Evidence-Based Approaches to End FGM
Evaluating Evidence-Based Approaches
This section brings together practical, evidence-based solutions that grassroots organisations across Kenya and Tanzania in communities with high prevalence of FGM are using to prevent and respond to FGM. They were shared through in-depth co-creation workshops and reflection sessions with 62 grassroots organisations working in diverse communities and contexts including those impacted by climate change and insecurity.
Rather than prescribing what every organisation must do, this tool supports reflection and adaptation. It highlights what's working, where, how and encourages continuous learning over time.
The section is also intended to contribute to the growing body of knowledge on what works to end FGM, building on and complementing existing publications such as:
- UN Joint Programme To End FGM: What Works to End Female Genital Mutilation (2025)
- Population Council, UN Joint Programme, and WHO research on evidence-informed interventions (2021)
To make the evidence more actionable and relevant, we've grouped the approaches into three tiers below based on both systematic evidence review of effective approaches to end FGM and grassroots experience: Proven approaches, promising approaches-evidence based and promising approaches-grassroots lived experience.
1 Proven Approaches
We have prioritised these three most widely validated solutions, drawn from both grassroots success and alignment with the global evidence base having demonstrated success in preventing and responding to FGM and improving outcomes for women and girls. They focus on: girls' education, women's economic empowerment, expanding girls' voice, agency and SRHR.
Each solution has also been developed into a Costed Solutions Template - a practical tool grassroots organisations can use in designing, funding, and communicating the impact of their work.
| Solution/intervention | How it works well | Where it works well | How to track change |
|---|---|---|---|
| Girls education | Keeps girls in school during years of high risk. Delays marriage and builds girls' self-confidence. Increases family investment in her future. | Works great in rural and pastoralist communities where education support is limited. Especially impactful for secondary/post-secondary girls. Works well when paired with SRHR, voice and agency and parental dialogues. | Track school re-enrolment, dropout, transition and completion. Observe families opting for school over FGM. Track number of scholarships awarded and the education support provided, mental & SRH health care and support. Interview girls & teachers. |
| Women's economic development | Reduces economic pressure to cut girls for marriage. Strengthens women's decision-making power. Families can choose safer paths for girls. | Works best in low-income rural/pastoralist areas/communities. Especially impactful where mothers/female figure heads are financially dependent. | Use simple tools like household surveys, follow-up visits, or storytelling to track families benefiting from economic initiatives (savings groups, IGAs, vocational training). Look for patterns: Are more girls staying in school? Are fewer families resorting to harmful coping strategies like FGM or early marriage? Track indirect indicators like reduction in seasonal migration or increased enrolment during transition years (primary to secondary). |
| Activities that expand SRHR and activate girls agency & voice | Builds confidence, decision-making skills, and resilience. Girls begin to say No which is the first step towards changing attitudes and influence peers. | Works well in both in- and out-of-school settings. Particularly important for younger girls (8–17) before major life decisions. | Girls speaking publicly, negotiating with parents, forming peer groups. Look for girls initiating change in schools/clubs. |
Girls education
How it works well
Keeps girls in school during years of high risk. Delays marriage and builds girls' self-confidence. Increases family investment in her future.
Where it works well
Works great in rural and pastoralist communities where education support is limited. Especially impactful for secondary/post-secondary girls. Works well when paired with SRHR, voice and agency and parental dialogues.
How to track change
Track school re-enrolment, dropout, transition and completion. Observe families opting for school over FGM. Track number of scholarships awarded and the education support provided, mental & SRH health care and support. Interview girls & teachers.
Women's economic development
How it works well
Reduces economic pressure to cut girls for marriage. Strengthens women's decision-making power. Families can choose safer paths for girls.
Where it works well
Works best in low-income rural/pastoralist areas/communities. Especially impactful where mothers/female figure heads are financially dependent.
How to track change
Use simple tools like household surveys, follow-up visits, or storytelling to track families benefiting from economic initiatives (savings groups, IGAs, vocational training). Look for patterns: Are more girls staying in school? Are fewer families resorting to harmful coping strategies like FGM or early marriage? Track indirect indicators like reduction in seasonal migration or increased enrolment during transition years (primary to secondary).
Activities that expand SRHR and activate girls agency & voice
How it works well
Builds confidence, decision-making skills, and resilience. Girls begin to say No which is the first step towards changing attitudes and influence peers.
Where it works well
Works well in both in- and out-of-school settings. Particularly important for younger girls (8–17) before major life decisions.
How to track change
Girls speaking publicly, negotiating with parents, forming peer groups. Look for girls initiating change in schools/clubs.
