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Perception and attitude of pregnant women in a rural community north-west Nigeria to female genital mutilation

Arch Gynecol Obstet. 2014 Sep 21. [Epub ahead of print]

Perception and attitude of pregnant women in a rural community north-west Nigeria to female genital mutilation.

Ashimi AO, Amole TG.

ABSTRACT

PURPOSE: Nigeria has the highest absolute number of residents who have undergone female genital mutilation (FGM) and most are carried out during infancy; however most reports on FGM are from urban based facilities hence we sought to know the perception and attitude of pregnant women residing in a rural community in northern Nigeria to FGM.

METHODS: A descriptive cross sectional study utilized a pretested structured interviewer administered questionnaire to assess the types of FGM known, reasons for performing it and willingness to support or perform FGM among 323 pregnant women attending antenatal care in two different health facilities.

RESULTS: Of the 323 respondents, 256 (79.3 %) were aware of the practice and the common varieties of FGM known to them were Gishiri cut in 137 (53.5 %) and Angurya cut 113 (44.1). The notable reasons for carrying out FGM in the community were tradition 88 (34.4 %), to ease difficulty in childbirth 69 (26.9 %) and better marriage prospect in 55 (21.5 %). Of the respondents that were aware of FGM; 100 (39.1 %) have experienced it and 55 (21.5 %) of those aware of it would subject their daughters to the procedure. There was statistically significant association between willingness to mutilate daughters by the respondents type of education (p = 0.014) and the type of facility they were receiving antenatal care (p = 0.001).

CONCLUSION: FGM is prevalent in this community with Gishiri cut being the commonest variety. It is often associated with difficult childbirth and many women would subject their daughters to this practice. Female education and empowerment is crucial to discontinuation of this practice.

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Female genital mutilation in infants and young girls: report of sixty cases observed at the general hospital of abobo (abidjan, cote d’ivoire, west Africa).

Int J Pediatr. 2014;2014:837471. doi: 10.1155/2014/837471. Epub 2014 Mar 4.FREE

Female genital mutilation in infants and young girls: report of sixty cases observed at the general hospital of abobo (abidjan, cote d’ivoire, west Africa).

Plo K, Asse K, Seï D, Yenan J.

ABSTRACT

The practice of female genital mutilations continues to be recurrent in African communities despite the campaigns, fights, and laws to ban it. A survey was carried out in infants and young girls at the General Hospital of Abobo in Cote D’Ivoire. The purpose of the study was to describe the epidemiological aspects and clinical findings related to FGM in young patients. Four hundred nine (409) females aged from 1 to 12 years and their mothers entered the study after their consent. The results were that 60/409 patients (15%) were cut. The majority of the young females came from Muslim families (97%); the earlier age at FGM procedure in patients is less than 5 years: 87%. Amongst 409 mothers, 250 women underwent FGM which had other daughters cut. Women were mainly involved in the FGM and their motivations were virginity, chastity, body cleanliness, and fear of clitoris similar to penis. Only WHO types I and II were met. If there were no incidental events occurred at the time of the procedure, the obstetrical future of these young females would be compromised. With FGM being a harmful practice, health professionals and NGOs must unite their efforts in people education to abandon the procedure.

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Female genital mutilation and efforts to achieve Millennium Development Goals 3, 4, and 5 in southeast Nigeria.

Int J Gynaecol Obstet. 2014 May;125(2):125-8. doi: 10.1016/j.ijgo.2013.11.008. Epub 2014 Feb 8.

Female genital mutilation and efforts to achieve Millennium Development Goals 3, 4, and 5 in southeast Nigeria.

Lawani LO, Onyebuchi AK, Iyoke CA, Okeke NE.

ABSTRACT

OBJECTIVE: To determine the prevalence of female genital mutilation (FGM), the common forms of FGM, reasons for the practice, associated obstetric outcomes, and how these have affected efforts to achieve Millennium Development Goals (MDGs) 3, 4, and 5 in southeast Nigeria.

METHODS: A prospective descriptive study of parturients in southeast Nigeria was conducted from January to December 2012. All primigravid women attending delivery services at 2 health institutions during the study period were recruited, examined, and classified using the 2008 WHO classification for FGM.

RESULTS: The mean age of the 516 participants was 27.24±4.80years and most (66.3%) had undergone FGM. Type II FGM was the most common form, accounting for 59.6% of cases. Most FGM procedures were performed in infancy (97.1%) and for cultural reasons (60.8%). Women who had undergone FGM had significantly higher risk for episiotomy, perineal tear, hemorrhage, cesarean delivery, neonatal resuscitation, fresh stillbirth/early neonatal death, and longer hospitalization, with higher risk ratios associated with higher degrees of FGM.

CONCLUSION: FGM is still a common practice in southeast Nigeria, where its association with adverse reproductive outcomes militates against efforts to achieve MDGs 3, 4, and 5.

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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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The Association of Female Circumcision with HIV Status and Sexual Behavior in Mali: A Multilevel Analysis.

J Acquir Immune Defic Syndr. 2013 Dec 27. [Epub ahead of print]

The Association of Female Circumcision with HIV Status and Sexual Behavior in Mali: A Multilevel Analysis.

Smolak A.

ABSTRACT

OBJECTIVE: In the regions of Africa where female circumcision (FC) is practiced it is often regarded as a protective against HIV infection because it is believed to help women resist “illicit” sexual acts. This study examines the association between FC, HIV status, and sexual risk behavior in Mali, while taking into account multilevel factors. The following hypothesis was tested: FC is associated with HIV positive status, but not with decreased sexual behavior.

