The impact of community led alternative rite of passage on eradication of female genital mutilation/cutting in Kajiado County, Kenya: A quasi-experimental study

INTRODUCTION: In Kenya, Female Genital Mutilation/Cutting (FGM/C) is highly prevalent in specific communities such as the Maasai and Somali. With the intention of curtailing FMG/C prevalence in Maasai community, Amref Health Africa, designed and implemented a novel intervention—community-led alternative rite of passage (CLARP) in Kajiado County in Kenya since 2009. The study: a) determined the impact of the CLARP model on FGM/C, child early and forced marriages (CEFM), teenage pregnancies (TP) and years of schooling among girls and b) explored the attitude, perception and practices of community stakeholders towards FGM/C. METHODS: We utilised a mixed methods approach. A difference-in-difference approach was used to quantify the average impact of the model with Kajiado as the intervention County and Mandera, Marsabit and Wajir as control counties. The approach relied on secondary data analysis of the Kenya Demographic and Health Survey (KDHS) 2003, 2008–2009 and 2014. A qualitative approach involving focus group discussions, in-depth interviews and key informant interviews were conducted with various respondents and community stakeholders to document experiences, attitude and practices towards FGM/C. RESULTS: The CLARP has contributed to: 1) decline in FGM/C prevalence, CEFM rates and TP rates among girls by 24.2% (p<0.10), 4.9% (p<0.01) and 6.3% (p<0.01) respectively. 2) increase in girls schooling years by 2.5 years (p<0.05). Perceived CLARP benefits to girls included: reduction in teenage marriages and childbirth; increased school retention and completion; teenage pregnancies reduction and decline in FGM/C prevalence. Community stakeholders in Kajiado believe that CLARP has been embraced in the community because of its impacts in the lives of its beneficiaries and their families. CONCLUSION: This study demonstrated that CLARP has been positively received by the Maasai community and has played a significant role in attenuating FGM/C, CEFM and TP in Kajiado, while contributing to increasing girls’ schooling years. CLARP is replicable as it is currently being implemented in Tanzania. We recommend scaling it up for adoption by stakeholders implementing in other counties that practice FGM/C as a rite of passage in Kenya and across other sub Saharan Africa countries.