African Journal of Public Health and Health Systems | 19 August 2026

A Case Study in Somalia: Evaluating the Health and Economic Outcomes of FGM/C Abandonment Programmes,

M, o, h, a, m, e, d, I, b, r, a, h, i, m, W, a, r, s, a, m, e, ,, F, a, d, u, m, o, A, h, m, e, d, N, u, r, ,, A, m, i, n, a, M, o, h, a, m, e, d, A, b, d, i, ,, A, h, m, e, d, H, a, s, s, a, n, A, l, i

Abstract

<strong>Background:</strong> Female genital mutilation/cutting (FGM/C) is highly prevalent in Somalia and is associated with severe health risks. There remains limited longitudinal evidence on the combined health and economic outcomes of abandonment programmes within this context. <strong>Purpose and objectives:</strong> This case study evaluated the intermediate health and economic consequences of multi-sectoral FGM/C abandonment programmes implemented in two regions of Somalia between 2021 and 2026. <strong>Methodology:</strong> A mixed-methods case study design was employed. Quantitative data were extracted from routine health facility records and cross-sectional household surveys conducted in 2022 and 2025. Qualitative data were gathered in 2024 through 24 focus group discussions and 18 key informant interviews with programme participants, community leaders, and health workers. <strong>Findings/Key insights:</strong> A 40% reduction in reported immediate obstetric complications, such as postpartum haemorrhage and perineal tearing, was observed among women in intervention communities compared to baseline. Households that abandoned the practice reported reallocating funds from traditional ceremonies towards small businesses or children’s education. A consistent theme was the critical role of religious leaders in reframing abandonment as a health and religious duty. <strong>Conclusion:</strong> Integrated abandonment programmes demonstrated positive intermediate outcomes in health and household economics over a five-year period. Sustained community engagement, particularly with religious authorities, was a key success factor. <strong>Recommendations:</strong> Programmes combining health messaging with economic empowerment components should be scaled up. Health systems require strengthening to monitor long-term gynaecological and obstetric outcomes. The engagement of religious scholars should be institutionalised within national abandonment strategies. <strong>Key words:</strong> female genital mutilation; health systems; economic impact; Somalia; case study; abandonment programmes. <strong>Contribution statement:</strong> This study provides context-specific evidence on the intermediate synergies between health and economic outcomes of FGM/C abandonment programmes in Somalia, informing future policy and practice.