TWEET CONFERENCE TRANSCRIPT: The Cost of FGM: Burden on the Health care Sector – May 20th, 2021.
Oparah Purity @Lady_Purity
FGM violates human rights. It is impossible to say how much society should spend to prevent it, but as shown by the results of some studies, any money spent on preventing FGM would be partially offset by savings to the health system.
Indeed, if the health system were to spend as much as I$ 5.82 per FGM–3 prevented or I$ 2.50 per FGM–2 prevented, the value of avoided obstetric complications would entirely offset the costs of prevention
Good evening all, and welcome to today’s edition of the @UNICEF_Nigeria Social media awareness campaign to end FGM under @GPtoendFGM.
FGM includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons.
More than 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated.
An extreme form of gender discrimination, it is recognized internationally as a violation of the human rights of girls and women: including the right to health, security and physical integrity and the right to be free from torture and cruel, inhuman or degrading treatment.
FGM has no health benefits and causes only harm. Women and girls who are subjected to FGM are at risk of both short- and long-term negative health consequences – including for their physical, sexual, mental, and social well-being.
The direct financial cost of treating the negative health complications caused by FGM can span generations, starting as early as childbirth.
This puts a significant economic burden on health systems and national budgets, especially in countries with rates of FGM greater than 10%.
FGM carries serious health consequences both for the girl or woman who undergoes the procedure and for her offspring.
The procedure can lead to direct medical complications. In a study of women in Nigeria who had FGM, the most common of these were severe pain and bleeding.Infection also poses an immediate risk.
Long-term health effects include psychologicaland psychosexualtrauma, infertility, susceptibility to bacterial vaginosis and genital herpes, and obstetric complications, including perinatal death.
This Tweet will be on a studyon the Estimating the obstetric costs of female genital mutilation in six African countries extracted from @WHO bulletin.
Prior studies have shown higher rates of Caesarean section, postpartum haemorrhage, prolonged hospitalization, and perinatal death among women who have suffered FGM.
Yet these obstetric complications account for only a small portion of the overall health impact of FGM in a population, and their financial costs are merely one among the many costs associated with FGM.
However, when the financial burden that FGM imposes on the health system is measured, it becomes obvious that caring for women who have undergone this procedure imposes an even greater economic burden and that the cost of efforts to prevent FGM can be wholly or partially offset by the savings generated when complications are prevented.
The objective of this paper is to build on prior estimates of the obstetric risks linked to FGM to estimate how much FGM-related obstetric complications cost the health-care system and society.
A large WHO study quantifying the relative risk of obstetric complications among African women by type of FGM made it possible to carry out this cost study.
In the WHO study, which was conducted from November 2001 to March 2003 in 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and the Sudan, women and their neonates were prospectively followed for adverse outcomes from admission before labour or in early labour until discharge.
The study was limited to 28 393 women who had a singleton delivery. Women’s FGM status was determined by direct examination of the external genitalia and in accordance with WHO’s four-category classification of FGM.
The relative risks of adverse maternal and infant health outcomes for each type of FGM (with no FGM as the reference category) were also estimated.
The losses of life and money are different in each country because of differences in fertility rates and in the proportion of medically attended deliveries.
Women who have more deliveries are more exposed to the risk of dying and of suffering complications.
Countries that have achieved higher rates of medically attended deliveries also incur higher medical costs because of the complications associated with such deliveries.
However, the model should not be interpreted to mean that the rate of attended deliveries should be reduced to lower the obstetric costs of FGM, but rather the opposite.
Because deaths from complications are more common when births take place at home, reducing attended deliveries would result in higher death rates.
FGM violates human rights. It is impossible to say how much society should spend to prevent it, but as shown by the results of our study, any money spent on preventing FGM would be partially offset by savings to the health system.
Indeed, if the health system were to spend as much as I$ 5.82 per FGM–3 prevented or I$ 2.50 per FGM–2 prevented, the value of avoided obstetric complications would entirely offset the costs of prevention.
An estimated $23 million or more were spent by bilateral, multilateral and private foundation donors in 2007 on activities surrounding the prevention of FGM.
However, the cost-effectiveness of such spending per case prevented is unknown. Typically, interventions for the prevention of FGM take the form of community-based programmes, media outreach and advocacy and often target religious leaders and excisors.
Inconclusion, Civil society should give the highest priority to addressing the human rights violation inherent in FGM.
However, measures to address the problem require financing.
Efforts to combat FGM have been traditionally underfunded, health ministries that invest in curbing the practice of FGM are likely to recover a large portion of the investment by saving money from prevented obstetric complications.
Societies would also benefit from other reduced costs, including the costs of treating FGM-related psychological and sexual health problems.
At this point, I will stop the conversation so we can reflect on the key points discussed as I entertain any questions. #Endcuttinggirls
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