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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 qualitative study of women’s lived experience after deinfibulation in the UK

Midwifery. 2013, 29(2); 154–158

A qualitative study of women’s lived experience after deinfibulation in the UK

Safari F

ABSTRACT

Objective: to explore women’s experiences of deinfibulation and its aftermath. Design: a qualitative study using semi-structured interviews with data collection via audio-recording and field notes. The audio-recorded interviews were transcribed verbatim and analysed using Interpretive Phenomenological Analysis (IPA) method for qualitative data analysis. Setting: recruitment for the study was carried out in an African Well Women Clinic in London, United Kingdom. Participants: there were nine women participants of Somali and Eritrean origin who had Female Genital Mutilation (FGM) type III previously and underwent deinfibulation between January 2008 and September 2009. Findings: key themes identified were the cultural meaning and social acceptability of deinfibulation; the consequences of deinfibulation within marital relationships; feelings about the appearance of genitalia post deinfibulation and thoughts on reinfibulation. Conclusions: marital factors and stability of the relationship influence the experience of deinfibulation. Those women who said they had discussed deinfibulation with their husband in advance, and that he had agreed to the procedure, reported less problems afterwards. Single women who had deinfibulation before marriage may face more difficulties in terms of social acceptability within their community. Implications for practice: sensitivity to social consequences of deinfibulation is important as well as recognition that these consequences vary. When deinfibulation is carried out for medical purposes some women may appreciate the offer of an official letter from a health-care practitioner confirming the medical nature of the procedure. The data suggests that deinfibulated women may dislike the new appearance of their genitalia; therefore, the practicality of performing a concurrent minor cosmetic surgery with deinfibulation procedure may need to be examined. The need for further research conducted in women’s primary language is pressing and should explore issues such as the situation of single women, men’s knowledge of the complications associated with FGM and the benefits of deinfibulation for infibulated women.

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Female genital cutting in Hargeisa, Somaliland: is there a move towards less severe forms?

Reprod Health Matters. 2014 May;22(43):169-77. doi: 10.1016/S0968-8080(14)43759-5.

Female genital cutting in Hargeisa, Somaliland: is there a move towards less severe forms?

Lunde IB, Sagbakken M.

ABSTRACT

According to several sources, little progress is being made in eliminating the cutting of female genitalia. This paper, based on qualitative interviews and observations, explores perceptions of female genital cutting and elimination of the phenomenon in Hargeisa, Somaliland. Two main groups of participants were interviewed: (1) 22 representatives of organisations whose work directly relates to female genital cutting; and (2) 16 individuals representing different groups of society. It was found that there is an increasing use of medical staff and equipment when a girl undergoes the procedure of female genital cutting; the use of terminology is crucial in understanding current perceptions of female genital cutting; religion is both an important barrier and facilitator of elimination; and finally, traditional gender structures are currently being challenged in Hargeisa. The findings of this study suggest that it is important to consider current perceptions on practices of female genital cutting and on abandonment of female genital cutting, in order to gain useful knowledge on the issue of elimination. The study concludes that elimination of female genital cutting is a multifaceted process which is constantly negotiated in a diversity of social settings.

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Reflections on female circumcision discourse in Hargeysa, Somaliland: purified or mutilated?

Afr J Reprod Health. 2014 Jun;18(2):22-35.FREE

Reflections on female circumcision discourse in Hargeysa, Somaliland: purified or mutilated?

Vestbøstad E, Blystad A.

ABSTRACT

In communities where female circumcision is carried out, increasingly large segments of the population have been exposed to strong arguments against the practice. This study aimed to explore diverse discourses on female circumcision and the relationship between discourses and practice among informants who have been exposed both to local and global discourses on female circumcision. A qualitative study was carried out in 2009/10 in Hargeysa, Somaliland, employing interviews and informal discussion. The main categories of informants were nurses, nursing students, returned exile Somalis and development workers. The study findings suggest that substantial change has taken place about perceptions and practice related to female circumcision; the topic is today openly discussed, albeit more in the public than in the private arena. An important transformation moreover seems to be taking place primarily from the severe forms (pharaoni) to the less extensive forms (Sunna).

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[The voice of women subjected to female genital mutilation in the Region of Murcia (Spain).] [Article in Spanish]

Gac Sanit. 2014 Mar 24. pii: S0213-9111(14)00047-8. doi: 10.1016/j.gaceta.2014.02.006. [Epub ahead of print]

[The voice of women subjected to female genital mutilation in the Region of Murcia (Spain).] [Article in Spanish]

Ballesteros Meseguer C, Almansa Martínez P, Pastor Bravo MD, Jiménez Ruiz I.

ABSTRACT

OBJECTIVE: To explore the perceptions of a group of women who underwent female genital mutilation on the impact of this practice on their sexual and reproductive health.

METHODS: We performed a phenomenological qualitative study in a sample of 9 sub-Saharan Africa women, whose mean age was 30 years old and who had lived in Spain for 1 to 14 years. These women underwent genital mutilation in their countries of origin. Data was collected using a socio-demographic survey and an in-depth, structured personal interview. Subsequently, we performed a thematic discourse analysis.

RESULTS: The discourses were grouped into four categories related to participants’ perceptions of female genital mutilation. These categories were intimate relationships, pregnancy, childbirth, and social impact.

CONCLUSIONS: The practice of female genital mutilation is maintained due to social and family pressure, transmitted from generation to generation and silenced by women themselves. This practice affects their sexual and reproductive health, as demonstrated by anorgasmia and dyspareunia. The women were satisfied with the healthcare received during pregnancy and childbirth. Nevertheless, most of them were not satisfied with family planning.

