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Evaluation report

2003 EGY: Attitudes and Values of Egyptian Opinion Leaders Towards FGM/C: A Qualitative Evaluation

Author: Abdel-Tawab, N.; Hala Youssef, P. H.

Executive summary

Background:

In Egypt, the practice of female genial mutilation / female circumcision (FGM/C) is almost universal. It is prevalent among most social, ethnic, religious as well as age groups. According to both the 1995 Demographic and Health Survey (DHS) and the 2000 Demographic and Health Survey (DHS), 97% of married women of reproductive age (15-49) in Egypt have been circumcised.

To effectively address public attitudes towards FGM/C, it is important to initiate a public dialogue on the issue in order to encourage acceptance of norms of non-practice. This could be achieved by communicating critical FGM/C messages to the public through key media programs where intellectuals and public figures (who are credible and respected by other social groups) would give out the message. However, prior to the introduction of the issue in the media, a "framing" analysis of the best way to present the issue must be undertaken to decide on the communication and message approach necessary to create the impact desired. Framing refers to the way an issue is phrased in the media and the extent that the communication approach used will affect the public conceptualization of the issue in the desired direction.

Purpose/Objective:

UNICEF has thus commissioned this qualitative study on the values of opinion leaders and media professionals regarding FGM/C to support the FGM/C sub-project objective of initiating a public debate on FGM/C in the larger context of addressing harmful practices against women. Findings of this study will be used to design appropriate communication strategies and media messages that establish a positive environment that is unfavorable to the practice of FGM/C. These communication activities would reinforce anti-FGM/C attitudes and hence would enable those who are socially pressured to abandon the practice.

Explore general knowledge, attitudes and values of Egyptian opinion leaders, namely media professionals and intellectuals from other disciplines, towards the practice of FGM/C and their willingness to participate in tackling it
Outline a number of communication approaches to publicly address FGM/C
Explore different message appeals and frames, which opinion leaders consider could have some impact on their target groups
Explore potential constraints that could impede public discussion of FGM/C

Methodology:

The sample for the present study included 21 highly respected opinion leaders representing various disciplines, namely mass media, medicine, religion, politics, social and behavioral sciences. The latter group included a professor of law, a professor of economics, a professor of behavioral sciences and a professor of psychology.

The following considerations were taken into account in selecting participants for the present study: (1) that they represent various disciplines, (2) that they include male as well as female, Moslems as well as Christians, (3) to select individuals who have an influence on public opinion either by virtue of their positions or their popularity. In order not to bias the study results, the investigators tried not to include participants with publicly-known opinions about the practice of FGM/C or who are known to be engaged in activities to promote or stop the practice.

Findings and Conclusions:

The study findings suggest that opinion leaders' knowledge about the practice was somewhat limited. Many participants believed that FGM/C was limited to the lower socio-economic groups or those living in rural areas, and that it was mostly performed by traditional healers. Although most participants were aware of the negative health consequences associated with the practice, some of them believed that such negative health consequences could be prevented if the procedure is performed under proper medical supervision.

The study results also showed some confusion about the religious foundations of the practice. Many participants, including the Christian priest, said that FGM/C was a purely social tradition that has nothing to do with religion. The two Moslem religious authorities believed that FGM/C was not a requirement but a praiseworthy practice for women, but one of them was more inclined to believe that since the practice has been shown to have negative health consequences, it should be abandoned.

The majority of participants were totally opposed to the practice, while two participants indicated that they were mostly opposed to the conditions under which the procedure is performed i.e. without anesthesia, by unskilled personnel who take too much off the girl's genitals. Three participants, on the other hand, strongly supported the practice on the basis of religious, moral or cosmetic grounds.

Most of the interviewed opinion leaders believed that it was culturally appropriate to put the issue of FGM/C for public debate, although many of them argued that there were other pressing social and health problems in the Egyptian society that are more worthy of such attention. Participants emphasized that FGM/C should not be treated as separate, but addressed along with other social and health issues such as illiteracy, unemployment, drug abuse etc. Moreover, participants emphasized that interventions to stop FGM/C require concerted efforts of several agencies such as the Ministry of Health and Population, Ministry of Education, medical schools, Ministry of Information, religious institutions as well as local NGOs. A high level of involvement of international agencies in the issue of FGM/C was not recommended by many of the study participants. Moreover, most participants were of the opinion that legislation to ban the practice would not be effective.

As to the role of the mass media, the majority of participants believed that the media could play a pivotal role in changing the public's attitudes about FGM/C as long as the topic is properly presented. It was recommended that a sensational approach be avoided and, instead, a more factual approach be used. Soap operas were suggested as the most attractive and effective way to convey messages against FGM/C to the public. Panel discussions that include a physician, a religious expert and a social scientist were also mentioned as helpful but not as appealing as soap operas. Participants, however, cautioned against discussing the topic of FGM/C in talk shows since directors have little control over what is said by the audience or the callers. Most convincing approaches, according to the interviewed opinion leaders, were the health consequences approach, and the religious expert, i.e. that the practice is not a religious requirement. The human rights / child rights approach was believed to be only suitable for addressing a more sophisticated public.

Many of the interviewed media professionals expressed willingness to present work on FGM/C if they are provided with accurate data on the subject. Interestingly, most of the interviewed media professionals indicated that there were no significant restrictions to presenting a topic like FGM/C on television, radio or in the press as long as it is done in a culturally sensitive way. Although media professionals indicated that the approval of senior officials is not required, they believed that getting support from higher authorities would encourage more T.V. producers and script writers to work on this topic.

Recommendations:

The issue of FGM/C can be raised in public debate along with other salient social and health issues such as unemployment, drug abuse, illiteracy etc.

Part of the awareness-raising campaigns against FGM/C should be directed at Egyptian intellectuals and opinion leaders. They need to know that the practice of FGM/C is prevalent in both rural and urban areas and among different socio-economic groups. Awareness-raising campaigns should also explain the physiology and anatomy of the female genital system, and emphasize that sexual desire is not determined by a woman’s genitals but by her brain.

A clear statement from Al-Azhar about the status of FGM/C in Islam is greatly needed to resolve the confusion around this issue in the minds of opinion leaders as well as the public.

Awareness-raising campaigns should highlight the long-term health consequences that cannot be prevented by medicalization e.g. psychological trauma, sexual complications, etc.

Media professionals should be encouraged to discuss the issue of FGM/C on their programs or in their writings.

It is important that all programs discussing FGM/C are based on accurate scientific data and that the topic be presented in a serious manner.

FGM/C should not be treated as a stand-alone issue but as part and parcel of a development package to tackle other social and economic issues in Egyptian society.

Last but not least, there is a dire need for well-designed studies that examine the long-term physical, psycho-sexual and social consequences of types I & II FGM/C, especially those that cannot be prevented by medicalization.