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 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 .