{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T19:42:26Z","timestamp":1788291746322,"version":"build-2803163510"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T00:00:00Z","timestamp":1582848000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T00:00:00Z","timestamp":1582848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod Health"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Female Genital Mutilation\/cutting (FGM\/C) is a tradition rooted in culture and involves the partial or total removal or other injury to the female genital organs for non-medical reasons. In Kenya, initiatives to abandon the practice have included \u2018alternative\u2019 ritualistic programmes (ARPs) combined with intensive community sensitisation about FGM\/C to achieve attitudinal and behavioural changes. While there are indications of the effectiveness of these interventions, FGM\/C continues to be practiced within certain groups in Kenya. This study explored the views of anti-FGM\/C advocates on the barriers and facilitators to tackling FGM\/C within the Meru community in Kenya.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data were obtained using 4 Focus Groups (FGs) with 30 anti-FGM\/C advocates from Tigania East and West in Meru county. Thematic framework analysis guided the analysis based on four main questions: 1) How has the cultural meaning of FGM\/C evolved over time? 2) What are the perceptions in relation to the effectiveness of anti-FGM\/C interventions? 3) How effective are interventions and campaigns to end FGM\/C in Meru county? 4) What actions are perceived as the most likely to bring about change?<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There has been a substantial shift in the culture of FGM\/C and the number of families carrying out the practice in Meru county has decreased in recent years. Participants noted five actions likely to bring about change; 1) reviving and supporting ARPs, 2) encouraging fathers\u2019 involvement in the upbringing of their daughters,3) inclusion of the topic of FGM\/C in the current education curriculum and public fora, 4) strengthening the community policing strategy -<jats:italic>Nyumba Kumi<\/jats:italic>, 5) and setting up community centers for orphans.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our findings demonstrate the significance of locally led initiatives to fight FGM\/C. It also became clear that change would have to start at the family level with parents, particularly fathers, taking on a more active role in the lives of their daughters. Providing education about FGM\/C to communities, particularly young men coupled with keeping girls in school appeared to be some of the most effective ways of fighting FGM\/C. At the community level, the church became particularly crucial in challenging the practice of FGM\/C.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12978-020-0884-5","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T16:02:58Z","timestamp":1582905778000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["\u201cPromote locally led initiatives to fight female genital mutilation\/cutting (FGM\/C)\u201d lessons from anti-FGM\/C advocates in rural Kenya"],"prefix":"10.1186","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3774-468X","authenticated-orcid":false,"given":"Purity","family":"Mwendwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Mutea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Joy","family":"Kaimuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoife","family":"De Br\u00fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Kroll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,28]]},"reference":[{"key":"884_CR1","unstructured":"WHO. Female genital mutilation 2018. https:\/\/www.who.int\/news-room\/fact- sheets\/detail\/female-genital-mutilation. Accessed 11 Apr 2019."},{"key":"884_CR2","unstructured":"UNICEF. Female genital mutilation\/cutting: a global concern [press release]. 2016. https:\/\/www.unicef.org\/media\/media_90033.html. Accessed 4 Sept 2017."