Reproduction, Child and Maternal Health: Critique of FGM Interventions in Mali

This article discusses the prevalence of female genital mutilation in Mali and critiques the interventions that have been used to stop the practice. It also suggests improvements for the future.

Running Head: REPRODUCTION, CHILD AND MATERNAL HEALTH
Reproduction, Child and Maternal Health
Name
Institution

REPRODUCTION, CHILD AND MATERNAL HEALTH 2
Reproduction, Child and Maternal Health
Introduction
Female genital mutilation or cutting (FGM) is described as all processes, which entail
incomplete or entire exclusion of the female outer genitalia or other harm to the feminine genital
organs for grounds that are non-medical. The prevalence of female genital mutilation in many
African and Middle-East countries is alarming given the risks that come with this practice. It is
projected that over 125 million females along with girls alive today have faced the cut in 29
nations in Africa, as well as the Middle-East in which FGM is more pronounced. The causes of
FGM comprise a mix of religious, cultural, as well as social elements within families along with
communities. FGM practice amounts to the violations of girls’ along with women’s rights where
the practice is censored by several global agreements along with codes and by nationwide laws
in several nations. Thus far, where it is accomplished, this act is in regard to custom, plus social
traditions to make sure that young girls are socially accepted in addition to marriageable, and to
maintain their standing plus honour. Female genital mutilation often perceived as a means to get
ready young girls for parenthood, as well as marriage, attempting FGM before they break their
virginity (plus matrimonial loyalty later). In Mali, the prevalence of FGM is more prevalent
among ethnic groups (White, Dynes, Rubardt, Sissoko & Stephenson, 2013).
The topic of critique of interventions towards eradicating FGM in Mali is worth
exploring because it will provide a platform on the future improvements. In addition, Mali is a
country that has no legislation on FGM that makes an ideal for this study. The paper will
primarily critique the interventions that have been used in Mali to stop FGM that is having
adverse effects on girls and women undergoing the cut.

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Country Profile (Mali)
In Mali, the proportion of women along with girls that have passed FGM is 91.4 per cent.
This pace of the practice of FGM has amplified from 85.2 per cent in the Demographic Health
Survey (DHS) 2006, although the northern parts were incorporated in the 2013 DHS report.
Thus, the attuned number for 2006 displaying incidence not including the northern areas to make
it analogous to 2013 was 92 per cent (Yoder & Khan, 2008). Therefore, when only matching the
areas that were surveyed in the two reports, the pace of female genital mutilation has decreased
vaguely. The incidence of female genital mutilation is only slightly greater amongst those living
in remote regions (91.8 per cent) as compared to urban regions (90.5 per cent) (United Nations
Population Fund, 2015). The rates of FGM are greatest in the southern along with the western
regions of Sikasso, Kayes, Bamako, as well as Koulikoro, as well as minimal in the northern
eastern parts of Gao and Kidal. In Mali, female genital mutilation is a social norm. The primary
grounds for practicing FGM in Mali comprise: social appreciation, additional enjoyment for the
males, hygiene, superior marriage prospect, ensuring virginity, and belief that it is a religious
requirement. Female genital mutilation is practised by religious, as well as non-religious Mali
people. Mali has a huge Muslim preponderance that have an incidence rate of 92.8 per cent.
Christians practice the cut at around 65.2 per cent, Animists at 77.2 per cent, and non-religious
people at 91 per cent (although the last two groups are minorities in Mali) (White et al., 2013).
FGM is undertaken principally by a traditional excisor. The majority of the girls along
with women in Mali undergo FGM under the age of 5 years (73 per cent). The age bracket 5-9
yeats is 14.6 per cent, ages 10-14 per cent constitute 6.7 per cent, 15+ per cent make up 0.4 per
cent and “unknown” make up 5.3 per cent. The mainstream of Mali people has understanding of

