Topic: Violence and abuse

Physical and psychological health care for girls and women with Female Genital Mutilation/Cutting

The study addresses the organization and utilization of health care services at the primary and secondary level due to physical and psychological health consequences of female genital mutilation. It will address the model of health care, and examine the patterns of utilization of health care services to discover if these patterns are governed by conditions due to beliefs and resistance, or conditions due to the health care system itself, i.e. as a consequence of high thresholds, low degree of availability, low accessibility or lack of symmetry in dialogue and communication. The project has three interconnected parts: identifying physical and psychological needs by comparing scores of traumatic stress between children who are cut and those who are not. It will explore health seeking believes and behavior, as well as explore how the mental and physical health care services coordinate and collaborate to satisfy the needs of minority women and children subjected to FGM/C. The project will apply mixed methods, i.e. both qualitative and quantitative. It will use Hopkins checklist, Harvard Trauma Questionnaire and  SCL 5 trauma instruments to screen for PTSD and depression. Indicators that capture psychosocial and physical health factors will be applied. The qualitative data will be collected with in-depths interviews, focus groups discussions and participant observation. The data will be hermeneutically analyzed following a thematic approach and a process analytical model. The main part of the study will take place in Norway. Screening for PTSD scores will take place among school children in the Gambia. The project will collaborate with user groups, service providers and African and European Universities.

2017 This project has been completed 2021

Project Manager

Project Members

Main objective

  1. To explore how the Norwegian health care system is organized and to
    what extent it ensures optimal provision and utilization of the services for
    FGM/C practicing minority Groups.
  2. To explore health seeking behavior within FGM/C practicing minority groups.
  3. To identify the physical and mental health care needs due to FGM/C from
    the perspectives of health care providers and affected Groups.


The project will apply mixed methods, i.e. qualitative and quantitative in the different work
packages. The project constitutes three work packages that will employ among others, quantitative
validated instruments to screen for PTSD and depression and questionnaires with indicators that
capture psychosocial and physical health factors. Questionnaires and other quantitative instruments
will be designed to match the level of literacy of the target groups.
Qualitative methods that will be used include in-depth interviews, focus group discussions,
extended case methods and participant observation. The qualitative data will be
hermeneutically analysed following a thematic approach and a process analytical model.


Ziyada, M. M., Johansen, R. E. B., Berthelsen, M., Lien, I. L., & Bendiksen, B. (2023). Factors associated with general practitioners’ routines and comfortability with assessing female genital cutting: a cross-sectional survey. BMC Health Services Research, 23(1). doi:10.1186/s12913-023-09085-4

Ziyada, M. M. (2022). Access to female genital cutting specialized services in Norway. Oslo: Institute of Health and Society, Faculty of Medicine, University of Oslo. (Series of dissertations submitted to the Faculty of Medicine, University of Oslo 978-82-348-0075-7). (Dissertation).

Bendiksen, B., Heir, T., Minteh, F., Ziyada, M. M., Kuye, R. A., & Lien, I. L. (2021). The association between physical complications following female genital cutting and the mental health of 12-year-old Gambian girls: A community-based crosssectional study. PLOS ONE, 16, 1-15. doi:10.1371/journal.pone.0245723

Lien, I. L. (2021). Health workers and Sub Saharan African women’s understanding of equal access to healthcare in Norway. PLOS ONE, 16(9). doi:10.1371/journal.pone.0255934

Ziyada, M. M., & Johansen, R. E. B. (2021). Barriers and facilitators to the access to specialized female genital cutting healthcare services: Experiences of Somali and Sudanese women in Norway. PLOS ONE, 16(9). doi:10.1371/journal.pone.0257588

Lien, I. L. (2020). Is the Ritual of Female Genital Mutilation an Event that Will Generate traumatic stress reaction for cut children? Cases from the Gambia, Eritrea and Somalia. In S. Johnsdotter (Ed.) Female Genital Mutilation/Cutting – The Global North and South (pp. 131-159). . doi:10.24834/isbn.9789178771240

Lien, I. L., & Hertzberg, C. (2020). A system analysis of the mental health services in Norway and its availability to women with female genital mutilation. PLOS ONE, 15(11), 1-19. doi:10.1371/journal.pone.0241194

Ziyada, M. M., Lien, I. L., & Johansen, R. E. B. (2020). Sexual norms and the intention to use healthcare services related to female genital cutting: A qualitative study among Somali and Sudanese women in Norway. PLOS ONE. doi:10.1371/journal.pone.0233440