1        Introduction

Female Genital Mutilation (FGM) is a global problem that predominantly impacts young girls from infancy to adolescence, and sometimes adult women. More than 200 million girls and women worldwide have experienced FGM, with approximately 3 million at risk annually (WHO, 2023). In Kenya, FGM has a longstanding presence and is strongly tied to cultural and traditional beliefs, notably among ethnic groups like the Maasai, Samburu, Kisii, Kuria, Pokot, and Somali. It is commonly regarded as a ceremonial transition for girls, preparing them for marriage and adulthood, while being associated with notions of cleanliness, beauty, and sexual purity for women  (Oloo, Wanjiru, & Newell-Jones, 2011).

Based on a 2020 report from United Nations Children’s Fund (UNICEF), approximately 21% of women and girls in Kenya have undergone FGM  (UNICEF, 2020). However, the prevalence of FGM varies significantly across different regions. The North Eastern region has the highest prevalence, reaching 97.5%, which can be attributed to the predominance of the Somali community in that area. Conversely, the Western region exhibits the lowest prevalence at 0.8%. Notably, rural areas tend to have a higher prevalence at 25.9% compared to urban areas at 13.8%. FGM is practiced across various ethnicities and religions, with Muslims (51.1%) and Somalis (93.6%) reporting the highest rates. On the other hand, Protestants and other Christians have the lowest prevalence at 17.9%. Please refer to Figure 1 for a visual representation of FGM prevalence in Kenya.

2        Female Genital Mutilation

World Health Organization (WHO) defines FGM as any non-medical procedures that involve either the partial or total removal of external female genitalia, or any other form of injury inflicted on female genital organs. It is important to note that FGM does not offer any health benefits to women or girls. Instead, it can lead to serious health problems such as severe bleeding and difficulty urinating. FGM can also cause cysts, infections, complications during childbirth, and increased risk of new-born deaths (WHO, 2023).

2.1       Types of Female Genital Mutilation

The World Health Organization (WHO) classifies FGM into four types It is important to note that all forms of FGM are considered a violation of human rights and have serious physical and psychological consequences for girls and women. Type 1, also known as clitoridectomy, involves the partial or total removal of the clitoris and/or the prepuce (the fold of skin surrounding the clitoris). Type 2, also known as excision, involves the partial or total removal of the clitoris and the labia minora (inner folds of the vulva), with or without removal of the labia majora (outer folds of the vulva). Type 3, also known as infibulation, involves the narrowing of the vaginal opening through the creation of a seal by cutting and repositioning the labia minora and/or labia majora, leaving only a small opening for the passage of urine and menstrual blood. Type 4 includes all other harmful procedures to the female genitalia for non-medical purposes, such as pricking, piercing, incising, scraping, or burning the genital area (WHO, 2023).

2.2       Short-term and Long-term complications after Female Genital Mutilation

Short-term complications include severe pain, bleeding, infection, and shock. In some cases, FGM can result in the need for immediate medical attention, such as blood transfusions, surgery, or even death. Long-term complications include chronic pain, difficulty urinating, painful menstrual periods, cysts, and sexual dysfunction. FGM can also cause childbirth complications, including increased risk of maternal and neonatal mortality and morbidity, and the need for emergency caesarean section.  In addition, there are physical and psychological harm, with serious and sometimes lifelong consequences. (Klein, Helzner, Shaypwitz, Kohlhoff, & Smith-Norowitz, 2018)

3        Cultural and Social Myths Surrounding Female Genital Mutilation in Kenya

Female Genital Mutilation is predominantly prevalent in developing countries such as Kenya. The practices of FGM exhibit variations across diverse cultures and communities, with underlying reasons deeply entrenched in tradition, social norms, and cultural beliefs. Although generalizations can be challenging, certain cultural beliefs and rationales are often associated with FGM. Within these communities, there exists a significant societal pressure on parents to subject their daughters to FGM as a means of marking their transition from adolescence to adulthood (Tuobia, 1994). By undergoing FGM, young girls seek acceptance and validation within their community. Conversely, abstaining from the practice can result in social exclusion and being ostracized by the community (Grose , et al., 2019).

