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Can we produce reliable estimates of the prevalence of FGM in England and Wales?

Professor Alison Macfarlane spoke about her longstanding work on the prevalence of FGM at a seminar held at City University London on Monday


Over the past few years Alison Macfarlane, Professor of Perinatal Health at City University London, has been working on estimates of Female Genital Mutilation (FGM) prevalence in England and Wales, partnering with the late Efua Dorkenoo of charities Forward and Equality Now which have been campaigning to raise awareness of the practice and its necessary eradication.

The talk, entitled ‘Can we produce reliable estimates of the prevalence of Female Genital Mutilation in England and Wales?’, highlighted Professor Macfarlane’s recent studies as well as the limitations associated with statistics in the area.

FGM is a longstanding concern of the Midwifery Department, and work in London dates back to work in the 1990s with by campaigns by women from Somali communities in Tower Hamlets who had been subjected to the practice and its associated health issues.

Defined by the World Health Organisation as comprising all procedures that involve partial or total removal of the female external genitalia and/or injury to the female genital organs for cultural or non-any other non-therapeutic reasons, FGM has been firmly in the media spotlight following the high profile Girls Summit which took place last year. Female Genital Mutilation is practised in a range of predominantly African and Middle Eastern countries and women from these countries have increasingly migrated to the UK in recent decades.

This raised profile has a huge amount to do with the work of the influential Efua Dorkenoo, an Honorary Visiting Senior Fellow in the School of Health Sciences, who sadly passed away last year. Having moved to the UK from Ghana to train as a nurse, it was in the UK that Efua first came across the practice and subsequently led campaigns for its eradication. Over the past ten years, she has worked with Professor Macfarlane on two successive studies to estimates the prevalence of the practice among women resident in England and Wales.

At the seminar, Professor Macfarlane then spoke about the most recent of these sets of estimates. Over the past couple of years she has been using a range of data, including census and birth registration data from the Office of National Statistics in combination with surveys by UNICEF and others in countries of origin, to indirectly estimate the prevalence of FGM in England and Wales as a whole and in each of its 395 local authorities and regions.

Speaking about the estimates that were published earlier this year, Professor Alison Macfarlane said: “To estimate the prevalence of FGM in areas of England and Wales, I used information from surveys in 29 countries where FGM is more commonly practised and for which national data are available were combined with information from the 2011 census about women living in each local authority area in England and Wales who had been born in those countries.”

The most recent study found that the highest estimated prevalence rates in the population were in London boroughs, with the highest prevalence being 4.7% of women in Southwark and 3.9% in Brent, compared to 0.5% in England and Wales as a whole. For the most part, people born in countries where FGM is practised tend to be concentrated in urban areas, but there are likely to be affected women and girls living in every local authority area.

“The fact is that the prevalence of FGM is zero nowhere,” said Professor Macfarlane. “As a result it is vital that we have such statistics as it enables local authorities to plan services for affected women and also to inform child protection for their daughters. We need to use such data as signposts to give people an idea of what is going on in their local area and enable them to plan accordingly.”

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