2 Promising Approaches (Evidence-Based)
This includes approaches actively being used by grassroots groups that are also recognised in What Works to End FGM publications by Population Council, UN Joint Programme, and WHO as effective or promising. These interventions often depend on context, delivery quality, or complementary support.
| Solution/intervention | How it works well | Where it works well | How to track change |
|---|---|---|---|
| Structured dialogues at family level | Shifts behaviour within the home, where many FGM decisions are made. Builds trust with parents/caregivers | Particularly effective in communities where social norms are tightly held and household heads( female figure heads or male figure heads) are key decision-makers. | Parents repeating new ideas. Families deciding against FGM. Families attending follow-up visits. |
| Community dialogues to raise awareness on the law and health risk of FGM | Aims to build understanding of the legal and health impacts of FGM, sometimes through structured dialogues. | Has limited impact if done without trust-building or follow-up. Can backfire if communities feel policed or shamed,lacking cultural sensitivities. Works better when it is community-owned, long term & linked to ongoing programmes. | Track shifts in public opinion over time. Include anonymous feedback to gauge resistance or misunderstanding. Use pre/post knowledge questions in community dialogues. |
| Working with religious leaders | Leverages respected voices to challenge harmful beliefs/norms that could be interpreted to have religious obligations and provide new moral framing. | Highly impactful in conservative or religiously influenced communities. Works when leaders are authentically engaged and publicly vocal. | Sermons or community talks include end FGM messages delinking FGM as a religious obligation. Followers quote religious leaders' statements. |
| Working with frontline health care workers | Equips local health actors to prevent medicalisation, spot at-risk girls, and provide mental health support for families. | High-prevalence areas where FGM is done by health workers( both registered & unregistered) or where girls pass through clinics. | Health workers reporting FGM cases, offering alternatives, or counseling families. Can track reduced referrals for cutting services. |
| Engagement of cultural leaders through community dialogues | Cultural leaders are seen as gatekeepers who can either reinforce or challenge norms. When they become allies, they can influence entire communities. | Works best when these leaders are well known, respected/ still have relevance, willing and empowered to speak publicly especially in highly traditional or rural settings. | Listen for shifts in public statements or meeting discussions. Map their influence over time using social network tracking or community feedback. |
| Media campaigns | Spreads awareness quickly through radio, TV, and digital platforms. Can shift general knowledge and create public pressure. | Works best when messages are context-specific and locally produced. Often more effective in all settings with access to media. | Use quick polls, digital surveys/SMS surveys, or engagement tracking (e.g. calls to action, radio call-ins) to see if messaging sticks. |
Structured dialogues at family level
How it works well
Shifts behaviour within the home, where many FGM decisions are made. Builds trust with parents/caregivers
Where it works well
Particularly effective in communities where social norms are tightly held and household heads( female figure heads or male figure heads) are key decision-makers.
How to track change
Parents repeating new ideas. Families deciding against FGM. Families attending follow-up visits.
Community dialogues to raise awareness on the law and health risk of FGM
How it works well
Aims to build understanding of the legal and health impacts of FGM, sometimes through structured dialogues.
Where it works well
Has limited impact if done without trust-building or follow-up. Can backfire if communities feel policed or shamed,lacking cultural sensitivities. Works better when it is community-owned, long term & linked to ongoing programmes.
How to track change
Track shifts in public opinion over time. Include anonymous feedback to gauge resistance or misunderstanding. Use pre/post knowledge questions in community dialogues.
Working with religious leaders
How it works well
Leverages respected voices to challenge harmful beliefs/norms that could be interpreted to have religious obligations and provide new moral framing.
Where it works well
Highly impactful in conservative or religiously influenced communities. Works when leaders are authentically engaged and publicly vocal.
How to track change
Sermons or community talks include end FGM messages delinking FGM as a religious obligation. Followers quote religious leaders' statements.
Working with frontline health care workers
How it works well
Equips local health actors to prevent medicalisation, spot at-risk girls, and provide mental health support for families.
Where it works well
High-prevalence areas where FGM is done by health workers( both registered & unregistered) or where girls pass through clinics.
How to track change
Health workers reporting FGM cases, offering alternatives, or counseling families. Can track reduced referrals for cutting services.
Engagement of cultural leaders through community dialogues
How it works well
Cultural leaders are seen as gatekeepers who can either reinforce or challenge norms. When they become allies, they can influence entire communities.
Where it works well
Works best when these leaders are well known, respected/ still have relevance, willing and empowered to speak publicly especially in highly traditional or rural settings.
How to track change
Listen for shifts in public statements or meeting discussions. Map their influence over time using social network tracking or community feedback.
Media campaigns
How it works well
Spreads awareness quickly through radio, TV, and digital platforms. Can shift general knowledge and create public pressure.
