Towards Zero Female Genital Mutilation

Male’, 12 February 2020 – On the 6th of February 2020 the world marked the International Day of Zero Tolerance for Female Genital Mutilation (FGM). On this occasion UNICEF released a report showing the practice of FGM in the Maldives. The report released by UNICEF is based in entirety on national statistics by the Government of the Maldives, namely the Maldives Demographic and Health Survey (M-DHS, 2016-17), which was published by the Ministry of Health in December 2018. https://dhsprogram.com/publications/publication-fr349-dhs-final-reports.cfm

The M-DHS 2016-17 is the most recent and most reliable source of demographic and health information in the Maldives. It is an internationally accepted survey based on a nationally representative sample of about 6,700 households, including 7,699 women and 4,342 men respondents (15-49 years) covering all atolls and the capital. 

The reports of M-DHS 2009 and M-DHS 2016-17 contain a wealth of information that policy makers need for making informed policy-decisions. UNICEF encourages the Maldivian researchers and media professionals to probe into these reports and share evidence-based guidance and advice to policy-makers in their relevant fields. While most of the facts scientifically documented in the two M-DHS reports are assuring that the Maldives is making impressive progress in the social and health wellbeing of its citizens, some other facts may be surprising to the public. For instance, the significant decline in the child immunization coverage from 94% (M-DHS 2009) to 77% (M-DHS 2016-17) is alarming and was a clear warning that eliminated vaccine-preventable diseases might possibly resurface in the Maldives, something which has materialized one year following the report publishing. In other words, a close reading of this information provided a prediction of the measles outbreak that took place in January 2020. There are alarming issues these two reports highlight such as the tolerance of domestic violence (M-DHS 2009), low levels of HIV prevention knowledge (both reports), and the practice of FGM. 

FGM is defined by the World Health Organization as, “all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons”. 

The M-DHS 2016-17 listed the different four types of FGM:

• Type 1: Clitoridectomy, which is the partial or total removal of the clitoris, and in very rare cases, only the prepuce,
• Type 2: Excision, which is the partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora,
• Type 3: Infibulation, which is the narrowing of the vaginal opening by cutting and repositioning the labia minora or labia majora, sometimes through stitching, with or without removal of the clitoris,
• Type 4: this includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area. 

The M-DHS 2016-17 did not investigate the different types of FGM practiced in the Maldives but suggested it is type 4, consisting mostly of small cuts/pricks to the genitals.  

M-DHS 2016-17 documented that:

• 13% of the women age 15-49 in the Maldives are circumcised (i.e. subjected to one of the 4 types of FGM).
• The prevalence of female circumcision (i.e. subjection to one of the 4 types of FGM) increases steeply with age, from 1% among women age 15-19 years to 38% among women age 45-49.  
• Variation in the prevalence of female circumcision (FGM) by region is not large. For instance, 10% of women in North Central region are circumcised compared to 15% in South region. 

The M-DHS 2016-17 report shows that while FGM is practiced in the Maldives, the practice is declining among young educated girls, which is a sign of a systematic public health effort over the past decades to eliminate a harmful practice. 

UNICEF encourages all policy-makers to continue to exert more efforts until all forms of FGM (girls’ circumcision) are completely eradicated and all girls are safe. 

UNICEF appreciates the fact that many members of the public are not happy to see the Maldives associated with the practice of FGM. While this is certainly not a reason for denying the well-established fact of the existence of FGM (as explained above), it is assuring, however, that most of the people in the Maldives seem to have no tolerance for FGM in their community.

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