REPRODUCTION, CHILD AND MATERNAL HEALTH 4
FGM practice; 98.3 per cent of females are aware of FGM and 98.8 per cent of males. On
continuing the FGM practice, 76.0 per cent of females were in support of FGM, and 98.8 per
cent of males (Yoder, Wang & Johansen, 2013). When surveyed, the majority of the people felt
that there was no benefit in NOT undertaking the cut, showing that FGM is firmly-entrenched
cultural tradition, which is seen as an acceptable custom in plus of itself. There is presently no
law exclusively criminalizing the practice in this country. However, the Penal Code must be
interpreted that covers the practice under its prohibition of serious physical injury. The National
Plan for the Eradication of the cut (Portant Code Des Personnes et de la Familie, 2011 (PNLE)
affirmed that female genital mutilation must be outlawed under the provisions of Penal Code,
although enforcement is still a primary a concern (Yoder & Khan, 2008).
Critique of FGM Interventions in Mali
There is a basic significance in comprehending the social structure in Mali to understand
the reasons FGM interventions have not been successful. The Fulani and Mande (together make
up 67 per cent of the population) are gerontocratic and patriarchal, which means power rests in
the hands of males plus the society is structure based on age. FGM is believed to be passed from
ancestors where it will not be questioned without confronting the authority. Polygamy is
widespread in Malian cultural groups, where 40 per cent of females are in polygamous
marriages, comprising 20 per cent of married young girls aged between 15 and 19 years (Banks,
Meirik & Farley, 2006).
There are many interventions in Mali that have been established but the majority of these
interventions have proved ineffective because of different social challenges and other factors that
undermine them. Non governmental organizations (NGOs) have been labouring to eliminate the

REPRODUCTION, CHILD AND MATERNAL HEALTH 5
practice in Mali from the 1960s. In addition, the early age where female genital mutilation takes
place leaves little space for interventions tailored for school-age kids to defy FGM. Anecdotally,
grandmothers along with mother-in-law are normally drawn in in making the decisions on
female genital mutilation. According to White et al (2013), women plays a leading role in
making decisions and access to maternal healthcare autonomously, plus that the powerful cause
in entrée is the mother-in-law mind-set. Because female genital mutilation is a social norm along
with ancestral custom, a nationwide (and society-wide) change on attitude is required prior to the
practice may be deserted. Provided that there are differing views of the FGM practice, significant
intervention is a challenge (White et al., 2013).
Interventions that comprise education regarding the negative outcomes of female genital
mutilation have been mainly regularly utilized internationally for the elimination of the practice,
as well as are a widespread aspect of many interventions in Mali. Nonetheless, persuading
individuals in regions with elevated incidence of FGM of the health implications has been a
problem. Complex childbirth along with long post-partum recuperation periods that are
frequently worsened by the practice are regularly perceived as the custom in the society (Ako &
Akweongo, 2009). Thus, the communities cannot link the health complications to FGM to the
process itself. Therefore, in Mali, the society explains these health complications among women
based on magic and taboos rather than FGM. Therefore, in line with empowering socities on the
health threats of female genital mutilation, lack of education (particularly for the elderly persons
in the society) is a primary challenge. Thus, there has too been a rise of novel health practitioners
who are not “specialists” performing the cut, where they are encouraged by the monetary gains.

