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Assessing Strategies for FGM/C Elimination in Sudan: A Proposed Model for Promoting Behaviour Change
Nada Alassad
This chapter focuses on understanding the key drivers that influence behaviour change around FGM/C in Sudan. It explores how behaviour can be transformed through strategic efforts, drawing upon a research study conducted in Sudan in 2019.
1 This research, conducted as part of a PhD at the European University Cyprus, is titled ‘Modeling the Impact of Social Marketing Programs in Combating FGM in Sudan: A Structural Equation Modeling Approach’. Ethical guidelines and university regulations were strictly followed. The study took place in Khartoum, with support from Sudan’s National Council for Child Welfare and other relevant authorities. The research leverages established models and theories of behaviour change, which have been widely discussed in the literature. The findings and insights from this study contribute to the broader global efforts aimed at eliminating FGM/C, offering a valuable perspective in the ongoing fight to end it. Through this work, the goal is to advance collective initiatives dedicated to ending this deeply entrenched practice and its devastating consequences.
Despite decades of intervention, awareness campaigns, education, and community engagement efforts, the prevalence of FGM/C remains alarmingly high. In Sudan, the practice continues to affect 86.6 per cent of women aged fifteen to forty-nine, and 31.5 per cent of girls under fourteen have also undergone it (UNICEF 2022).
2 UNICEF Sudan (2022). Female Genital Mutilation in Sudan. Factsheet. https://www.unicef.org/sudan/reports/female-genital-mutilation-sudan [Accessed 18 July 2025]. However, variations exist in prevalence, type, and associated customs across the different regional and ethnic groups in eighteen states. In practising communities, women often cite reasons such as cleanliness, social acceptance, improved marriage prospects, and chastity as justifications for continuing the practice (Elduma 2018).
In Sudan, the most prevalent types of FGM/C are infibulation (also known as pharaonic circumcision or WHO Type 3) and excision (also known as clitoridectomy or WHO Type 1. See the textbox on p. 24 for details of WHO classifications). These practices are particularly common in the northern and eastern regions of Sudan (ibid.). In addition, sometimes the vaginal opening is deliberately enlarged using a sharp instrument. Although this form is less commonly practised, it still poses significant health risks. There are also cases where uncircumcised women are pressured into having the procedure prior to marriage. Infibulated Sudanese women usually undergo reinfibulation after giving birth (ibid.). Regardless of the type, all forms of FGM/C are associated with severe consequences for women’s health, sexuality, and social, emotional and psychological well-being.
Extensive efforts have been made in Sudan to raise awareness about FGM/C through orientation sessions, involvement of religious leaders, and empowerment of women to resist this practice. The health risks associated with FGM/C are widely publicised. Though the practice persists, it is important to note that positive changes are emerging, which will be discussed in the following pages.
The staggering statistic of 86.6 per cent prevalence raises an important question: are the strategies currently in place truly effective, or do they only scratch the surface? It also raises questions about the suitability of long-standing methods and the cultural resonance of the messages being delivered. There are gaps in delivery and engagement that need addressing. While we understand that behaviour change is a slow process, the weak results despite substantial investments of time, effort, and resources force us to confront an uncomfortable truth: we must reconsider our approach. There is a pressing need to consider whether different, more innovative approaches are necessary to match the scale of the challenge. The fight against FGM/C requires strategies that extend beyond traditional communication and engagement methods. A willingness to reimagine interventions and critically evaluate the efficacy of existing tools is essential.