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The Somali community living in Kenya has practiced the severest form of female genital mutilation/cutting (FGM/C), infibulation, for centuries. To understand the context within which the practice takes place, and how its complications are managed, FRONTIERS undertook a diagnostic study in North Eastern Province and in the Eastleigh area of Nairobi. The study found that the health system is ill equipped to serve women who have been cut, and particularly infibulated women who are pregnant and delivering, stemming from an overall weakness in the availability and quality of maternal and neonatal heath services. Specific recommendations could strengthen these services so as to competently manage women with FGM/C: improved management of complications associated with FGM/C within the framework of improving safe motherhood services, interventions with health providers through ensuring that staff adhere to MOH policy, and community-level discussions to create a climate for behavior change. As a contribution to reducing maternal morbidity and mortality, these interventions will provide lessons that the MOH can use in its efforts to achieve the Millennium Development Goals and identify the feasibility of working with communities that have proved highly resistant to external influences on traditional practices such as FGM/C.






A Research Agenda to End Female Genital Mutilation/Cutting (FGM/C) in a Generation; Frontiers in Reproductive Health