REPRODUCTION, CHILD AND MATERNAL HEALTH 6
Therefore, these changes to females indefinite to the society are even more harmful, plus they
destabilize the annihilation of FGM (Wing, 2008).
The religious-based interventions in the eradication in Mali are designed to show that
female genital mutilation is not well-matched with the religion of a specific community.
However, religious interventions in Mali in eradication of the practice have not been successful
because of the social norms that have been created that make it hard for religious leaders to
penetrate and change these attitudes. In addition, religious leaders and teachers have been found
to support FGM in many occasions that make it hard for intervening by different organizations
and the government. Religious beliefs in witchcraft describe female genital mutilation
complications as supernatural punishment (Yoder, Wang & Johansen, 2013). Wahabia Islam
teaches the reality that anti-FGM dialogue is component of grand western ideologies that
contradict to African and Islam custom. In addition, it has been found that low literacy numbers
of Imams, particularly in rural regions have continued to impede interventions towards
eradicating FGM. Poor access to internet services may make communication hard and the poor
road networks to remote areas might be obstacles to organizations trying to penetrate these areas
to educate the people regarding the dangers of FGM (Berg, Underland & Odgaard-Jensen, 2014).
Despite the challenges faced in Mali in the implementation of FGM interventions, there
some success that has been attained. The government policy and support has been influential
towards the abolition of the practice in Mali (Dawson, Homer, Turkmani, Black & Varol, 2015).
There are many reports that Mali’s legal atmosphere for NGOs is one of the mainly helpful in
African nations. Non-governmental organizations may effortlessly record, as well as are
commonly free to articulate their viewpoints on policy matters on FGM, although they face

REPRODUCTION, CHILD AND MATERNAL HEALTH 7
challenges while registering for tax exemptions plus government contracts. PNLE program has
been successful in fighting FGM since it was founded in 2002 by the state through the Ministry
of Woman Promotion, Child and Family. PNLE coordinate programmes related to the
eradication of FGM. Population Services International, s assessment of PNLE demonstrates that
considerably fewer males and females with an uncut daughter intention to cut her in the prospect,
a decrease from 51 per cent to 38 per cent (Wing, 2008).
Improvements for the Future
Healthcare professionals and providers must not perform any kind of female genital
mutilation in any environment-neither must they execute reinfibulation following the delivery.
The training of healthcare professionals should be trained in Mali through effective training
programs and session to provide care for women and girls agonising from the problems linked to
female genital mutilation, comprising exceptional care in childbirth for females that have by now
went through the cut. Training healthcare professionals to help post-women FGM will be an
important approach in the future to help change the existing norms towards eradicating of FGM
in Mali. Female genital mutilation is an issue, which needs definite cultural proficiency to
promote communication, counselling, care, as well as avoidance plus several healthcare experts
in Mali do not have, where they will benefit from the training (Anand, Stanhope & Occhino,
2014). Cultural competency training among the healthcare professionals will enhance the health
outcome along with the quality of care. In addition, the training should equip the healthcare
professionals to counsel females recovering from the consequences of the cut plus their
immediate families, as well as provide advice them to look for care for their problems along with
psychological health outcomes (Jacoby & Smith, 2013).

REPRODUCTION, CHILD AND MATERNAL HEALTH 8
In addition, there is the need to create supportive legislative and regulatory frameworks.
It is evident that in Mali, there are no legislations that outlaw FGM other than the penal codes.
The Malian government must adopt, implement, as well as enforce legislation that addresses
FGM, to affirm its obligation to preventing FGM plus to guarantee that women’s along with
girls’ human rights. On the other hand, the current regulations on FGM, like child-protection
laws along with the criminal laws on regard to physical damage. In order to evade deviance and
FGM becoming secretive, it is crucial that all lawful act considers the extent of social acceptance
of FGM among different ethnicities in Mali, plus that it is part of the wider program, which
includes direct actions to authorize practicing societies to dump FGM (Arora & Jacobs, 2016).
Conclusions
Mali has not adequately addressed the problem of FGM because of the social barriers that
has continued to undermine interventions directed towards elimination of FGM. FGM is
fundamentally a social plus ancestral custom. To fashion programmes, the government and
organizations must be careful of the patriarchal along with age-based hierarchical organization of
Mali. The healthcare professionals should trained to how to help the affected women and girls on
how to progress well after FGM. The government should create supportive legal, as well as
educational framework with matching national guidelines along with the practices, which may
guide the activities of all ranks of the healthcare professionals. These include reporting, as well
as monitoring customs plus offering the essential budget to dishearten medicalization of female
genital mutilation within the general structure of complete eradication of the practice in Mali.

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