Public education programmes and projects to build assertiveness among women are needed to break the silence and secrecy surrounding practices such as child marriage and Female Genital Mutilation (FGM), according to a leading expert on gender-based discriminatory practices.

Naana Otoo-Oyortey, the Executive Director of FORWARD - an organisation committed to enhancing the well-being and dignity of African girls and women - called for more research into the global spread of FGM and child marriage, as she spoke to staff at the Commonwealth Secretariat's London headquarters on 16 April.

"If you look at practices like FGM, it's women who spearhead these customs and tell their daughters not to talk about it," said Ms Otoo-Oyortey.

"I think it's very important to create spaces for women to talk. We must build assertiveness among women and it's important to start this from an early age."

Ms Otoo-Oyortey was one of the panellists at a Human Rights talk on promoting sexual and reproductive health in Commonwealth countries. The Secretariat offers assistance to the Commonwealth in examining the main legal challenges preventing women and adolescents from accessing sexual and reproductive health services.

Fellow panellist, Marge Berer, Editor of Reproductive Health Matters Journal, said: "We talk about reproductive rights but they are not largely binding on states. Reproductive rights are not technically recognised as human rights in any convention though the right to health is recognised and reproductive health is a part of health. The problem with human rights is that while they are binding on all the states who have signed the convention, there is little power to enforce them.

"Violations can be condemned, recommendations can be made, but there is little power to enforce them.

"Given the high levels of reproductive and sexual ill-health, high levels of maternal deaths and morbidity in the least developed countries, we can ask: where are women's rights to health and when are they coming?"

FGM includes procedures that intentionally alter or injure female genital organs for non-medical reasons - World Health Organization

According to Ms Otoo-Oyortey:

- three million girls undergo FGM annually, which could lead to long-term health problems such as cysts (a tumor in the skin or ovary), and difficulty conceiving and giving birth;

- the problem is global - an estimated 24,000 girls are at risk of FGM within England and Wales;

- Child marriage can impede international development assistance due to higher mortality rates (girls who give birth before they are 19 years of age are twice as likely to die during child birth) and the cycle of poverty;

- even where laws against child marriage are in place, a large proportion of girls still marry before their 18th birthday.

Ms Otoo-Oyortey concluded: "Somebody has to complain and somebody has to report this - but how many young girls are able to do this? There is community endorsement for these practices.

"Public education is critical - if you do not have awareness, the silence may continue."