A realist synthesis of controlled studies to determine the effectiveness of interventions to prevent genital cutting of girls.
A realist synthesis of controlled studies to determine the effectiveness of interventions to prevent genital cutting of girls.
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DOI：
10.1179/2046905513y.0000000086
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发表时间：
2013-11
影响因子：
1.8
通讯作者：
Denison EM
中科院分区：
文献类型：
--
作者：
Berg RC;Denison EM
背景资料：切割女性生殖器官是一种传统做法，涉及出于非医疗原因部分或全部切除或以其他方式伤害女性生殖器官。虽然目前的趋势表明，这种做法正在变得不那么普遍，但多达3 000万女孩可能仍然面临切割女性生殖器的风险。鉴于相关的风险和侵犯女童和妇女人权的行为，通过预防性干预措施阻止这种做法。目的：从现实的角度系统地审查反对切割女性生殖器的干预措施的有效性。研究方法：现实主义的综合方法解决了背景机制结果（CMO）的干预，试图解释干预的成功或失败。所涉及的过程暴露了策略在不同背景下的有用性。结果：纳入8项有效性研究和27项背景研究。所有有效性研究均采用对照、前后对照研究设计。它们形成了五大类干预措施：培训、正规课堂教育、媒体传播、外联和宣传以及非正规成人教育。社区营销办公室的组合表明，改变切割女性生殖器行为的拟议动力似乎主要是传播信息。一些干预措施的可接受性和成功取决于将放弃女性生殖器切割的努力纳入更大范围的相关问题中。然而，如果有系统的预先规划，包括彻底的社区分析，并确保宗教领袖承诺停止切割女性生殖器，干预措施本可以取得更大的成功。结论：这项分析的结果指出了在不同情况下促进废除切割女性生殖器官方案取得成功的条件，可用于今后的预防工作，以减少女孩遭受切割女性生殖器官的风险。
Background: Female genital mutilation/cutting (FGM/C) is a traditional practice which involves the partial or total removal or other injury to the female genital organs for non-medical reasons. Although current trends indicate that the practice is becoming less prevalent, as many as 30 million girls may still be at risk of FGM/C. Given the associated risks and violation of the human rights of girls and women, the practice is discouraged through preventative interventions. Aims: To systematically review the effectiveness of anti-FGM/C interventions, applying a realist perspective. Methods: The realist synthesis approach addressed context-mechanisms-outcomes (CMO) underlying intervention in an attempt to explain interventions’ success or lack thereof. The process involved exposed the usefulness of strategies in different contexts. Results: Eight effectiveness studies and 27 context studies were included. All of the effectiveness studies employed a controlled, before-and-after study design. They formed five broad categories of intervention: training, formal classroom education, media communication, outreach and advocacy, and informal adult education. The CMO configurations showed that the proposed engine behind changing behaviours regarding FGM/C appeared largely to be dissemination of information. Some interventions’ acceptability and success rested on the incorporation of FGM/C abandonment efforts within a larger set of related issues. However, greater success of the interventions could have materialised with systematic pre-planning involving thorough community analyses and securing religious leaders’ commitment to halting FGM/C. Conclusion: The results of this analysis point to conditions that facilitate the success of FGM/C abandonment programmes in different contexts and can be used in future prevention efforts to reduce the risk of girls being subjected to FGM/C.