An assessment of the alternative rites approach for encouraging abandonment of female genital mutilation in Kenya

The alternative rite is a public ritual of passage, accompanied by family life education (FLE), that simulates the traditional FGM ritual without actually circumcising the girls. This study, conducted among four ethnic groups in three program districts, addresses the factors that influence the adoption of the alternative rite and evaluates the effect of its training component on the girls who participated. FGM practices vary among the four sites. Type 1 of FGM (clitoridectomy) and Type 2 (excision) are practiced in all four sites. There are indications in all sites of changes in the way FGM is practiced, particularly a move towards reducing the harm caused through medicalization, particularly in the predominantly Abagusii and Maasai ethnic group sites, and the use of individual instruments. Those families who choose to have their daughters participate in the alternative rite are slightly more likely to have ever attended school, more likely not to be members of the Catholic or Pentecostal churches, slightly less likely to be laborers or farm workers, more likely to be of higher socioeconomic status, slightly more likely to have females with more positive gender attitudes, and more likely to already not be cutting their daughters and to express regret for those already cut. The FLE training given to the participating girls has an effect on their awareness and knowledge about reproductive health issues, but also appears to engender somewhat less positive attitudes towards the practice of family planning among unmarried partners and adolescents, including condom use. The MYWO sensitization activities that preceded and accompanied the alternative rite have played a role in the behavior change process among those who have adopted it, though not in isolation from other influences operating in the communities, notably the stance taken by certain churches and individuals" beliefs that the practice should be discontinued. The contribution that an alternative rite intervention can make to abandoning FGM depends on the sociocultural context in which it is practiced. Successful replication of the approach will require a good understanding of the role of public (as opposed to familial) ceremonies in the culture, and a judgement as to what format for the ritual is most appropriate for helping those that have decided to abandon the practice to actually do so. (Author abstract, modified)