Methodological Issues 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.

Abstract

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.