Where it works well
Works best when messages are context-specific and locally produced. Often more effective in all settings with access to media.
How to track change
Use quick polls, digital surveys/SMS surveys, or engagement tracking (e.g. calls to action, radio call-ins) to see if messaging sticks.
3 Promising Approaches (Grassroots/Lived Experience)
These reflect over three decades of lived experience from grassroots organisations working at the frontlines. They are seen as impactful by those implementing them and are deeply embedded in local practices and they merit further exploration and documentation.
| Solution/intervention | How it works well | Where it works well | How to track change |
|---|---|---|---|
| Work that applies an intersectional lens | Recognises that girls and women face multiple, overlapping forms of exclusion such as disability, poverty, ethnicity, displacement, or being out of school that can increase vulnerability to FGM. By addressing FGM alongside other barriers e.g. access to SRHR, stigma, education, or livelihoods, the response becomes more holistic, respectful, and effective. | Particularly important in marginalised or overlooked populations, including girls with disabilities, indigenous or minority communities, girls in conflict zones, impacted by climate change or humanitarian settings. Most effective when implemented by trusted community insiders or grassroots groups with specialised access. | Look at how your work responds to the full reality of girls' lives not just the impact of FGM. Track shifts in related factors like access to education, livelihood opportunities, exposure to climate-related shocks or changing gender norms. Ask questions like: "Are girls facing multiple risks (e.g. poverty, displacement, early marriage) more included and supported over time?" "Are we adapting our approach to reflect the different experiences of girls and women in our community?" Use reflective tools like inclusion checklists, community mapping to uncover intersecting risks and resilience factors, focus group discussions to hear how girls and families describe change in their lives. |
| Long term & core support to those working at the grassroots | Provides time and flexibility to adapt to complex contexts. Allows for deeper trust-building and sustained impact. | Vital in any high-prevalence setting. Especially important where rapid change is unrealistic. | Organisation retains their core human resource and support and grows. Able to respond to community needs quickly. Funders receive quality reports without micromanagement. |
| Alternative Rites of Passage(ARP) at family level | Offers families a non-cutting ritual that symbolically marks the transition to 'womanhood'. Works best when it builds on community customs/norms and is embraced by the immediate family, not just the wider community. | Works better when co-designed with communities and led by girls and women themselves. Shows more promise at the household level than large-scale public events. | Track family-level uptake. Ask: "Are families continuing FGM voluntarily?" Use follow-ups or household visits after ceremonies. |
| Engagement of men and boys through community dialogues | Can promote shared responsibility for ending FGM and builds long-term support for gender equality.Has mostly been proposed as a solution when the leadership or majority of programme personnel are male. | To be impactful it is necessary to work with and listen to women and girls first to inform programming on the needs of women and girls affected by FGM. The implementation of male engagement strategies that do no harm and are accountable to girls & women, shift power to girls and women, are evidence-based, evidence-building, are inclusive and intersectional, and are embedded in human rights principles and gender transformative. | Track behaviour shifts through focus group discussions/KII prioritise girls and women's perspectives on male engagement interventions, cross-checking men's self-reported perspectives. Develop feedback loops about women and girls leadership and experiences in the interventions. |
| Working with ex-cutters | Leverages the moral authority of former practitioners who publicly renounce cutting and advocate against FGM. | Useful when ex-cutters are safe, well-supported, and not exploited or shamed. Most credible when change is self-motivated, not donor-driven/organisational-driven. | Monitor community perception of their role. Are people listening to them? Follow how many families are influenced through ex-cutter outreach. |
| Supporting a movement of young people as champions | Builds momentum for social change from within communities. Youth shift conversations with peers, families, and leaders. | Urban or connected rural communities with youth organising potential. Amplified via social media, radio, digital, drama. | Track events organised by youth. Capture testimonies from other young people. Watch how youth gain trust from their communities and families. |
| Supporting the leadership and movement of survivors of FGM | Survivor-led movements create safe spaces for healing, build solidarity, and drive culturally relevant advocacy from lived experience. | In contexts where survivors have agency, have had access to psychosocial support, trusted community spaces, or trauma-informed leadership pathways. It works especially well when there's funding and mentorship that survivors can use to form or lead groups safely, without retraumatisation or tokenism. | Document the creation and visibility of survivor-led groups. Track participation in leadership or speaking roles. Ask survivors how their involvement has influenced decision-making, community attitudes, or policy discussions. Use anonymous feedback loops to capture their safety, confidence, and sense of influence over time. |
Work that applies an intersectional lens
How it works well
Recognises that girls and women face multiple, overlapping forms of exclusion such as disability, poverty, ethnicity, displacement, or being out of school that can increase vulnerability to FGM. By addressing FGM alongside other barriers e.g. access to SRHR, stigma, education, or livelihoods, the response becomes more holistic, respectful, and effective.