Within certain cultures in Kenya, there exists a belief that FGM serves to uphold the virginity and purity of young women prior to marriage. This stems from the high value placed on virginity as a prerequisite for marriage within these communities. FGM is employed as a means to exert control over a woman's sexuality by diminishing or eliminating sexual pleasure through the removal or alteration of genitalia. According to the beliefs held by some communities, this practice reduces the likelihood of a woman engaging in extramarital affairs (Klein, Helzner, Shaypwitz, Kohlhoff, & Smith-Norowitz, 2018).

Additional cultural beliefs surrounding FGM include the notion that it fosters hygiene and cleanliness by eliminating aspects of the female genitalia perceived as unclean or impure. While some communities mistakenly link FGM to religious beliefs, it is crucial to emphasize that no major religion advocates or endorses the practice. Nevertheless, certain communities may associate FGM with religious or spiritual rituals, mistakenly believing it to be a requirement of their faith (WHO, 2023).

In certain communities, FGM is practiced to conform to social norms and uphold cultural identity. These communities despite growing international awareness about the harms of FGM, continue to uphold the practice as a means of adhering to societal expectations to preserve their cultural heritage and sense of identity. FGM is often viewed as an integral aspect of their cultural legacy (Moges, 2009).

4         Efforts and Challenges of Eradicate Female Genital Mutilation in Kenya

African Medical and Research Foundation (AMREF) stated that Kenya has made significant progress in reducing FGM prevalence, with a decline from 38% in 2003 to 15% in 2022  (AMREF, 2023). This success can be attributed to multi-faceted interventions, including commitments made by the former Kenyan president to stop FGM by the year 2022 (UNFPA Kenya, 2020). Passing the Prohibition of Female Genital Mutilation Act in 2011, has made FGM illegal and punishable by law. The government has also developed national policies and action plans to address FGM comprehensively (28 TOO MANY, 2016).

Numerous organizations and governmental bodies have undertaken various initiatives to combat FGM, including conducting awareness campaigns, workshops, and community dialogues. These endeavors have a common goal of educating communities about the detrimental consequences of FGM while aiming to transform attitudes, beliefs, and social norms associated with the practice. Examples are Maendeleo ya Wanawake Organization (MYWO). which is a prominent women's rights organization in Kenya, AMREF, UNICEF and National Gender and Equality Commission (NGEC) that plays a crucial role in advocating for gender equality and women's rights (Williams-Breault, 2018) .

Alternative rites of passage programs, such as the Tasaru Ntomonok Initiative, offer education and life skills to girls while preserving cultural heritage. Grassroots organizations and community leaders play a crucial role in engaging affected communities through empowerment and highlighting the negative consequences of FGM. An example is "Nitasimama Imara" (meaning "I will stand firm"), a program led by men and boys in Elgeyo Marakwet, aimed at ending FGM and promoting gender equality (Chege, Askew, & Liku, 2001). A mobile app called "PASHA" was launched in 2022 to facilitate the reporting of cases. (Waweru, 2022).

Challenges in eradicating Female Genital Mutilation (FGM) include the significant role of economic factors, as poverty and vulnerability lead families to see it as an investment in their daughters' marriage prospects. Some individuals even rely on performing FGM for income. Addressing these economic factors is essential for achieving lasting change. The COVID-19 pandemic has further exacerbated the issue, with an increase in FGM cases due to school closures, leaving young girls more vulnerable (Global G.L.O.W, 2021). Other challenges include deeply entrenched cultural norms, resistance to change, limited access to education and information, social pressure, community acceptance, and weak enforcement of laws and policies.

5        Conclusion

In recent years, increasing awareness and activism surrounding FGM in Kenya have propelled efforts to eradicate the practice. NGOs, government agencies, and community-based organizations are actively engaged in educating families and communities about the harmful consequences of FGM, while advocating for alternative rites of passage for girls. Campaigns are also underway to promote reporting of FGM cases and provide comprehensive support, including medical and psychological care, to survivors. Despite these efforts, ending FGM in Kenya remains a complex and formidable challenge. It necessitates sustained endeavors to transform deeply ingrained cultural beliefs and practices, as well as to address the underlying social, economic, and gender disparities that perpetuate this harmful tradition.

