I don’t want more kids and I’m afraid to get pregnant,” said Fatima*, a 37-year-old Syrian refugee and mother of six, at a UNFPA-supported clinic.

For years, Aja Babung Sidibeh would gathered girls together in the Central River Region of the Gambia and prepared them to take part in an initiation rite. The girls would come stay with her until a circumciser arrived to cut them – a practice known as female genital mutilation...