Guideline No. 395-Female Genital Cutting.

OBJECTIVES: To decrease the likelihood that the practice of female genital cutting (FGC) be continued in the future and to improve the care of girls and women who have been subjected to FGC or who are at risk by providing (1) information intended to strengthen knowledge and understanding of the practice, (2) information regarding the legal issues related to the practice, (3) guidance for the management of its obstetrical and gynaecological complications, and (4) guidance on the provision of culturally competent care to girls and women affected by FGC. OPTIONS: Strategies for the primary, secondary, and tertiary prevention of FGC and its complications. OUTCOMES: The short- and long-term consequences of FGC. INTENDED USERS: Health care providers delivering obstetrical and gynaecological care. TARGET POPULATION: Women from countries where FGC is commonly practised and Canadian girls and women from groups who may practise FGC for cultural or religious reasons. EVIDENCE: Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library in September 2010 using appropriate controlled vocabulary (e.g., Circumcision, Female) and key words (e.g., female genital mutilation, clitoridectomy, infibulation). Searches were updated and incorporated in the guideline revision December 2018. VALIDATION METHODS: The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. BENEFITS, HARMS, AND COSTS: There are no anticipated harms or costs to health care facilities with implementation of this guideline. Benefits may include a greater willingness of women living with FGC to seek timely care. SUMMARY STATEMENTS: RECOMMENDATIONS.

Directive clinique No 395 - Excision génitale féminine.

OBJECTIFS: La présente directive clinique vise à diminuer la probabilité que la pratique de l'excision génitale féminine (EGF) se poursuive et à améliorer les soins prodigués aux filles et aux femmes qui ont subi une EGF ou qui risquent d'en subir une en fournissant (1) des renseignements destinés à améliorer les connaissances et la compréhension de la pratique, (2) des renseignements sur les enjeux juridiques liés à cette pratique, (3) des directives relatives au traitement des complications obstétricales et gynécologiques connexes et (4) des directives sur la compétence culturelle dans la prestation de soins aux filles et femmes touchées par l'EGF. OPTIONS: Des stratégies de prévention primaire, secondaire et tertiaire de l'EGF et de ses complications. RéSULTATS: Les conséquences à court et à long terme de l'EGF. UTILISATEURS CIBLES: Les fournisseurs de soins de santé qui fournissent des soins obstétricaux et gynécologiques. POPULATION CIBLE: Les femmes originaires de pays où l'EGF est couramment pratiquée ainsi que les filles et femmes canadiennes issues de groupes où l'EGF est parfois pratiquée pour des motifs culturels ou religieux. DONNéES PROBANTES: Des recherches ont été effectuées en septembre 2010 dans le moteur PubMed et les bases de données CINAHL et Cochrane Library au moyen d'une terminologie contrôlée appropriée (p. ex. Circumcision, Female) et de mots-clés en anglais (p. ex. female genital mutilation, clitoridectomy, infibulation) afin de rassembler la littérature publiée sur le sujet. Les recherches ont été mises à jour et intégrées à la révision de la directive clinique en décembre 2018. MéTHODES DE VALIDATION: La qualité des données probantes contenues dans le présent document a été évaluée en fonction des critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs. AVANTAGES, PRéJUDICES, ET COûTS: Aucun coût ni préjudice n'est anticipé pour la mise en œuvre de cette directive clinique dans les établissements de santé. Au nombre des avantages, la directive pourrait inciter les femmes ayant subi une EGF à solliciter rapidement des soins. DÉCLARATIONS SOMMAIRES: RECOMMANDATIONS.

United Nations Millennium Development Goals 4 and 5: augmenting the role of health professional associations.

The present study aimed to assess changes in the organizational capacity of health professional associations (HPAs) before and after a structured capacity building intervention, which included strategic investment of resources at institutional and technical levels. Self-assessments of organizational capacity were conducted by seven HPAs from low-resource countries involved in the FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health. The self-assessment tool comprised a questionnaire focusing on five core organizational dimensions, completed through a participatory and externally facilitated process. Differences were assessed using the two-sided sign test. All seven HPAs made improvements, with gains in an overall index (P=0.017) and in the specific dimensions of culture (P=0.016), operational capacity (P=0.016), performance (P=0.03), and functions (P=0.016). Increased capacity contributed to the ability of each HPA to enhance their credibility and assume leadership in national efforts to improve maternal and newborn health.

RETIRED: Female genital cutting.

This document has been archived because it contains outdated information. It should not be consulted for clinical use, but for historical research only. Please visit the journal website for the most recent guidelines.This document has been archived because it contains outdated information. It should not be consulted for clinical use, but for historical research only. Please visit the journal website for the most recent guidelines.

