Tag Archives: Ethiopia

Labor, delivery and postpartum complications in nulliparous women with female genital mutilation admitted to Karamara Hospital

FREEEthiop Med J. 2017 Jan;55(1):11-7.

Labor, delivery and postpartum complications in nulliparous women with female genital mutilation admitted to Karamara Hospital.

Gudu W, Abdulahi M.

ABSTRACT

Objectives: To assess labor, delivery and postpartum complications in nulliparous women with FGM/C and evaluate the attitude of mothers towards elimination of FGM. Methods: A prospective hospital based study using structured questionnaire was conducted between January to March 2015 at Karamara hospital, Jijiga, Ethiopia. All nulliparous women admitted for labor and delivery were included. Data were collected regarding circumcision status, events of labor, delivery; postpartum and neonatal outcomes as well as attitude of mothers towards elimination of FGM/C. Results: Two hundred sixty four (92.0%) of the women had FGM/C with most (93.0%) undergoing Type III FGM. The mean age of the women was 22 yr. Failure to progress in 1st stage and prolonged 2nd stage of labor occurred in 165 (57.0%) and 189 (65.6%) of the cases respectively. Caesarean section was performed in 17.0% and instrumental delivery in 23.0%. 64.5% required episiotomies, 83.3% had an anterior episiotomy, 29 % had perineal tears, 25.7%% experienced post-partum hemorrhage and 24% postpartum infection. Among the newborns, there were 6.4% perinatal deaths; 18.8 % low birth weight and 1.5% birth injuries. Almost all complications were more frequently seen in circumcised compared to non-circumcised women. Conclusions: The prevalence of FGM is high and it substantially increases the risk of many maternal complications. Health professionals should be aware of these complications and support/care of women with FGM should be integrated at all levels of reproductive health care provision. Capacity building of responsible health professional should be initiated in the area with intensification of FGM eradication activities.

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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.

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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.

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Prevalence and associated factors of circumcision among daughters of reproductive aged women in the Hababo Guduru District, Western Ethiopia: a cross-sectional study. Gajaa M1, Wakgari N2, Kebede Y3, Derseh L3.

BMC Womens Health. 2016 Jul 22;16:42. doi: 10.1186/s12905-016-0322-6.

Prevalence and associated factors of circumcision among daughters of reproductive aged women in the Hababo Guduru District, Western Ethiopia: a cross-sectional study.

Gajaa M, Wakgari N, Kebede Y, Derseh L

ABSTRACT

BACKGROUND: Female genital mutilation is currently a public health problem which needs investigation and immediate action. Ethiopia is the second-ranked African country in terms of having higher numbers of circumcised girls. This study aimed to determine prevalence and associated factors of circumcision among daughters of reproductive aged women. METHODS: A community based cross-sectional study was conducted on 610 mothers. The total sample was allocated proportionally in three randomly selected kebeles based on the number of reproductive age mothers with at least one daughter under 15 years old. A systematic random sampling technique was used to draw the respondents. A structured and interviewer administered questionnaire was used to collect data. Logistic regression analyses were used to see the association of different variables. RESULTS: Out of 610 mothers, 293 (48 %) had at least one circumcised daughter. Having a good knowledge about genital mutilation (Adjusted Odds Ratio [AOR] =0. 14, 95 % CI: 0.09-0.23), positive attitude (AOR = 0. 26, 95 % CI: 0.16-0.43), being literate (AOR = 0.50, CI: 0.28-0.91) and living in urban area (AOR = 0.30, 95 % CI: 0.17-0.51) had a lower odds of female genital mutilation. In addition, not knowing genital mutilation as a crime (AOR = 5, 95 % CI: 3.07-8.19), and being in the age group of 40-49 (AOR = 2.56, 95 % CI: 1.40-4.69) had a higher odds of having circumcised daughter. Furthermore, fathers being traditional religion followers (AOR = 0.22, 95 % CI: 0.07-0.74) had less odds of having a circumcised daughter as compared to those who follow Ethiopian Orthodox Christian. CONCLUSIONS: In this study, about half of the mothers had at least one circumcised daughter. Mothers’ knowledge, attitude, age, residence, educational status and fathers’ religion were significantly associated with female genital mutilation. Hence, convincing mothers about the ill effects of circumcision and working with religious leaders is recommended.

