Tag Archives: Attitude to health

Public attitudes toward health, disease, and the medical care system.

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


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.

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Female circumcision in Nigeria and attitudes towards its discontinuation

Afr J Med Med Sci. 2015 Dec;44(4):343-54.

Female circumcision in Nigeria and attitudes towards its discontinuation.

Gbadebo BM, Afolabi RF, Adebowale AS


BACKGROUND: Female Circumcision (FC) is a harmful traditional practice and remains a public health problem particularly in the era of HIV/AIDS. Aside its numerous health implications, it can cause infertility, complications in childbirth and increased risk of newborn deaths. FC is widely practised in Nigeria. OBJECTIVE: The study assessed the level of FC, daughters’ circumcision and attitude towards discontinuation of the practice among women of reproductive age. METHODS: Data were extracted from the 2008 Nigeria Demographic Health and Survey. Data were analysed using Chi-square and binary logistic regression models (á = 0.05). RESULTS: Among the respondents, prevalence of FC was 49.2% with 30.6% having circumcised their daughters and 25.8% wishing the practice to continue. About 56% of circumcised women also circumcised their daughters whereas only 2.9% of uncircumcised women circumcised their daughters. Approximately 69.8% of women who had circumcised their daughters would like FC to continue compared to 8.8% of those who never circumcised any of their daughters. The likelihood of FC was higher (OR = 2.07; C.I = 1.85-2.30) among Moslems compare to Christians. Igbo women were less likely to discontinue FC compared to women of Hausa/Fulani ethnic group despite controlling for the confounding variables (OR = 0.57; C.I = 0.35-0.91). CONCLUSION: Female circumcision is still practiced in all parts of Nigeria and a high proportion of women reported that the practice should continue. There is need to intensify efforts on the campaign against female circumcision in Nigeria.

Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria

S Afr Med J. 2016 Jul 4;106(8):822-3. doi: 10.7196/SAMJ.2016.v106i8.10124.

Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria

Adeniran AS, Ijaiya MA, Fawole AA, Balogun OR, Adesina KT, Olatinwo AW, Olarinoye AO, Adeniran PI


BACKGROUND: The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C). OBJECTIVE: To determine knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it. METHODS: A cross-sectional survey among male adolescent students in Ilorin, Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM, USA). A p-value of <0.05 was taken as significant. RESULTS: Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years, range 14 – 19), 1 184 (77.1%) were aware of FGM/C, 514 (33.5%) supported female circumcision, 362 (23.6%) would circumcise their future daughters, 420 (27.3%) were of the opinion that FGM/C had benefits, mostly as a necessity for womanhood (109, 7.1%), and 627 (40.8%) perceived it as wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C, and 42.2% recommended education as the most important intervention to achieve this. CONCLUSION: Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C.

Women’s position and attitudes towards female genital mutilation in Egypt: A secondary analysis of the Egypt demographic and health surveys, 1995-2014

BMC Public Health. 2015 Sep 10;15(1):874. doi: 10.1186/s12889-015-2203-6. FREE

Women’s position and attitudes towards female genital mutilation in Egypt: A secondary analysis of the Egypt demographic and health surveys, 1995-2014.

Van Rossem R, Meekers D, Gage AJ


BACKGROUND: Female genital mutilation (FGM) is still widespread in Egyptian society. It is strongly entrenched in local tradition and culture and has a strong link to the position of women. To eradicate the practice a major attitudinal change is a required for which an improvement in the social position of women is a prerequisite. This study examines the relationship between Egyptian women’s social positions and their attitudes towards FGM, and investigates whether the spread of anti-FGM attitudes is related to the observed improvements in the position of women over time.

METHODS: Changes in attitudes towards FGM are tracked using data from the Egypt Demographic and Health Surveys from 1995 to 2014. Multilevel logistic regressions are used to estimate 1) the effects of indicators of a woman’s social position on her attitude towards FGM, and 2) whether these effects change over time.

RESULTS: Literate, better educated and employed women are more likely to oppose FGM. Initially growing opposition to FGM was related to the expansion of women’s education, but lately opposition to FGM also seems to have spread to other segments of Egyptian society.

CONCLUSIONS: The improvement of women’s social position has certainly contributed to the spread of anti-FGM attitudes in Egyptian society. Better educated and less traditional women were at the heart of this change, and formed the basis from where anti-FGM sentiment has spread over wider segments of Egyptian society.

