[{"bbox": [97, 152, 1134, 233], "category": "Text", "text": "Tharaka Nithi and Taita Taveta having relatively high prevalence rates compared to other regions. It has been estimated by UNHCR that 97% of girls under the age of 8 in Dadaab camp in Kenya, most of whom originate from Somalia and Ethiopia, have undergone FGM."}, {"bbox": [97, 244, 1134, 485], "category": "Text", "text": "The decision to have the girls cut is usually taken by her parents or other close family members and the choice to leave the girl uncut often meets with strong opposition from the community, as FGM is a deeply entrenched tradition within social, economic and political structures and this perpetuates gender inequality and power imbalances. This situation is worsened by the low levels of awareness among the community on the existing anti-FGM laws and the negative effects of FGM on the Sexual Reproductive Health of women and girls. It is further exacerbated by inadequate prevention and response mechanisms against FGM and Child Marriage by duty bearers both at national and county levels. While the economic impact of FGM is well documented, the economic drivers of FGM beyond socio-economic factors such as poverty, level of education and women's economic and social independence are less documented, and could be an area of research under the proposed action."}, {"bbox": [97, 495, 1134, 737], "category": "Text", "text": "While significant progress and positive trends have been noted in Kenya in recent years, new trends also emerge, which require specific attention. The majority of women and girls in Kenya are cut by traditional practitioners, including traditional birth attendants. However, girls are now increasingly being cut by health care providers (i.e. medicalization of FGM), in hospitals, at home, or at neutral places using surgical tools, antiseptics and anaesthetics. Some of the reasons for medicalization of FGM include the reduction of immediate complications while allowing the women and girls to adhere to their cultural obligations, and financial benefits for the practitioners. Medicalization of FGM has been documented among the Kisii and Somali communities in Kenya. Studies suggest that medicalization is an adaptation to awareness of health complications and the legal banning of the practice, thus underscoring the need for actions that target health care providers."}, {"bbox": [97, 746, 1134, 828], "category": "Text", "text": "Cross border FGM has emerged as a new trend that threatens the gains made towards FGM eradication, with Kenya being an increasingly attractive destination for FGM services for girls from across the East African region. The cross border dimension of FGM practices makes a strong case for targeting actions in Kenyan border counties."}, {"bbox": [97, 839, 1134, 974], "category": "Text", "text": "Most recently, even in communities where FGM was traditionally practiced on older girls, there is a shift in age with evidence of a trend over time to mutilate girls at younger ages. In Taita Taveta for example, FGM is still widespread (23%), with infants who are barely a-week old being cut behind closed doors. Findings from a study by the Ministry of Public Service and Gender indicated that approximately 61.3% of infants under the age of 5 years have been subjected to FGM in the Taita Taveta county."}, {"bbox": [97, 985, 1074, 1040], "category": "Text", "text": "Identification of main stakeholders and corresponding institutional and/or organizational issues (mandates, potential roles, and capacities) to be covered by the action:"}, {"bbox": [97, 1051, 237, 1077], "category": "Section-header", "text": "**Duty bearers:**"}, {"bbox": [134, 1089, 1134, 1224], "category": "List-item", "text": "- The **Anti-FGM Board** is the government agency mandated with oversight and coordination of Anti-FGM interventions in the Country. It heavily depends on donor funding to undertake its mandate due to inadequate funding from the government. In addition, the Anti-FGM Board lacks the ability, both financial and technical, to facilitate real-time data and information gathering on FGM, from the community to national level. In this action, the Anti-FGM Board will play a key coordinating role."}, {"bbox": [134, 1224, 1134, 1436], "category": "List-item", "text": "- **Line Ministries** (Health, Justice, Interior, Youth, and Gender and Affirmative Action) will be instrumental for linking programme actions to their ministry action plans in the elimination of harmful practices that affect the health and well-being of women and girls, and also provide legal oversight and guidelines on dealing with effects of FGM, referral pathways, mental health and psychosocial support, counselling, education, other socio-economic empowerment opportunities for women and girls, and institutionalization of anti-FGM commitments. Together with county governments, they will also be key in planning and facilitating the programme activities at community level and in leading SRHR policy and guidelines review and implementation of selected SRHR frameworks that the programme will work on."}, {"bbox": [134, 1436, 1134, 1569], "category": "List-item", "text": "- **Judiciary offices of the Attorney General** and **Office of the Director of Public Prosecution**: The primary mandate of enforcement of the law and protection of young girls against FGM, and prosecution of perpetrators lies with these two offices. The programme will engage the two offices to review enforcement mechanisms from county to county, including accessing factors for non-implementation of the law prohibiting FGM practices."}, {"bbox": [134, 1569, 1134, 1623], "category": "List-item", "text": "- **Target County Governments**: (Gender Officers, County Commissioners, County First ladies, County Assemblies committees on Gender etc.) The relevant stakeholders at the county and community level will"}, {"bbox": [1037, 1681, 1144, 1707], "category": "Page-footer", "text": "Page 6 of 22"}]