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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

ABSTRACT

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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A cross sectional study on factors associated with harmful traditional practices among children less than 5 years in Axum town, north Ethiopia, 2013.

Reprod Health. 2014 Jun 21;11:46. doi: 10.1186/1742-4755-11-46.FREE

A cross sectional study on factors associated with harmful traditional practices among children less than 5 years in Axum town, north Ethiopia, 2013.

Gebrekirstos K, Abebe M, Fantahun A.

ABSTRACT

BACKGROUND: Every social grouping in the world has its own cultural practices and beliefs which guide its members on how they should live or behave. Harmful traditional practices that affect children are Female genital mutilation, Milk teeth extraction, Food taboo, Uvula cutting, keeping babies out of exposure to sun, and Feeding fresh butter to new born babies. The objective of this study was to assess factors associated with harmful traditional practices among children less than 5 years of age in Axum town, North Ethiopia.

METHODS: Community based cross sectional study was conducted in 752 participants who were selected using multi stage sampling; Simple random sampling method was used to select ketenas from all kebelles of Axum town. After proportional allocation of sample size, systematic random sampling method was used to get the study participants. Data was collected using interviewer administered Tigrigna version questionnaire, it was entered and analyzed using SPSS version 16. Descriptive statistics was calculated and logistic regressions were used to analyze the data.

RESULTS: Out of the total sample size 50.7% children were females, the mean age of children was 26.28 months and majority of mothers had no formal education. About 87.8% mothers had performed at least one traditional practice to their children; uvula cutting was practiced on 86.9% children followed by milk teeth extraction 12.5% and eye borrows incision 2.4% children. Fear of swelling, pus and rapture of the uvula was the main reason to perform uvula cutting.

CONCLUSION: The factors associated with harmful traditional practices were educational status, occupation, religion of mothers and harmful traditional practices performed on the mothers.

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HIV/AIDS and female genital mutilation in the Somali’s nomads of eastern Ethiopia: a discussion paper.

World Hosp Health Serv. 2006;42(3):27-31.

HIV/AIDS and female genital mutilation in the Somali’s nomads of eastern Ethiopia: a discussion paper.

Omar M, Mohamed K.

Institute of Health Sciences and Public Health Research, University of Leeds, United Kingdom.

ABSTRACT

Female Genital Mutilation (FGM) is widely practised among the Somali nomads in Eastern Ethiopia. It may be categorized as one of many harmful traditional practices such as uvula cutting, gum piercing, cauterization and blood letting, which are conducted by unskilled traditional healers in unhygienic conditions, and which potentially increase the risk of HIV transmission. Other factors also play a significant role in the perpetuation of the HIV/AIDS epidemic in the region, such as lack of awareness, misconception about the routes of HIV transmission and ways of prevention, the practice of polygamy, and window inheritance. Pervasive poverty and recurrent famine also fuel the epidemic. Lack of official pastoralist-specific policy and strategy on HIV and FGM further complicates the problem. This paper discusses the possible relationship in terms of health risk between HIV/AIDS and FGM in the Horn of Africa and calls for more concerted efforts, including further research in order to address this potential risk.

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Vaginal calculus following severe form of female genital mutilation: a case report.

Ethiop Med J. 2008 Apr;46(2):185-8.

Vaginal calculus following severe form of female genital mutilation: a case report.

Yusuf L, Negash S.

Department of Gynecology, Medical Faculty, Addis Ababa University, Ethiopia.

ABSTRACT

We present a case of vaginal calculus formation following an initial insult of female genital mutilation (FGM) and crocodile bite to the external genital. A literature review made with regards to acute and late complication of female genital mutilation. Female genital cutting existed as early as the 5th century B.C. This ritualistic practice has affected the physical, mental, and social well being of women and undermined the basic reproductive and sexual health rights of the female population. Worldwide, 85-114 million girls and young women are subjected to this dreadful practice. It is mostly practiced in Africa and Middle East. Various authors classify female genital cutting differently. The World Health Organization classifies FGM in to FOUR types. Female genital mutilation is associated with immediate, intermediate and long-term complications (1-4). The complications are strongly related to the variant of the mutilation, especially of the third and the fourth types where introcision or vaginal scraping is performed. Vaginal calculus formation is a rare phenomenon. Our patient had a total obliteration of the introitus, vaginal calculus formation and urethra-vaginal fistula, which were surgically managed and corrected.

