Measuring ‘harmful cultural practices’ using randomised response techniques: female genital cutting in Africa

Our goal is to develop new techniques to measure the scale and predictors of harmful cultural practices (HSPs) in low-income settings. These will transform understandings of why practices persist despite long-standing eradication efforts. The focus is on female genital cutting (FGC) in an Ethiopian population where rates (and risks to health) are high, and publicly-expressed views imply change in attitudes and practice. Characterising the extent of HCPs such as FGC is difficult as respondents may understate their practice/preferences (e.g. due to illegality) or overstate them (e.g. due to social pressures). Random response techniques (RRTs) are a powerful tool to elicit true responses to sensitive questions and identify variation in response biases. To date, these techniques have been under-applied to public health questions, and low-income settings.

We will develop innovative RRT infrastructure to investigate HCPs in Africa, to demonstrate the utility of such methods, and to establish a network of collaborating universities, policy-makers and NGOs. The work will enable a major research bid concerning multiple HCPs from sites across Africa, identifying individuals at greatest risk, and the social drivers of behavioural change.