Category Archives: Original research

Attitude toward female genital mutilation among Somali and Harari people, Eastern Ethiopia.

FREEInt J Womens Health. 2016; 8: 557–569.

Attitude toward female genital mutilation among Somali and Harari people, Eastern Ethiopia.

Abathun AD, Sundby J, Gele AA

ABSTRACT

Background: Female genital mutilation (FGM) is a worldwide problem, and it is practiced by many communities in Africa and Asia as well as immigrants from those areas. This practice results in short- and long-term health consequences on women’s health. Like many other developing countries, FGM is widely practiced in Ethiopia, especially among Somali and Harari ethnic groups. Despite intensive campaigns against FGM in Ethiopia, since 2011, it has been practiced in the aforementioned communities. There is no recent information as to whether these campaigns have an impact on the attitude and practice of the community regarding FGM. This qualitative research was aimed at exploring the attitudes of Somali and Harari people between 18 and 65 years toward FGM. Methods: A purposive sampling technique was used to recruit 64 (32 in each region) participants. Data were collected from October to December 2015 in Somali and Harari Regions. Results: The findings showed that there was a strong support for the continuation of the practice among female discussants in Somali region, whereas male discussants from the same region and the majority of the participants from Harari region had a positive attitude toward the discontinuation of the practice. Marriageability was the major reason for practicing FGM in Somali region, whereas making girls calm, sexually inactive, and faithful for their husbands were mentioned in Harari region. Although young men in both the regions prefer to marry uncircumcised girls, the study showed that there are some differences in the attitude toward the FGM practice between the people in the two regions. Conclusion: The findings show that there is an attitudinal difference between the people in the two regions, which calls for behavioral change communication using women-centered approach and culturally appropriate strategies. As young people in both the regions had the intention to marry uncircumcised girls, there has to be a strong advocacy and multisectoral collaboration to stop FGM in both the regions.

This article can be accessed in this LINK.

Counselling professionals’ awareness and understanding of female genital mutilation/cutting: Training needs for working therapeutically with survivors.

FREECouns Psychother Res. 2017 Dec;17(4):309-319. doi: 10.1002/capr.12136. Epub 2017 Jul 20.

Counselling professionals’ awareness and understanding of female genital mutilation/cutting: Training needs for working therapeutically with survivors.

Jackson C

ABSTRACT

Background: There is a dearth of literature that has looked at the psychological  impact of female genital mutilation/cutting (FGM/C), and little is known about the understanding and awareness of FGM/C amongst counselling professionals. Method: An online survey was completed by 2073 BACP members. The survey covered four broad themes: demographics; awareness and understanding of FGM/C; experience of working therapeutically with survivors; and FGM/C training. Descriptive and inferential analyses were undertaken on quantitative data, and thematic content analysis was undertaken on qualitative data. Results: Only a small proportion of respondents (10%) had knowingly worked with survivors of FGM/C. Overall, respondents lacked confidence in their awareness and understanding of FGM/C, including their safeguarding duties. Having cultural respect, knowledge and understanding was perceived as the most helpful factor
when working with this client group. Less than a quarter of respondents had undertaken any training with regard to FGM/C, although the vast majority expressed a desire to do so. Discussion: This research has highlighted the importance of improving signposting to existing training and educational resources around FGM/C, as well as the need to develop new resources where appropriate. The importance of embedding cultural competency into core practitioner training, not just training specific to FGM/C, is paramount.

This article can be accessed in this LINK.

I knew how it feels but couldn’t save my daughter; testimony of an Ethiopian mother on female genital mutilation/cutting.

FREEReprod Health. 2017 Dec 1;14(1):162. doi: 10.1186/s12978-017-0434-y.

I knew how it feels but couldn’t save my daughter; testimony of an Ethiopian mother on female genital mutilation/cutting.

Adinew YM, Mekete BT

ABSTRACT

BACKGROUND: World Health Organization defines female genital mutilation/cutting as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. The practice is common in Ethiopia, especially among Somali (99%) ethnic groups. Even though FGM/C is labeled illegal practice according to the revised 2005 Penal Code of the country, the practice is still responsible for misery of many girls in Ethiopia. METHODS: This personal testimony is presented using woman’s own words. Data were collected through in-depth interview with a woman at Gursum health center, Somali regional state, eastern Ethiopia on June 19/2016. The interview was conducted in a private environment and original names were changed to overcome ethical concerns. Informed written consent was obtained from the participant prior to data collection. The interview was audio-taped using a digital voice recorder, later transcribed and translated verbatim from the local language, Amharic to English. RESULTS: The study participant described a range of experiences she had during her own and her daughter’s circumcision. Three themes emerged from the woman’s description: womanhood, social pressure and stigmatization of uncircumcised women and uncertain future. CONCLUSION: Even though the national prevalence may show a decline, FGM/C is still practiced underground. Thus, anti-FGM/C interventions shall take in to account elders influence and incorporate a human rights approach rather than relying merely on the dire health consequences. Further exploration of the determinants of FGM/C on a wider scale is recommended.