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Incontinence and trauma: sexual violence, female genital cutting and proxy measures of gynecological fistula.

Soc Sci Med. 2009 Mar;68(5):971-9. doi: 10.1016/j.socscimed.2008.12.006. Epub 2009 Jan 6.

Incontinence and trauma: sexual violence, female genital cutting and proxy measures of gynecological fistula.

Peterman A, Johnson K.

University of North Carolina, Department of Public Policy, Chapel Hill, NC 27599-3435, USA. apeterma@email.unc.edu

ABSTRACT

Obstetric fistula, characterized by urinary or fecal incontinence via the vagina, has begun to receive attention on the international public health agenda, however less attention has been given to traumatic fistula. Field reports indicate that trauma contributes to the burden of vaginal fistula, especially in regions wrought by civil unrest, however evidence is largely anecdotal or facility-based. This paper specifically examines the co-occurrence of incontinence and two potential sources of trauma: sexual violence and female genital cutting using the most recent Demographic and Health Surveys in Malawi, Rwanda, Uganda and Ethiopia. Multivariate selection models are used to control for sampling differences by country. Results indicate that sexual violence is a significant determinant of incontinence in Rwanda and Malawi, however not in Uganda. Simulations predict that elimination of sexual violence would result in from a 7 to a 40% reduction of the total burden of incontinence. In contrast, no evidence is found that female genital cutting contributes to incontinence and this finding is robust for types of cutting and high risk samples. Results point to the importance of reinforcing prevention programs which seek to address prevention of sexual violence and for the integration of services to better serve women experiencing both sexual violence and incontinence.

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Successful Cultural Change: the Example of Female Circumcision among Israeli Bedouins and Israeli Jews from Ethiopia.

Isr J Psychiatry Relat Sci. 2012;49(3):178-83.FREE

Successful Cultural Change: the Example of Female Circumcision among Israeli Bedouins and Israeli Jews from Ethiopia.

Bellmaker RH.

Beersheva Mental Health Center, Ben-Gurion University of the Negev, Beersheva, Israel.

ABSTRACT

Female genital mutilation (FGM) is practiced in many areas of the world, including the Middle East, Africa and Australia. Although it is most common in Muslim populations it is not a dictate of Islam. In the 1980s this practice was reported among Bedouin tribes, originally nomadic, in the southern area of Israel. Almost all of the women interviewed in the first study intended to continue the practice by performing FGM on their daughters including educated women who were teachers, dental assistants or university students. A second study was therefore done based in the obstetrical clinic where only women from tribes reporting to undergo FGM were examined for signs of FGM by an experienced gynecologist, in the presence of an Arabic-speaking female nurse and translator, as part of a gynecologic examination that was indicated for other reasons. In no cases was clitoridectomy or any damage to the labia found. All women had a small scar from a 1cm. incision somewhere on the labia or prepuce of the clitoris. this study concluded that the importance of the ritual in this population was unrelated to its severity. the ritual had apparently become over time a small symbolic scar, even though this population continued to believe in its importance. By contrast, a group of Ethiopian Jews who had immigrated to Israel was interviewed by an Amharic translator, and examined during routine gynecological examination in the same manner as the Bedouin group above. In Ethiopia, FGM is universal among Christian, Muslim and Jewish groups. All women interviewed reported that FGM was universal in Ethiopia, but none intended to continue this practice with their daughters. All stated that this was a practice that would be left behind in their country of origin. on physical examination many of the women had amputation of the clitoris. the conclusion of this study was that the severity of the operation performed had no relation to the social and cultural adherence to the operation, since the Ethiopian Jews who practiced a more severe form of the operation intended to abandon this practice while the Muslim Bedouin who had a much milder form intended to continue it. A follow-up study in 2009 of the Bedouin population of southern Israel has found that FGM had disappeared, both by self-report of women under the age of 30, and by physical examination of women under the age of 30 in an obstetrical clinic. these results suggest an optimistic approach toward cultural change involving unhealthy cultural practices and emphasize the importance of cognitive approaches to cultural change.

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