Prevalence Of Female Genital Cutting Research Articles

The medicalisation of female genital cutting in Kenya: a threefold exposition

In Kenya, the prevalence of Female Genital Cutting (FGC) is slowly decreasing. Simultaneously, the practice is increasingly being performed by healthcare providers rather than traditional circumcisers, which may pose the risk of legitimising the practice. To date, the underlying mechanisms remain poorly understood. Using the 1998, 2008-09, and 2014 Kenyan Demographic Health Surveys, this study aims to enhance understanding by mapping both FGC prevalence and medicalisation rates across birth cohorts and ethnic groups. Additionally, the study delves into data from the Kisii community, where FGC medicalisation is particularly high, to examine the association between medicalisation and a mother’s social position, as she is typically the primary decision-maker regarding the practice. Findings reveal that the coexisting trends of decreasing prevalence and increasing medicalisation exhibit significant ethnic variation. Among the Kisii, greater wealth is associated with higher odds of a medicalised cut compared to a traditional cut, while higher education and media use are linked to higher odds of not undergoing cutting at all compared to a medicalised cut. Our findings nuance the international community’s premise that the medicalisation of FGC hinders the eradication of the practice.

Cutting through complexity: An intersectional analysis of female genital cutting in Indonesia

Female genital cutting (FGC) in Indonesia is still prevalent, and it is increasingly prevalent in urban than in rural areas. This study analyzed the prevalence of FGC in Indonesia and the urbanization and medicalization of FGC practices. Specifically, it addresses the critical questions of how urbanization affects the prevalence of FGC, why the medicalization of FGC became prevalent in urban areas, and how it proceeded with the commercialized form of FGC. This study reviews the existing literature and analyses secondary data from government survey reports and policy documents to answer these questions. The results indicate that the high prevalence of FGC in Indonesia is caused by the complexity of the ambiguity of the government’s stance and policy towards FGC and the influence of the actors involved in FGC practices, such as the government, religious organizations, and medical professionals. Hence, legal measures and comprehensive and culturally sensitive strategies are needed to abandon FGC practices in Indonesia.

Changing the Narrative: What Student Midwives Need to Know About Deinfibulation

In the final instalment of a two-part series about female genital cutting (FGC)*, Denise Hall and Krystyna Nowobilska-Dean explore deinfibulation as a clinical skill that can be used to facilitate vaginal birth for FGC survivors**. For detailed information surrounding the anatomy of the vulva, the global prevalence of FGC, pretexts underpinning the perpetuation of FGC and arguments for culturally sensitive FGC midwifery education and care, please refer to the first article in this series.1 *Female genital cutting is used in lieu of female genital mutilation (FGM). **Individuals affected by FGC are referred to as survivors rather than victims.

Medicalization of Female Genital Cutting in Sapele Local Government Area, Delta State, Nigeria: The Implication for Health Care Provision in Nigeria

Background: Female genital cutting (FGC) affects over 200 million girls and women globally. It is inimical to health and increasingly being performed by healthcare providers. Medicalization of FGC is proposed by its proponents to reduce and prevent the incidence of its complications and though perceived to be safer, it is unethical and unjustifiable. This study assessed medicalization of FGC in Sapele Local Government Area, Delta State and made recommendations geared towards ending its practice.Methods: A descriptive cross-sectional study was conducted among reproductive age women (15 – 44 years) selected using multi-stage sampling. Pre-tested structured questionnaire was used to obtain quantitative data from 502 women while a focus group discussion guide was used to obtain qualitative data. Data was analyzed using SPSS version 20.0 and by themes. Results were presented as tables and narratives.Results: Prevalence of FGC was 277 (55.2%), of which 223 (80.5%) were medicalized. The mean age of cutting was 16.8 ± 5.46 years and nurses performed majority 220 (79.4%) of them. Few 44 (8.8%) of the respondents were aware of possible complications of FGC. Qualitative findings indicated that FGC is still being practiced with nurses being reported as major practitioners.Conclusion: Despite concerted efforts to eliminate FGC, its practice is still propagated with increasing heath workers as practitioners. Advocacy and health education for women and girls as well as training and retraining of health care providers is imperative to check this trend.

Prevalence and Barriers to Ending Female Genital Cutting: The Case of Afar and Amhara Regions of Ethiopia.

