Table 4

Analysis of study outcomes

Primary Outcomes
ANC clients reporting that their provider implemented components of PCC for FGM prevention approach
Intervention (n=819) Control (n=810) Adjusted OR* §
(95% CI)
P value ICC
Provider asked client if they have undergone FGM634 (77%)245 (30%)8.9 (6.9 to 11.5)<0.001N/A
Provider asked client about the client’s personal beliefs regarding FGM616 (75%)217 (27%)9.7 (7.5 to 12.5)<0.001N/A
Provider discussed with client why FGM should be prevented629 (77%)244 (30%)9.2 (7.1 to 11.9)<0.001N/A
Provider discussed with client how FGM could be prevented592 (72%)232 (29%)7.7 (6.0 to 9.9)<0.001N/A
Client satisfied with how FGM was addressed by provider during clinical visit684 (84%)348 (43%)6.6 (5.1 to 8.4)<0.001N/A
Difference in mean scores (95% CI)
Mean score of implementing PCC approach (out of 5)3.9 (3.8–4.0)1.6 (1.5–1.7)2.3 (2.1 to 2.5)<0.001N/A
Mean score of PCC+appropriate FGM prevention and care (out of 8)6.2 (5.9–6.6)3.7 (3.2–4.1)2.6 (2.0 to 3.2)<0.001N/A
ANC clinical preparedness to offer FGM prevention and care services
Intervention (n=82) Control (n=81) P value ICC
Clinics with ALL correct responses for preparedness56 (68%)22 (27%)<0.001N/A
Difference in mean scores
(95% CI)
Mean score of clinical preparedness (out of 4)3.4 (3.2–3.6)2.6 (2.4–2.9)0.8 (0.4 to 1.1)<0.001N/A
Intervention (n=115) Control (n=117) Adjusted OR* ‡
(95% CI)
P value ICC
Providers using level one intervention package106 (92%)65 (56%)10.1 (4.6 to 22.4)<0.001N/A
Secondary outcomes
Intervention (n=115) Control (n=117) Adjusted OR*‡ (95% CI) P value ICC
Providers with appropriate interpersonal communication skills82 (71%)68 (58%)1.8 (1.0 to 3.2)0.035N/A
Providers with high self-efficacy93 (81%)99 (85%)0.7 (0.3 to 1.4)0.317N/A
Providers reporting less supportive attitudes towards FGM84 (73%)85 (73%)1.0 (0.5 to 1.8)0.993N/A
Providers with high confidence scores¶113 (98%)104 (89%)7.0 (1.5 to 32.3)0.012N/A
Unadjusted OR
(95% CI)
Providers not supportive of FGM110 (96%)114 (97%)0.7 (0.2 to 3.3)0.677N/A
Providers not supportive of medicalised FGM114 (99%)116 (99%)1.0 (0.1 to 15.9)0.990N/A
Providers with correct FGM-related knowledge responses9 (8%)1 (1%)9.8 (1.2 to 79.0)0.031N/A
Difference in mean
scores (95% CI)
Mean score of FGM-related knowledge (out of 6)2.5 (2.2–2.7)1.6 (1.5–1.8)0.8 (0.5–1.1)<0.001N/A
Other ANC client outcomes
Intervention (n=819) Control (n=810) Adjusted OR†§
(95% CI)
P value ICC
Clients reporting less support for FGM after ANC clinical visit424 (52%)237 (29%)5.4 (2.4 to 12.4)<0.0010.66
Clients reporting that they were strongly opposed to FGM498 (61%)382 (47%)2.4 (1.1 to 5.2)0.0230.62
Clients reporting that they intend to have their daughters cut96 (12%)209 (26%)0.3 (0.1 to 0.7)0.0040.6
Clients reporting that they would prefer healthcare provider to cut daughters53 (7%)139 (17%)0.2 (0.1 to 0.5)<0.0010.54
Clients wishing to be active in FGM prevention677 (83%)535 (66%)3.2 (1.6 to 6.2)0.0010.5
  • *Single-level multivariable adjusted models.

  • †Multilevel multivariable adjusted models.

  • ‡Provider outcomes adjusted for sex, years of service, FGM status, FGM-related training, any specific training on communication/counselling and PCC and whether the provider had conducted FGM in the past.

  • §Client outcomes adjusted for age, educational level, FGM status and exposure to level one information, education and communication materials.

  • ¶This analysis includes 217 observations instead of 232 because of missing data on some covariates

  • ANC, antenatal care; FGM, female genital mutilation; ICC, intracluster correlation coefficient; OR, Odds ratio; PCC, person-centred communication .