The impact of health education on attitudes of parents and religious leaders towards female genital mutilation

Background Previous studies conducted in Iraqi Kurdistan have reported that parent's decisions to circumcise their daughters are based on religious or cultural beliefs. Despite the widespread practice of female genital mutilation (FGM), the effectiveness of educational strategies to change attitudes towards FGM has not been examined in this region. The present investigation examined the effectiveness of a short-term educational intervention to change the attitudes of parents and religious leaders towards FGM. Methods 192 Mullahs (religious leaders), 212 Mokhtars (traditional leaders) and 523 parents in rural areas in Iraqi Kurdistan were invited to participate in a pre-and post-test community-based interventional study in 2017. The Health Belief Model informed the intervention, and participants' attitudes were compared across two stages of the study. Results The attitudes of Mullahs, Mokhtars and parents substantially changed from a position of supporting female circumcision to expressing a wish to abandon the practice and not cut their future daughters (OR 1.57, 95% CI 1.02 to 2.42; OR 1.99, 95% CI 1.3 to 3.04 and OR 0.13, 95% CI 0.09 to 0.18, respectively). Conclusions The present study suggests that brief educational interventions can be an effective strategy for changing the attitudes of parents and public leaders towards FGM. Health education is a useful strategy for changing attitudes. However, such interventions must be delivered alongside other strategies to ensure a multifaceted approach to addressing complex social dynamics. A comprehensive public health approach is, therefore, necessary that includes legal measures, community-based action and an appropriate health system approach.