of our local partners, a clear funding gap has emerged – and it’s hampering their impact.

During the last decade or so, donors have told me time and time again that the reason no foundation finances major efforts to tackle FGM is because of a lack of robust evidence around which interventions work best. As this evidence is put into practice more and more by frontline partners, this statement no longer stacks up.

On February 6, International Day To End FGM, we are launching The Five Fund, a dedicated fund for grassroots activist groups – initially in Djibouti and Somaliland – to translate the evidence we are collecting into financing for the strategies that work. Our focus will be on getting both the latest information as well as critical funding to the local level, while making sure experts on the frontlines can make informed decisions on how to fuel and scale up their efforts to end FGM.

We now have a much better overview of what approaches work. It is critical that we trust, empower and fund locally-based activists to use this evidence to deliver their own impact, as we accelerate work to end this devastating abuse, which has existed for thousands of years.

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