How to know what works when intervention programs lack time and money for evaluations?

A report describing results from a systematic review of programs seeking to reduce female genital mutilation/cutting in several African countries offers this conclusion:

[Our] systematic review shows that there is a paucity of high quality evaluations of the effectiveness of interventions to reduce the prevalence of FGM/C. We included eight controlled studies assessing the effectiveness of five broad categories of interventions, set in seven different countries in Africa. We identified no controlled interventions that had taken place in other parts of the world. All of the evaluation studies were characterized by low methodological quality. Thus, while our calculated effect sizes for prevalence of FGM/C, knowledge, beliefs, and intentions about FGM/C suggested that there appear to be positive developments as a result of interventions, the low quality of the body of evidence affects the interpretation of results and draws the validity of the findings into doubt.

In other words, if one is seeking rigorous, control-trial tested findings about intervention effectives for FGM/C intervention programs, we don’t have it.

In spite of these dismal conclusions, the 156 page report provides a more positive overall contribution by describing several important programs. And even though they lack formal, statistically dependable evaluations, they do seem to be headed in the direction of reducing the practice of FGM/C.

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