Categories
Archives Blog Original research

Trends in female circumcision between 1933 and 2003 in Osun and Ogun States, Nigeria (a cohort analysis).

Afr J Reprod Health. 2006 Aug;10(2):48-56.

Trends in female circumcision between 1933 and 2003 in Osun and Ogun States, Nigeria (a cohort analysis).

Adeokun LA, Oduwole M, Oronsaye F, Gbogboade AO, Aliyu N, Wumi A, Sadiq G, Sutton I, Taiwo M.

Association for Reproductive and Family Health, Ibadan, Oyo State. arfh@skannet.com.ng

ABSTRACT

The international movement against female circumcision gained momentum in the past two decades. Although recent studies report decline in the practice none has studied the cohort effect or provided plausible explanation for such decline. Changes in female circumcision occurring in two southwestern States of Nigeria between 1933 and 2003 were tracked in a cross-sectional survey using cohort analysis. 1174 female live births to 413 women were included in the analysis. About fifty-three percent of all females were circumcised. The prevalence dropped from 64.9% during the period 1933-60 to 25.7% for the period 2000-2003. For first order births, the corresponding rates were 58.8% and 25.0%. The decline for first-born females comes a decade before other birth orders. Age and education of mother are two main factors of the decline. Global consensus or legal enforcement plays secondary roles. Understanding how modernisation affects the decline in female circumcision should receive greater attention.

There is no LINK to view this article online.

Categories
Archives Blog Original research

Adolescent sexual and reproductive health in the Niger Delta region of Nigeria–issues and challenges.

Afr J Reprod Health. 2007 Apr;11(1):113-24. FREE

Adolescent sexual and reproductive health in the Niger Delta region of Nigeria–issues and challenges.

Okonta PI.

Department of Obstetrics and Gynaecology, College of Health Sciences, Delta State University, Abraka, Delta State. Patrickokonta@Yahoo.com

ABSTRACT

There has been an increasing awareness of the need to pay special focus on the adolescent and their sexual and reproductive h
ealth. This article reviews the sexual and reproductive health of adolescents in the Niger Delta region (NDR) of Nigeria. The objective is to bring to focus these important issues in the region. Adolescents in the NDR engage in unhealthy sexual behaviour characterized by early age at sexual initiation, unsafe sex and multiple sexual partners. The local socioeconomic condition exerts extra pressure on the adolescent with negative reproductive health consequences. There is urgent need to develop a time bound strategic framework and plan to redress this situation. This will require the participation of all stake holders.

This article can be accessed in this LINK.

Categories
Archives Blog Original research

Genital lesions complicating female genital cutting in infancy: a hospital-based study in south-east Nigeria.

Ann Trop Paediatr. 2007 Dec;27(4):285-90.

Genital lesions complicating female genital cutting in infancy: a hospital-based study in south-east Nigeria.

Ekenze SO, Ezegwui HU, Adiri CO.

Paediatric Surgical Unit, Department of Surgery, Federal Medical Centre, Owerri, Nigeria. soekenze@yahoo.com

ABSTRACT

BACKGROUND: Despite the global outcry against female genital cutting (FGC), the practice continues in many African communities. The morbidity of this practice on the girl child deserves more attention.

OBJECTIVE: To determine the genital lesions complicating childhood FGC and the underlying factors that sustain this practice among the Igbos in south-east Nigeria.

METHODS: Prospective evaluation of girls with genital complications of FGC between January 2003 and June 2005 at the Federal Medical Centre, Owerri, south-east Nigeria. The girls’ mothers were interviewed at presentation and subsequent visits to determine their perception and attitudes towards FGC.

