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Improve health services for IDP women in Somalia by turning women who perform FGM into agents of change

Improve access to medical and sanitation facilities and turn IDP women, especially those who previously performed FGM, into agents of change

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What specific problem(s) are you trying to address?

One out of every 12 women in Somalia die due to pregnancy related causes. Female Genital Mutilation is done on girls between the ages 4 to 11 and the practice can be linked to the high numbers of Mother and Child death as the fetus is exposed to a range of infectious diseases and faces the risk of having its head crushed in the damaged birth canal. FGM has no foundation in religion, but is widely believed to be a religious obligation. It is therefore important to work with the religious community when raising awareness on the dangers of FGM. Another element to combatting FGM is to target the women who perform the procedure and steer them away and incentivize them to another type of livelihood

What are some of your unanswered questions about the problem(s) you are working to address?

1) How to best mobilize the community so that we will be able to communicate the positive impact of having a midwifery training center/ How to be able to have a clear and frank conversation on taboo subjects without causing resentment, 2) How to best target those who depend on conducting FGM as a livelihood and incentivize them to change livelihood.

Explain Your Idea

In order to decrease the high rates of maternal mortality and morbidity caused by complications during pregnancy/ delivery in IDP camps in Kismayo, the capacity of IDP women needs to be improved so that they can steer away from traditional harmful practices that only act to exacerbate the current maternal death and morbidity rates. Accordingly, increasing the capacity of local IDP women is done by targeting women who previously conducted FGM and provide them with midwifery training, information on the health implications of FGM as well as what Islam states about FGM. The target group does not only have to be those who have conducted FGM but also other young women who want to learn how to become midwives. These women will be provided with resources and linkages to health care clinics so that they can conduct midwifery services to IDP women in need. Women who previously conducted FGM can become agents of change and spokespersons to eradicate FGM as a practice. The community also receive access to health and sanitation facilities leveraged through our already existing activities. This can improve Health services resilience and preparedness.

Name the three most important ways that your idea will address your identified problem(s).

1. By increasing access too medical and sanitation facilities as well as skilled staff in IDP camps, more displaced mothers can receive medical attention during delivery. 2. By targeting women who perform FGM, and provide them with resources to conduct another livelihood as well as make them into spokespersons against FGM, we provide an incentive to steer away from conducting FGM as a livelihood. 3. By economically empower 40 women, they will be able to take charge of their own situation as well as act as role models in the community.

How is your idea unique?

Our idea is unique in that it takes a multidimensional approach to manage the current situation, focusing on IDPs, linking capacity building with livelihood creation, constructing medical and sanitation facilities, thus reduce vulnerability, and improve access to midwifery services and by especially targeting those who previously depended on FGM for a livelihood. ARC as an organization has extensive experience working with IDP’s, livelihood creation, skills development and Health. We can create synergies between already existing activities in the target area in order to accomplish maximum impact. As we have been operating in Somalia since 2011, providing essential humanitarian assistance in areas where other international organisations cannot access, we believe that we are the most suitable to conduct this type of intervention.

What are some outstanding concerns or questions that you have regarding your idea?

There is risk that trained women leave the camps in order to pursue better employment opportunities elsewhere either in urban areas or abroad.

Who are your end users?

The target beneficiaries are first and foremost all those who live in the targeted IDP camp, especially IDP girls 0-18 who are at risk of FGM and IDP girls/women 18-65 who are interested in becoming midwifes. 40 Midwives to be trained and provided livelihood opportunities. Furthermore, 480 women to be reached through monthly information sessions. The community will thus benefit as the practice of FGM decreases and access to midwifery services increases. They will also receive access to health and sanitation facilities leveraged through our already existing activities.

Where will your idea be implemented?

  • Somalia

What is the primary type of emergency setting where your innovation would operate?

  • Armed conflict
  • Prolonged displacement
  • Extreme drought
  • Epidemic
  • Community at risk of disaster

Tell us more about the emergency setting that you intend to implement in

The community suffers from a protracted humanitarian situation caused by conflict, poverty, lack of access to basic services as well as morbidity. Main challenges that exists in IDP camps in Kismayo, includes overcrowding, land tenure conflicts and forced evictions as well as seasonal droughts and floodings. Somalia is a patriarchical society where women have limited judicial rights and ability to conduct their own livelihoods.

What is your organization's name?

American Refugee Committee (ARC)

Tell us more about you.

American Refugee Committee (ARC) is an international nonprofit organization based in Minneapolis, USA and active in 29 countries. ARC Somalia provides life-saving and self-reliance assistance to refugees, displaced persons and communities affected by natural and man-made disasters, including primary and curative health care, water and sanitation, protection services, restoration of strategic health and water infrastructure, sustainable use of natural resources, shelter/housing for returning refugees as well as sustainable livelihood projects including, microcredit/income generation, Women Economic Empowerment, Technical Vocational Training and formal education.

Organizational Characteristics

  • International/global organization

What is the current scale of your proposed innovation?

