Treatment of Health Complications due to Female Genital Mutilation/Cutting in Tanzania: Curriculum Build, Implementation, and Evaluation

ABSTRACT Female genital mutilation/cutting (FGM/C) affects girls and women throughout the world, with 3 million girls cut each year. The highest rates of FGM/C are in East Africa. There are significant reproductive, sexual, and mental health consequences for girls and women impacted by FGM/C. Healthcare providers (HCPs) require training to meet these needs, yet globally there is a dearth of training programs. Effectiveness studies of FGM/C training are even rarer. Tanzania has a high FGM/C rate, yet we found in preliminary studies that healthcare students were unprepared to meet the need of these patients. The goal of the proposed study is to develop training materials specific to the needs of HCPs within Tanzania, deliver a pilot intervention/training program, and study the effectiveness of the program at Muhimbili University of Health and Allied Sciences (MUHAS). In order to meet that goal, it is critical that training materials are developed carefully, with attention to both cultural and ethical concerns facing healthcare providers within the country. There are three specific aims. In Aim 1 we will conduct a social ecological needs assessment of the healthcare needs of women in Tanzania who have experienced FGM/C. The results of Aim 1 will be used to adapt a promising training program to accomplish our second aim. In Aim 2 we will develop a FGM/C training tailored to the Tanzanian context. A core component of Aim 2 will be to use a train the trainer program. In Aim 3 we will evaluate the effectiveness of the training through a randomized, controlled, single blinded trial of the training (intervention) against a waitlist control arm (n=200 students per arm; 400 in total). In Aim 3 we will assess medical, nursing, and midwifery students’ improvements in knowledge, attitudes, and clinical skills. Development and testing of a tailored training course about FGM/C for students in health care, if effective, has high potential to be integrated into existing curriculum; and be widely adopted as a new standard of training for health professionals across both low prevalence and high prevalence FGM/C areas.