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Two hundred million girls and women in the world are estimated to have undergone female genital mutilation (FGM), and another 15 million girls are at risk of experiencing it by 2020 in high prevalence countries (UNICEF, 2016. Female genital mutilation/cutting: a global concern. 2016). Despite decades of concerted efforts to eradicate or abandon the practice, and the increased need for clear guidance on the treatment and care of women who have undergone FGM, present efforts have not yet been able to effectively curb the number of women and girls subjected to this practice (UNICEF. Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change. 2013), nor are they sufficient to respond to health needs of millions of women and girls living with FGM. International efforts to address FGM have thus far focused primarily on preventing the practice, with less attention to treating associated health complications, caring for survivors, and engaging health care providers as key stakeholders. Recognizing this imperative, WHO developed guidelines on management of health complications of FGM. In this paper, based on foundational research for the development of WHO’s guidelines, we situate the practice of FGM as a rights violation in the context of international and national policy and efforts, and explore the role of health providers in upholding health-related human rights of women at girls who are survivors, or who are at risk. Findings are based on a literature review of relevant international human rights treaties and UN Treaty Monitoring Bodies.

Nutrition is a direct contributor and target to Sustainable Development Goal 2 (“End hunger achieve food security and improved nutrition and promote sustainable agriculture”) a foundation and pre-requisite to Sustainable Development Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”) and a decisive enabler to the remaining goals of the Sustainable Development Agenda 2030. The World Health Organization (WHO) supports all Member States to achieve “a world free of all forms of malnutrition where all people achieve health and well-being” a vision supported by our work with Member States and their partners to ensure universal access to effective nutrition actions and to healthy and sustainable diets1 in the context of the overall effort to ensure universal health coverage2. To do this WHO uses its convening power to help facilitate and align priority setting to mainstream nutrition in the health and development agenda; develop evidence-informed guidance supported by the highest quality science and ethical frameworks; support the adoption of guidance its implementation and the integration of effective actions into existing or new delivery platforms in the health systems. WHO guidelines are documents developed by WHO containing recommendations for clinical practice or public health policy and programmes. A recommendation tells the intended end-user of the guideline what he or she can or should do in specific situations to achieve the best health and nutrition outcomes possible individually or at the population level. It offers a choice among different interventions or measures having an anticipated positive impact on health and nutrition and implications for the use of resources.3 The WHO Department of Nutrition for Health and Development (NHD) develops guidelines in accordance with the procedures established in the WHO Handbook for Guideline Development.2 The WHO guideline development process ensures that WHO guidelines are of high methodological quality and are developed through an independent transparent evidence-informed consensual decision-making process. Though the process with which WHO develops guidelines is highly structured systematic and transparent the process for priority setting (i.e. prioritizing topics4 for guideline development) has been a dynamic one in order to accommodate new and renewed high-level commitments from the WHO Secretariat as well as emerging issues arising from discussions among Member States in the Governing Body fora such as the World Health Assembly (WHA). The priority issues are determined by their importance (i.e. magnitude prevalence and distribution of disease or nutrition problems) or the existence of preventable or modifiable biological behavioural and contextual determinants (risk factors). Updating guidelines is challenging if evidence has to be retrieved to support an increasing number of recommendations. In this situation it is important to give priority to assuring the principle of “primum non nocere” (first do no harm) to address controversial areas and to set a position on areas in which new evidence has emerged and requires prompt action. Ensuring a well-understood and efficiently communicated prioritization process is therefore crucial as external partners and stakeholders play an important role in the WHO guideline implementation process. Independence and transparency of the prioritization process gives the Organization a means of providing assurance that the process is free of any undue influence that may affect the reputation and objectivity of WHO. Therefore in an effort to maintain transparency in the normative work of WHO and to enhance the understanding of the process used to prioritize topics for guideline development among Member States and stakeholders the Department of Nutrition for Health and Development (NHD) is leading the work on making the prioritization process more accessible and has developed an online tool to further facilitate the participation of Member States and their stakeholders in the guideline prioritization process. This process aims to complement the decisions of the World Health Assembly (WHA) the decision-making body of WHO. (Excerpts