Female genital cutting (FGC) remains highly prevalent in Ethiopia, in spite of a slowly decreasing trend over the last decade. In an effort to inform and strengthen FGC interventions in Ethiopia, this study aimed to assess FGC prevalence in cross-administrative border* districts and to explore barriers to ending FGC. A mixed methods, cross-sectional study was employed in three districts in the Afar and Amhara regions in Ethiopia. A sample of 408 women with female children under the age of 15 were included in the study. Additionally, 21 key informant interviews and three focus group discussions were held with local government officials and community stakeholders. The study found that the prevalence of FGC among mothers interviewed was 98%. Seventy-four percent of the female children of participants had undergone FGC. Of the youngest (last born) female children, 64.7% had experienced FGC. The participation of respondents in cross-administrative FGC practices ranged from 4% to 17%. Quantitative analysis found that knowledge and attitude towards FGC, level of literacy, place of residence, and religious denomination were associated with FGC practice. The study also found that the lack of participatory involvement of local women in programs that aim to end FGC and the lack of suitable legal penalties for those who practice FGC exacerbate the problem. A significant proportion of participants support the continuation of FGC practices in their communities. This finding indicates that FGC practice is likely to persist unless new approaches to intervention are implemented. It is recommended that a comprehensive response that couples community empowerment with strong enforcement of legislation is administered in order to effectively end FGC in Ethiopia by 2025, in alignment with the national plan against Harmful Traditional Practices. * Cross-administrative border means a border between two regional states in Ethiopia. In this document, it refers to the movement of people between Amhara and Afar regional states.

The medicalisation of female genital cutting: Harm reduction or social norm?

Today, female genital cutting is increasingly practised by trained healthcare providers. While opposition to medicalised female genital cutting (FGC) is strong, little is known about the underlying motivation for this medicalisation trend in practising communities. We formulated three hypotheses based on medicalisation theories. The medicalisation of FGC: (i) is stratified and functions as a status symbol, (ii) functions as a harm-reduction strategy to conform to social norms while reducing health risks and (iii) functions as a social norm itself. Conducting multilevel multinomial regressions using the 2005, 2008 and 2014 waves of the Egyptian Demographic Health Survey, we examined the relationship between the mother's social position, the normative context in which she lives and her decision to medicalise her daughter's cut, compared to the choice of a traditional or no cut. We found that an individual woman's social position, as well as the FGC prevalence and percentage of medicalisation at the governorate level, was associated with a mother's choice to medicalise her daughter's cut. Further research on factors involved in decision-making on the medicalisation of FGC is recommended, as an in-depth understanding of why the decision is made to medicalise the FGC procedure is relevant to both the scientific field and the broader policy debate.

Factors associated with female genital cutting in Yemen and its policy implications

BackgroundA tremendous number of girls in Yemen are still subjected to female genital cutting (FGC), which carries an increased risk of health complications and violates children's rights. This study describes the prevalence of FGC in four Yemeni provinces and investigates the determinants of FGC. MethodsWe analyzed data from women aged 15 to 49 years who responded to a sub-national household survey conducted in six rural districts of four Yemeni provinces in 2008–2009. Logistic regression was used to estimate the association between individual and household socioeconomic factors and FGC practices and attitudes. ResultsThe prevalence of women's FGC was 48% while daughters' FGC was 34%. Almost 45.8% of the women surveyed believe the FGC practice should discontinue. Higher odds of FGC practice and positive attitude towards it were associated with older age, family marriage, and lower tertiles of wealth and education indices. Early marriage was also associated with increased odds of FGC practice (p < 0.01). ConclusionsSocioeconomic indices and other individual factors associated with FGC are differing and complex. Younger generations of women are more likely to not have FGC and to express negative attitudes towards the tradition. Appropriate strategies to invest in girls' education and women's empowerment with effective engagement of religious and community leaders might support the change of attitudes and practice of FGC in the younger generation.

West African Immigrant Perspectives on Female Genital Cutting: Experiences, Attitudes, and Implications for Mental Health Service Providers

This small pilot study analyzed the experiences of female genital cutting (FGC) among West African immigrants in New York City from three West African countries (the Gambia, Guinea, and Mali) with FGC prevalence rates of 76, 97, and 89%, respectively, among girls and women aged 15 to 49 years. Nine women participated in two focus group sessions. In the first group, five female participants ranged in age from18–20, and in the second, four participants ranged in age from 31 to 44. Focus group data were analyzed using a grounded theory approach. Despite the small sample size, the findings of this exploratory study highlight important aspects of immigrant women’s experiences regarding FGC and indicate the need for further exploration. Participants drew from personal experiences to discuss FGC and their views of the practice. Salient themes that emerged included the secretive and violent nature of the practice, the primacy of matriarchal decision-makers, the fear among immigrant mothers that their children would be subjected to FGC without their consent, and health care encounters in the USA. The findings of this study are considered in light of their implications for research, service provision, and policy.

