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 FGM | 634 (77%) | 245 (30%) | 8.9 (6.9 to 11.5) | <0.001 | N/A |
Provider asked client about the client’s personal beliefs regarding FGM | 616 (75%) | 217 (27%) | 9.7 (7.5 to 12.5) | <0.001 | N/A |
Provider discussed with client why FGM should be prevented | 629 (77%) | 244 (30%) | 9.2 (7.1 to 11.9) | <0.001 | N/A |
Provider discussed with client how FGM could be prevented | 592 (72%) | 232 (29%) | 7.7 (6.0 to 9.9) | <0.001 | N/A |
Client satisfied with how FGM was addressed by provider during clinical visit | 684 (84%) | 348 (43%) | 6.6 (5.1 to 8.4) | <0.001 | N/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) | <0.001 | N/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) | <0.001 | N/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 preparedness | 56 (68%) | 22 (27%) | – | <0.001 | N/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) | <0.001 | N/A |
Intervention (n=115) | Control (n=117) |
Adjusted OR* ‡
(95% CI) | P value | ICC | |
Providers using level one intervention package | 106 (92%) | 65 (56%) | 10.1 (4.6 to 22.4) | <0.001 | N/A |
Secondary outcomes | |||||
Intervention (n=115) | Control (n=117) | Adjusted OR*‡ (95% CI) | P value | ICC | |
Providers with appropriate interpersonal communication skills | 82 (71%) | 68 (58%) | 1.8 (1.0 to 3.2) | 0.035 | N/A |
Providers with high self-efficacy | 93 (81%) | 99 (85%) | 0.7 (0.3 to 1.4) | 0.317 | N/A |
Providers reporting less supportive attitudes towards FGM | 84 (73%) | 85 (73%) | 1.0 (0.5 to 1.8) | 0.993 | N/A |
Providers with high confidence scores¶ | 113 (98%) | 104 (89%) | 7.0 (1.5 to 32.3) | 0.012 | N/A |
Unadjusted OR
(95% CI) | |||||
Providers not supportive of FGM | 110 (96%) | 114 (97%) | 0.7 (0.2 to 3.3) | 0.677 | N/A |
Providers not supportive of medicalised FGM | 114 (99%) | 116 (99%) | 1.0 (0.1 to 15.9) | 0.990 | N/A |
Providers with correct FGM-related knowledge responses | 9 (8%) | 1 (1%) | 9.8 (1.2 to 79.0) | 0.031 | N/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) | <0.001 | N/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 visit | 424 (52%) | 237 (29%) | 5.4 (2.4 to 12.4) | <0.001 | 0.66 |
Clients reporting that they were strongly opposed to FGM | 498 (61%) | 382 (47%) | 2.4 (1.1 to 5.2) | 0.023 | 0.62 |
Clients reporting that they intend to have their daughters cut | 96 (12%) | 209 (26%) | 0.3 (0.1 to 0.7) | 0.004 | 0.6 |
Clients reporting that they would prefer healthcare provider to cut daughters | 53 (7%) | 139 (17%) | 0.2 (0.1 to 0.5) | <0.001 | 0.54 |
Clients wishing to be active in FGM prevention | 677 (83%) | 535 (66%) | 3.2 (1.6 to 6.2) | 0.001 | 0.5 |
*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 .