Ce document a été archivé, car il contient des informations périmées. Il ne devrait pas être consulté pour un usage clinique, mais uniquement pour des recherches historiques. Veuillez consulter le site web du journal pour les directives les plus récentes.

Strengthening the organizational capacity of health professional associations: the FIGO LOGIC Toolkit.

Health professional associations, including national associations of obstetrics and gynecology, can have a leading role in influencing and developing health policy and practice. However, in low- and middle-resource countries, the organizational capacity to facilitate this role is often insufficient. The International Federation of Gynecology and Obstetrics LOGIC (Leadership in Obstetrics and Gynaecology for Impact and Change) Initiative has been developing the capacity of national associations in Africa and Asia. Through this work, an electronic resource of materials (http://figo-toolkit.org/) has been brought together to support organizational capacity development, addressing domains such as culture, strategic planning, human resources, project and financial management, performance, external relations, membership services, and the development and revision of clinical guidelines.

The role of health professional associations in the promotion of global women's health.

Health professional associations, especially those from countries with the highest maternal death burden, have vital roles to play in improving maternal and newborn health and in achieving the Millennium Development Goals 4 and 5. Possessing the knowledge, skills, and influence to positively impact practice at the service delivery level, they can also advocate for change at the policy level and lobby for higher priority and greater investment in the maternal and newborn health field at the national level. The ability of professional associations to assume this leadership is nevertheless contingent on their institutional capacities to achieve planned goals and objectives in support of their organizational mission and strategic priorities. Since 1998, the Society of Obstetricians and Gynaecologists of Canada (SOGC) has been supporting the capacity development efforts of peer professional associations in low-resource countries. SOGC's work in this specific area has led it to develop and pilot an Organization Capacity Improvement Framework (OCIF) that guides professional associations, incrementally, in successive cycles of capacity development. Building on capacity developed within previous capacity-building cycles, this article summarizes and reports on the recent outcomes of the Asociación de Gynecoloígia y Obstetricia de Guatemala's (AGOG) organizational development efforts and the impact they have had in positioning the association as an important contributor in national efforts to improve maternal and newborn health outcomes in the country.

Development of health professional associations' organizational capacities in low-income countries: myth or reality in Haiti?

Over the last decade, the Société haïtienne d'obstétrique et de gynécologie (SHOG) has positioned itself as a key player in the maternal and neonatal health agenda in the country. This transformation arose from the association's commitment to strengthening its organizational capacities in order to enhance its operations and consolidate its contribution to the national efforts to reduce maternal and infant mortality. The SHOG benefited from the SOGC's technical assistance to reinforce its organizational capacities, support that it received as part of the SOGC Partnership Program from professional associations working in low-income countries. We describe the results of the SHOG's organizational assessments in 2008 (in the middle of the five-year cycle) and in 2006, according to the organizational capacity development approach promoted by the SOGC. A comparison of the 2008 and the 2006 assessment results shows that the SHOG progressed substantially during that period, shifting from "basic-moderate" to "moderate" regarding its organizational capacity, its operational capacities and its relationships with other organizations, including the way it is perceived by interested parties involved in the maternal and neonatal health agenda. The SHOG's experience shows that the SOGC's approach to capacity development can assist professional associations committed to reinforcing their organizational capacities in a tangible way. This will enhance their contribution to the national efforts pertaining to maternal and newborn health in their country.

Methodology for assessment and development of organization capacity.

Through capacity-building initiatives with obstetrics and gynaecology organizations in Guatemala, Haiti, and Uganda, the Society of Obstetricians and Gynaecologists of Canada has developed the organization capacity improvement framework (OCIF), a model for strengthening associations' essential organizational capacities. The OCIF focuses on capacity development within the organization over time, rather than on individual training and short-term outcomes. A cycle of assessing, planning, implementing, and measuring improvement builds rigour into the process while encouraging participation, understanding, and commitment to sustainable capacity development.

SOGC Partnership Program 1998-2006: building organization capacity to support improved maternal and neonatal health.

Through its partnership program with professional obstetrics and gynaecology associations in resource-poor environments, the Society of Obstetricians and Gynaecologists of Canada has developed a model for capacity assessment and development. The use of this model in Guatemala, Haiti, and Uganda has demonstrated its potential for facilitating cultural shifts in the perception of reproductive care, for providing clinical expertise in promoting educational activities, for enabling enhanced technical capacity, for political engagement, and for broad-based community and professional engagement.