Sociodemographic factors associated with female genital cutting among women of reproductive age in Nigeria

Objectives: The aims of the study were to determine the prevalence of female genital cutting (FGC) among women of reproductive age in Nigeria and identify the sociodemographic factors associated with the practice. Methods: A secondary analysis of the 2013 Nigeria Demographic and Health Survey was carried out in 38,948 women of reproductive age (15–49 years). Results: The prevalence of FGC among respondents was almost 25%, most of whom (82%) had undergone the procedure when they were under 5 years of age. Traditional circumcisers performed 72.2% of all procedures. Type 2 was the common form (62.6%) of FGC. Almost a quarter of respondents (23.1%) wanted the practice to continue. Women aged 45–49 years were approximately twice as likely to have undergone FGC compared with women aged 15–19 years (odds ratio [OR] 2.41; 95% confidence interval [CI] 1.99, 2.92; p < .001). Women from parts of Nigeria other than the North East zone were significantly more likely to have experienced FGC (p < .001). Women of Yoruba ethnicity were significantly more likely to have experienced FGC compared with women of Hausa/Fulani ethnicity (OR 4.86; 95% CI 3.03, 8.12; p < .001). Conclusions: Our findings have programmatic implications for ending the practice of FGC in Nigeria. Elimination efforts should be intensified among women of Yoruba ethnicity. To instigate behavioural change, communication interventions should particularly target residents in parts of Nigeria other than the North East zone.

Prevalence and associated factors of female genital cutting among young adult females in Jigjiga district, eastern Ethiopia: a cross-sectional mixed study.

PurposeThe aim of this study was to assess the prevalence and associated factors of female genital cutting (FGC) among young adult (10–24 years of age) females in Jigjiga district, eastern Ethiopia.MethodsA school-based cross-sectional mixed method combining both quantitative and qualitative research methods was employed among 679 randomly selected young adult female students from Jigjiga district, Somali regional state, eastern Ethiopia, from February to March 2014 to assess the prevalence and associated factors with FGC. A pretested structured questionnaire was used to collect data. The qualitative data were collected using focus group discussion.ResultsThis study depicted that the prevalence of FGC among the respondents was found to be 82.6%. The dominant form of FGC in this study was type I FGC, 265 (49.3%). The majority of the respondents, 575 (88.3%), had good knowledge toward the bad effects of FGC. Four hundred and seven (62.7%) study participants had positive attitude toward FGC discontinuation. Religion, residence, respondents’ educational level, maternal education, attitude, and belief in religious requirement were the most significant predictors of FGC. The possible reasons for FGC practice were to keep virginity, improve social acceptance, have better marriage prospects, religious approval, and have hygiene.ConclusionDespite girls’ knowledge and attitude toward the bad effects of FGC, the prevalence of FGC was still high. There should be a concerted effort among women, men, religious leaders, and other concerned bodies in understanding and clarifying the wrong attachment between the practice and religion through behavioral change communication and advocacy at all levels.

Interventions to Stop Female Genital Cutting and the Evolution of the Custom: Evidence on Age at Cutting in Senegal

Legal sanctions and awareness campaigns are increasingly used to try to reduce female genital cutting (FGC). In this article, I show that these interventions against FGC, rather than leading to the abandonment of the practice, can have unintended and potentially harmful effects on the way FGC is performed. Using DHS data from Senegal, I find that girls born in a year and a region where the law against FGC has been legally enforced are cut almost one year earlier. No significant effect of the law is found on the prevalence of FGC. Using a unique dataset from the region of Kolda in Senegal, I find a decreasing trend in age at cutting after the year of the introduction of the law sanctioning FGC. In both cases, I interpret the decrease in age as the result of a process of de-ritualisation and individualisation of FGC due to the push towards the secrecy of the practice.

