• Owolabi Bjälkander, Bailah Leigh, Grace Harman, Staffan Bergström, and Lars Almroth.
• Division of Global Health, Department of Public Health, Karolinska Institute, Stockholm, Sweden. owolabi.bjalkander@ki.se
• Afr J Reprod Health. 2012 Dec 1; 16 (4): 119-31.

AbstractThe objectives of this study were to identify decision makers for FGM and determine whether medicalization takes place in Sierra Leone. Structured interviews were conducted with 310 randomly selected girls between 10 and 20 years in Bombali and Port Loko Districts in Northern Sierra Leone. The average age of the girls in this sample was 14 years, 61% had undergone FGM at an average age of 7.7 years (range 1-18). Generally, decisions to perform FGM were made by women, but father was mentioned as the one who decided by 28% of the respondents. The traditional excisors (Soweis) performed 80% of all operations, health professionals 13%, and traditional birth attendants 6%. Men may play a more important role in the decision making process in relation to FGM than previously known. Authorities and health professionals' associations need to consider how to prevent further medicalization of the practice.

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