The Philadelphia International Women’s Project (PIWP)

The Philadelphia International Women’s Project (PIWP)

CLINICAL CARE

Clinical and social care providers in the United States receive little or no formal training to care for women and girls affected by FGM/C. Provider unpreparedness can lead to poor patient outcomes, such as neglect, or mismanagement of problems related to FGM/C, and can discourage patients from seeking care.

We surveyed medical providers (students, residents, and clinicians) in the Philadelphia region and found that while nearly two-thirds had encountered FGM/C at least once, less than 14% had received formal training in FGM/C care. Thus, provider education is a key priority of PIWP. Our team offers lectures and workshops to multidisciplinary professionals on a range of core competencies related to FGM/C care, including cultural sensitivity, legal considerations, and prevention.

Drexel University Women’s Care Center (WCC) provides evidence-based gynecology, obstetrics, preventive care, and family planning services to a diverse, minority, and under-served population in Philadelphia. As the clinical home of PIWP, WCC delivers community-informed, culturally sensitive care to women and girls affected by FGM/C. Under the leadership of Dr. Sandra Wolf, Medical Director, and Dr. Jasjit Beausang, PIWP clients receive the full spectrum of reproductive health services regardless of insurance status or ability to pay. As part of a client-centered, holistic approach to wellness, each PIWP client meets with a full care team including the lead clinician, Peer Specialist, and resident-in-training.

PEER SUPPORT SERVICES

Peer-to-peer support is the cornerstone of PIWP’s success. Trained, culturally and linguistically congruent Peer Specialists based at African Family Health Organization (AFAHO) conduct outreach and education to diverse communities affected by FGM/C. Peer Specialists work to address the complex individual, interpersonal, community, and structural barriers imposed by the practice of FGM/C, ultimately breaking down powerful social stigmas. Providing integrated, culturally sensitive support, Peer Specialists connect clients to key clinical and social resources to support each woman’s journey, including educational support groups and group-based sex therapy. Peer Specialists also provide medical accompaniment to the WCC clinic, serving as language interpreters and cultural brokers between clients and clinicians. Peer support empowers clients to overcome the silence surrounding FGM/C and achieve their wellness goals. fostering a new culture of community health.

A FOCUS ON SEXUAL HEALTH

FGM/C can have a significant impact on sexual health and functioning. Pain, diminished desire, and inhibited sexual response are pervasive complaints. Women often feel that “something was taken away” from them and wonder if they can get it back. In response to these concerns, PIWP offers group-based sex therapy to affected women. Sex therapy groups are led by a licensed practitioner and give women the space to explore their questions and experiences among the safety of their peers, ultimately decreasing stress and optimizing well-being. There are currently two groups that meet on a monthly basis, one for West African clients and the other for Sudanese clients.

State(s):
Pennslyvania

Administering Organization:
Nationalities Service Center (NSC); Drexel Medicine Women's Care Center; African Family Health Organization (AFAHO)

Program Objectives:
Female genital mutilation/cutting (FGM/C) is an extreme form of gender-based violence that affects over 200 million women and girls globally and over half a million in the United States. FGM/C is linked to numerous immediate and long-term health problems, including pain, infection, childbirth complications, psychological injuries, and death. The greater Philadelphia region is home to the 8th largest population of women and girls impacted by or at risk of FGM/C in the U.S. Immigrant women affected by FGM/C face significant barriers to high quality health care, including insurance status, discrimination, low health literacy, cultural and linguistic barriers, and provider inexperience. The taboo, secretive belief system around FGM/C often prevents women from seeking care or voicing their experiences and concerns. The Philadelphia International Women's Project (PIWP) was established in 2016 as a partnership between Nationalities Service Center (NSC), the Drexel University Women’s Care Center (WCC), and the African Family Health Organization (AFAHO). PIWP is a comprehensive, community-based health care home that aims to improve the health and wellness of women affected by FGM/C through four major strategies: community outreach, peer-to-peer support, clinical services, and provider education.

Resource Materials:
To view PIWP resources, visit http://serc.mb.ca/wp-content/uploads/2018/08/Wrk-with-Women-Girls-2015.pdf

Groups Served by Program:
Since the launch of PIWP in July of 2016, over 250 immigrant women from 17 countries in Western and Eastern Africa have enrolled in clinical and/or social services. This does not include those reached through education sessions, support groups and other general outreach.

Program Funding:
The Philadelphia International Women's Project is supported by funding from the U.S. Office on Women's Health under the Department of Health and Human Services.

Program Staffing and Training:
PIWP is staffed by a multidisciplinary professional team with expertise in clinical OBGYN, public health, social work, and human sexuality.

Program Evaluation:
Program evaluation is conducted with support from the Office on Women's Health and the Public Health Management Corporation (PHMC). On the client side, PIWP gathers data on number of clients enrolled, services sought, and attendance at support and sex therapy groups. We also track the number of clinical providers and other community stakeholders who receive training on FGM/C. Finally, we are engaged in a number of research investigations to help us understand the complex healthcare needs, attitudes, and experiences of women affected by FGM/C.

Program Outcomes:
As of October 2018, PIWP clinicians have delivered 342 clinical encounters to 239 unique patients and have completed 37 examinations for asylum claims. We have trained over 600 medical providers and over 200 non-medical providers in best practices for working with clients affected by FGM/C. Finally, PIWP has hosted over 15 sex therapy groups. Additional program outcomes are currently being measured through research and will be reported when available.

Additional Comments:
For more information about PIWP, please visit our website at www.drexelmedicine.org/piwp.

Program Contact:
Emily Finley 267-507-6623 edf37@drexel.edu

Program Dates:
July 2016 - present (November 2018)

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