Where it works well
Particularly important in marginalised or overlooked populations, including girls with disabilities, indigenous or minority communities, girls in conflict zones, impacted by climate change or humanitarian settings. Most effective when implemented by trusted community insiders or grassroots groups with specialised access.
How to track change
Look at how your work responds to the full reality of girls' lives not just the impact of FGM. Track shifts in related factors like access to education, livelihood opportunities, exposure to climate-related shocks or changing gender norms. Ask questions like: "Are girls facing multiple risks (e.g. poverty, displacement, early marriage) more included and supported over time?" "Are we adapting our approach to reflect the different experiences of girls and women in our community?" Use reflective tools like inclusion checklists, community mapping to uncover intersecting risks and resilience factors, focus group discussions to hear how girls and families describe change in their lives.
Long term & core support to those working at the grassroots
How it works well
Provides time and flexibility to adapt to complex contexts. Allows for deeper trust-building and sustained impact.
Where it works well
Vital in any high-prevalence setting. Especially important where rapid change is unrealistic.
How to track change
Organisation retains their core human resource and support and grows. Able to respond to community needs quickly. Funders receive quality reports without micromanagement.
Alternative Rites of Passage(ARP) at family level
How it works well
Offers families a non-cutting ritual that symbolically marks the transition to 'womanhood'. Works best when it builds on community customs/norms and is embraced by the immediate family, not just the wider community.
Where it works well
Works better when co-designed with communities and led by girls and women themselves. Shows more promise at the household level than large-scale public events.
How to track change
Track family-level uptake. Ask: "Are families continuing FGM voluntarily?" Use follow-ups or household visits after ceremonies.
Engagement of men and boys through community dialogues
How it works well
Can promote shared responsibility for ending FGM and builds long-term support for gender equality.Has mostly been proposed as a solution when the leadership or majority of programme personnel are male.
Where it works well
To be impactful it is necessary to work with and listen to women and girls first to inform programming on the needs of women and girls affected by FGM. The implementation of male engagement strategies that do no harm and are accountable to girls & women, shift power to girls and women, are evidence-based, evidence-building, are inclusive and intersectional, and are embedded in human rights principles and gender transformative.
How to track change
Track behaviour shifts through focus group discussions/KII prioritise girls and women's perspectives on male engagement interventions, cross-checking men's self-reported perspectives. Develop feedback loops about women and girls leadership and experiences in the interventions.
Working with ex-cutters
How it works well
Leverages the moral authority of former practitioners who publicly renounce cutting and advocate against FGM.
Where it works well
Useful when ex-cutters are safe, well-supported, and not exploited or shamed. Most credible when change is self-motivated, not donor-driven/organisational-driven.
How to track change
Monitor community perception of their role. Are people listening to them? Follow how many families are influenced through ex-cutter outreach.
Supporting a movement of young people as champions
How it works well
Builds momentum for social change from within communities. Youth shift conversations with peers, families, and leaders.
Where it works well
Urban or connected rural communities with youth organising potential. Amplified via social media, radio, digital, drama.
How to track change
Track events organised by youth. Capture testimonies from other young people. Watch how youth gain trust from their communities and families.
Supporting the leadership and movement of survivors of FGM
How it works well
Survivor-led movements create safe spaces for healing, build solidarity, and drive culturally relevant advocacy from lived experience.
Where it works well
In contexts where survivors have agency, have had access to psychosocial support, trusted community spaces, or trauma-informed leadership pathways. It works especially well when there's funding and mentorship that survivors can use to form or lead groups safely, without retraumatisation or tokenism.
How to track change
Document the creation and visibility of survivor-led groups. Track participation in leadership or speaking roles. Ask survivors how their involvement has influenced decision-making, community attitudes, or policy discussions. Use anonymous feedback loops to capture their safety, confidence, and sense of influence over time.
Catalysts For Change
We know from experience that using a combination of proven approaches, supported by local knowledge and evidence as lived experience, is likely to be the most effective in ending FGM.
Most, if not all, of the solutions gain strength and sustainability when supported by broader enabling factors. These include presence, awareness, and consistent implementation of national and local laws and policies that prohibit FGM and promote the rights and well-being of children which act as critical catalysts.
While legal frameworks alone may not change behaviour, they create the protective and normative space in which community-led solutions, especially those rooted in education, empowerment, and economic opportunity can take root and grow. The impact of these solutions are even more amplified when linked to grassroots action, enforcement mechanisms, and trust in institutions.