A Theoretical Framework for Evaluating a Dedicated Clinic's Management of Female Genital Mutilation/Cutting Complications in Bo, Sierra Leone

Le résumé fourni par la source

Female genital mutilation/cutting (FGM/C) remains prevalent in Sierra Leone, with significant associated health complications. Although dedicated clinics have been established in some regions, such as Bo, there is a lack of a robust, context-specific framework to systematically evaluate their management strategies and outcomes. This article addresses this gap by proposing a comprehensive theoretical framework for evaluating the management of FGM/C-related complications within a dedicated clinic setting. Developed through a synthesis of relevant public health and clinical management theories—including the socio-ecological model and chronic disease management frameworks—the framework is explicitly adapted to Sierra Leone's socio-cultural and healthcare context. It delineates four interdependent evaluation domains: clinical outcomes, patient-reported experiences, healthcare provider competencies, and community integration. A core tenet is the necessity of measuring both objective clinical indicators, such as reductions in obstetric fistula, and subjective psychosocial well-being. This framework provides a structured, holistic basis for assessing care quality and long-term impact, moving beyond simplistic metrics. It is intended to inform the development of standardised monitoring tools and requires empirical testing and refinement with local stakeholders. Ultimately, this work contributes a novel, rigorous tool to the African obstetric and gynaecological literature for evaluating specialised FGM/C care programmes.

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