From the first campaigns run mostly by churches and colonial powers early in the twentieth century, through increasing international engagement from pioneer African and European women, WHO and other international organizations, and international and local NGOs and CBOs, the approaches has changed and varied.
Learning from the initial campaigns that were more successful in spurring anti-colonial reactions than anti-FGM/C conviction, through focus on health risks and human rights, most current activists develop programs in which the communities themselves take the lead in identifying the problem and seeking solutions. This has shown promising results.