Health care providers\u27 and mothers\u27 perceptions about the medicalization of female genital mutilation or cutting in Egypt: A cross-sectional qualitative study [Arabic]

The medicalization of FGM/C has been increasing significantly in Egypt making it the country with the highest rate of medicalization. In this qualitative study, we explore the drivers and motives behind why health-care professionals perform FGM/C and why mothers rely on them to perform the practice on their daughters

Too Young to Be a Mother: A Description of the Lives of Married Adolescent Girls in Egypt

Improving the status and health of women is high on the agenda of the Ministry of Health and Population in Egypt. Investing in the lives of women who marry in their teens has long-term benefits for these girls and their children. Valid information is needed, however, to address these girls’ special needs. Adolescent health is currently one of the major concerns of the Ministry of Health and Population, as is delaying early marriage and addressing the reproductive and other health needs of married girls. The Ministry was a fieldwork partner with the Population Council, providing data collection from primary health care physicians throughout the country for the “Adolescent and Social Change” Survey (ASCE) in 1997. This monograph is an in-depth analysis of the ASCE survey data. It portrays the context in which married girls are living, describes their characteristics, marriages, and reproductive practices, and makes them visible for the first time, which is hoped will contribute to improving their situation

Socialization to gender roles and marriage among Egyptian adolescents

Using nationally representative survey data, this paper explores gender role socialization and attitudes toward marriage among unmarried Egyptian adolescents aged 16-19 years. We examine the daily activities of adolescent boys and girls, views about age at marriage and desirable qualities in a spouse, and various indicators of gender role attitudes including opinions about whether wives should defer to husbands, about sharing household decisionmaking, and about responsibility for domestic tasks. Our findings reflect strong gender differentiation: girls have much less free time than boys, are much less mobile, are much less likely to participate in paid work, and have heavier domestic responsibilities regardless of whether or not they are in school. Girls favor a later age at marriage for both sexes, but particularly for boys. Boys are significantly more likely than girls to favor educational inequality between spouses. While neither boys nor girls have particularly progressive gender role attitudes, girls are significantly more likely to express less traditional attitudes. Multivariate analyses indicate that girls’ and boys’ attitudes do not vary consistently and significantly by socioeconomic background; in particular, increased schooling does not always promote egalitarian attitudes. The implications of these findings for policies and programs are discussed

'A boy would be friends with boys... and a girl... with girls' : gender norms in early adolescent friendships in Egypt and Belgium

Purpose: A gender analysis was conducted to illuminate the key elements of friendships highlighted by early adolescent girls and boys in two sites for the purpose of better understanding the impact of gender norms on adolescent friendships in different contexts. Methods: Narrative interviews with early adolescents were conducted in two sites: Assiut, Egypt (n = 37) and Ghent, Belgium (n = 30). The interviews were recorded, transcribed, translated into English, and coded using Atlas.ti for analysis. Results: In both Assiut and Ghent, early adolescents reported some similarities in defining key characteristics of their same-sex friends as well as in the activities they share. However, differences were noticed among boys and girls within each site. In addition, the scope of shared activity was broader in Ghent than in Assiut. In both sites, few opposite-sex friendships were reported. Gender norms influenced choice of friends as well as the type and place of shared activities. Conclusions: Building on knowledge that adolescent friendships guide and reinforce attitudes, beliefs, and behaviors that impact immediate and long-term health, our findings indicate that gender norms inform early adolescent friendships, which may impact healthy development

National efforts toward FGM-free villages in Egypt: The evidence of impact

This report is a midterm evaluation and documentation of the process and approach of the FGM-Free Village Model implemented in Egypt by the National Council of Childhood and Motherhood with assistance from the Population Council. In a comparison of responses from women and men in intervention groups to those in nonintervention (control) villages, data analysis shows that the program has been successful in changing views and attitudes toward female genital mutilation (FGM). FGM is an entrenched generational practice, and eradicating it in a community requires concerted effort over an extended period of time. This evaluation strongly recommends that efforts be continued by means of a sustained and protracted process. Advocacy and awareness-raising efforts that take a holistic multisectoral approach constitute best practices that must to be sustained in order to maintain their impact for future generations

The decline of female circumcision in Egypt: Evidence and interpretation

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl’s marriageability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than were their mothers. Circumcision may have begun to decline prior to the time when the current cohort of girls were at risk; however, the data hint at a temporal association between the decline and the 1994 International Conference on Population and Development (ICPD) in Cairo, a time when the campaign against circumcision gained momentum. Over half of circumcised girls reported that the procedure was performed by a physician or nurse rather than a traditional practitioner. This represents a substantial increase over rates of “medicalized” circumcision found among earlier cohorts of Egyptian women. Even among circumcised girls, support for the practice is by no means universal, with 14 percent saying they think the procedure is unnecessary and a further 28 percent expressing ambivalence. A multivariate analysis indicates that girls who have been or are currently in school, who live in urban governorates, and who are older are more likely to believe that circumcision is not obligatory. When the analysis includes boys as well as circumcised girls, a large gender gap emerges, with boys considerably more supportive of the practice than are their female counterparts

