Speakers - 2026

Title: Beyond Women-Centered Approaches: Gendered Family Decision-Making and Opportunities for Gender-Transformative Interventions to End Female Genital Mutilation in Mali

Abstract

Background:

Female genital mutilation (FGM) remains a significant public health and human rights concern affecting more than 230 million women and girls worldwide. Mali continues to report one of the highest prevalence rates globally despite decades of prevention efforts. Many interventions have focused primarily on women and girls, yet FGM is embedded within broader family structures and gendered power relations. Understanding how decision-making occurs within households is essential for designing more effective and culturally responsive interventions.

Methods:

This qualitative study explored perceptions of FGM among 64 purposively selected participants from five urban and rural regions of Mali. Participants represented a broad range of stakeholders, including fathers, mothers, grandmothers, adolescents, religious leaders, traditional practitioners, community leaders, health professionals, and civil society representatives. In-depth interviews were conducted in local languages, audio-recorded, translated into English, and analyzed using reflexive thematic analysis.

Results:

Participants described FGM as a family-centered practice shaped by interconnected gender roles rather than individual decisions. Fathers were commonly viewed as the final household decision-makers, while grandmothers served as custodians of cultural traditions and mothers implemented decisions through preparation and organization. Women occupied dual roles as both guardians of tradition and potential advocates for abandonment. Men were recognized as influential but frequently under-engaged in prevention initiatives despite their authority within households. Across participant groups, there was broad consensus that sustainable abandonment requires respectful engagement of fathers, mothers, grandmothers, adolescents, religious leaders, health professionals, and community leaders through culturally grounded dialogue and evidence-informed education.

Conclusions:

The findings suggest that interventions focused exclusively on women may overlook critical household decision-makers and influential family relationships. A gender-transformative, family-centered approach that promotes shared responsibility and intergenerational dialogue may provide a more effective pathway toward sustainable abandonment of FGM. This framework offers practical guidance for clinicians, researchers, policymakers, and community organizations seeking to design culturally responsive reproductive health interventions in high-prevalence settings.

What will the audience take away from your presentation?

Participants attending this presentation will be able to:

• Understand how gendered household decision-making influences the continuation of FGM.
• Recognize the distinct but interconnected roles of fathers, mothers, grandmothers, and community leaders in shaping FGM-related decisions.
• Apply a gender-transformative, family-centered framework when designing reproductive health and FGM prevention programs.
• Identify practical strategies for engaging men, women, adolescents, religious leaders, and healthcare providers in culturally appropriate abandonment efforts.
• Translate qualitative evidence into community-engaged interventions, implementation research, and policy initiatives aimed at improving women's reproductive health.