References

• 28 TOO MANY. (2016). FGM LEGISLATION IN KENYA. Retrieved from 28 TOO MANY: https://www.28toomany.org/country/kenya/ 
• AMREF. (2023). Statement on the status of female genital mutilation (fgm) in Kenya on the commemoration of the zero tolerance day to fgm on 6th February 2023. Retrieved May 7, 2023, from Amref: https://amref.org/position-statements/statement-on-the-status-of-female-genital-mutilation-fgm-in-kenya-on-the-commemoration-of-the-zero-tolerance-day-to-fgm-on-6th-february-2023/#:~:text=The%20collective%20efforts%20in%20Kenya,among%20women%20of%20reprod
• AMREF. (2023). STATEMENT ON THE STATUS OF FEMALE GENITAL MUTILATION (FGM) IN KENYA ON THE COMMEMORATION OF THE ZERO TOLERANCE DAY TO FGM ON 6TH FEBRUARY 2023. Retrieved May 7, 2023, from Amref: https://amref.org/position-statements/statement-on-the-status-of-female-genital-mutilation-fgm-in-kenya-on-the-commemoration-of-the-zero-tolerance-day-to-fgm-on-6th-february-2023/#:~:text=The%20collective%20efforts%20in%20Kenya,among%20women%20of%20reprod
• Chege, J., Askew, I., & Liku, J. (2001). An assessment of the alternative rites approach for encouraging abandonment of female genital mutilation in Kenya . Population Council.
• Global G.L.O.W. (2021). COVID-19 and the Rise of FGM in Kenya. Global G.L.O.W. Retrieved from https://globalgirlsglow.org/covid-19-and-the-rise-of-fgm-in-kenya/
• Grose , R. G., Hayford, S., Cheong, Y. F., Garver, S., Kandala, N.-B., & Yount, K. (2019). Community influences on female genital mutilation/cutting in Kenya: norms, opportunities, and ethnic diversity. Journal of health and social behavior, 60(1), 84-100. Retrieved from https://journals.sagepub.com/doi/pdf/10.1177/0022146518821870
• Klein, E., Helzner, E., Shaypwitz, M., Kohlhoff, S., & Smith-Norowitz, T. (2018). Female Genital Mutilation: Health Consequences and Complications—A Short Literature Review. Obstetrics and Gynecology International, 1-7. doi: 10.1155/2018/7365715
• Moges, A. (2009). What is Behind the Tradition of FGM? African Women organization.
• Olajide, A., & Zaman, M. (2021, February). Let’s work together to end FGM in Kenya. Standard. Retrieved May 7, 2023, from Unicef Kenya: https://www.standardmedia.co.ke/opinion/article/2001402502/lets-work-together-to-end-fgm
• Oloo, H., Wanjiru, M., & Newell-Jones, K. (2011). Female genital mutilation practices in Kenya: The role of alternative rites of passage. A case study of Kisii and Kuria districts. doi:10.31899/rh2.1075
• Tuobia, N. (1994). Female Circumcision as a Public Health Issue. New England Journal of Medicine, 331(11), 712-716. doi:doi:10.1056/nejm199409153311106
• UNFPA Kenya. (2020). Presidential Commitment To End Female Genital Mutilation By 2022. Retrieved from UNFPA: https://kenya.unfpa.org/en/news/presidential-commitment-end-female-genital-mutilation-2022
• UNICEF. (2020, March). A profile of female genital mutilation in Kenya. Retrieved May 7, 2023, from Unicef for every child: https://data.unicef.org/resources/a-profile-of-female-genital-mutilation-in-kenya/
• Waweru, M. (2022). PASHA, A mobile app to help fight FGM in kuria launched. Mummytales. Retrieved from https://mummytales.com/pasha-a-mobile-app-to-help-fight-fgm-in-kuria-launched/
• WHO. (2023, January 31). Female genital mutilation. Retrieved May 7, 2023, from WHO: https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation#:~:text=Overview,organs%20for%20non%2Dmedical%20reasons.
• Williams-Breault, B. (2018). Eradicating Female Genital Mutilation/Cutting. Health Hum Rights., 20(2), 223-233. Retrieved May 17, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293358/