1. What Makes People Abandon Female Genital Mutilation/Cutting? Experiences from Senegal and Burkina Faso Nafissatou J. Diop International Day of Zero Tolerance for Female Genital Cutting Washington D.C. February 6, 2007

2. Information Based on Several Studies Senegal Breakthrough in Senegal, 1998 Evaluation of a community based program 2000-2004 Evaluation of the long term impact of the Tostan program, 2006 Burkina Testing a community based program 2000- 2004 Is Female Genital Cutting declining in Burkina Faso? An assessment of the evidence 2004-2006

3. Outline of the Presentation Current statistics of FGC in Burkina and Senegal The mental map: What is still there? Observation: Change - people are abandonning the practice.Why? - Tostan intervention in Senegal - CNLPE interventions in Burkina Faso Perceptions of innovation - not cutting girls Conclusion

4. What are the Statistics on FGM/C in Burkina Faso?

5. Prevalence of FGM/C Among Women Aged 15-49 Since 1996 1996 (INSD) : 66% 1999 (DHS) : 72% 2000 (Ouéd D.) : 85% 2001 (Sangli G.) : 75.5% 2001 (Ouéd I.) : 76.4% 2002 (Kaboré Y.) : 76.9% 2003 (EDS): 77%

6. PASSORE Boulkiemdé Bazéga Sanguié 4 provinces have a prevalence of less than 50% Prevalence among women 15-49 years old by province Sources: Sangli Kaboré Yimian INSD Kaboré Idrissa

7. Prevalence Among Daughters 0-10 years old SurveysYear 0-10 years15-49 years % INSD199636,4 (1204)66,4 (1654) PEBC 2001 2003 6 (556) 2,6 (690) 70,4 (608) 71 (720) Ouédraogo D.200015,6 (940)85,1 (879) Sangli20019,8 (1215)75,5 (1632) Ouedraogo I.200112 (1018))76,4 (1861) Kabore200218,7 (nd)76,9 (3150) Selected studies

8. What are the Statistics on FGM/C in Senegal?

9. Prevalence rate of FGM/C 28 % national rate among mothers; 20% among daughters DHS 2005

10. Proportion of girls aged 0 - 10 years not cut following a Tostan intervention

11. No reported cases of FGC in the villages «In this village FGC is condemned by the population. Tostan conducted education activities so we learned the harsh trials for health » Religious leader, Kolda Disappearance of traditional excisors «The excisor who was doing it died. Her daughter didnt take it over » Woman not participating in the program, Diabougou In villages where Tostan worked

12. Where Are We With the Reasons to Continue the Practice?

13. Why the Practice of FGC Continues: The Mental Map WHO. 1999. What works what doesnt work.

14. A. Psychosexual and Social Reasons Social acceptability Less Control of womens sexuality Chastity and virginity Yes Marriagibility Less The honor of the family Yes, but modern stigma is unmarried pregnancy (no longer uncut woman) Hygienic and esthetism No Religious requirement Marginal If We Follow the Mental Map

15. B. Community enforcement mechanisms Fear of punishment by God or supernatural forces No Divorce and refusal to marry uncut girls Marginal No clear opposition to mariage Cultural mix particularly in cities Migration and exposition to western world Obligation to cut a wife that comes from a non-practicing community No Poems and songs glorifying FGC and humiliating non cut girls Disappeared If We Follow the Mental Map

16. People are Abandonning the Practice Why?

17. CNLPE Strategy CNLPE is a government body; 13 institutions (Army, Health, Social,Defense, Communication, Justice, ….) CNLPE strategies consist of: - Implementation of the law - Free telephone line for denunciation (SOS excision 80 00 11 12) - Capacity building and advocacy work - Education of communities on the risks of FGM/C Health consequences Legal implications (arrested, condemned) - Decentralized system of operating

19. Tostan Strategy Comprehensive educational program for women on hygiene, human rights, womens health and problem solving Bring knowledge and awareness on health and life skills Empower women through building confidence to participate and be pro-active

20. Tostan Strategy Promote self development through the use of adapted educational materials Participatory approach emphasizing peaceful strategies for social change Create a mobilization movement by bringing together several villages for societal change: Public declaration of abandonment

22. How the Change is Perceived When We Look at the Theory of Diffusion

23. Diffusion Model COMMUNICATION CHANNELS KNOWLEDGEPERSUASIONDECISIONIMPLEMENTATIONCONFIRMATION Prior Conditions: Previous practice * Felt needs/problems * Innovativeness * Norms Characteristics of decision-maker Socioeconomic characteristics Personality variables Communication behavior Perceived characteristics of the innovation Relative advantage Compatibility Complexity Trialability Observability Adoption Continued Adoption Later Adoption Rejection Discontinuance Continued Rejection Rogers 1995.

