Decision-Making Process in Female Genital Mutilation: A Systematic Review

Female genital mutilation/cutting “FGM/C” is a deep-rooted damaging practice. Despite the growing efforts to end this practice, the current trends of its decline are not enough to overcome the population’s underlying growth. The aim of this research is to investigate the FGM/C household decision-making process and identify the main household decision-makers. A review of peer-reviewed articles was conducted by searching PubMed, JSTOR, Ovid MEDLINE, Ovid EMBASE, EBSCO, and CINAHL Plus via systematic search using keywords. The found publications were screen using inclusion and exclusion criteria in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After critical appraisal, seventeen articles were included in this review. The data extracted from the articles regarding FGM/C household-decision making process and decision-makers were analyzed using narrative analysis. FGM/C decision-making process varies from a region to another; however, it generally involves more than one individual, and each one has different power over the decision. Fathers, mothers, and grandmothers are the main decision-makers. It was shown from this review that opening the dialogue regarding FGM/C between sexes may lead to a productive decision-making process. The participation of fathers in the decision-making may free the mothers from the social-pressure and responsibility of carrying on traditions and create a more favorable environment to stop FGM/C practice.