Good evening, we welcome you to our weekly Twitter conference, I am@thesocial_nerd and Co- anchoring with me today is @thonyayeni and @_chzy

Our topic today is “Enhancing the role of the health system in FGM data collection”. Before we commence we want to say Barka de sallah to all Muslims faithful.  May the blessings of Allah be with you all.

We appreciate your roles in ending FGM in this generation. We shouldn’t forget that Islam doesn’t support FGM.

Before we dive into the main topic of the tweet, we would love to give you a background of FGM.

FGM stands for:

F – Female

G – Genital

M – Mutilation

FGM is defined by @WHO as “all procedures that involve partial or total removal of the external female genitalia or other injury to the female genitalia for non-medical reasons”. FGM is a form of Child abuse and different laws has been set against it. The law against it varies from state to state in Nigeria.

According to @WHO, A good health system delivers quality services to all people, when and where they need them. The exact configuration of services varies from country to country. The World Health Organisation (WHO) classifies FGM into 4 types. WHO classifies FGM/C into four categories with subdivisions.

FGM Type I: partial or total removal of the clitoris and/or the prepuce (Clitoridectomy). The 2 subdivisions are, FGM Type Ia: removal of the prepuce/clitoral hood (circumcision) and FGM Type Ib: removal of the clitoris with the prepuce.

FGM Type II: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision)

The 3 subdivisions are of FGM Type II are; FGM Type IIa: removal of the labia minora only; FGM Type IIb: partial or total removal of the clitoris and the labia minora; and FGM Type IIIc: partial or total removal of the clitoris, the labia minora and the labia majora

FGM Type III: Narrowing of the vaginal orifice with the creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).

The 2 subdivisions are, FGM Type IIIa: removal and appositioning the labia minora with or without excision of the clitoris; and FGM Type IIIb: removal and appositioning the labia majora with or without excision of the clitoris

It is estimated that over 200 million girls and women worldwide are living with or at risk of suffering the associated negative health consequences of FGM. Every year 3 million girls and women are at risk of FGM and are therefore exposed to the potential negative health consequences of this harmful practice.

FGM has no known health benefits, and those girls and women who have undergone the procedure are at great risk of suffering from its complications throughout their lives. The procedure of FGM is painful and traumatic, and is often performed under unsterile conditions by a traditional practitioner who has little knowledge of female anatomy or how to manage possible adverse events.

A health system, also sometimes referred to as health care system or as healthcare system, is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations but in all cases it requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; well maintained facilities and logistics to deliver quality medicines and technologies.

One of the goals of World Health Organization (WHO), is to direct and coordinate authority for health within the United Nations system and to promote a goal of universal health care: to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.  According to WHO, healthcare systems’ goals are good health for the citizens, responsiveness to the expectations of the population, and fair means of funding operations Progress towards them depends on how systems carry out four vital functions: provision of health care services, resource generation, financing, and stewardship.

Over time, more and more initiatives have been taken at the international and national levels in order to strengthen national health systems as the core components of the global health system.  Like most social systems, health systems are complex adaptive systems where change does not necessarily follow rigid epidemiological models.

Also, over time, an increasing number of tools and guidelines are being published by international agencies and development partners to assist health system decision-makers to monitor and assess health systems strengthening including human resources e.t.c.

The health system offers a good platform to facilitate FGM abandonment and provide care to survivors.  According to NCBI, Data on FGM in most Heath care system has so far been negligible for several reasons including lack of adequate trained man power on FGM in some.

The main focus on collecting FGM data from various health care settings is to provide nationally consistent information on those women and girls who have had FGM, and to better inform those involved on what to do.  The roles of Health care system in data collection cannot be over empathized, some of their roles include the recording and sharing of FGM information locally, specifically for the provision of care.

  • Health care system should be provided with health care workers who have sufficient information about FGM.
  • Health care system should be provided with adequate and appropriate Data reporting tools, this will enable them report appropriately.
  • Health care system should be provided with E- Reporing or ICTD tools which can be assessed at anywhere and at any point in time.

