This chapter should be cited as follows:
Kihara AB, Koigi PK, et al, Glob. libr. women's med.,
ISSN: 1756-2228; DOI 10.3843/GLOWM.417833

The Continuous Textbook of Women’s Medicine Series – Gynecology Module

Volume 1

Female genital mutilation

Volume Editor: Professor Anne-Beatrice Kihara, University of Nairobi, Kenya,
President-elect. The International Federation of Gynecology and Obestetrics FIGO
President, African Federation of Obstetricians and Gynecologists (AFOG)

Chapter

Communication Advocacy Strategy Toolkit to End Female Genital Mutilation/Cutting (FGM/C)

First published: July 2022

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INTRODUCTION

Female genital mutilation/cutting (FGM/C) remains a global problem.¹ As such, there remains a strong need to address the problem on multiple levels. This communication advocacy toolkit is a hybrid of multiple existing models that has been customized to the African context, where the scourge of FGM/C remains highly prevalent.²

MATERIALS USED TO CREATE THIS TOOLKIT

The materials used to create this toolkit include the following:

• The MassTAPP Communications Toolkit.³
• Create a Communication Toolkit.⁴
• Version 3.0 of the Interact Communication Toolkit.⁵
• The UNFPA Midwives Toolkit for the abandonment of FGM.⁶
• The UNICEF Advocacy Toolkit on ending child marriage.⁷
• The 2020 review of web-based toolkits for healthcare practitioners working with women and girls affected/at risk of FGM/C.⁸
• The End FGM Advocacy Toolkit by the European Network.⁹
• Reporting on Female Genital Mutilation: A toolkit for journalists and editors – guidelines for gender-sensitive reporting.¹⁰

WHAT IS ADVOCACY IN RELATION TO FGM?

In this toolkit, we adopted the End FGM-European Network definition of Advocacy: “A deliberate, strategic and non-discriminatory human rights-based process, formed around evidence and the experiences of rights-holders, aimed at influencing decision-makers and other relevant stakeholders in order to hold duty-bearers to account, achieve change in policy and practice, and thus contribute to the ending of the practice of female genital mutilation”.¹¹

SECTIONS OF THIS TOOLKIT

We adapt and modify the MassTAPP model, which focuses on the following steps: contextualized analysis; identifying the target audience; developing the message; crafting the communications strategy; and monitoring and evaluating the communication campaign.³ These steps are outlined as follows:

STEP I: CONTEXTUAL ANALYSIS

It is vital to begin by identifying a strategy for prevention/elimination of FGM that can benefit from organizing a communication campaign. At bare minimum, this should include the following: an understanding of the challenges prevalent in the community; determination of the available fiscal, human, and technological and chronological resources to address the problem; and appreciation of how the intended communication advocacy strategy may optimize the overall objective of prevention and elimination of FGM/C. It is vital to remember that not all prevention strategies may directly lend themselves to the use of communications tactics, and that there shall be a need to ensure that there is significant buy-in if the strategy is to bear fruit.³ Analysis of the legal and policy framework and gathering of the available evidence are vital to ensuring that the strategy is appropriately adapted to the prevailing circumstances in the community of interest.⁹

STEP II: IDENITFYING THE TARGET AUDIENCE

It is vital to identify and define the primary target audience (the stakeholders who can directly empower the attainment of the objectives) in relation to their expertise, scope of influence, attitude, accountability profile, and mode of access.⁹ They are the group that contribute to the problem or solution through their action or inaction.³ The secondary target audience, despite not having direct influence over FGM, will typically be the messenger that optimizes contact with the primary audience.^3,9 In order to optimize the effectiveness of the intervention and to minimize the effort required to reach the intended target audience, it is important to perform a stakeholder analysis¹² and prioritize them accordingly using Mendelow’s power-dynamism matrix.¹³

STEP III: DEVELOPING THE MESSAGE

This utilizes the knowledge gleaned from the first two steps to empower the development of a culturally appropriate message that can reach the stakeholders and motivate them to respond according to the desired objectives. It requires the development of a message triangle, which comprises the following: the problem statement (include supporting evidence and an example); the problem strategy (outlines the goal); and the call to action.^3,9 The main benefit of using a message triangle is its ability to enhance the objectivity of the communication, thereby optimizing emphasis on the saliency of the key points.^14,15 It is important to strive for cultural and linguistic sensitivity – pass across your message in a manner that will not evoke untoward reactions or hostility from your target audience.