},{"key":"884_CR3","doi-asserted-by":"publisher","unstructured":"Johansen REB, Diop NJ, Laverack G, Leye E. What Works and What Does Not: A Discussion of Popular Approaches for the Abandonment of Female Genital Mutilation. Obstet Gynecol Int. 2013. https:\/\/doi.org\/10.1155\/2013\/348248.","DOI":"10.1155\/2013\/348248"},{"key":"884_CR4","unstructured":"Denison E, Berg RC, Lewin S, Fretheim, A. Effectiveness of interventions designed to reduce the prevalence of female genital mutilation\/cutting. Report from Kunnskapssenteret Nr 25\u20132009. https:\/\/www.fhi.no\/globalassets\/dokumenterfiler\/rapporter\/2009-og-eldre\/rapport_0925__fgm_kjonnslemlestelse.pdf. ."},{"key":"884_CR5","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/S0020-7292(03)00229-7","volume":"82","author":"NF Toubia","year":"2003","unstructured":"Toubia NF, Sharief EH. Female genital mutilation: have we made progress? Int J Gynecol Obstet. 2003;82:251\u201361.","journal-title":"Int J Gynecol Obstet"},{"key":"884_CR6","doi-asserted-by":"publisher","unstructured":"Chege JN, Askew I, Liku J. An assessment of the alternative rites approach for encouraging abandonment of female genital mutilation in Kenya. US Agency for International Development. 2001. doi:https:\/\/doi.org\/10.31899\/rh1.1009. Accessed 6 Feb 2016.","DOI":"10.31899\/rh1.1009"},{"key":"884_CR7","doi-asserted-by":"publisher","unstructured":"Graamans EP, Zolnikov TR, Smet E, Nguura PN, Leshore LC, Ten Have S. Lessons learned from implementing alternative rites in the fight against female genital mutilation\/cutting. Pan Afr Med J. 2019;32. https:\/\/doi.org\/10.11604\/pamj.2019.32.59.17624.","DOI":"10.11604\/pamj.2019.32.59.17624"},{"key":"884_CR8","unstructured":"Kenya Bureau of Statistics-Government of Kenya. Demographic and Health Survey 2014. Rockfield, MD USA 2016 https:\/\/dhsprogramcom\/publications\/publication-fr308-dhs-final-reportscfm Accessed 11 Mar 2017."},{"key":"884_CR9","first-page":"129","volume-title":"Female circumcision in Africa: culture, controversy and change","author":"L Thomas","year":"2000","unstructured":"Thomas L. \"Ngaitana (I will circumcise myself)\": lessons from colonial campaigns to ban excision in Meru, Kenya. In: Shell-Duncan B, Hernlund Y, editors. Female circumcision in Africa: culture, controversy and change. Boulder: Lynne Rienner Publishers, Inc.; 2000. p. 129\u201350."},{"key":"884_CR10","unstructured":"Muchui, D. War against female circumcision bearing fruit in Meru. [Daily Nation Newspaper]. 2015.http:\/\/www.nation.co.ke\/counties\/meru\/War-against-female-circumcision-Meru\/1183302-3008376-1kp3ez\/index.html. Accessed 11 Jan 2017."},{"key":"884_CR11","unstructured":"Muchui, D. Girl died after FGM procedure; medics say. [Daily Nation Newspaper].2019. https:\/\/www.nation.co.ke\/counties\/meru\/Girl-died-after-FGM-procedure\/1183302-4996162-6bslrx\/index.html. Accessed 11 April 2019."},{"key":"884_CR12","unstructured":"Njeru, A. Tough war in bid to end FGM in Meru. [Daily Nation Newspaper].2018. https:\/\/www.nation.co.ke\/counties\/meru\/Tough-war-in-fight-against-FGM-Meru\/1183302-4902434-15ltr01z\/index.html. Accessed 11 Apr 2019."},{"key":"884_CR13","unstructured":"Evelia H, Sheikh M, Askew I. Contributing towards efforts to abandon Female Genital Mutilation\/Cutting in Kenya: A situational analysis. Nairobi: Ministry of Gender, Sports, Culture and Social Services, Republic of Kenya.2007. https:\/\/pdfs.semanticscholar.org\/7e64\/2619041c4e3bfa0551ba401825b0d68c4087.pdf Accessed 16 Nov 2016."},{"key":"884_CR14","unstructured":"WHO. Female Genital Mutilation programmes to date: what works and what doesn\u2019t. [Policy Brief]. 2011. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/75195\/WHO_RHR_11.36_eng.pdf?sequence=1. Accessed 6 June 2016."},{"key":"884_CR15","unstructured":"Murithi K. Shun FGM, First Lady Urges Meru Residents. [The Star newspaper, Nairobi] 2015. https:\/\/www.the-star.co.ke\/counties\/north-eastern\/2015-05-29-shun-fgm-first-lady-urges-meru-residents\/. Accessed 1 June 2015."},{"key":"884_CR16","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1136\/bmj.311.7000.299","volume":"311","author":"J Kitzinger","year":"1995","unstructured":"Kitzinger J. Qualitative research. Introducing focus groups. 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All respondents signed an informed consent and confidentiality over participants\u2019 identity was maintained throughout the study and will be maintained in any future publications and presentations.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"30"}}