While the number and diversity of African immigrants in the United States (US) has increased, their needs and practices remain poorly understood and there is a growing need to assess their health care needs and practices in order to provide this population with effective services. In the US, the influx of immigrants from African countries with high Female Genital Cutting (FGC) prevalence rates has exposed medical and mental health professionals unfamiliar with this procedure to multiple dilemmas in service provision, including legal and ethical considerations around child protection and how to respond appropriately to physical, sexual and emotional problems caused by FGC. The purpose of this study is to understand the impact of FGC on Female African immigrants in the New York City metropolitan area from the perspective of both the women who have endured the procedure and their health care providers. The long term goals of this study are to develop the foundation for interventions: a) to reduce the occurrence of FGC through sensitive education within African immigrant communities; b) to work with women who have had the procedure on how to work with their health care providers and thereby take the best care of themselves; and c) to train professionals to provide culturally-sensitive clinical services for those who have already undergone the procedure or are at risk for it. Findings from such a study could be an initial step towards developing training and practice policies for service providers. The research team for this project reflects a strong background and extensive experience in conducting research with immigrant populations, and in particular with West African immigrants, and in reproductive health, trauma, and support networks. Throughout this project, the PI will consult with her mentors: Drs. Denise Hien (research with women and trauma) and Beatrice Krauss (research with reproductive health, HIV and support networks) and her collaborators, Drs. Adriana Espinosa and Tracy Chu will contribute their data analysis and research expertise. In addition, there will be two graduate- level female Research Assistants (RAs) in health or behavioral sciences with at least one year of interview and research experience to assist the PI in recruiting, interviewing and analysis. The RAs will receive extensive training from the PI on FGC, interviewing on extremely sensitive topics, using and introducing the respondents to Audio Computer Self Interview Technology (ACASI) and verifying its correct use. They will also receive additional training in grounded theory approach in order to identify emergent themes in the focus groups. Finally, two undergraduate students from the City College of New York (CCNY), which is part of the City University of New York (CUNY) will be given the opportunity to gain research experience by assisting with administrative aspects of the project.
Given the lack of information about West African immigrant women and girls regarding FGC and the fact that West African immigrant girls and women utilize US health care systems and resources, along with the conflicting data about the impact of FGC, this project aims to understand the physical and psychological consequences of FGC on female West African immigrants from the viewpoints of both West African immigrant women and their health care providers. Thorough understanding of these factors is fundamental to promoting appropriate care, particularly for those who have had FGC and report negative sequelae. Findings from this pilot study can also be used to understand the experiences, attitudes and practices in the West African immigrant community regarding FGC and to inform interventions aimed at improving service provision for women who report negative sequelae.
