Infancia y Violencia de Género: Prevención de la Mutilación Genital Femenina desde el ámbito sanitario / Childhood and Gender Violence: Prevention of Female Genital Mutilation from Healthcare sector

La Mutilación Genital Femenina (MGF) es considerada un tipo de violencia de género. Se realiza generalmente en la infancia, afectando gravemente la salud de estas niñas y mujeres. OBJETIVO PRINCIPAL: analizar los protocolos sanitarios creados para prevenir la MGF en España. METODOLOGÍA: Se ha realizado una búsqueda documental consultando las webs oficiales del gobierno central y de las Comunidades Autónomas. Se incluyeron protocolos sobre la actuación y prevención ante la MGF. RESULTADOS PRINCIPALES: 5 guías fueron seleccionadas tras excluir protocolos que no fueran exclusivamente sanitarios y aquellos anteriores al 2009. Estas guías comparten pautas de prevención para profesionales de la salud en función de la edad de la niña en riesgo. CONCLUSIÓN PRINCIPAL: para prevenir la MGF, las guías analizadas defienden una formación sanitaria transversal, incluyendo aspectos éticos y jurídicos. Proponen recursos para realizar la entrevista y pautas de actuación según edad

OBJECTIVE: Female Genital Mutilation (FGM) is considered a type of gender-based violence. It is usually done in childhood, seriously affecting the health of these girls and women. The objective of this work is to analyze the health protocols created to prevent FGM in Spain. METHODS: A documentary research has been carried out by consulting the official websites of the central government and the Autonomous Regions. Spanish protocols on action and prevention against FGM were included. RESULTS: 5 guides were selected after excluding protocols that were not exclusively sanitary and those prior to 2009. These guides share prevention guidelines for health professionals based on the age of the girl at risk. CONCLUSIONS: In order to prevent FGM, the analyzed guides defend transversal health training, including ethical and legal aspects. They propose resources to conduct the interview and guidelines for action according to age

Female genital mutilation in the UK: considerations for best nursing practice.

Female genital mutilation (FGM) is any process that injures or removes part or all of the external female genital organs for non-medical reasons. FGM is a growing public health concern in the UK because of an increase in migration from countries where it is widely practised. Education on FGM for nurses is key to supporting women who have undergone the practice, as well as safeguarding girls and women who are at risk. Nurses must understand the history and culture of FGM as well as the long-term health complications to be able to support affected women both professionally and sensitively.

The experience of NHS care for women living with female genital mutilation.

This qualitative study aims to explore and analyse the experiences of women living with female genital mutilation (FGM) who have sought help from healthcare providers within the NHS. Nine women aged 20-46 years were recruited from support organisations in the north-west of England and interviewed about their experiences of NHS care and if any screening had taken place in relation to the consequences of living with FGM. The interviews were undertaken in English, audiotaped, transcribed and analysed using a framework analysis method. Eight of the women had given birth and the main contact with the NHS had been with midwifery, gynaecology and paediatric services. Three key themes emerged from the qualitative data: involvement with healthcare professionals; silent suffering; and compassionate communication. Findings highlight the importance of sensitive and culturally competent communication nurses require to support women and refer them to appropriate services.

Intervención de la matrona hospitalaria en una gestante con mutilación genital femenina. A propósito de un caso / Intervention of the hospital midwife in the case of a pregnant women who had undergone female genital mutilation. A case study

La mutilación genital femenina, condenada por todos los países miembros de la Organización de las Naciones Unidas, se ha extendido alrededor del mundo como consecuencia de los flujos migratorios, y se realiza al amparo de una costumbre, tradición o cultura. En España está penada como delito de lesiones según el Código Penal vigente. Mediante un caso clínico se revisan las principales actuaciones de la matrona ante dicha lesión en una gestante en el trabajo de parto. Se exponen los datos recogidos en la exploración física y valoración según el modelo de Virginia Henderson, y se desarrolla un plan de cuidados completo. Del caso se puede concluir que, en el ámbito hospitalario, las matronas pueden y deben reforzar y completar el trabajo con estas mujeres y sus familias de informar, educar y fortalecer la decisión de no mutilar, el cual debería haber sido iniciado en el centro de salud (AU)