Enhancing the roles of health care system can help bridge the large gaps that exist in community and professional knowledge of the consequences and treatment of FGM.

Also, one of the importance uses of Data gotten from health care system is that such can be made for policy reform in health, legislation, and community programs to provide the best healthcare, protect children, and help communities abandon this harmful practice.

Data gotten from health care system can be use to provide intervention by donor organizations. Data gotten from health care system can be used to monitor and track the new cases of FGM in each locality.

It’s important that Health care system provide adequate and unbiased data to the appropriate quarters.

There is need to train Health care providers on guidance for collecting and reporting cases of FGM.  This guidance should provide information on:

  • Identifying when a girl (including an unborn girl) or young woman may be at risk of FGM and responding appropriately to protect them;
  • Identifying when a girl or young woman has had FGM and responding appropriately to support them; and measures that can be implemented to prevent and ultimately eradicate the practice of FGM.

FGM data collection requires the Health system to record, collect and return detailed information about FGM within the patient population.

Data should be submitted every time the woman or girl has a procedure /treatment related to her FGM or gives birth to a baby girl, and every time FGM is identified (by a clinician or self-reported), not just the first time.  During FGM data collection, the following should be noted: patient demographic data, specific FGM information, referral and treatment information.

FGM Data collection can be done during Immunization services for places where FGM is performed on children.  FGM data collection can also be done while taking the medical history of a patient.

Monitoring and Evaluation (M&E) is an important process that helps improve performance and achieve results.  Its goal is to measure outputs, outcomes and impact, to improve management of programs such as #endcuttinggirls

M&E is critical for designing and tracking interventions targeting violence against women, like At the programme level, the purpose of M&E is to track implementation and outputs systematically, and measure the effectiveness of programs

M&E provides information on what an intervention program is doing, how well it performs and whether it’s aims and objectives are achieved

In the fight to #endcuttinggirls, Accurate tracking and reporting of incidents, recoveries, program reach, etc, by all stakeholders is pertinent to future intervention activities

It is also an important part of accountability to funding agencies and stakeholders.

Through monitoring, all stakeholders involved in ending FGM and ; activities, reporting and documentation, finances and budgets, and supplies and equipment, are held accountable and overall progress is kept in check.

Positive changes and improvements can be made in between interventions, solving unplanned issues and improving client reach and quality of services to

Evaluations in programs designed to #endcuttinggirls can be carried out by external agencies, project staff, health workers and other stakeholders, or by a combination of the latter three groups and external agencies.

Ideally, the use of EMR in developed health systems makes for an ease of tracking interventions at the health facility level.

Where we lack an EMR system, it is up to health workers to accurately record client’s information, enabling M&E staff to provide timely reports that determine when and how changes can be made during the course of an intervention

A good health system enables tracking from the point of entry of an FGM client, through intervention inputs (treatment or counseling), to outputs (successful recoveries).

It is important to sensitize health workers, about their approach and suitable algorithms to use when attending to FGM clients.

It is of upmost importance that correct information from clients are captured in the appropriate data collection tools.

Every stakeholder has an important role to play in ensuring accurate and efficient data collection.

Appropriate use of National Health Management Information System (NHMIS) tools must be enforced at health facilities to improve data collection.

The Role of up to date data collection, analysis and interpretation cannot be overemphasized in the fight to end FGM as the data collected can influence policy changes amongst other things

We also encourage individuals and families to make the work of healthcare workers easier and also ensure that the government has correct data

With this we have come to the end of today’s conference,  join us again for another episode of our weekly twitter conference next week Thursday, promises to be enlightening , you can start asking questions now and they’ll be promptly responded to

To learn more about the EndCuttingGirls Social Media Campaign to end FGM, please visit and follow our social media handles on Facebook, Twitter, Instagram and YouTube, using @endcuttinggirls