Evidence map›Paper›PMID 38964796›Full record

Trial reportBMJ open2024

Cluster randomised trial of a health system strengthening approach applying person-centred communication for the prevention of female genital mutilation in Guinea, Kenya and Somalia.

Mamadou Dioulde Balde, Patrick Muia Ndavi, Vernon Mochache, Anne-Marie Soumah, Tammary Esho, James Munyao King'oo, Jackline Kemboi, Alpha Oumar Sall, Aissatou Diallo, Wisal Ahmed and 7 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Capacity building for healthcare workers on preventing and managing female genital mutilation: Impact on knowledge, attitudes, skills, and quality of care-A systematic review.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Mamadou Dioulde BaldeCentre for Research in Reproductive Health in Guinea, Conakry, Guinea.
Patrick Muia NdaviDepartment of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya.
Vernon MochacheDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Anne-Marie SoumahCentre for Research in Reproductive Health in Guinea, Conakry, Guinea.
Tammary EshoAmref International University, Nairobi, Kenya.
James Munyao King'ooDepartment of Biochemistry and Biotechnology, Technical University of Kenya, Nairobi, Kenya.
Jackline KemboiDepartment of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya.
Alpha Oumar SallCentre for Research in Reproductive Health in Guinea, Conakry, Guinea.
Aissatou DialloCentre for Research in Reproductive Health in Guinea, Conakry, Guinea.
Wisal AhmedUnited Nations Population Fund, Addis Ababa, Ethiopia.
Karin SteinDivision of Healthier Populations, World Health Organization, Geneva, Switzerland.
Khurshed NosirovDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Soe Soe ThwinDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Max PetzoldPublic Health and Community Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
Muna Abdi AhmedCentral Statistics Department, Ministry of Planning and National Development, Hargeisa, Somaliland, Somalia.
Ahmed DiriyeData and Research Solutions, Hargeisa, Somaliland, Somalia.
Christina PallittoDepartment of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland pallittoc@who.int.ORCID 0009-0007-1700-6774

Funding

World Health Organization 001
6 · The paper itself

Abstract

introductionThere is limited evidence on effective health systems interventions for preventing female genital mutilation (FGM). This study tested a two-level intervention package at primary care applying person-centred communication (PCC) for FGM prevention.

methodsA cluster randomised trial was conducted in 2020-2021 in 180 antenatal care (ANC) clinics in Guinea, Kenya and Somalia. At baseline, all clinics received guidance and materials on FGM prevention and care; at month 3, ANC providers at intervention sites received PCC training. Data were collected from clinic managers, ANC providers and clients at baseline, month 3 and month 6 on primary outcomes, including delivery of PCC counselling, utilisation of level one materials, health facility preparedness for FGM prevention and care services and secondary outcomes related to clients' and providers' knowledge and attitudes. Data were analysed using multilevel and single-level logistic regression models.

resultsProviders in the intervention arm were more likely to deliver PCC for FGM prevention compared with those in the control arm, including inquiring about clients' FGM status (adjusted OR (AOR): 8.9, 95% CI: 6.9 to 11.5; p<0.001) and FGM-related beliefs (AOR: 9.7, 95% CI: 7.5 to 12.5; p<0.001) and discussing why (AOR: 9.2, 95% CI: 7.1 to 11.9; p<0.001) or how (AOR: 7.7, 95% CI: 6.0 to 9.9; p<0.001) FGM should be prevented. They were more confident in their FGM-related knowledge (AOR: 7.0, 95% CI: 1.5 to 32.3; p=0.012) and communication skills (AOR: 1.8; 95% CI: 1.0 to 3.2; p=0.035). Intervention clients were less supportive of FGM (AOR: 5.4, 95% CI: 2.4 to 12.4; p<0.001) and had lower intentions of having their daughters undergo FGM (AOR: 0.3, 95% CI: 0.1 to 0.7; p=0.004) or seeking medicalised FGM (AOR: 0.2, 95% CI: 0.1 to 0.5; p<0.001) compared with those in the control arm.

conclusionThis is the first study to provide evidence of an effective FGM prevention intervention that can be delivered in primary care settings in high-prevalence countries. TRIAL REGISTRATION AND DATE: PACTR201906696419769 (3 June 2019).

Indexed as

Circumcision, FemaleHealth Knowledge, Attitudes, PracticeAdolescentAdultCommunicationCounselingFemaleGuineaHumansKenyaPatient-Centered CarePregnancyPrenatal CarePrimary Health CareSomaliaYoung AdultBehaviorEDUCATION & TRAINING (see Medical Education & Training)Patient-Centered CarePrimary CarePrimary PreventionPUBLIC HEALTH

Identifiers

PMID38964796
PMCPMC11227771

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.