Quality of services offered to women with female genital mutilation across health facilities in a Kenyan county

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Article (peer-reviewed)

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Background: Female genital mutilation (FGM) curtails women’s health, human rights and development. Health system as a critical pillar for social justice is key in addressing FGM while executing the core mandate of disease prevention and management. By leveraging opportune moments, events and experiences involving client-provider interactions, relevant FGM-related communications, behavior change and management interventions can be implemented through health facilities or in communities. It is unclear whether Kenyan health system has maximized this strategic advantage and positioning to address FGM. Objective: Determine the quality of services offered to women with FGM across health facilities in West Pokot county, Kenya. Methods: A mixed quantitative data collection strategies were used. These included: client-provider interactions observations with (61) health care workers (HCWs) and women with FGM seeking services; client-exit interviews with (360) women with FGM seeking services. These approaches sought to determine the content and quality of FGM-related care services; and service data abstractions involving records on services sought/offered from (10) facilities in West Pokot. Results: A large (76%) proportion of women had experienced FGM aged 11–15 years, were married between 15 and 19 years (39%), had primary (47.5%) or no education (33%) with incomeConclusion: Health systems in high prevalent settings actively interface with women with FGM, despite the primary reason for seeking services not being FGM. Despite high number of women having undergone the cut, diagnosis, prevention, care services, and documentation of FGM and related complications are suboptimal. This underscores the need for health system strengthening in response to the practice with consideration for training kits for HCWs, empowering HCWs, anchoring of FGM indicators in the HMIS, documentation and IEC material to support FGM prevention at service delivery points, and overall integration of FGM into health programs.