The mother to daughter transmission of Female Genital Cutting in emigration as evidenced by Italian survey data

Normal 0 14 false false false IT X-NONE X-NONE MicrosoftInternetExplorer4 The feminization of African international migration flows has led to an increased presence of women in immigration contexts who have undergone Female Genital Cutting (FGC). In Italy, as well as in other countries, there is an increasing need to have detailed information about this practice among immigrants. This has led researchers to gather primary data in order to investigate topics such as its prevalence and parents’ attitudes on circumcising their daughters. The theoretical background used in practicing countries to analyse the persistence of the practice also needs to be adapted to the immigrants’ new life context. According to this approach, the FGC occurrence among the daughters of women born in practicing countries was modelled using data from the First Italian Survey of the Sexual and Reproductive Health of Migrant Women (2010). Multilevel random intercept logistic regressions were performed to examine which characteristics of the daughters, mothers and community are associated with the daughters’ FGC experience. The results showed a lower prevalence of FGC among immigrant communities than that estimated in the countries of origin. The multilevel analysis indicated that younger children born in emigration have a lower risk of FGC, with selected characteristics of the mothers and community also being relevant in reducing the continuation of the practice. Patrizia FARINA, Associated Professor, Department of Sociology and Social Reasearch, University of Milan - Bicocca, Milan, Italy. E-mail: patrizia.farina@unimib.it . Livia Elisa ORTENSI, Post Doc Researcher, Department of Sociology and Social Reasearch, University of Milan - Bicocca, Milan, Italy. E-mail: livia.ortensi1@unimib.it . /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

In the Best Interests of the Child: Preventing Female Genital Cutting (FGC)

Female Genital Cutting (FGC), the practice of cutting, sewing and altering the genitals of girl children, is a significant global human rights issue, with two to three million girls subjectedtoitannually.Prevalenceisconcentratedintwenty-sevennorthernAfricancountries and Yemen, and, with migration, it is also present in Western countries. It is a highly emotionally charged and contested issue. Globally, activists and communities, including those within practising countries, argue that it causes severe and irreparable harm to girls and women. It is understood as abuse and a violation of the ‘best interests of the child’. Yet, within practising communities, FGC is generally believed to be ‘in the best interests of the [girl] child’. The writers contend that social workers, child welfare and health professionalsinWesterncountriesshouldbeequippedtoassistresidentsfrompractisingcommunities to recognise the harm, change attitudes and practices, and together ensure the protection of their girls from this form of abuse. Drawing on international literature, this article addresses FGC prevalence and harm, its cultural and social bases and effective prevention strategies internationally, together with strategies for practitioners to harness communities’ commitment to their children’s best interests by abandoning FGC.

The Global Online Sexuality Survey: Public Perception of Female Genital Cutting among Internet Users in the Middle East

Female genital cutting (FGC) is a ritual involving cutting part or all of the female external genitalia, performed primarily in Africa. Understanding the motivation behind FGC whether religious or otherwise is important for formulating the anti-FGC messages in prevention and awareness campaigns. The study aims to provide an investigation of opinion over FGC, the root motive/s behind it, in addition to the current prevalence of FGC among Internet users in the Middle East. The Global Online Sexuality Survey was undertaken in the Middle East via paid advertising on Facebook®, comprising 146 questions. The main outcomes are the prevalence of and public opinion on FGC among Internet users. 31.6% of 992 participants experienced FGC at an average age of 9.6 ± 3.5 years, mostly in Egypt (50.2%). FGC was performed among both Muslims (36.9%) and Christians (18.8%), more in rural areas (78.7%) than urban (47.4%), and was performed primarily by doctors (54.7%) and nurses (9.5%). Whether or not it is necessary for female chastity, FGC was reported as highly necessary (22.5%), and necessary (21.6%). This was more among males, particularly among those with rural origin, with no difference as per educational level. This is in contrast to only 3.7% regarding FGC as a mandate of Islam. Religious opinion among Muslims was: 55.4% anti-FGC and 44.6% pro-FGC. An important motivation driving FGC seems to be males seeking female chastity rather than religion, especially with FGC not being an Islamic mandate, not to undermine the importance of religion among other motives. School and university education were void of an effective anti-FGC message, which should be addressed. There is a shift toward doctors and nurses for performing FGC, which is both a threat and an opportunity. We propose that the primary message against FGC should be delivered by medical and paramedical personnel who can deliver a balanced and confidential message.