This article can be accessed in this LINK

Married women’s negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

Clinical Simulation in Nursing. 2017 Dec;14:79-84. doi: 10.1016/j.srhc.2017.09.003. Epub 2017 Sep 30.

Married women’s negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

Chai X, Sano Y, Kansanga M, Baada J, Antabe R

ABSTRACT

OBJECTIVE: Married women’s ability to negotiate for safer sex is important for HIV prevention in sub-Saharan Africa, including Kenya. Yet, its relationship to female genital mutilation is rarely explored, although female genital mutilation has been described as a social norm and marker of womanhood that can control women’s sexuality. Drawing on the social normative influence theory, this study addressed this void in the literature. METHODS: We analysed data from the 2014 Kenya Demographic and Health Survey using logistic regression. Our sample included 8,602 married women. Two indicators of safer sex, namely the ability to refuse sex and the ability to ask for condom use, were explored. RESULTS: We found that women who had undergone genital mutilation were significantly less likely to report that they can refuse sex (OR=0.87; p<.05) and that they can ask for condom use during sexual intercourse (OR=0.62; p<.001) than their counterparts who had not undergone genital mutilation, while controlling for theoretically relevant variables. CONCLUSION: Our findings indicate that the experience of female genital mutilation may influence married women’s ability to negotiate for safer sex through gendered socialization and expectations. Based on these findings, several policy implications are suggested. For instance, culturally sensitive programmes are needed that target both married women who have undergone genital mutilation and their husbands to understand the importance of safer sexual practices within marriage.

This article can be accessed in this LINK

 

The ‘heat’ goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya.

Reprod Health. 2017 Dec 2;14(1):164. doi: 10.1186/s12978-017-0433-z.FREE

The ‘heat’ goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya.

Esho T, Kimani S, Nyamongo I, Kimani V, Muniu S, Kigondu C, Ndavi P, Guyo J

ABSTRACT

BACKGROUND: Female genital mutilation/cutting (FGM/C) has been implicated in sexual complications among women, although there is paucity of research evidence on sexual experiences among married women who have undergone this cultural practice. The aim of this study was to investigate the sexual experiences among married women in Mauche Ward, Nakuru County. METHODS: Quantitative and qualitative data collection methods were used. Quantitative data were obtained from 318 married women selected through multistage sampling. The women were categorized into: cut before marriage, cut after marriage and the uncut. A questionnaire was used to collect demographic information while psychometric data were obtained using a female sexual functioning index (FSFI) tool. The resulting quantitative data were analyzed using SPSS® Version 22. Qualitative data were obtained from five FGDs and two case narratives. The data were organized into themes, analyzed and interpreted. Ethical approval for the study was granted by Kenyatta National Hospital-University of Nairobi Ethics and Research Committee. RESULTS: The mean age of the respondents was 30.59 ± 7.36 years. The majority (74.2%) had primary education and 76.1% were farmers. Age (p = 0.008), number of  children (p = 0.035) and education (p = 0.038) were found to be associated with sexual functioning. The cut women reported lower sexual functioning compared to the uncut. ANOVA results show the reported overall sexual functioning to be significantly (p = 0.019) different across the three groups. Women cut after marriage (mean = 22.81 ± 4.87) scored significantly lower (p = 0.056) than the uncut (mean = 25.35 ± 3.56). However, in comparison to the cut before marriage there was no significant difference (mean = 23.99 ± 6.63). Among the sexual functioning domains, lubrication (p = 0.008), orgasm (p = 0.019) and satisfaction (p = 0.042) were significantly different across the three groups. However, desire, arousal and pain were not statistically different. CONCLUSION: Generally, cut women had negative sexual experiences and specifically adverse changes in desire, arousal and satisfaction were experienced among cut after marriage. FGM/C mitigating strategies need to routinely provide sexual complications management to safeguard women’s sexual right to pleasure subsequently improving their general well-being.

This article can be accessed in this LINK

Introduction of culturally sensitive HIV prevention in the context of female initiation rites: an applied anthropological approach in Mozambique

LMEJ Afr AIDS Res. 2009;8(4):491-502.

Introduction of culturally sensitive HIV prevention in the context of female initiation rites: an applied anthropological approach in Mozambique

Kotanyi S, Krings-Ney B

ABSTRACT

In Mozambique, initiation rites represent the most appropriate socio-cultural context for dealing with sexuality for a large part of the population. As the group most vulnerable to HIV exposure, HIV-prevention counselling could be ideally introduced to young women during initiation rites. This article demonstrates how interventions can take advantage of the positive aspects of this tradition. We discuss local notions of social ‘contamination’ versus biological ‘contamination,’ and we present a culturally sensitive communication strategy to bridge the divergent paradigms around AIDS-similar symptoms. Because of the emotional importance of the initiation rites, the suggested approach goes far beyond cognitive knowledge. After training, the godmothers in initiation rites became highly motivated to teach novice girls about HIV prevention and they trained other elderly women as well. Thus, the initiation rites turned into a process of empowerment for women in their own communities. A central agenda of the female initiation rites in Mozambique is to inculcate respect towards ancestors, elders, authorities and others; however, this respectful attitude between genders and between generations is disappearing due to factors like warfare and the cash economy. HIV-prevention counselling may be successfully introduced into initiation rites because of the unconscious, emotional impact of the process on the initiates’ behaviour. Other studies have shown that cognitive knowledge is not enough to lead to behavioural changes. Without changing the traditional initiation rites for females, which in Mozambique includes no genital cutting, a complementary approach introduces HIV-prevention counselling during ritual counselling moments, thereby motivating godmothers and novice girls and young women to be more aware and take precautions to prevent HIV infection.