24. Perceived Benefits of Not Cutting The greater perceived relative advantage, the more rapid the rate of adoption and change Sensibilisation, Education raise awareness. It contributes to change people perception of the practice « In our community, this was an habit, we were doing it because it was a custom. People were laughing at those who were not cutting their daughter. But we understood, with the education campaigns that FGC do not bring any advantage to anybody. The bad consequences are important » (Mixed Focus Groups, Houét) Recognize the complication of FGC or hear testimony of women on the subject is a major step for some people

25. Perceived Benefits of Not Cutting People are recognizing a relative economic advantage of not cutting girl. « If you take off the clitoris today, you will lost your hair by paying prescriptions and she can die (…) This is why abandon this practice has more advantage for us» (Focus adults men, Zoundwéogo) « It is better to have an uncut woman to avoid problems. The day you will have a child, you will be a husband with a lot of problems, as the delivery will cost you more than for an uncut woman » (focus students Houet)

26. The implementation of the law Contributed heavily in the abandonment of the practice in Burkina and plays the role of gatekeeper among communities that receive the Tostan program. Perception of the people is that the law is very strict and it is necessary to obey. « Yes it is because of the interdiction that I dont want my daughter to be cut » (woman i favor of the practice of FGC, mossi, Ouaga-Kadiogo) « Since the law has been voted, which coincide with the public declaration of Diabougou, this practice has ended. There is girls in this village that reached the age of marriage and who are uncut » leader, Keur simbara Perceived Complexity for Practicing FGM/C (Not practicing is simpler)

27. The community system of surveillance « Everybody has abandoned, because if everybody abandon and I practice it, if they see me they are going to denunciate me » (Community Leader against the practice, 56, Oudalan) « We discussed with the community to raise awarness. I know that if we caught someone practicing FGC, we will tell him/her « Don;t do it again or I will denounce you » but this case hasnt happened yet. » Woman leader, Diabougou Perceived Complexity for Practicing FGM/C (Not practicing is simpler)

28. Traditional leaders involvement in community activities provided stronger and more visible support to the abandonment « Here this is our chief. The chief told us that he doens want to here about FGC in his village in the short and long term, he doensnt want to hear that a woman has been cut or want to cut someone …» (Focus adult women, Gourma ) The contact with other cultures create a confrontation of ideas and beliefs and support the decision « Because people travel, they are going everywhere, they bring back information on FGC and its consequences. They explain it to the community and they abandon the practice because of what they saw » men leader, 70 ans,Korézéna, Oudalan ) « The world has changed, mentality have changed, all the girls are going to school now. There is a lot of mix up of people » Men, Malicounda Perceived Compatibility of Not Cutting

29. The level of education contributes to the abandonment of the practice « My mother told me that this is because of my elder brother who is a teacher, otherwise I would have been cut like her » (Girls non cut, 19 years old, Saouga, Oudalan ) Religious groups, particularly Christian, play a role in the abandonment «We were the first ones to abandon this practice. The pastor preached against and we took it as a commandment. » (Male Community Leader, 37 years old, Bazèga ) Perceived Compatibility of Not Cutting

30. Reaching the Critical Mass People that have abandoned the practice are important (large numbers; started 6 or 7 years ago) There is a critical mass in terms of change of attitude But in terms of behavior change, 2 voices: « The fear of denunciation and the change in the practice (family practice) make it difficult to know what is happening in your neighbors house » « Communities highlight the fact that people have abandonned, but the number of cut women is still high and this hides the increase of the number of uncut girls. The critical mass will be reached with time ». Health providers observe the abandonment: Girls received in consultation are not cut Young women that come to deliver are not cut

31. Commonalities: Factors Affecting Speed of Abandonment Enabling environment: Policy (law), democracy (media) Comprehensive, well structured, holistic intervention Decentralized operating system, but a strong coordination mechanism Long-term education of communities (constant; different channels) Organized diffusion system Involvement of leaders to become key actors Responsibility of communities to maintain the surveillance system

32. But We Need to Support families/people that have abandoned cutting - Pioneer women were stigmatized (Senegal); Need new messages to motivate, mechanism for rewards Non cut girls are stigmatized with cultural changes - Western dress, sexuality, sex outside of marriage, pregnancy, abortion - the older generation sees this behavior as a consequence of the abandoment of cutting and loss of accompanying education Keep up commitment, include life skills education for young people and parent/child communication programs

33. For More Information: www.popcouncil.org/frontiers email: frontiers@pcdc.org ……..