The decline of female circumcision in Egypt: Evidence and interpretation [Arabic]

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl’s marriageability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than were their mothers. Circumcision may have begun to decline prior to the time when the current cohort of girls were at risk; however, the data hint at a temporal association between the decline and the 1994 International Conference on Population and Development (ICPD) in Cairo, a time when the campaign against circumcision gained momentum. Over half of circumcised girls reported that the procedure was performed by a physician or nurse rather than a traditional practitioner. This represents a substantial increase over rates of “medicalized” circumcision found among earlier cohorts of Egyptian women. Even among circumcised girls, support for the practice is by no means universal, with 14 percent saying they think the procedure is unnecessary and a further 28 percent expressing ambivalence. A multivariate analysis indicates that girls who have been or are currently in school, who live in urban governorates, and who are older are more likely to believe that circumcision is not obligatory. When the analysis includes boys as well as circumcised girls, a large gender gap emerges, with boys considerably more supportive of the practice than are their female counterparts

Toward FGM-free villages in Egypt: A mid-term evaluation and documentation of the FGM-free village project

This Population Council report is a mid-term evaluation and documentation of the process and approach of the FGM-Free Village Model in Egypt. The objective of this report is to create a knowledge base of information to support policy dialogue on female genital mutilation (FGM) and to assist in transferring knowledge about the model to other communities across Egypt and other countries where FGM is practiced. Impact evaluation at the community level shows the significant impact of the project in changing views and attitudes toward FGM among intervention groups. However, it also shows that FGM is an entrenched generational problem that requires concerted efforts over an extended period of time. The report strongly recommends that efforts be continued through a sustained and protracted process: advocacy and awareness-raising efforts that take a holistic multi-sectoral approach constitute best practices that need to be continued in order to maintain impact for the coming generations

Exploration of gender norms and socialization among early adolescents : the use of qualitative methods for the global early adolescent study

Purpose: The Global Early Adolescent Study (GEAS) was launched in 2014 with the primary goal of understanding the factors in early adolescence that predispose young people to subsequent sexual risks, and conversely, those that promote healthy sexuality across different cultural contexts. The present article describes the methodology that was used for the first phase of GEAS, which consisted of conducting qualitative research to understand the gendered transitions into adolescence and the role that gender norms play within the key relationships of adolescents. Researchers from each of the sites that had completed data collection were also elicited for their feedback on the key strengths, challenges, and lessons learned from conducting research among 11- to 14-year-old adolescents. The purpose of this article is to present the description of each of the methods that were used in GEAS, as well as the researchers' perspectives of using the methods among early adolescents in their sites. Methods: The GEAS is being implemented through a collaboration of university and nongovernmental institutions from 15 cities: Assiut (Egypt) Baltimore (U.S.), Blantyre (Malawi), Cape Town (South Africa), Cochabomba (Bolivia), Cuenca (Ecuador), Edinburgh (Scotland), Ghent (Belgium), Hanoi (Vietnam), Ile-Ife (Nigeria), Kinshasa (DRC), Nairobi (Kenya), New Delhi (India), Ouaga-dougou (Burkina Faso), and Shanghai (China). Approximately 30 in-depth interviews among adolescents and 30 in-depth interviews with their parent/guardian were conducted at each site, with adults and adolescents interviewed separately. To build trust and increase engagement among the adolescent participants, we used two different visual research methods: (1) timeline exercise which was small group based and (2) the Venn diagram exercise which was conducted individually and used at the start of the in-depth interview. Results: The visual aspects of both the timeline and the Venn diagrams not only helped to produce data for the purposes of the study, but also were a successful way of engaging the adolescent participants across sites. While the narrative interviews produced extremely rich data, researchers did notice that there were a few challenges among the younger adolescents. Challenges were related to the length of the interview, comprehension of questions, as some of the questions were either too abstract or asked adolescents about an experience they had not yet had and therefore could not address or articulate. Conclusions: Conducting the first phase of GEAS revealed important insights for research with participants who are in this developmental phase of early adolescence. Methods that involve greater engagement and those that are visual were shown to work well irrespective of the cultural setting

Married adolescent girls in rural Assiut and Souhag: Limited choices and unfulfilled reproductive health needs

According to the Survey of Young People in Egypt 2014, a significant proportion of young women residing in rural Upper Egypt were reported to be married before 18. Early marriage deprives a girl of education and employment opportunities and places her at risk of early and repeat pregnancy, gender-based violence, and sexually transmitted infections. The present study examines the sexual and reproductive health needs of married adolescent girls (MAGs) in rural Upper Egypt and identifies key contextual and cognitive factors that could mitigate or exacerbate the effects of early marriage on their sexual and reproductive health. The report finds that MAGs in rural Assiut and Souhag are experiencing multiple social, economic, and health vulnerabilities. However, despite their dire situation, there are several windows of opportunity that could be capitalized on. The report includes a list of policy and program recommendations that could empower MAGs, address their health needs, and ultimately eliminate child marriage