DESIGN:: The sample consists of 13,015 Malian women of reproductive age (15-49 years old). The sample is a nationally representative survey of randomly selected respondents using a stratified multistage sampling strategy. Measures included biospecimens for HIV antibody testing and survey results reporting on: number of partners, sexual debut, premarital sex, and sociodemographics.

METHODS:: Multilevel modeling (MLM) was used to assess the significance of difference in HIV status and sexual behavior with FC. MLM was also used to adjust for age, education, ethnicity, wealth, religion, region, household, and community membership. Multiple imputation with 10 imputations corrected for 10% missing data.

RESULTS:: Participants with FC were at 2.100 (p<0.001; 95% CI: 1.844, 2.389) higher odds of being HIV positive. Women with FC did not significantly differ from women without FC in number of sexual partners (p=0.634), age of sexual debut (p=0.888), or odds of having premarital sex (p=0.575).

CONCLUSION:: FC is associated with HIV positive status, but not with a decrease in sexual risk behavior. These findings have important implication for FC and HIV prevention.

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Female genital mutilation: a literature review.

Nurs Stand. 2013 Sep 4-10;28(1):41-7. doi: 10.7748/ns2013.09.28.1.41.e7750.

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

ABSTRACT

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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Estimates of female genital mutilation/cutting in 27 African countries and Yemen.

Stud Fam Plann. 2013 Jun;44(2):189-204. doi: 10.1111/j.1728-4465.2013.00352.x.

Estimates of female genital mutilation/cutting in 27 African countries and Yemen.

Yoder PS, Wang S, Johansen E.

ICF Macro, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705, USA. Stan.Yoder@icfi.com

ABSTRACT

The practice of female genital mutilation/cutting (FGM/C) has been documented in many countries in Africa and in several countries in Asia and the Middle East, yet producing reliable data concerning its prevalence and the numbers of girls and women affected has proved a major challenge. This study provides estimates of the total number of women aged 15 years and older who have undergone FGM/C in 27 African countries and Yemen. Drawing on national population-based survey data regarding FGM/C prevalence and census data regarding the number of women in each country, we find that almost 87 million girls and women aged 15 and older have been cut in these 28 countries. Producing reliable figures for the number of women affected by FGM/C in these countries allows researchers and program directors to better comprehend the impact of the practice and to mobilize resources for advocacy against it.

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Prevalence of and factors affecting female genital mutilation among schoolgirls in Eastern Sudan.

Int J Gynaecol Obstet. 2013 Mar;120(3):288-9. doi: 10.1016/j.ijgo.2012.09.018. Epub 2012 Dec 7.

Prevalence of and factors affecting female genital mutilation among schoolgirls in Eastern Sudan.

Ali AA, Okud A, Mohammed AA, Abdelhadi MA.

Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, Kassala, Sudan. abuzianab73@yahoo.com

There is no ABSTRACT available for this article

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Impact of the complete ban on female genital cutting on the attitude of educated women from Upper Egypt toward the practice

Int J Gynaecol Obstet. 2013 Mar;120(3):275-8. doi: 10.1016/j.ijgo.2012.10.010. Epub 2012 Dec 11.

Impact of the complete ban on female genital cutting on the attitude of educated women from Upper Egypt toward the practice.

Hassanin IM, Shaaban OM.

Department of Obstetrics and Gynecology, Faculty of Medicine, Sohag University, Sohag, Egypt.

OBJECTIVE: To compare the prevalence of female genital cutting (FGC) before and 5 years after the law completely banned the practice in Egypt, and evaluate the attitude of educated mothers of girls toward FGC in Upper Egypt.

METHODS: All women attending 2 outpatient clinics in Upper Egypt were approached from January 1 through November 30, 2011. A trained nurse interviewed those who had daughters, and factors influencing their attitude toward FGC were evaluated. The participants in a previous study done in the same locality acted a historical comparison group.

RESULTS: The percentage of women who had FGC performed on at least 1 daughter was significantly lower in 2011 than in 2006 (71.6% vs 77.8%, P=0.04). The main reason for performing FGC, given by 42.6% of the participants, was family pressure. The percentage of FGC procedures practiced by physicians was significantly lower in 2011 than it was in 2006 (34.6% vs 39.3%, P=0.04).

CONCLUSION: The decrease in prevalence of FGC after its complete ban was small after 5 years, with little change in attitude among educated families in Upper Egypt. In addition to the current law, a change in attitude will be needed to wipe out this custom.

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Female genital mutilation in Sierra Leone: who are the decision makers?

Afr J Reprod Health. 2012 Dec;16(4):119-31.FREE

Female genital mutilation in Sierra Leone: who are the decision makers?

Bjälkander O, Leigh B, Harman G, Bergström S, Almroth L.

Division of Global Health, Department of Public Health, Karolinska Institute, Stockholm, Sweden. owolabi.bjalkander@ki.se

ABSTRACT

The objectives of this study were to identify decision makers for FGM and determine whether medicalization takes place in Sierra Leone. Structured interviews were conducted with 310 randomly selected girls between 10 and 20 years in Bombali and Port Loko Districts in Northern Sierra Leone. The average age of the girls in this sample was 14 years, 61% had undergone FGM at an average age of 7.7 years (range 1-18). Generally, decisions to perform FGM were made by women, but father was mentioned as the one who decided by 28% of the respondents. The traditional excisors (Soweis) performed 80% of all operations, health professionals 13%, and traditional birth attendants 6%. Men may play a more important role in the decision making process in relation to FGM than previously known. Authorities and health professionals’ associations need to consider how to prevent further medicalization of the practice.

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