Evidence map›Paper›PMID 37316320›Full record

ArticleBMJ open2023

National and international programmatic perspective on facilitators and barriers for Sudan's health sector response on female genital mutilation (2016-2018): a qualitative study.

Wisal Ahmed, Amira Adam, Nancy Puttkammer, Stephen Gloyd, Carey Farquhar

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 87% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Wisal AhmedDepartment of Global Health, University of Washington, Seattle, Washington, USA wisal@uw.edu.ORCID 0000-0001-8155-8249
Amira AdamDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Nancy PuttkammerDepartment of Global Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-6693-9278
Stephen GloydDepartments of Global Health and Health Systems and Population Health, University of Washington, Seattle, Washington, USA.
Carey FarquharDepartments of Global Health, Epidemiology and Medicine, University of Washington, Seattle, Washington, USA.
University of Washington · US

Funding

Scientific/Technical CoreP2CHD042828 · NICHD · UNIVERSITY OF WASHINGTON · PI SARA R. CURRAN · 2017 to 2026
$6.3M
NICHD NIH HHS P2C HD042828
6 · The paper itself

Abstract

objectivesTo explore the facilitators and barriers that affected the design and implementation of the first 3 years of Sudan's largest health programme on female genital mutilation (FGM).

designWe used a qualitative case study guided by the Consolidated Framework for Implementation Research to conduct in-depth interviews with programme managers and for thematic data analysis.

settingAbout 14 million girls and women in Sudan are affected by FGM, which is mainly performed by midwives (77%). Since 2016, Sudan has received substantial donor funding to develop and implement the largest global health programme to stop midwives' involvement and improve the quality of FGM prevention and care services.

participantsEight Sudanese and two international programme managers representing governmental, international and national organisations and donor agencies participated in interviews. Their job positions required detailed involvement in planning, implementing and evaluating diverse health interventions in the areas of governance, building knowledge and skills of health workers, strengthening accountability, monitoring and evaluation and creating an enabling environment.

resultsRespondents identified funding availability and comprehensive plans, integration of FGM-related interventions within existing priority health intervention packages and presence of an evaluation and feedback culture within international organisations as implementation facilitators. The barriers were low health system functionality, low inter-organisational coordination culture, power asymmetries in decision-making during planning and implementation of nationally-funded and internationally-funded interventions, and non-supportive attitudes among health workers.

conclusionUnderstanding the factors affecting planning and implementation of Sudan's health programme addressing FGM may potentially mitigate barriers and improve results. Interventions which change midwives' supportive values and attitudes towards FGM, strengthen health system function and increase intersectoral and multisectoral coordination including equitable decision-making among relevant actors, may be needed to address the reported barriers. The impact of these interventions on the scale, effectiveness and sustainability of the health sector response merits further study.

Indexed as

Circumcision, FemaleBlack PeopleData AnalysisFemaleGovernmentHumansSudanHealth policyPRIMARY CAREPUBLIC HEALTHQUALITATIVE RESEARCH

Identifiers

PMID37316320
PMCPMC10367081
OpenAlexW4380628261

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.