'It is what was handed over to us as our heritage and must not be taken away just like that': Traditional birth attendants' attitudes towards the elimination of intergenerational female genital mutilation/cutting in Osun State, Nigeria.

Abstract

Female genital mutilation/cutting is a harmful practice that violates the sexual and reproductive health rights of women and girls. The practice is often perpetrated directly or indirectly from one generation to another as a way of preserving the culture, thus making it difficult to tackle using ordinary prevention interventions. The purpose of the study was to assess the attitude of the traditional birth attendants as community leaders towards the elimination of intergenerational female genital mutilation/cutting (FGM/C) of girls and to determine their level of readiness and preparedness towards achieving it in Osun State, Nigeria. A qualitative research design, using the adapted REPLACE community readiness tool to end female genital mutilation/cutting interview guide, was used to individually interview eight traditional birth attendants who were identified through purposive sampling method as community leaders and key informants. Thematic Analysis was used to analyze the data which yielded female genital mutilation/cutting as traditional heritage, defiance against government efforts and debunking all "western" information about dangers of female genital mutilation to women as lies as findings. The current defensive attitudes of the TBAs as community leaders and custodians of the FGM/C tradition are that of denial and resistance which is characterised by misconception and incorrect knowledge about the issue as well as misconception and lack of support for addressing the issue which is an indication of low level of no readiness for any intervention to prevent or eliminate FGM/C in Osun state, Nigeria. Serious engagement and dialogue between policy makers and health professionals on FGM/C and its effects on women is highly recommended for effective FGM/C elimination strategies to be co-developed with community leaders. Such engagements should adopt a non-confrontational, respectful, and honest approach so as to not alienate the TBAs.