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Amref Health Africa is Africa’s leading health charity, working primarily with women and girls to help them secure their right to health and break the cycle of poverty.

Through strengthening health systems, training health workers, and improving access to vital care and services across the African continent, Amref’s vision is of a world where everyone – including the most marginalised people and communities – can exercise their human right to health. Founded and headquartered in Nairobi, Kenya, Amref has a decades-long history of facilitating community-led health improvements across the African continent.

With help from the players of People’s Postcode Lottery, Amref is working to end the practice of Female Genital Mutilation/Cutting (FGM/C) across Africa. Not only does FGM/C inflict grave physical and psychological harm, but it is also directly linked with child marriage, teenage pregnancy, and school dropouts. In many communities, girls go through 'the cut' as a rite of passage into womanhood: it is often viewed as a necessary pre-cursor to marriage, and subsequently to falling pregnant, which leaves girls with no choice but to drop out of school – taking away their chance to pursue their education and fulfill their dreams.

Amref Health Africa partners with practising communities to support girls in learning more about their sexual health and rights. Beginning in 2009, Amref worked with Maasai communities in Kenya and Tanzania to develop a Community-Led Alternative Rite of Passage (CL-ARP) ceremony, which still celebrates the cultural tradition of a girl’s transition into womanhood, without the physical or psychological damage of 'the cut'. To date, 20,000 girls in Kenya and Tanzania have graduated from a CL-ARP ceremony and been able to continue their education.

In 2018, support from the players of People’s Postcode Lottery helped Amref establish its End FGM/C Centre of Excellence, which provides strategic leadership and coordination of Amref’s End-FGM/C work across five countries: Kenya, Tanzania, Senegal, Ethiopia and Uganda. By training local ambassadors from practising communities to advocate for the abandonment of FGM/C, the Centre is instrumental in changing attitudes towards the practice, which are often deeply anchored in longstanding social gender norms and beliefs. By working closely with the whole community – from the girls themselves to their families, their teachers, community leaders, and boys and young men – Amref ensures that change is truly sustainable.

"The reasons FGM/C is practiced vary from one community to the next," says Dr Tammary Esho, Director of Amref Health Africa's End-FGM Centre of Excellence. "It’s important to first understand what FGM/C means to the community in question. We create the conditions in which people feel comfortable talking about gender equality, bodily autonomy, and sexual and reproductive health - and we go from there."

An independent evaluation conducted in 2020 showed that, over the course of 10 years, Amref’s Community-Led Alternative Rites of Passage (CL-ARP) model resulted in a 24.2% decrease in the practice between 2009 and 2019 in Kajiado County, Kenya. It also led to an increase in the number of years of schooling girls completed, and to a reduction in child, early and forced marriage (CEFM), and teenage pregnancy.

Following the outbreak of COVID-19 in March 2020, rates of FGM/C rose sharply among practising communities. School closures meant that girls no longer had access to the protective network that schools provide, affording their families the freedom to pass them through 'the cut' without repercussions. In response, Amref Health Africa urgently adapted its End-FGM/C programmes, training additional community ambassadors and carrying out extensive community awareness activities.

Nice Leng’ete, Amref’s Global End-FGM Ambassador, says: "My hope is to see every girl become the woman of her dreams."

Players of People's Postcode Lottery have raised £1 million for Amref Health Africa UK and its work to end FGM/C.

Image: Adrian Mgaya

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