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BMC Health Serv Res. 2018 Jul 24;18(1):579. doi: 10.1186/s12913-018-3396-z.

Knowledge, attitudes and practices of primary healthcare professionals to female genital mutilation in Valencia, Spain: are we ready for this challenge?

Author information

Faculty of Nursing and Chiropody, University of Valencia, Calle Jaume Roig, s/n, 46010, Valencia, Spain.
University of Valencia, Valencia, Spain.
Faculty of Nursing and Chiropody, University of Valencia, Calle Jaume Roig, s/n, 46010, Valencia, Spain.
University of Valencia, Valencia, Spain.
Obstetrics and Gynaecology Service, Hospital Clínico Universitario of Valencia, Av. de Blasco Ibáñez, 17,46010, Valencia, Spain.
Faculty of Medicine and Dentistry, Department of Obstetrics, Gyneacology and Peadiatrics, University of Valencia, Av. de Blasco Ibáñez, 15,46010, Valencia, Spain.



The practice of Female Genital Mutilation (FGM) is a deeply-rooted tradition in 30 Sub-Saharan and Middle-East countries which affects approximately 200 million women and girls worldwide. The practice leads to devastating consequences on the health and quality of life of women and girls in both the short and long term. Globalizing processes and migration flows have recorded cases of this practice worldwide representing for healthcare professionals an emerging challenge on how to approach their healthcare in a transcultural, ethical and respectful way. No survey to assess knowledge, attitudes and practices on FGM among primary healthcare professionals has been conducted in the Valencian region of Spain to date.


The main purpose of this study is to assess the perceptions, knowledge, practices and attitudes of the primary healthcare professionals in relation to FGM in the Clínic-Malvarrosa healthcare area of Valencia. A cross-sectional descriptive study was conducted based on a self-administered questionnaire to general practitioners, paediatricians, nurses, midwives, gynaecologists, social workers and others.


A total of 321 professionals answered the questionnaire. Less than 5% of professionals answered that they had ever found a case of FGM during their professional practice and 21.8% answered that they had ever worked with population at risk of FGM. Almost 15% of professionals answered that they had received training on FGM but of those who had received training, only 22.7% correctly identified the typology of FGM and less than 5% correctly identified the geographical area. Only 6.9% of the respondents admitted to know some protocol of action, being midwives, paediatricians and social workers the most aware professionals of such protocols.


This study demonstrates that FGM is a problem present in the population attending primary healthcare services in Valencia. However, the professionals showed a profound lack of knowledge around concept, typology, countries of prevalence of FGM and existent protocols of action. It is healthcare professional duty to recognize this situation and to follow the right protocols of action, refer these women and their families to the most appropriate services and professionals that fit their needs, ensuring a multidisciplinary, positive and transcultural care for these families.


Female genital mutilation; KAP study; Primary health care; Professional practice; Women’s health

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