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Spatial modelling and mapping of female genital mutilation in Kenya.

BMC Public Health. 2014 Mar 25;14(1):276. doi: 10.1186/1471-2458-14-276.FREE

Spatial modelling and mapping of female genital mutilation in Kenya.

Achia TN.

ABSTRACT

BACKGROUND: Female genital mutilation/cutting (FGM/C) is still prevalent in several communities in Kenya and other areas in Africa, as well as being practiced by some migrants from African countries living in other parts of the world. This study aimed at detecting clustering of FGM/C in Kenya, and identifying those areas within the country where women still intend to continue the practice. A broader goal of the study was to identify geographical areas where the practice continues unabated and where broad intervention strategies need to be introduced.

METHODS: The prevalence of FGM/C was investigated using the 2008 Kenya Demographic and Health Survey (KDHS) data. The 2008 KDHS used a multistage stratified random sampling plan to select women of reproductive age (15-49 years) and asked questions concerning their FGM/C status and their support for the continuation of FGM/C. A spatial scan statistical analysis was carried out using SaTScan™ to test for statistically significant clustering of the practice of FGM/C in the country. The risk of FGM/C was also modelled and mapped using a hierarchical spatial model under the Integrated Nested Laplace approximation approach using the INLA library in R.

RESULTS: The prevalence of FGM/C stood at 28.2% and an estimated 10.3% of the women interviewed indicated that they supported the continuation of FGM. On the basis of the Deviance Information Criterion (DIC), hierarchical spatial models with spatially structured random effects were found to best fit the data for both response variables considered. Age, region, rural-urban classification, education, marital status, religion, socioeconomic status and media exposure were found to be significantly associated with FGM/C. The current FGM/C status of a woman was also a significant predictor of support for the continuation of FGM/C. Spatial scan statistics confirm FGM clusters in the North-Eastern and South-Western regions of Kenya (p < 0.001).

CONCLUSION: This suggests that the fight against FGM/C in Kenya is not yet over. There are still deep cultural and religious beliefs to be addressed in a bid to eradicate the practice. Interventions by government and other stakeholders must address these challenges and target the identified clusters.

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Archives Blog Review

Labia Minora Elongation and its implications on the health of women: A Systematic Review

Int J Sex Health. 2013. DOI:10.1080/19317611.2013.851139LME

Labia Minora Elongation and its implications on the health of women: A Systematic Review

Martínez Pérez G, Tomás Aznar C, Bagnol B

ABSTRACT

Labia Minora Elongation is a female genital modification practice categorized among the types included in the fourth group of female genital mutilation. In this paper we display the results of a systematic review of the evidence-based knowledge published on the health risks and benefits of Labia Minora Elongation as informed by African female respondents who are insiders of the practice. No other systematic review on this specific topic has been published before. A methodological bibliographic search was done in scientific databases, by manual referencing and by contacting experts on this area of knowledge. Seventeen papers turned out eligible for this review, which correspond to nine different studies. Eight of these studies were conducted in Eastern and Southern African countries and one was carried out in Italy. This review concludes that pain at the beginning of the practice, nuisances related to the use of caustic herbs, and stigmatization in failing to comply with the practice are the principal health risks associated to labia minora elongation. At the same time, there is evidence that labial elongation may benefit the sexual health and well being of women. More research of a quantitative nature is necessary to determine its prevalence across the practicing cultures and to precise its implications on the sexual and reproductive health for the women who engage in this female genital modification.

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Archives Blog Original research

Is there an association between female circumcision and perinatal death?

Bull World Health Organ vol.80 no.8 Genebra Aug. 2002

Is there an association between female circumcision and perinatal death?

Birgitta Essén, Birgit Bödker, N-O. Sjöberg, Saemundur Gudmundsson, P-O. Östergren, & Jens Langhoff-Roos

ABSTRACT

OBJECTIVE: In Sweden, a country with high standards of obstetric care, the high rate of perinatal mortality among children of immigrant women from the Horn of Africa raises the question of whether there is an association between female circumcision and perinatal death. 
METHODS: To investigate this, we examined a cohort of 63 perinatal deaths of infants born in Sweden over the period 1990–96 to circumcised women. 
FINDINGS: We found no evidence that female circumcision was related to perinatal death. Obstructed or prolonged labour, caused by scar tissue from circumcision, was not found to have any impact on the number of perinatal deaths. 
CONCLUSION: The results do not support previous conclusions that genital circumcision is related to perinatal death, regardless of other circumstances, and suggest that other, suboptimal factors contribute to perinatal death among circumcised migrant women.

This article can be accessed in this LINK