Coordinator :Dr. Abraham Hodgson (Director)
Investigators :Patricia Akweongo, M.P.H.
Collaboration :Navrongo Health Research Centre (With Technical Support from Population Council)
Funding :United States Agency for International Development
Status :On-going Period Covered:August 1999 – December 2005
Size :The baseline survey included 3,031 girls aged 12-19. This number has increased for each year of the
survey as new respondents are added in (those who turn 12 or those who move into the study area). In addition,
the comparison area was expanded in 2002. The total number of eligible respondents for 2002 was 6,086.
The Female Genital Mutilation (FGM) project is a quasi-experimental study designed to test the hypothesis that FGM can be eradicated by community organisation and action in a setting where the practice has been widespread. The respondents, a cohort of 3,224 girls are used to monitor excision status, knowledge, and beliefs over time.
OBJECTIVE
To accelerate the abandonment of the practice of female genital cutting in the Kassena-Nankana district of northern Ghana
APPROACH
To date, the Navrongo FGM Experiment is the only longitudinal experimental trial designed to test hypotheses on strategies for fostering social change in FGM practice. Cells test hypotheses about the relative impact of a direct FGM problem-focused approach versus a livelihood and development-focused approach versus a combination of the two approaches. In general, interventions involve mobilization of all social stakeholders in the practice and techniques for introducing ideational change. Research has qualitative and quantitative arms designed to produce insights into the determinants and consequences of FGM related social change and to assess intervention impact through monitoring circumcision incidence
RESULTS AND EXPERIENCE
The project is only midway through the intervention cycle, thus results cannot yet be determined. However trends are positive and show that prevalence of female genital cutting is declining. If such trends continue, we anticipate that the final evaluation will reflect a significant impact due to the intervention.
EVALUATION
The impact of the intervention will be assessed in an evaluation of study area change in the practice of FGM in 2004. Incidence of FGM among adolescent girls in the study area will be compared by experimental cell. The baseline survey of all adolescent girls aged 12–19 in the study area, administered in the last quarter of 1999, will be linked with each subsequent yearly follow-up survey to assess the relative impact of each arm of the experiment on FGM incidence. Using a statistical model, the impact of the experiment on FGM status will be estimated by a discrete time hazard model to gauge the effect of experimental exposure on the cumulative odds that FGM will occur.
PUBLICATIONS
Adongo, Phillip, Patricia Akweongo, Fred Binka, and Cheikh Mbacke. 1998. “Female genital mutilation: socio-cultural factors that influence the practice in Kassena-Nankana District, Ghana.” African Journal of Reproductive Health 2(2):25-36.
Mbacke, Cheikh, Phillip Adongo, Patricia Akweongo, and Fred Binka. 1998. “Prevalence and correlates of female genital mutilation in the Kassena-Nankana District of northern Ghana.” African Journal of Reproductive Health 2(2):13-24.
WORKING PAPERS
Akweongo, Patricia, Fred Binka, Evelyn Sakeah, Cornelius Debpuur, James F. Phillips. “The preliminary impact of a broad-based intervention to decrease the incidence of female genital mutilation: Lessons learned from the Navrongo FGM Experiment”. Presented at the Annual Conference of the American Public Health Association, Philadelphia, Pennsylavani, November 10-13, 2002.
Nazzar, Alex, Letitia Reason, Phlip Adongo. 1999. "Community-based Strategic Planning: Utilizing social research for developing a culturally appropriate program for FGM prevention in a traditional area of northern Ghana." Paper presented at the 1999 PAA conference in New York, NY.
Akweongo, Patricia, S. Appiah-Yeboah, E. Sakeah, E. Jackson and J. Phillips. 2001. “The women’s thing: Gender roles sustaining the practice of female genital mutilation in northern Ghana.” Paper presented at the 2001 PAA conference in Washington, DC.
Jackson, Elizabeth F., Patricia Akweongo, Evelyn Sakeah, Abraham Hodgson, Rofina Asuru, and James F. Phillips. 2002. “The social correlates of denial of female genital mutilation among women in the Kassena-Nankana District of northern Ghana.” Paper presented at the American Public Health Association (APHA) Conference in Philadelphia, November 11, 2002.