Female genital mutilation, condemned by all UN member countries has spread throughout the world as a result of migratory flows and is practiced under the guise of a custom, tradition or culture. In Spain, it is punishable as a personal injury offence under the current penal code. A clinical case study reviewed the main actions of the midwife in this kind of injury in a pregnant woman during labour. The data collected from the physical examination and the midwife's assessment according to the Virginia Henderson model are presented and a complete care plan developed. From the case it can be concluded that in the hospital area, midwives can and should reinforce and complete the work with these women and their families, of informing, educating and reinforcing the decision not to mutilate. This work should have been started in, the health centre (AU)

A survey of Australian midwives' knowledge, experience, and training needs in relation to female genital mutilation.

BACKGROUND: Female genital mutilation (FGM) involves partial or total removal of the external female genitalia or any other injury for non-medical reasons. Due to international migration patterns, health professionals in high income countries are increasingly caring for women with FGM. Few studies explored the knowledge and skills of midwives in high income countries. AIM: To explore the knowledge, experience and needs of midwives in relation to the care of women with FGM. METHODS: An online self-administered descriptive survey was designed and advertised through the Australian College of Midwives' website. RESULTS: Of the 198 midwives (24%) did not know the correct classification of FGM. Almost half of the respondents (48%) reported they had not received FGM training during their midwifery education. Midwives (8%) had been asked, or knew of others who had been asked to perform FGM in Australia. Many midwives were not clear about the law or health data related to FGM and were not aware of referral paths for affected women. CONCLUSION: As frontline providers, midwives must have appropriate up-to-date clinical skills and knowledge to ensure they are able to provide women with FGM the care they need and deserve. Midwives have a critical role to play in the collection of FGM related data to assist with health service planning and to prevent FGM by working closely with women and communities they serve to educate and advocate for its abandonment. Therefore, addressing educational gaps and training needs are key strategies to deliver optimal quality of care.

Riesgo de mutilación genital femenina. Propuesta de diagnóstico de enfermería / Risk for female genital mutilation. Proposal for nursing diagnosis

Objetivo principal: Desarrollar un diagnóstico enfermero para la detección y prevención de la Mutilación Genital Femenina (MGF). Metodología: La creación del presente diagnóstico se basa en un exhaustivo estudio bibliográfico en bases de datos como LILACS, CUIDEN, TESEO y Web of Sciencie; y otras fuentes documentales de organismos internacionales. Propuesta diagnóstica: "Riesgo de Mutilación Genital Femenina" se define como: Susceptible a la ablación parcial o total de los genitales externos femeninos y otras lesiones de los genitales, ya sea por razones culturales, religiosas o por cualquier otra causa no terapéutica que pueda comprometer la salud. Se establecen para él los siguientes factores de riesgo: Falta de conocimiento familiar sobre el impacto de la práctica en la salud física; Falta de conocimientos familiares sobre el impacto de la práctica en la salud reproductiva; y Falta de conocimientos familiares sobre el impacto de la práctica en la salud psicosocial. Además se incluye la siguiente población en riesgo sobre la que se debe realizar el seguimiento: ser niña o mujer; residir en el país donde se acepta la práctica; pertenecer a un grupo étnico en el que se realiza la práctica; pertenecer a una familia en la que alguna mujer haya sido sometida a MGF; actitud favorable de la familia hacia la práctica; y planificación para visitar el país de origen de la familia. Conclusión: La creación de un diagnóstico de riesgo para la prevención de la MGF, sitúa a Enfermería como una pieza clave su erradicación

Objective: To develop a nursing diagnosis for the detection and prevention of Female Genital Mutilation (FGM). Methods: The creation of this diagnosis is based on exhaustive bibliographic research of databases such as LILACS, CUIDEN, TESEO y Web of Sciencie; as well as other documentary sources from international entities. Diagnostic proposal: "Risk for Female Genital Mutilation" is defined as: Susceptible to full partial ablation of the female external genitalia and other lesions or the genitalia, whether for cultural, religious or any other non-therapetic reasons, which may compromise health. The following risk factors are established for this diagnosis: Lack of family knowledge about impact of practice on physical health; Lack of family knowledge about impact of practice on reproducitive health; Lack of family knowledge about impact of practice on psychosocial health. It also includes the following at-risk population that should be monitored: To be female (woman or girl); Residing in country where practice is accepted; Family leaders belong to ethnic group in which practive is accepted; Belonging to family in which any female member has been subjected to practice favorable attitude of family towards practice; and Planning to visit family's country origin. Conclusions: The creation of an "at-risk" nursing diagnosis for the prevention of FGM would situate nursing at the forefront of efforts to eradicate this practice