This article can be accessed in this LINK

Delivering culturally sensitive, sexual health education in western Kenya: a phenomenological case study.

Afr J AIDS Res. 2017 Sep;16(3):193-202. doi: 10.2989/16085906.2017.1349682.

Delivering culturally sensitive, sexual health education in western Kenya: a phenomenological case study.

Lacey G

ABSTRACT

While generic programmes have been created to raise sexual health awareness, these cannot always be applied to communities whose cultures and circumstances make them especially vulnerable to infection. Taking a phenomenological approach, this paper examines the circumstances of the Gusii people of Kisii, Kenya, and examines the specific challenges of providing sexual health education to the community as experienced by an ethnic Gusii woman, Joyce Ombasa. Joyce’s story reveals that the Gusii living in and around rural villages have several cultural characteristics that make them susceptible to HIV/AIDS and that render community health education problematic, especially if offered by a female educator of the same ethnicity. Women cannot teach men. Discussions of sex and condom use, and viewing the naked bodies of the opposite sex are taboo. Promiscuity is commonplace and there is a reluctance to use condoms and to undergo HIV testing. Female circumcision persists and there is a high rate of sexual violence, incest and intergenerational sexual intercourse. In addition, government policies and legislation threaten to exacerbate some of the sexually risky behaviours. Bringing HIV education and female empowerment to the rural Gusii requires a culturally sensitive approach, discarding sexual abstinence messages in favour of harm minimisation, including the promotion of condom use, regular HIV testing and the rejection of female circumcision and intergenerational sex. Trust needs to be built through tactics such as adopting a complex and fluid outsider identity and replacing formal sex education with training in income generating skills and casual discussions regarding condoms and sexual health.

This article can be accessed in this LINK

Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran.

FREEIran J Public Health. 2017 Sep;46(9):1265-1274.

Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran.

Daneshkhah F, Allahverdipour H, Jahangiri L, Andreeva T

ABSTRACT

BACKGROUND: Female genital mutilation is an intentional inhumane procedure that threatens girls and women’s health. It is especially widespread in developing countries due to cultural, traditional and religious preferences. The aim of the current study was to investigate how circumcision affects women’s sexual function. METHODS: This cross-sectional study was conducted in the urban and rural area of Piranshahr County, Iran, in 2015 among convenience samples of 200 women, 15-49 yr old, who were applying to health care centers for receiving routine health care services. Data collection was conducted with the use of a self-administered written questionnaire to assess female sexual function, mental well-being, and quality of life. RESULTS: Significant differences were found between circumcised and non-circumcised women in total score of female sexual function index (FSFI) in domains of desire, arousal, vaginal moisture, orgasm, satisfaction, and pain [(P<0.001), MD(95%CI)=5.64(3.64 to 7.64)] and based on Hotelling’s T-square, significant differences were found in dimensions of quality of life and FSFI. CONCLUSION: The revealed sexual dysfunction among mutilated women gives ground to require that public health systems take actions aimed at implementing special sexual education program to improve sexual functions of mutilated women and changing beliefs and social norms in the community level.

This article can be accessed in this LINK

Acquired Clitoromegaly: A Gynaecological Problem or an Obstetric Complication?

FREEJ Clin Diagn Res. 2016 Dec;10(12):QD10-QD11. doi: 10.7860/JCDR/2016/23212.9072. Epub 2016 Dec 1.

Acquired Clitoromegaly: A Gynaecological Problem or an Obstetric Complication?

Gupta M, Saini V, Poddar A, Kumari S, Maitra A.

ABSTRACT

Acquired non-hormonal clitoromegaly is a rare condition and is due to benign or malignant tumours and sometimes idiopathic. Few cases of clitoral abscesses have been reported after female circumcision. We hereby report a case of clitoral abscess causing acquired clitoromegaly following an obstetrical surgery.

This article can be accessed in this LINK

Labial fusion: A rare cause of urinary retention in reproductive age woman and review of literature.

FREETurk J Urol. 2017 Mar;43(1):98-101. doi: 10.5152/tud.2017.58897. Epub 2017 Mar 1.

Labial fusion: A rare cause of urinary retention in reproductive age woman and review of literature.

Erdoğdu E, Demirel C, Tahaoğlu AE, Özdemir A.

ABSTRACT

Labial fusion usually affects prepubertal girls and postmenopausal women, it may  rarely occurs in reproductive years in the absence of predisposing factors such as vulvar infections, dermatitis, trauma, female circumcision and lichen sclerosis. Should be considered in differential diagnosis in the differential diagnosis of urinary retention even if the patient doesn’t have history of sexual intercourse.

This article can be accessed in this LINK