Population Council

This report documents the evaluation of the Tostan approach, a village empowerment programme implemented by a non-governmental organisation (NGO) based in Thiès, Senegal. The evaluation revealed that women who participated in the programme have higher levels of knowledge and improved attitudes concerning gender-based violence, female genital cutting (FGC), and reproductive health (RH).

The basic education programme consists of four modules: hygiene, problem solving, women’s
health, and human rights. Through these four themes, emphasis was placed on enabling the participants, who were mostly women, to analyse their own situation more effectively and thus find the best solutions for themselves. The Supra Regional Project for the Elimination of Female Genital Cutting of GTZ funded implementation of the programme in 90 villages in Kolda Region, and the Population Council’s Frontiers in Reproductive Health Program, with
funding from USAID, used this opportunity to evaluate the programme in 20 villages.

The evaluation included women and men participating in the education programme who were interviewed before and after the intervention, and again two years later, to measure shifts in awareness, attitudes and behavior concerning RH and FGC. A group of women and men from 20 similar villages that did not receive the education programme were interviewed at the same time to serve as a comparison group. To test the
impact of the programme on community members’ willingness to abandon FGC, the proportion
of respondents’ daughters aged 0 to 10 years whose parents reported they had been cut was used as the primary outcome indicator.

Information the evaluation team obtained indicated that the education programme increased the awareness of women and men about human rights, gender-based violence, FGC and RH, but awareness of human rights, violence and FGC also increased in the comparison site, although to a lesser extent.
The consequences of FGC were better known, as were issues concerning contraception, pregnancy surveillance and child survival. In general, women’s knowledge improved more than men’s, except for with regard to sexually transmitted infections (STIs) and HIV. Diffusion of information from the education programme within villages worked well, as other women and men living in the intervention villages also
increased their knowledge on most indicators. For all indicators, apart from those concerning violence, the experimental group improved significantly more than the comparison group.

Information the evaluation team obtained indicated that the attitudes improved in the experimental group, with women and men denouncing discrimination, violence and FGC. Attitudes towards FGC also improved in the comparison group, but to a lesser extent than in the experimental group. There was a dramatic decrease in the approval of FGC, although a small proportion of women (16%) participating
in the programme did not change their attitude. Regret for having cut their daughters increased and fewer women were willing to cut their daughters in the future. Women perceived men’s attitudes towards contraception as improving. However, the intervention group showed higher levels of positive attitudes than the comparison group.

No change in use of contraception was observed over time, but pregnancy surveillance and use of delivery services improved compared with the comparison group, although delivery in health facilities remained low because of their inaccessibility. Communities have mobilised around maintaining peace and reducing discrimination, through establishment of committees for peace and management of conflicts.

The report states that the impact of the Tostan programme on women and men’s well being has been substantial. The programme has been able to bring about a social change within the community
and to mobilise the villagers for better environmental hygiene, respect for human rights and improvement of health, as well as specifically reducing support for and practice of FGC. Extending the Tostan programme to other areas of Senegal and to other African countries
could make a difference to the well-being of women and of the community as a whole.

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Click here to access additional reports and data on the replication of the Tostan programme in Burkina Faso.