Propuesta de diagnóstico de Síndrome Post Mutilación Genital Femenina / Proposal for nursing diagnosis: Post Female Genital Mutilation Syndrome

Objetivo: Desarrollar un diagnóstico enfermero para la detección y prevención de la MGF. Metodología: La creación del presente diagnóstico se basa en un exhaustivo estudio bibliográfico en bases de datos como LILACS, CUIDEN, TESEO y Web of Sciencie; y otras fuentes documentales de organismos internacionales. Resultados principales: Síndrome post Mutilación Genital Femenina se define como: el deterioro de una serie de dominios de la salud como consecuencia de una mutilación genital femenina. Este diagnóstico se sitúa en el dominio 11, seguridad/protección y se posiciona en la clase 3: violencia. Se establecen para él las siguientes características definitorias: fase aguda, respuestas físicas crónicas, respuestas relacionadas con la sexualidad, alteraciones obstétricas crónicas y respuestas psicológicas. Conclusión principal: La creación del presente diagnóstico de síndrome facilita a los y la profesionales de enfermería el abordaje de las consecuencias sobre la salud de la Mutilación Genital Femenina y sitúa a Enfermería como una pieza clave para su abordaje y erradicación (AU)

Objective: To develop a nursing diagnosis for the detection and prevention of FGM. Methods: The creation of this diagnosis is based on exhaustive bibliographic research of databases such as LILACS, CUIDEN, TESEO y Web of Sciencie; as well as other documentary sources from international entities. Results: Post Female Genital Mutilation Syndrome is defined as: Deterioration of a range of health domains as a result of female genital mutilation.This diagnosis belongs to domain 11: safety/protection and class 3: violence. The following defining characteristics are established for this diagnosis: Acute phase, chronic responses physical, sexuality, chronic obstetric alterations and psychological responses. Conclusions: Via the diagnosis presented herein, early detection might be procured by nursing professionals of those women and young girls having undergone this traditional practice, thereby being able to treat any possible resultant sequelae (AU)

Australian midwives' perspectives on managing obstetric care of women living with female genital circumcision/mutilation.

Female genital mutilation (FGM) or female circumcision is a global health issue with increasing international migration of affected women and girls to countries unfamiliar with the practice. Western health care providers are unfamiliar with FGM, and managing obstetric care presents challenges to midwives who are in the forefront of care provision for the women. The participants in this Heideggerian qualitative interpretive study elucidated the strategies they used in overcoming the particular physical, emotional, and gynecological health issues with which mutilated women present. Ongoing emphases on women-centered, culturally competent maternity care are germane to optimal maternity care of circumcised women.

What nurses need to know about female genital mutilation.

Female genital mutilation, also known as female circumcision (FGM/C) is a deep-rooted practice in some countries that needs to be addressed if the health needs of women and girls are to be met. FGM/C has no medical or health benefits. This article will discuss the different types of FGM/C, the law and legal implications and urological complications. Urology nurses need to be aware of what their medical roles and legal responsibilities are so that they are able to sensitively and holistically care for girls and women living with or at risk of FGM/C.

FGM and midwifery practice.

Midwives in the UK should have appropriate education in order to provide optimum care for women with female genital mutilation (FGM) and know how to safeguard any children who could be at risk. In addition to this, women with FGM have a right to progress though their pregnancy and beyond, safely and confidently, in a supportive environment, and must be empowered to do so. Efforts are being strengthened by the government to tackle the issue of FGM and prevent further cases; therefore all those working in maternity care need to ensure they are equipped to deal with this issue. This article focuses on some of the factors that should be considered in the identification and referral of women with FGM, the planning of their maternity care and related safeguarding issues.