  • Community - 1+ communities within 1 country

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

ARC Somalia has a registered office in Nairobi Kenya, as well as registered field offices in Mogadishu, Kismayo, Hargeisa, Garowe, Laascaanood, Afmadow, Dhobley and Balcad.

What is your organizational status?

  • Registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Roll-out/Ready to Scale: Completed a pilot and am ready / in process of expanding.



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Hi @Anges and Team!

An important reminder, Refinement Phase closes this Thursday, October 26 at 11:30pm PST.

We can only consider complete submissions, so please make sure that you have reviewed the Feedback and Refinement Phase Checklists and answered all of the questions on the platform. Note that we added one more multiple choice question to the end of the form.

If you're having trouble figuring out how to edit your idea, please refer to this guidance:

Best of luck!

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Hi Agnes  and Team,

We’re excited to share feedback and questions with you from a set of experts that are supporting this Challenge.

We encourage you to think about this feedback as you continue to improve your idea, whether that’s refining it or adding more context. You are welcome to respond in the comments section and/or to incorporate feedback into the text of your idea. Your idea and all associated comments will all be reviewed during the final review process, but all critical information should be in the body of your contribution somewhere.

Some things Experts were excited about:
One expert shared, “this idea is tackling a number of different issues through its proposed activities and, if successful, would increase the number of safe baby deliveries, reduce the prevalence of FGM in this IDP population, and increase some women's economic strength.”
“This is a desirable initiative, in principle and valuable to the multiple end users. It seems practical, although the costs of training the midwives (plus the quality of the training) and their subsequent income options are unclear - further information may help illustrate how sustainable this idea is.”You do a great job addressing the Challenge prompt.

Some questions Experts had were:
What’s prevalence of FGM in camps in Kismayo and data around the problem? How many women will be served? Do health workers have the necessary skills and training around FGM?
How are women selected to participate?
Would like to understand the broader work on education and referral to other health services - e.g. what will the women and girls reached through the 'information sessions' learn about their rights and broader sexual and reproductive health issues/available services?
“FGM is a sensitive topic - and many of the women and girls in the camps may have experienced severe trauma already. This idea is strong but should have a very clear 'do no harm' strategy. - you rightly point out the risk of the trained midwives leaving for other opportunities elsewhere - it would be interesting to know what mitigating approaches they could take to limit this risk. It would also be helpful to know how the midwives are trained (by whom) and who would pay their salaries in the camp after the training is complete. Do you employ Somali staff and do you work with any other smaller organisations in order to implement projects?”

Thank you for sharing the important work you are doing.

In case you missed it, check out this Storytelling Toolkit ( for inspiration on crafting strong and compelling stories as well as the recorded Office Hour ( Storytelling is an incredibly useful tool to articulate an idea and make it come to life for those reading it. Don’t forget - the last day to make changes to your contribution on the OpenIDEO platform is October 26 at 11:30PM PST.

Have questions? Email us at

We look forward to reading more, and thank you for the important work that you are doing!


Any idea that to reduce or eliminate female genital mutilation or cutting FGM/C is appreciable and important in order to save the future baby girls. Since, both Somaila and Afar pastoral are practicing the worst form of FGM/C practice type 3 according to WHO classification. Therefore, every days both pastoral women's and girls are suffering and die by FGM/C related health problem. According to demographic and health survey /DHS/ data of FGM type 3 practicing country its one of the factor of high rate of Neonatal Mortality and morbidity rate. As per my opinion, I believe that it needs to stop this harmful traditional practice at any form of strategies, approaches, and innovation ideas.

As for your idea, its not enough to stop or reduce the FGM practice who previously conducted FGM can become agents of change and spokespersons to eradicate FGM. Because, the FGM/C practice is directly linked with society social norms, beliefs, and culture. As per our long year experience of the sector it would be better to build your idea focusing on pregnant mother, Circumcises-er or TBAs, religious and clan leaders and In school youth conversation. Working with pregnant mother is valuable to protect the future baby daughter. Since, the pregnant mothers have a full responsibility to do or not FGM or you can focus that depend on your context. The other thing is religious leaders, the majority Muslim country practicing FGM as a requirement of Muslim religion. In addition, in school youth also the future generation that to be focused to End FGM practice. As mentioned above, If you accept that, I would like to suggest you to revise your target groups in order to stop FGM as per your context. Thank you!

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Thank you so much for your feedback! I agree with you that of course in order to tackle phase 3 FGM, we need to look at the issue holistically. Involving the religious community is essential, which I also mentioned in the proposal. This is a point of departure in order to ensure that those who depend on conducting FGM are equipped with other skills that can help them to adopt other livelihood strategies. Also, by not only targeting those who conduct FGM but also offering young women in general a way in to the labour market and work with community awareness we hope that women will share their experiences and find a way to change practices by themselves. The religious community is essential in order to bring a context and provide religious justifications for why change is necessary, but as the practice is conducted by women it is also important that women talk to other women on this issue. Thank you!