UNICEF. (2008). Long-term evaluation of the Tostan Programme in Senegal: Kolda, Thies and Fatick Regions. Section of Statistics and Monitoring, Division of Policy and Practice. New York, NY: UNICEF.  

The main objective of the evaluation was to assess the lasting impact – in 2006 - of the Tostan basic education program undertaken between 1997 and 2000.  The quantitative portion measured changes in the prevalence rate of female genital cutting among girls, their age at first marriage, and improvements to the health status of mothers and children.  In its qualitative component, the evaluation aimed to examine Tostan’s establishment process in the villages, to understand how villages organized their participation in the public declarations, and to learn women’s opinions about the impact of the program.  The evaluation was conducted for UNICEF under the direction of Macro International Inc. by the Centre for Research in Human Development and the Population Council in Dakar.

The evaluation found that:

• The Tostan basic education program increased the level of knowledge, changed attitudes and behavior in the participating communities,
• Public declarations represented a significant moment in the decision-making process for the community, with data indicating that actual abandonment took place following this demonstration of collective commitment,
• The Tostan program accelerated the abandonment of FGC. Among villages that participated in the Tostan program and a public declaration, prevalence of FGC dropped by approximately 70%   compared to a drop of 40% in control villages,
• Among women with uncut girls, the rate of women reporting they did not have the intention to cut their daughter was three times as high in Tostan communities than control villages,
• Public declarations and the Tostan program contributed to a slight reduction in the prevalence of marriage of girls under 15 years old, and the tendency to delay the age at first marriage was even stronger among women aged 15-18 years, and
• The communities reached through organized diffusion also showed dramatic decreases in prevalence of FGC and positive signs in early marriage abandonment.

Tostan’s understanding of social norms and the diffusion of the decision in the intra-marrying networks confirms the evaluations findings that a critical mass of community members will abandon the practice at the time of the public declaration, and the prevalence rate will diminish over time as families cease to cut their daughters.

The long-term evaluation of the Tostan program has shown through rigorous measurement that the approach based on human rights, long-term involvement in the community, and public declaration contributes significantly to the abandonment of FGC and child/forced marriage.  The evaluation is currently being used as evidence to formulate the second national action plan for the total abandonment of FGC in Senegal by 2015 in partnership with the Ministry of Family, UNICEF and UNFPA among other government and nongovernmental partners.

The Population Council published a separate report on the findings of the qualitative portion of the long-term impact evaluation of the Tostan program.  

UNICEF, in partnership with the Gambia government through the national Women’s Bureau, and Tostan launched a three-year CEP initiative in The Gambia (2006 – 2009), directly targeting some 80 Mandinka & Fula communities and some 63 adopted communities/ villages in URR.  The process evaluation findings indicate in general that the Tostan programme, and its approach & strategies are well suited for sustained community- led development capable of eventually leading to the abandonment of FGM/C in 40 % or more of the project communities in The Gambia.  There is empirical and anecdotal evidence from the study to confirm that the project objectives are being realized to a large extent.  

"Tostan will achieve all project goals in a timely manner and with a high degree of quality.  The Tostan approach should, however, not be narrowly interpreted as being an intervention only targeting the abandonment of harmful practices such as female genital cutting (FGC) or early and forced marriage.  The program, divided into two parts consisting of more than one hundred interactive sessions on democracy, human rights, problem solving, hygiene and health, is one of the most important factors contributing to the success of the intervention.  Impressive outcomes have been achieved, which include—amongst many others—improved utilization of health services, community organizational development, empowerment of communities, particularly women, and social-mobilization activities."

In 2004, Frontiers in Reproductive Health (with the Population Council) conducted an experimental study to evaluate the success of Tostan’s nonformal education program in 20 villages in which it had been implemented.  (They used 20 control villages where the program had not been implemented.)  The researchers found that, in terms of knowledge, attitudes, and behavior regarding reproductive health, human rights and FGC, Tostan’s program results were significant.  The study states:

The impact of the Tostan program on women’s and men’s well-being has been substantial.  The program has been able to bring about a social change within the community and to mobilize the villagers for better environmental hygiene, respect for human rights, and improvement of health.  Extending the Tostan program to other areas of Senegal and to other African countries could make a difference in the well-being of women and of the community as a whole.

Diop, Nafissatou J., Djingri Ouoba, Zakari Congo, Molly Melching, Baya Banza, Georges Guiella, and Inge Baumgarten.  " Experience from a community-based education program in Burkina Faso: The Tostan program," FRONTIERS Final Report. Washington, DC: Population Council.

The Population Council reported on a collaborative project between Tostan and Mwangaza Action in Burkina Faso designed to replicate the Tostan program.  The project was highly successful, as made clear in the project evaluation:

In Burkina Faso, the community-based education [Tostan] programme involved 23 villages. … During the implementation of the Tostan programme … many positive changes occurred in the participating villages.  The communities now promote reproductive health and human rights and hold regular clean-up activities for improving public hygiene.  Also, these villages are now standing up against violence toward women.  The utilization of health services, antenatal care, family planning and child health have significantly increased. […] At the end of the programme, the 23 communities made a public declaration for abandonment of the practice of FGC in front of 5,000 villagers, religious, traditional and political leaders, the media and programme managers from government, NGOs, and international organizations.

The movement to end FGC in Senegal is cited as one of eight innovations that promote women’s empowerment and gender equality throughout history.

Start with a Girl highlights Tostan for its innovative programs in the effort to eliminate FGC.

This report describes why and how to initiate effective investments that will give adolescent girls in developing countries a full and equal chance for rewarding lives and livelihoods.  Tostan is cited for its work on community development and FGC abandonment.

Based on the 2004 evaluation conducted by the Population Council and cited above, Gryboski, et al. in Health Bulletin: A Publication of the Population Reference Bureau compared five community-based programs deemed effective for improving health care.  Tostan, one of the five programs, was given the highest overall score for community participation because of our efforts to work on health goals identified by the community.

UNICEF featured Tostan’s program as a leading FGC intervention, meeting all six of its recommended key elements for FGC abandonment, in the 2005 UNICEF Innocenti Digest entitled Ending a Harmful Traditional Practice: Female Genital Mutilation/Cutting.