A/HRC/29/20 64. Despite the commitment of Governments to address the practice, in many instances support in the form of shelters and other services for victims and girls at risk are inadequate. Very few countries make provisions in law or policy to offer protection following allegations of female genital mutilation. The practice does not fit easily into systems to prevent violence against women or child protection systems. For instance, in several European countries, agencies that typically report on suspected child abuse cases do not report female genital mutilation as they are often unaware of its occurrence. Furthermore, most domestic violence shelters do not accommodate children, constraining many girls to take refuge in schools or in the home of community leaders, at times with limited access to food or sanitation and exposure to further risks. 65. In the area of service provision, a key challenge is the lack of evidence on effective interventions and strategies to mitigate the health consequences of female genital mutilation. This includes a need to improve the knowledge base about obstetrical and gynaecological consequences.25 66. The persistence of social norms that perpetuate female genital mutilation, differences in the underlying reasons for the practice and cultural environments where it takes place make it particularly challenging to eliminate the practice. However, the positive results of programmes to prevent female genital mutilation demonstrate that attitudes in support of the practice can be successfully addressed. V. Conclusions and recommendations 67. States have the obligation to respect, protect and fulfil the right of women and girls to live free from female genital mutilation. Good practices in a number of countries should be supported, increased in scale and replicated. They include: (a) The establishment of comprehensive policies, such as action plans, involving all relevant ministries and other stakeholders, including religious and community leaders, teachers, health providers and the media; (b) The adoption and implementation of legislation that prohibits female genital mutilation, in accordance with international human rights laws; (c) Comprehensive education and awareness-raising programmes targeting women and men at all levels of society, including religious and community leaders, on the harm and root causes of female genital mutilation and responses; (d) Campaigns to change societal norms that drive the practice, and the creation of an enabling and supportive environment for the human rights of women; (e) Campaigns that delink the practice from religion, and the debunking of social norms, harmful stereotypes and cultural beliefs that perpetuate discrimination on the basis of sex, gender, age and other intersecting factors; (f) The incorporation of guidelines on female genital mutilation into medical education and training curricula; 25 16 WHO has identified four thematic areas where research is needed to improve clinical management on the basis of significant gaps in the evidence and controversy regarding optimal management: (a) obstetric outcome and post-partum perineal re-education; (b) defibulation outside of pregnancy or labour; (c) clitoral reconstruction; and (d) training, skills and confidence of health care providers. See J. Abdulcadir, M.I. Rodriguez and L. Say, “Research gaps” (see para. 5, footnote 4).