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Labia minora elongation as understood by Baganda male and female adolescents in Uganda.

Cult Health Sex. 2013 Aug 1. [Epub ahead of print]LME

Labia minora elongation as understood by Baganda male and female adolescents in Uganda.

Martínez Pérez G, Namulondo H, Tomás Aznar C

ABSTRACT

Labia minora elongation is a common traditional female genital modification practice among the members of the Baganda ethnic group in Uganda. In 2002, a study carried out by the Padua Working Group on Female Genital Mutilation analysed how Baganda girls residing in Wakiso District graphically represented their experiences of labia minora elongation. In the present study, using the same methodology and in the same geographic setting 10 years later, we asked young men and women to prepare graphical representations of this rite. The purpose was to learn about how the practice is perceived and represented, describing the differences found in their testimonies, and comparing the findings with the former study. A total of 36 respondents (21 male and 15 female), aged between 9 and 15 years old participated in the study. The drawings were analysed using a three-themes analysis frame with a focus on setting, subject and operator. Differences were detected between how young women and men represented this practice. Educational interventions may be helpful to address the doubts, concerns, anxieties and misconceptions that Baganda youth may have concerning traditional genital practices.

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Contextualization of female genital mutilation since nursing. Analysis videographic

Enferm. glob. vol.11 no.25 Murcia Ene. 2012FREE

Contextualization of female genital mutilation since nursing. Analysis videographic. (Article in Spanish)

Pastor Bravo, MM, Almansa Martínez P, Ballesteros Meseguer C, Pastor Rodríguez JD

ABSTRACT

The purpose of this paper is to analize the audiovisual documents relating to the ritual of the female genital mutilation.
Material and method: pursuit and review of the video footage that give us information about the female genital mutilation in context, and be a primary source of information.
Results: The anlysis of the video footage obtained allows us to identify a large amount of data in order to study the female genital mutilation in context. To analyze the collected information 10 categories have been stablished.
Conclusion: The visual documents are a essential source of research for the analysis of the female genital mutilation ritual; they are a tool to consider in the training of health professionals in this area, which affects health of women and immigrant children. The knowledge obtained due to this review can be used in order to approach in a cultural way the female genital mutilation.

Key words: female genital mutilation; female circumcision; ablation; nursing; analysis of audiovisual; qualitative study.

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Meaning-making of female genital cutting: children’s perception and acquired knowledge of the ritual.

Int J Womens Health. 2013 Apr 15;5:165-75. doi: 10.2147/IJWH.S40447. Print 2013.FREE

Meaning-making of female genital cutting: children’s perception and acquired knowledge of the ritual.

Schultz JH, Lien IL.

Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway.

ABSTRACT

How do girls who have undergone female genital cutting understand the ritual? This study provides an analysis of the learning process and knowledge acquired in their meaning-making process. Eighteen participants were interviewed in qualitative indepth interviews. Women in Norway, mostly with Somali or Gambian backgrounds, were asked about their experiences of circumcision. Two different strategies were used to prepare girls for circumcision, ie, one involving giving some information and the other keeping the ritual a secret. Findings indicate that these two approaches affected the girls’ meaning-making differently, but both strategies seemed to lead to the same educational outcome. The learning process is carefully monitored and regulated but is brought to a halt, stopping short of critical reflexive thinking. The knowledge tends to be deeply internalized, embodied, and morally embraced. The meaning-making process is discussed by analyzing the use of metaphors and narratives. Given that the educational outcome is characterized by limited knowledge without critical reflection, behavior change programs to end female genital cutting should identify and implement educational stimuli that are likely to promote critical reflexive thinking.

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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.

ABSTRACT

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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How experiences and attitudes relating to female circumcision vary according to age on arrival in Britain: a study among young Somalis in London

Ethn Health. 2004 9(1): 75-100. DOI:10.1080/1355785042000202763

How experiences and attitudes relating to female circumcision vary according to age on arrival in Britain: a study among young Somalis in London

Morison LA, Dirir A, Elmi S, Warsame J, Dirir S

ABSTRACT

Objective. To examine the association between age on arrival in Britain and experiences and attitudes relating to female circumcision among young, single Somalis living in London.

Design. The study population consisted of single male and female Somalis aged 16–22 years living in the Greater London area. Quantitative data were collected using a cross‐sectional survey based on snowball sampling aiming to obtain data on 100 males and 100 females. Qualitative data were collected from 10 males and 10 infibulated females.

Results. Quantitative data were obtained for 94 females and 80 males. Living in Britain from a younger age was associated with increased assimilation in terms of language, dress and socialising. Seventy per cent of the females reported being circumcised with two‐thirds of operations being infibulation. Those who were living in Britain before the usual age range for circumcision (before age six) were less likely to be circumcised (42%) than those who arrived after the usual age range for circumcision (11 or older) (91%). During in‐depth interviews, health and sexual problems due to female circumcision were described with great emotion and interviewees acknowledged the association between the importance of virginity for marriage and circumcision. Half of males who arrived aged 11 or older wanted a circumcised wife compared with less than a quarter of those who arrived at a younger age. Eighteen per cent of female respondents and 43% of males intended to circumcise any daughters. Females were less likely than males to agree with the assumptions about sexuality and religion that underpin the practice. Substantial proportions of respondents perceived that their parents’ expectations in terms of marriage and circumcision were more traditional than their own.

Conclusion. Living in Britain from a younger age appears to be associated with abandonment of female circumcision and with changes in the underlying beliefs on sexuality, marriage and religion that underpin it. Groups identified with more traditional views towards female circumcision include males, older generations, new arrivals and those who show few signs of social assimilation.

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