The School Nurse's Role in Addressing Female Genital Mutilation.

Female genital mutilation/cutting (FGM/C) is the practice in some immigrant populations of cutting or causing injury to the female genital organs for non-medical reasons. The incidence of FGM/C has increased by 314% in school-aged children according to a study published in 2016. The school nurse is in an optimal position to identify children at risk and build collaborative relationships to treat the students affected by the practice. FGM/C is child abuse and carries both federal and state legal consequences. It is important for the school nurse to understand the cultural context, legal guidance, and social consequences of this practice within the greater community. The school nurse should work to develop interagency guidelines to provide safe processes for the child and the family. The most effective programs use a combination of educational strategies for families and communities along with law enforcement to help abolish the practice.

Key points for abolishing Female Genital Mutilation from the perspective of the men involved.

INTRODUCTION: female Genital Mutilation is internationally considered an affront on human rights and an act of violence against women and young girls. Furthermore, it hierarchises and perpetuates inequality and denies the right to bodily and psychosocial integrity of women and young girls. AIMS: to detect the key points for the abolition of Female Genital Mutilation as well as the necessary resources for its eradication. MATERIAL AND METHOD: a qualitative methodology with an ethnonursing perspective, via semi-structured interviews, held both individually and in groups, in 21 men familiar with Female Genital Mutilation. FINDINGS: through the voices of men familiar with this tradition, five key points are presented for its gradual eradication: sensitisation and awareness building, team action, abolition-promoting media, focusing action on rural areas and applying educational means before punitive ones. CONCLUSION AND PRACTICAL IMPLICATIONS: awareness-raising via the combined efforts of families, communities and governments, together with the promotion of health education programmes in demonstrating the complications derived from this practice, play a vital part in eradicating Female Genital Mutilation.

Nursing Care of Women Who Have Undergone Genital Cutting.

Female genital cutting (FGC), commonly called female genital mutilation, affects millions of women but is poorly understood by many health care providers. FGC procedures intentionally alter the female genital organs for nonmedical reasons and include partial or total removal of female genital organs. These procedures, which have no medical value, are usually done between birth and puberty. Health consequences vary in severity but can be devastating. Women who have experienced FGC may be reluctant to seek health care or to disclose their condition to providers. Suggestions for culturally competent care of women who have experienced FGC are outlined, focusing on understanding the cultural beliefs and values of women who have undergone these procedures and providing informed and sensitive care.

Estrategias para el abordaje y prevención de la mutilación genital femenina desde la Enfermería: Una revisión videográfica / Strategies aimed at approaching and preventing the female genital mutilation from nursing: Video-graphic review

Objetivo principal: Identificar las estrategias que pueden utilizarse en la prevención de la mutilación genital femenina en inmigrantes originarias de países donde se realiza esta práctica. Metodología: revisión de la videografía. La búsqueda se realizó de octubre de 2013 a febrero de 2014, utilizando las palabras clave "mutilación genital femenina", "ablación del clítoris" y "female genital mutilation". Se seleccionaron 9 vídeos. Resultados: la estrategia para prevenir la práctica es la información. Los testimonios en contra también son eficaces. En España se utilizan mediadores interculturales y la carta de no mutilación. Conclusión principal: las enfermeras pueden trabajar la prevención de la mutilación genital proporcionando información sobre sus consecuencias, reforzando la información con mediadores interculturales o testimonios disponibles en vídeos. También disponen de recursos ante riesgo inminente de mutilación

Objective: To identify strategies that can be used in the prevention of female genital mutilation on immigrant groups that come from countries where female genital mutilation is a traditional practice. Methods: Systematic videography review. Research was made between October 2013 and February 2014. Keywords used were "mutilación genital femenina", "ablación del clítoris" and "female genital mutilation". From all the videos obtained, 9 were selected. Thematic Sections: Information is the strategy to prevent the practice of female genital mutilation. Experience and testimonials are also effectives. In Spain, there are intercultural parameters and the no mutilation letter. Conclusions: Nurses can work in the prevention of the genital mutilation by providing information on the consequences of this practice, strengthening information by intercultural mediators or video testimonials. Nurses also have resources to prevent any imminent mutilation risk