in Measuring the Impact of Interventions Against
Female Genital Cutting
Ian Askew, Associate Director for Africa, Frontiers in Reproductive
Health Program Population Council Nairobi, Kenya
Version: March 4th 2003
Ian Askew is a social scientist by training, and has 20 years
of international experience in the field of reproductive health,
including over 12 years living and working in sub-Saharan Africa.
He is a Senior Associate with the Population Council, and heads
the Council’s office in Nairobi, Kenya. As the Associate Director
for Africa of the Council’s Frontiers in Reproductive Health program,
Ian also directs numerous research projects that seek to improve
the quality of reproductive health services throughout the region.
Since 1994, this program has included several diagnostic and intervention
research studies into FGC in several African countries.
With increasing efforts being made to introduce systematic interventions
for encouraging abandonment of female genital cutting (FGC) comes
the need to better understand how such interventions work and what
effects they have. Many interventions are based on theoretical models
of behavior change and so studies to evaluate them should develop
indicators appropriate to the type of behavior change anticipated.
Systematic evaluations need also to use some form of quasi-experimental
design to be able to attribute change to the intervention and not
to any ‘natural’ change in FGC behavior or other activities that
may be concurrent. A sustained change in the prevalence of FGC is
the ultimate indicator and there are several ways this can be measured,
although with many limitations given intimate nature of the practice.
Moreover, appropriate sample sizes must be calculated and used be
able to draw valid conclusions. Many of those implementing FGC interventions
are not familiar with such basic research principles and so there
is an urgent need to ensure that projects are well designed so that
valid conclusions concerning their true effectiveness can be drawn.