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Epidemiology, Regional Characteristics, Knowledge, and Attitude Toward Female Genital Mutilation/Cutting in Southern Iran

J Sex Med. 2015 Jul;12(7):1577-83. doi: 10.1111/jsm.12938. Epub 2015 Jul 2.
Epidemiology, Regional Characteristics, Knowledge, and Attitude Toward Female Genital Mutilation/Cutting in Southern Iran
Dehghankhalili M, Fallahi S, Mahmudi F, Ghaffarpasand F, Shahrzad ME, Taghavi M, Fereydooni Asl M
INTRODUCTION: Female genital mutilation/cutting (FGM/C), also known as female circumcision, is an ancient traditional procedure that involves partial or total removal of the female external genitalia for nonmedical reasons. Although it is well described in African and some Arabic countries, data from Iran are scarce. AIM: To describe the epidemiology, regional characteristics, knowledge, and attitude toward FGM/C in Southern Iran. METHODS: This cross-sectional study was conducted during a 36-month period from 2010 to 2013 in Hormozgan, a southern province of Iran near the Persian Gulf. We included 780 women in six major rural areas of the province who referred to healthcare centers for vaccination, midwifery, or family planning services. All participants underwent complete pelvic examination to determine the type of FGM. The questionnaire consisted of several sections such as demographic and baseline characteristics, and two self-report sections addressing the knowledge and attitude toward FGM/C and its complications. Baseline sociodemographic characteristics including age, educational level, marital status, religion, and nationality were the independent variables. RESULTS: Among the participants, 535 (68.5%) had undergone FGM/C. FGM/C was associated with higher age (P = 0.002), Afghan nationality (P = 0.003), Sunni Islam as religion (P = 0.019), illiteracy (P < 0.001), and family history of FGM/C in mother (P < 0.001), sister (P < 0.001), and grandmother (P < 0.001). Ancient traditions in the area (57.1%) were mentioned as the most important factor leading to FMG/C. Urinary tract infection was the most common reported complication (60.4%). CONCLUSION: FGM/C is a common practice in rural areas of Southern Iran. It is associated with increased age, illiteracy, Sunni Islam religion, Afghan nationality, and positive family history. Lack of knowledge toward FGM/C is the main cause of its high prevalence and continuation in the area. Dehghankhalili M, Fallahi S, Mahmudi F, Ghaffarpasand F, Shahrzad ME, Taghavi M, and Fereydooni Asl M. Epidemiology, regional characteristics, knowledge, and attitude toward female genital mutilation/cutting in Southern Iran.

Intention toward the continuation of female genital mutilation in Bale Zone, Ethiopia

Int J Womens Health. 2015 Jan 9;7:85-93. doi: 10.2147/IJWH.S74832. eCollection 2015.

Intention toward the continuation of female genital mutilation in Bale Zone, Ethiopia

Bogale D, Markos D, Kaso M


BACKGROUND: Female genital mutilation (FGM) is a harmful traditional practice that is deeply rooted in Africa. It is associated with health complications and human rights violations. Research on intention for the continuation of FGM and the social determinants underpinning this practice are scarce. Therefore, this study intended to assess the intention of women toward the continuation of FGM among Bale Zone reproductive-age women.

METHODS: A community-based cross-sectional study design supplemented by qualitative methods was conducted in 2014. A total of 634 reproductive-age women were involved in the quantitative part of the study. The respondents were drawn from five randomly selected districts of Bale Zone. The total sample was allocated proportionally to each district based on the number of reproductive-age women it has. Purposive sampling method was used for qualitative study. Then, data were collected using a pretested and structured questionnaire. The collected data were analyzed by Statistical Package for Social Sciences for Windows version 16.0. Multiple logistic regressions were carried out to examine the existence of a relationship between intentions for the continuation of FGM and selected determinant factors.

RESULTS: This study revealed that 26.7% of the respondents had intention for the continuation of FGM. Religion, safeguarding virginity, tradition, and social values were the major reasons for the perpetuation of this practice. Circumcised respondents and those who were not able to read and write were ~3 (adjusted odds ratio = 2.89, 95% confidence interval = [1.33, 6.20]) and 7.58 (adjusted odds ratio = 7.58, 95% confidence interval = [3.47, 16.54]) times more likely intending the continuation of FGM than uncircumcised and those who attended secondary-level education and above, respectively.