RESULTS: The average age at presentation was 3.5 years (range 1-5) and the genital cutting procedures were performed 8-90 days after birth. The procedure was undertaken by traditional practitioners in 14 (66.7%) girls and by nurses in 7 (33.3%) girls. Twelve girls (57.1%) had type I genital cutting and nine (42.9%) type II. Inclusion clitoral dermoid cyst and labial fusion were the complications in 13 (61.9%) and eight (38.1%), respectively. Treatment involved complete excision of the cysts and operative division of the labial fusion. Post-operative complications were wound infection (5) and labial adhesion (2). With duration of admission ranging from 3 to 5 days, the average cost of managing each child was $120. Of the girls’ mothers, 15 (71.4%) had been educated to secondary level and 17 (80.1%) were aware of the campaign against FGC. Regrettably, all the mothers had genital cutting themselves during childhood and 13 (61.9%) stated that they would like to perpetuate the practice for socio-cultural reasons. Despite this, they all volunteered that FGC is enforced by the child’s paternal relations.

CONCLUSION: Childhood FGC contributes to appreciable morbidity among girls, a large proportion of whom are not managed in a hospital setting. The cost of managing these complications can be enormous, especially in low-resource settings. Girl child education to tertiary level and the involvement of traditional rulers and local decision-makers in the campaign against FGC might help to eradicate the practice.

This article can be accessed in this LINK.

Categories
Archives Blog Original research

Female genital mutilation among Edo people: the complications and pattern of presentation at a pediatric surgery unit, Benin City.

Afr J Reprod Health. 2009 Mar;13(1):17-25. FREE

Female genital mutilation among Edo people: the complications and pattern of presentation at a pediatric surgery unit, Benin City.

Osifo DO, Evbuomwan I.

Pediatric Surgery Unit, Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria. Leadekso@yahoo.com

ABSTRACT

This prospective study on female genital mutilation among Edo people was based on female children and parents who presented on account of it at the University of Benin Teaching Hospital, Benin City, Nigeria, between January 2002 and December 2007. During the period, 51 female children aged 10 days and 18 years presented with complications following genital mutilation. Twenty-nine were brought by their parents for mutilation while 67 parents interviewed believed strongly on female genital mutilation with 47 mothers mutilated. Religio-cultural and superstitious beliefs were the main indications and the type of mutilation ranged from excision of clitoridal tip in 10 (19.6%) children to complete excision of the clitoris, labia minora and inner layer of majora in 7 (13.7%). Complications ranged from clitoridal cyst formation in 21 (41.2%) to life threatening infections with one mortality due to tetanus infection.

This article can be accessed in this LINK

 

Categories
Archives Blog Original research

Lower genital tract lesions requiring surgical intervention in girls: perspective from a developing country

J Paediatr Child Health. 2009 Oct;45(10):610-3. doi:10.1111/j.1440-1754.2009.01574.x. Epub 2009 Sep 14.

Lower genital tract lesions requiring surgical intervention in girls: perspective from a developing country.

Ekenze SO, Mbadiwe OM, Ezegwui HU.

Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria. sebekenze@gmail.com

ABSTRACT

AIM: To determine the spectrum, outcome of treatment and the challenges of managing surgical lesions of lower genital tract in girls in a low-resource setting. METHOD: Retrospective study of 87 girls aged 13-years and younger, with lower genital tract lesions managed between February 2002 and January 2007 at the University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Clinical charts were reviewed to determine the types, management, outcome of treatment and management difficulties. RESULTS: The median age at presentation was 1 year (range 2 days-13 years). Congenital lesions comprised 67.8% and acquired lesions 32.2%. The lesions included: masculinized external genitalia (24), vestibular fistula from anorectal malformation (23), post-circumcision labial fusion (12), post-circumcision vulval cyst (6), low vaginal malformations (6), labial adhesion (5), cloacal malformation (3), bifid clitoris (3) urethral prolapse (3), and acquired rectovaginal fistula (2). Seventy-eight (89.7%) had operative treatment. Procedure related complications occurred in 19 cases (24.4%) and consisted of surgical wound infection (13 cases), labial adhesion (4 cases) and urinary retention (2 cases). There was no mortality. Overall, 14 (16.1%) abandoned treatment at one stage or another. Challenges encountered in management were inadequate diagnostic facilities, poor multidisciplinary collaboration and poor patient follow up. CONCLUSION: There is a wide spectrum of lower genital lesion among girls in our setting. Treatment of these lesions may be challenging, but the outcome in most cases is good. High incidence of post-circumcision complications and poor treatment compliance may require more efforts at public enlightenment.

