Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study
Abstract Background Female genital mutilation/cutting (FGM/C) is a cultural practice associated with health consequences, women rights and deprivation of dignity. Despite FGM/C-related health consequences, circumcised women may encounter additional challenges while seeking interventions for reproduc...
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | BMC International Health and Human Rights |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12914-020-0222-6 |
| _version_ | 1818949560093900800 |
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| author | Samuel Kimani Caroline W. Kabiru Jacinta Muteshi Jaldesa Guyo |
| author_facet | Samuel Kimani Caroline W. Kabiru Jacinta Muteshi Jaldesa Guyo |
| author_sort | Samuel Kimani |
| collection | DOAJ |
| description | Abstract Background Female genital mutilation/cutting (FGM/C) is a cultural practice associated with health consequences, women rights and deprivation of dignity. Despite FGM/C-related health consequences, circumcised women may encounter additional challenges while seeking interventions for reproductive health problems. Experiences of women/girls while accessing health services for reproductive health problems including FGM/C-related complications in poor, remote and hard to reach areas is poorly understood. We sought to explore barriers to care seeking among Somali women with complications related to FGM/C in public health facilities in Kenya. Methods We drew on qualitative data collected from purposively selected women aged 15–49 years living with FGM/C, their partners, community leaders, and health providers in Nairobi and Garissa Counties. Data were collected using in-depth interviews (n = 10), key informant interviews (n = 23) and 20 focus group discussions. Data were transcribed and analyzed thematically using NVivo version 12. Results Barriers were grouped into four thematic categories. Structural barriers to care-seeking, notably high cost of care, distance from health facilities, and lack of a referral system. Concerns regarding perceived quality of care also presented a barrier. Women questioned health professionals’ and health facilities’ capacity to offer culturally-sensitive FGM/C-specific care, plus ensuring confidentiality and privacy. Women faced socio-cultural barriers while seeking care particularly cultural taboos against discussing matters related to sexual health with male clinicians. Additionally, fear of legal sanctions given the anti-FGM/C law deterred women with FGM/C-related complications from seeking healthcare. Conclusion Structural, socio-cultural, quality of service, and legal factors limit health seeking for reproductive health problems including FGM/C-related complications. Strengthening health system should consider integration of FGM/C-related interventions with existing maternal child health services for cost effectiveness, efficiency and quality care. The interventions should address health-related financial, physical and communication barriers, while ensuring culturally-sensitive and confidential care. |
| first_indexed | 2024-12-20T09:04:38Z |
| format | Article |
| id | doaj.art-ae66b419e278444a8efb8f87fa0a95b7 |
| institution | Directory Open Access Journal |
| issn | 1472-698X |
| language | English |
| last_indexed | 2024-12-20T09:04:38Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC International Health and Human Rights |
| spelling | doaj.art-ae66b419e278444a8efb8f87fa0a95b72022-12-21T19:45:46ZengBMCBMC International Health and Human Rights1472-698X2020-01-0120111210.1186/s12914-020-0222-6Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative studySamuel Kimani0Caroline W. Kabiru1Jacinta Muteshi2Jaldesa Guyo3Africa Coordinating Centre for the Abandonment of FGM/C (ACCAF), University of NairobiPopulation Council-KenyaPopulation Council-KenyaAfrica Coordinating Centre for the Abandonment of FGM/C (ACCAF), University of NairobiAbstract Background Female genital mutilation/cutting (FGM/C) is a cultural practice associated with health consequences, women rights and deprivation of dignity. Despite FGM/C-related health consequences, circumcised women may encounter additional challenges while seeking interventions for reproductive health problems. Experiences of women/girls while accessing health services for reproductive health problems including FGM/C-related complications in poor, remote and hard to reach areas is poorly understood. We sought to explore barriers to care seeking among Somali women with complications related to FGM/C in public health facilities in Kenya. Methods We drew on qualitative data collected from purposively selected women aged 15–49 years living with FGM/C, their partners, community leaders, and health providers in Nairobi and Garissa Counties. Data were collected using in-depth interviews (n = 10), key informant interviews (n = 23) and 20 focus group discussions. Data were transcribed and analyzed thematically using NVivo version 12. Results Barriers were grouped into four thematic categories. Structural barriers to care-seeking, notably high cost of care, distance from health facilities, and lack of a referral system. Concerns regarding perceived quality of care also presented a barrier. Women questioned health professionals’ and health facilities’ capacity to offer culturally-sensitive FGM/C-specific care, plus ensuring confidentiality and privacy. Women faced socio-cultural barriers while seeking care particularly cultural taboos against discussing matters related to sexual health with male clinicians. Additionally, fear of legal sanctions given the anti-FGM/C law deterred women with FGM/C-related complications from seeking healthcare. Conclusion Structural, socio-cultural, quality of service, and legal factors limit health seeking for reproductive health problems including FGM/C-related complications. Strengthening health system should consider integration of FGM/C-related interventions with existing maternal child health services for cost effectiveness, efficiency and quality care. The interventions should address health-related financial, physical and communication barriers, while ensuring culturally-sensitive and confidential care.https://doi.org/10.1186/s12914-020-0222-6Female genital mutilation or cuttingFGM/CBarriersHealth care seekingSomaliKenya |
| spellingShingle | Samuel Kimani Caroline W. Kabiru Jacinta Muteshi Jaldesa Guyo Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study BMC International Health and Human Rights Female genital mutilation or cutting FGM/C Barriers Health care seeking Somali Kenya |
| title | Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study |
| title_full | Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study |
| title_fullStr | Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study |
| title_full_unstemmed | Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study |
| title_short | Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study |
| title_sort | exploring barriers to seeking health care among kenyan somali women with female genital mutilation a qualitative study |
| topic | Female genital mutilation or cutting FGM/C Barriers Health care seeking Somali Kenya |
| url | https://doi.org/10.1186/s12914-020-0222-6 |
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