The role of communities and leadership in ending female genital mutilation in Tanzania: an exploratory cross-sectional qualitative study in Tanga.

Background: Female genital mutilation (FGM) is one of the diehard cultures in the Mediterranean and sub-Saharan Africa. The act involves chopping off part of the female genitals in varying degrees depending on the society. The motive behind this practice includes reducing female sexual desire, a sign of maturation, and retaining the culture. The current study explored the roles of community members and leaders in the fight against FGM; and the reasons for continuing the practice in some societies.

Method: We did an exploratory cross-sectional qualitative study between June - July 2020 in six purposively selected villages from Kilindi and Handeni districts in Tanga that were part of the five years implementation project. The project was named Alternative Right of Passage (APR) by Amref Health Africa Tanzania to eradicate FGM. The interventions were to sensitize the community on the effects of FGM on women's health, educate and create demand for girl children to attend and complete school. Ethnic leaders and village members aged 19 years and above were purposively selected. Due to the sensitive nature of the study, FGDs were conducted separately between men and women. In addition, we did the inductive thematic analysis.

Results: Four main themes emerged from the analysis; (1) the history of FGM and reasons behind persistent FGM practices, (2) Challenges to abandonment of FGM, (3) strategies to be used to eradicate FGM, and (4) Key change agents in ending FGM. It was reported that the FGM practice was inherited from elders years ago and is believed to reduce women's sexual desire when the husband travels away for a long time. Some societies still practice FGM secretly because marrying an uncircumcised girl is a curse, as the husband and children will die. Some older women still practice FGM as they still hold the ancient culture. Constant communication with community leaders, seniors, and the young generation on complications of FGM will fasten efforts toward eradicating FGM practice.

Conclusion: There are sporadic cases done secretly associated with FGM practice since the ant-FGM campaign, so this should be the reason to continue with the campaign. Winning the tribal/ethnic leaders can facilitate better achievement in the fight against FGM. In addition, social diffusion with inter-tribe marriages was also singled out as one of the factors that will make FGM practice unfamiliar to the communities in the future.