This article can be purchased in this LINK

Categories
Archives Original research

The Impact of Female Genital Cutting on First Delivery in Southwest Nigeria

Stud Fam Plann. 2002 June 33(2):173–184

The Impact of Female Genital Cutting on First Delivery in Southwest Nigeria

Slanger TE, Snow RC, Okonofua FE

ABSTRACT

To date, data linking obstetric morbidity to female genital cutting in populations with less severe types of cutting have been limited to case reports and speculation. In this cross-sectional study, 1,107 women at three hospitals in Edo State, Nigeria, reported on their first-delivery experiences. Fifty-six percent of the sample had undergone genital cutting. Although univariate analyses suggest that genital cutting is associated with delivery complications and procedures, multivariate analyses controlling for sociodemographic factors and delivery setting show no difference between cut and noncut women’s likelihood of reporting first-delivery complications or procedures. Whereas a clinical association between genital cutting and obstetric morbidity may occur in populations that have undergone more severe forms of cutting, in this setting, apparent associations between cutting and obstetric morbidity appear to reflect confounding by social class and by the conditions under which delivery takes place.

This article can be purchased in this LINK

Categories
Archives Original research

Spatial distribution of female genital mutilation in Nigeria.

Am J Trop Med Hyg. 2009 Nov;81(5):784-92. doi: 10.4269/ajtmh.2009.09-0129.FREE

Spatial distribution of female genital mutilation in Nigeria.

Kandala NB, Nwakeze N, Kandala SN.

University of Warwick, Clinical Sciences Research Institute, Coventry, United Kingdom. n-b.kandala@warwick.ac.uk

ABSTRACT

The harmful effects of female genital mutilation (FGM) on women are recognized worldwide. Although it is practiced by persons of all socioeconomic backgrounds, there are differences within countries and between communities. The aim of this study was to use the 2003 Nigeria Demographic and Health Survey data to determine the spatial distribution of the prevalence of FGM and associated risk factors. Data were available for 7,620 women; 1,673 (22.0%) interviewed had had FGM and 2,168 women had living children, of whom 485 (22.4%) daughters had undergone FGM. Unmarried women were more likely to report a lower prevalence of FGM. Modernization (education and high socioeconomic status) had minimal impact on the likelihood of FGM, but education plays an important role in the mother’s decision not to circumcise her daughter. It follows from these findings that community factors have a large effect on FGM, with individual factors having little effect on the distribution of FGM.

This article can be accessed for free in this LINK

Categories
Archives Blog Original research

Comparative Study of Meanings, Beliefs, and Practices of Female Circumcision Among Three Nigerian Tribes in the United States and Nigeria

J Transcult Nurs. April 2004 15: 103-113

Comparative Study of Meanings, Beliefs, and Practices of Female Circumcision Among Three Nigerian Tribes in the United States and Nigeria

Prisca O. Anuforo, Lola Oyedele, Dula F. Pacquiao, Kean University

ABSTRACT

The study was conducted to gain insight into the meanings, beliefs, and practices of female circumcision among three Nigerian tribes in the United States and Nigeria. Participant-observations occurred in three sites in Nigeria (Ibadan, Lagos, and Owerri) and in Essex County, New Jersey (Newark, Irvington, and East Orange). A total of 50 informants included adult males and females from the three main Nigerian ethnic tribes: Igbo, Yoruba, and Hausa. Leininger’s culture care theory of diversity and universality was the study framework. Findings revealed existence of similarities and differences in the cultural meanings, beliefs, and practices among the tribes. Religion, education, and occupation were significant factors influencing informants’ attitudes toward continuation of the practice. Government-sponsored public education and influence by the media were found to increase informants’ awareness of complications of female circumcision. Changes in attitudes toward the practice and use of alternative practices were evident.

This article can be purchased in this LINK

Categories
Archives Blog Original research

Dispelling the myths and beliefs toward female genital cutting of woman: assessing general outpatient services at a tertiary health institution in Enugu state, Nigeria.

East Afr J Public Health. 2010 Mar;7(1):64-7.

