Female genital mutilation (FGM) is becoming less common worldwide, but when it does occur, it is increasingly performed by professional healthcare workers, the UN World Health Organization (WHO) warned on Monday.
While the health sector worldwide plays a key role in stopping the abusive practice of FGM and supporting survivors, in several regions, evidence suggests otherwise.
As of 2020, an estimated 52 million girls and women were subjected to FGM at the hands of health workers - that's around one in four cases.
"Health workers must be agents for change rather than perpetrators of this harmful practice," said Dr Pascale Allotey, WHO 's Director for Sexual and Reproductive Health and Research.
She insisted that cutting is a "severe violation of girls' rights" which critically endangers their health.
Evidence has shown that FGM causes harm, regardless of who performs it - but it can be more dangerous when performed by health workers, as a "medicalised" procedure can result in more severe wounds, WHO warned in a statement on Monday.
As part of ongoing efforts to halt the practice altogether, the UN agency issued new guidelines urging greater action from doctors, governments, and local communities.
FGM in retreat
Cutting - which encompasses any procedure that removes or injures parts of the female genitalia for non-medical reasons - also requires high-quality medical care for those suffering its effects, WHO says.
Since 1990, the likelihood of a girl undergoing genital mutilation has dropped threefold, but 30 countries still practise it, putting four million girls each year at risk.
FGM can lead to short and long-term health issues, from mental health conditions to obstetric risks and sometimes the need for surgical repairs.
The newly published guidelines from WHO also suggest ways to improve care for survivors at different stages in their lives.
'Opinion leaders'
Putting an end to the practice is within the realm of the possible - and some countries are heading in that direction, the UN health agency said.
"Research shows that health workers can be influential opinion leaders in changing attitudes on FGM, and play a crucial role in its prevention," said Christina Pallitto, a senior author of the study at Scientist at WHO and the Human Reproduction Programme (HRP).
"Engaging doctors, nurses and midwives should be a key element in FGM prevention and response, as countries seek to end the practice and protect the health of women and girls," she said.
Unrelenting efforts to stop FGM have led countries including Burkina Faso to reduce rates among 15 to 19-year-olds by 50 per cent in the past three decades.
Likewise, prevalence fell by 35 per cent in Sierra Leone and 30 per cent in Ethiopia - thanks to action and political will to enforce bans and accelerate prevention.
WHO in 2022 published a prevention training package for primary care health workers, to highlight the risks of the practice and equip them to engage sensitively with communities, while factoring in local culture and perspectives.
"Because of this training, I am now able to raise women's awareness [of FGM] and persuade them about the... disadvantages," said one health worker during the launch.
