Protocol for a Non-Randomized, Pre-Post Intervention Study to Evaluate an Education Program on Female Genital Mutilation Health Risks Among Young Adults in Chamwino District, Tanzania

Abstract Background: Female genital mutilation (FGM) remains a significant public health issue in Tanzania, with high prevalence in the Dodoma region. Limited health information and targeted interventions for at-risk young adults hinder the abandonment of the practice across generations. This protocol describes a study designed to evaluate the impact of a community-based educational program on raising awareness of FGM health risks among young adults (15 to 19 years) in Chamwino District, Dodoma region, Tanzania. Methods: This study will employ a community-based, mixed-methods design. The quantitative component will be a non-randomized, single-arm, pre-post study with a follow-up multi-stage cluster sample extracted from schools and hospital wards, completing surveys pre- and post-intervention to assess changes in FGM awareness level. The qualitative component will involve interviews with young mothers (15-19) who have undergone FGM to explore their lived experiences. The intervention will include training in schools, hospitals, community gatherings, household visits, and community champions. The primary outcome will be the changes in level of awareness of FGM, whereas the secondary the change in attitudes, lived experiences, prevalence, and feasibility. Quantitative data will be entered and in SPSS V25 to produce univariate and multivariate statistics accordingly. Qualitative data will undergo inductive thematic analysis, as inspired by Braun & Clarke. Discussion: This study will provide critical evidence on the effectiveness of a multi-faceted educational intervention in increasing FGM awareness and changing attitudes among a key demographic. The use of a mixed-methods approach will allow for a comprehensive understanding of both the quantitative impact and the contextual, lived realities of FGM. The findings are expected to inform public health policies and targeted interventions aimed at accelerating the abandonment of FGM in Tanzania and similar contexts. Keywords: Awareness, Educational Intervention, Female Genital Mutilation, Mixed-Methods, Pre-Post Study, Young Adults, Tanzania