Dispelling the myths and beliefs toward female genital cutting of woman: assessing general outpatient services at a tertiary health institution in Enugu state, Nigeria.

Ekwueme OC, Ezegwui HU, Ezeoke U.

Reproductive Health Unit, Department of Obstetrics & Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.

CONTEXT: The practice of female genital mutilation (FGM) has continued because it is deeply entrenched in tradition and culture especially in developing countries where the victims are often its strongest proponents. This study aimed at using accurate information to dispel the traditional myths and beliefs about FGM among
woman.
METHODS: Using a before and after intervention evaluation research design, interviewer administered questionnaires were administered to a sample of 100 women drawn by systematic sampling from the General Outpatient Department of University of Nigeria Teaching Hospital. Information’s on their knowledge,
attitude and behaviour towards FGM were elicited pre-and-post intervention.
RESULTS: Pre-intervention, knowledge of the respondents on the true meaning of FGM was 54% and that of the 6 complications enlisted on average was 22.2%. Seventy (70.0%) believed that FCM is good and should be continued based mainly on culture and tradition (85.7%). Among the 29(29.0%) respondents against FGM,
26(89.7%) and 24(82.8%) said it increases risk of HIV/AIDS and pregnancy complications respectively. Respondents displayed a high negative and stigmatizing attitude toward the uncircumcised women. Seventy-four (74.0%) said they are promiscuous. Additionally, 49% said they are shameful, 14% cursed/outcast while 66% would not recommend them for marriage. Post-intervention, 85% of the respondents now understood full meaning of FGM and  71.3% on the average knew the complications. While only 11% now support FGM, 83% were against the practice. The stigmatizing attitudes held against uncircumcised women decreased significantly from baseline to post-intervention as follows: promiscuous 74% to 22%, shameful 49% to 12%, outcast/cursed 14% to 2%, and not good for marriage from 66% to 19%. The differences in the baseline and post-intervention data on knowledge, beliefs and attitudes of the respondents toward FGM were statistically significant (p < 0.001).
CONCLUSION: Educational intervention programme has been successful used to impact knowledge, change beliefs and negative attitudes of women toward FGM.

There is no LINK to view this article online.

Categories
Blog Original research

The impact of health education on attitudes towards female genital mutilation (FGM) in a rural Nigerian community.

Eur J Contracept Reprod Health Care. 2008 Sep;13(3):289-97.

The impact of health education on attitudes towards female genital mutilation (FGM) in a rural Nigerian community.

Asekun-Olarinmoye EO, Amusan OA.

Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Osun State, Nigeria. estoaskol@yahoo.com

OBJECTIVES: To determine the level of practice of female genital mutilation (FGM) and the impact of a health education intervention in Shao community. MATERIALS AND METHODS: Intervention study using a multistage sampling technique. The instrument was a pre-tested, structured questionnaire. The survey was supplemented by an in-depth interview of the traditional excisors. RESULTS: Most respondents (88.0%) cited traditional excisors as operators of the procedure, while 7.8% mentioned health workers. Factors found to be statistically significantly associated with the practice of FGM are age, gender and educational status of respondents (p<0.05). The age at which FGM is usually performed was put at under one year old by 60.3% of respondents. All respondents cited type II FGM as the type practised in the community. Most (88.0%) of the female respondents were excised. A greater proportion of men than women did not want the practice of FGM stopped in the pre-intervention stage; however, there was a statistically significant decrease in the proportion of males who did not want the practice of FGM stopped in the post-intervention stage. Also, there was a statistically significant increase in the proportion of respondents who had no intention to excise future female children in the post-intervention stage (p<0.05). Legislation, female literacy and empowerment, educating men and provision of alternative vocation for excisors were means suggested by respondents for stopping the practice. CONCLUSION AND RECOMMENDATIONS: The health education intervention had a positive impact on the attitude of respondents towards FGM. However, for sustainable behavioural changes that will lead to elimination of FGM practice, we recommend placing FGM elimination efforts within a comprehensive development strategy and the larger context of reproductive health and gender education in Nigeria.

This article can be purchased in this LINK