Determinants of prevention and impact on health for women with female genital mutilation – A qualitative study with experts

• Interventions with the focus of preventive strategies play a decisive role in reducing the health consequences of women and girls who are affected by female genital mutilation/circumcision (FGM/C). • Key factors of sustainable prevention work against FGM/C are intercultural sensitivity and early awareness which should be taught in training. • Moreover, experts who working in the field of prevention of FGM/C should have a good connectivity within the community. Due to increasing global migration female genital mutilation/cutting (FGM/C) also affects women and girls who live outside countries with high prevalence of FGM/C. Therefore, prevention strategies are essential FGM/C affects populations living immigration countries, including Germany. The aim of this study was to explore the perspective of experts on enablers and barriers of FGM/C prevention and to examine the impact of preventative measures on the health of women with FGM/C. This qualitative study consisted of a purposive sample of experts involved in prevention of FGM/C. A semi-structured interview guideline was used for the interviews which were conducted between June and July 2024. The data were evaluated using qualitative content analysis by using a deductive-inductive approach. In total, 12 experts were interviewed. The sample comprised gynaecologists, consultants (social and welfare workers) and one plastic surgeon. Educational work, mental health support, and connectivity were considered important enablers of prevention. Barriers were identified on intra- and interpersonal levels as well as on the structural level, such as trauma-related barriers, language barriers, lack of cultural sensitivity and problems caused by asylum regulations. The results demonstrate important insights into the experiences of experts working in the field of prevention of FGM/C in Germany. A migrant-sensitive health care should be an important goal for each host country to ensure health equity. Based on the experts’ views, it is crucial to train professionals working in the field of FGM/C with special consideration of culturally sensitive approaches.