CONCLUSION: The study shows that the intention toward the persistence of the practice is high in Bale Zone. Rural residents, those who were not able to read and write, and circumcised respondents were more likely to continue the practice.

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J Biosoc Sci. 2014 Jul 3:1-16. [Epub ahead of print]


Patra S, Singh RK.


Female genital cutting (FGC) is widely practised in Kenya. However, its prevalence has declined over the last two decades (38.0% in 1998 KDHS, 32.2% in 2003 KDHS and 27.1% in 2008-09 KDHS), implying changes in behaviours and attitudes of Kenyans towards FGC. This study provides an overview of changing attitudes of women towards FGC in Kenya. An extensive literature review was undertaken and 2008-09 Kenya Demographic and Health Survey data were used to focus on the present scenario. Analyses were based on a national sample of 2284 circumcised women. About 68% of these women wanted to discontinue FGC, and attitudes towards discontinuation were found to vary with women’s background characteristics. Surprisingly, 92.5% of circumcised women of the North-Eastern province still wished to continue FGC, and for Muslims the percentage was 72.2%. About 36% of circumcised women responded that their daughters were already circumcised. Only 13% of circumcised mothers intended their daughters to be circumcised in the future. The study shows that the attitude of Kenyan women, irrespective of their circumcision status, has been changing gradually towards the discontinuation of circumcision of their daughters.

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Female genital mutilation: a literature review.

Nurs Stand. 2013 Sep 4-10;28(1):41-7. doi: 10.7748/ns2013.

Female genital mutilation: a literature review.

Terry L, Harris K.

Faculty of Health and Social Care, London South Bank University, UK. terrylm@lsbu.ac.uk


Female genital mutilation (FGM) is a harmful practice involving the removal or alteration of parts of the female genitalia for non-therapeutic reasons. It may be carried out on cultural grounds, and is associated with immediate and long-term physical and psychological problems. This literature review explores the prevalence of and attitudes to FGM, personal experiences of women who have undergone the procedure and effective nursing care of this patient group.

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Attitudes toward Female Circumcision among Men and Women in Two Districts in Somalia: Is It Time to Rethink Our Eradication Strategy in Somalia?

Obstet Gynecol Int. 2013;2013:312734. doi: 10.1155/2013/312734. Epub 2013 Apr 18. FREE

Attitudes toward Female Circumcision among Men and Women in Two Districts in Somalia: Is It Time to Rethink Our Eradication Strategy in Somalia?

Gele AA, Bø BP, Sundby J.

Department of Social Science, Oslo University College, 0167 Oslo, Norway ; Section for International Health, Department of General Practice and Community Medicine, University of Oslo, 0167 Oslo, Norway.


Somalia has the highest global prevalence (98%) of female circumcision (FC), and, despite a long history of abandonment efforts, it is not clear as to whether or not these programmes have changed people’s positive attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Hargeisa and Galkayo districts to the practice of FC. Methods. A purposive sampling of 24 Somalis, including activists and practitioners, men and women, was conducted in Somalia. Unstructured interviews were employed to explore the participants’ knowledge of FC, their attitudes toward the continuation/discontinuation of the practice, and the type they want to continue or not to continue. Result. The findings of this qualitative study indicate that there is a strong resistance towards the abandonment of the practice in Somalia. The support for the continuation of Sunna circumcision is widespread, while there is a quite large rejection of Pharaonic circumcision. Conclusion. Therefore, since the “zero tolerance policy” has failed to change people’s support for the continuation of the practice in Somalia, programmes that promote the pinch of the clitoral skin and verbal alteration of status, with the goal of leading to total abandonment of FC, should be considered for the Somali context.

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Fewer younger women are undergoing female genital mutilation, study finds.

BMJ. 2013 Jul 25;347:f4754. doi: 10.1136/bmj.f4754. FREE

Fewer younger women are undergoing female genital mutilation, study finds.

Gulland A.


The practice of female genital mutilation is becoming less widespread in countries with low prevalence of the practice, prompting the children’s charity Unicef to say there are strong signs it will become a “vestige of the past.”

A statistical report on the 29 countries in Africa and the Middle East where the practice is most prevalent shows that in some countries the practice is declining rapidly.1 Researchers used 70 household surveys conducted over a 20 year period, as well as carrying out new surveys, to look at the changing landscape surrounding female genital mutilation.

Researchers asked women and girls aged 15 to 19 years whether they had undergone the procedure, which in most cases takes place before the age of 10. They asked the same question …

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