An example of this is illustrated in the following scenario:

• If an organization is addressing a certain rural community that practices adolescent FGM as an initiation into womanhood, and has managed to get all of the members of that community together in a social hall or in the market place for a community talk on FGM/C, the message that may be passed may sound something like the following:
  • The problem statement: in community XXXX, we see that women are an important part of the community. This is because there has been a high value in ensuring that women can be identified as being different from girls. Indeed, the women are even seen sitting separately from the girls, and they seem to have a different status. It is also true that they normally undergo "the cut" in order to change from a girl into a woman. Almost every woman here has undergone this cut. However, we found that there are many young ladies that got very sick or died immediately after having this cut done, and many ladies here have died or gotten very sick after having children. Some are even having difficulty having children. Almost all of the ladies we asked about this say that they feel a lot of pain when they come together with their husbands or when they have to pass urine. Indeed, they are suffering a lot because of having undergone this cut, and their ability to live and enjoy their lives is significantly reduced. This, in turn, makes their husbands, children, parents, friends, and work suffer when they are sick or if they die.
  • The problem strategy: since the girls and women are so important in the lives of this community, is it possible to find a way to prevent their suffering? Yes, there is… If we could come up with another way of having a girl graduate into a woman, like being counselled by the older women on how to behave as a woman, changing their dressing as a symbol of the change, and handling them like women, all without putting them through the cut, then they would be able to grow into women who can serve this community better because they will be happier and healthier, will live longer, and will no longer be suffering.
  • Call to action: let us come together and be champions in protecting our girls and women from suffering that can be avoided.
    This strategy has avoided vilifying the victims, practitioners, and relatives, all of whom were part of the equation that resulted in the ongoing suffering, but because of eliciting cultural sensitivity and tailoring the message to the population of interest, then it may have become possible to enlist their support to alleviate suffering from a deeply ingrained cultural practice, thereby stopping the problem at its grassroots.
• If the same organization was addressing local politicians, they would probably focus on the fact that the loss of life and suffering from illness may adversely affect their ability to get elected.
• If the same organization was addressing human rights activists and the government, the focus would be on the criminality of FGM/C, the legally binding international treaties in effect, the need for national laws proscribing the practice, the high cost of managing the complications of FGM/C, and the economic impact of the loss of productivity due to the loss of length and quality of life.
  There is therefore an absolute need to tailor the message to the target audience, particularly in the context of using negative messaging.¹⁶

STEP IV: CRAFTING THE COMMUNICATION STRATEGY

In order to effectively reach the target audience, the choice of an appropriate communication channel is vital. Various communication channels are available:^3,9

• Interpersonal communications like lobbying using elevator pitches, negotiating with stakeholders that have different priorities, and taking advisory roles as professional societies/experts.
• Local educational outreaches: these include meetings with target groups in social halls, public speaking forums, and meetings hosted by those with significant influence in the locality.
• Campaigns in the mass media: these include interviews, public service announcements, branded advertisements. These are vital to gain and mobilize public support in order to apply democratic tools like peaceful protests, rallies, public actions, and petitions.
• Use of social media: this is also a platform of campaigning, and reaches audiences that primarily use the internet. It is also an avenue of enforcing mass action.
• Use of non-traditional communications like mobile billboards, street art, transit communications like posters in vehicles, and guerrilla marketing strategies (human placards or posters in public bathrooms).
• Partnerships: the formation of strategic partnerships with other organizations that share similar goals expands the scope and sphere of influence by providing strength in numbers and reducing duplicity of effort

“It’s not what you say, but how you say it!”
Mae West

STEP V: MONITORING AND EVALUATION

It is important to ensure that you can measure the effectiveness of the advocacy strategy. Some of the parameters that can be used include the following: number of requests for materials or information; attendees at various events; tracking web visits (new and repeated); number of people reached on social media and their reactions; number of positive news stories promoting the message in mainstream media; number of new members/partners gained; and stakeholders expressing support for the prevention/elimination of FGM/C.³ The key areas in evaluating the message passed are the relevance, retention and reach of the message (ibid).

The tools for these steps are provided in Appendix A.

CONCLUSION

Developing and executing a concise communication advocacy strategy is vital to ensuring that it is possible to address the practice of FGM/C with the aim of preventing and eliminating it.

PRACTICE RECOMMENDATIONS

APPENDIX A: COMMUNICATION ADVOCACY TOOLS

TOOL I: LOGIC MODEL FOR USE IN ADDRESSING FEMALE GENITAL MUTILATION^3,7,9

TOOL II: TARGET AUDIENCE ANALYSIS TOOL^3,6,9

TOOL III: MESSAGE DEVELOPMENT TOOL^3,10

• What is your core message? __________________________________________________________________________________________________
  ________________________________________________________________________________________________________________________________
  ________________________________________________________________________________________________________________________________
  ________________________________________________________________________________________________________________________________
  ________________________________________________________________________________________________________________________________
• Core components of the message triangle:
  • Problem:
    • What problem are you addressing? ___________________________________________________________________________________
    • Why is it significant to your target audience? _________________________________________________________________________
      ________________________________________________________________________________________________________________________
  • Strategy:
    • How are you and your team addressing the problem? _______________________________________________________________ ________________________________________________________________________________________________________________________
  • Call to action:
    • What steps can your target audience take? __________________________________________________________________________
    • How does your target audience’s intended action get you closer to achieving your desired outcome? ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________
  • Combine the above responses in² into one concise statement: _________________________________________________________ ___________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________
  • Checklist to ensure that the message will reach your target audience: (Indicate “Yes” or “No”)
    • Is your message:
      • Clear? ________
      • Compelling? ________
      • Free of jargon? ________
    • Does your message:
      • State a position? ________
      • Propose a solution? ________
      • Provide a call to action? ________

TOOL IV: CREATING AND IMPLEMENTING A COMMUNICATION STRATEGY^3,10

TOOL V: MONITORING AND EVALUATION³

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