Focusing particularly on countries where there is a high prevalence of FGM.

 

Dissemination and implementation of the recommendations in this guideline on the prevention of female genital mutilation and clinical management of complications are crucial next steps necessary to improve the quality of health care (prevention and management) and to improve health outcomes for women and girls living with or at risk of FGM. The following actions will be taken to ensure that the guideline is disseminated and implemented. The guideline will be available in electronic and print formats. It will be translated into Arabic and French and disseminated through a broad network of international partners, including WHO country and regional offices; ministries of health; WHO collaborating centres; professional associations; other United Nations agencies, particularly UNFPA and UNICEF, who lead the UNFPA–UNICEF Joint Programme on FGM; and NGOs. In addition, a separate executive summary publication aimed at clinicians and a wide range of policy-makers and programme managers will be developed and disseminated through WHO country offices and their respective partners, focusing particularly on countries where there is a high prevalence of FGM. The systematic reviews, which informed the development of this guideline, will also be published in a special issue of an international peer-reviewed journal (they are listed in Annex 5 and are available upon request prior to publication). In terms of implementation, WHO has been supporting health ministries in countries where there is a high prevalence of FGM to develop and implement national health sector plans of action on FGM, which include elements of health worker training, policy actions, accountability frameworks and information and education resources aimed at health workers and health service users. These plans of action on FGM have been developed and implemented based on information in the earlier version of the WHO guidelines (42) and the FGM clinical handbook (7); they will be updated as needed based on this new edition of the guideline. Multisectoral stakeholder engagement at the country and regional levels will enable successful introduction of evidence-based policies and interventions to prevent FGM and improve health outcomes among women and girls living with FGM. Health worker professional associations, ministries of health, educators, trainers and civil society organizations will be engaged in coordination with key partners from other sectors. A series of webinars and in-person capacity-building and information-sharing sessions will be held with relevant stakeholders in the health arena in countries with a high prevalence of FGM to ensure that the recommendations contained in this guideline are adapted and implemented as relevant and appropriate to each country and its health system, to meet their needs. Several existing mechanisms will promote monitoring and evaluation (M&E) of the uptake and impact of the guideline at the country level. An M&E framework has been developed in countries that have already developed national health sector plans of action on FGM. This framework and the accompanying indicators appear in a forthcoming WHO publication, to be titled A measurement guide for the health sector on female genital mutilation, which details how countries can generate, compile, analyse and synthesize FGM-related data. The guide supports a stepped approach to data use based on epidemiological factors, health systems factors, existing measurement mechanisms and information systems on FGM and on sexual, reproductive, maternal, neonatal, child and adolescent health more broadly, and how these systems can potentially be amended to include indicators on FGM services and response. The guideline also addresses feasibility issues related to countries’ health management informationsystems and proposes timelines for collecting and analysing data. Other data sources, such as assessments of service provision, service availability and readiness, and targeted clinical audits, can also help to identify gaps in service provision and implementation.