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

ObjectiveTo compare the prevalence of female genital cutting (FGC) before and 5years after the law completely banned the practice in Egypt, and evaluate the attitude of educated mothers of girls toward FGC in Upper Egypt. MethodsAll 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. ResultsThe 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). ConclusionThe decrease in prevalence of FGC after its complete ban was small after 5years, 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.

Predictors of female genital cutting among university students in northern Nigeria

Female genital cutting (FGC) is a harmful cultural practice that is perpetrated against women and children. Little is known about the extent of this custom among university students in northern Nigeria. Using self-administered questionnaires, we studied the prevalence and determinants of FGC among female university students in Kano, Nigeria (n =359). The prevalence of FGC was 12.1% (95% confidence interval =8.8–15.8%). Awareness and disapproval of FGC among the study population was very high (96% and 91%, respectively). In multivariate regression models, ethnicity and geographic origin were significant predictors of female circumcision. A comprehensive legal and educational framework and the support of civil society, governments and development partners is required to address this form of gender discrimination.

Female genital cutting: current practices and beliefs in western Africa

To conduct a cross-national comparative study of the prevalence and correlates of female genital cutting (FGC) practices and beliefs in western Africa. Data from women who responded to the Multiple Indicator Cluster Surveys between 2005 and 2007 were used to estimate the frequencies of ever having been circumcised, having had a daughter circumcised, and believing that FGC practices should continue. Weighted logistic regression using data for each country was performed to determine the independent correlates of each outcome. The prevalence of FGC was high overall but varied substantially across countries in western Africa. In Sierra Leone, Gambia, Burkina Faso and Mauritania, the prevalence of FGC was 94%, 79%, 74% and 72%, respectively, whereas in Ghana, Niger and Togo prevalence was less than 6%. Older age and being Muslim were generally associated with increased odds of FGC, and higher education was associated with lower odds of FGC. The association between FGC and wealth varied considerably. Burkina Faso was the only country in our study that experienced a dramatic reduction in FGC prevalence from women (74%) to their daughters (25%); only 14.2% of the women surveyed in that country said that they believe the practice should continue. The prevalence of FGC in western Africa remains high overall but varies substantially across countries. Given the broad range of experiences, successful strategies from countries where FGC is declining may provide useful examples for high-prevalence countries seeking to reduce their own FGC practices.

Intergenerational Attitude Changes Regarding Female Genital Cutting in Nigeria

The practice of female genital cutting (FGC) is widespread in Nigeria and varies from one ethnic group to another. In 1994, Nigeria joined members of the 47th World Health Assembly in a resolution to eliminate the practice, and since then, several steps has been taken to achieve this objective. Nigeria joined members of the 47th World Health Assembly sixteen years ago in a resolution to eliminate female genital mutilation. This study uses data from 420 women aged 15?49 years who had at least one surviving daughter to investigate changes in FGC prevalence among mothers and daughters. The sample was systematically selected through stratified random sampling across the six states of southwest Nigeria. Focus group discussion, and an in-depth interview with fourteen women considered to be specialist in FGC were also held to compliment data generated from the interview. The analysis indicated an FGC prevalence rate of 75% and 71% for mothers and daughters, respectively. It further indicated that the practice is rooted in tradition despite the fact that 52% of the respondents are aware of the health hazards of FGC. Educated mothers were found to be less likely to favor the cutting of their daughters. It is suggested that educational campaigns aimed toward parents should be intensified. Legal recourse, prohibition of operations, improvement in women's status, and sex education are also suggested as means of eradicating the practice.

Prevalence of female genital cutting among Egyptian girls

Female genital cutting (FGC) is the collective name given to traditional practices that involve partial or total cutting away of the female external genitalia whether for cultural or other non-therapeutic reasons. In Egypt, the result of the Demographic Health Survey in 2000 revealed that 97% of married women included in the survey experienced FGC. The aim of this study is to measure the prevalence of FGC among schoolgirls in Egypt. Multistage random technique was applied for site selection. First, Egypt was divided into five geographical areas; Greater Cairo, Lower Egypt, Upper Egypt, Sinai and Suez Canal Region. Second, from each governorate, two educational districts were selected randomly (except Luxor). In each of the selected districts, the schools were divided into primary, preparatory and secondary schools. In each education stage, the schools were divided into rural, urban, government and private. The total number of females interviewed was 38,816. The prevalence of FGC among schoolgirls in Egypt was 50.3%. The prevalence of FGC was 46.2% in government urban schools, 9.2% in private urban schools and 61.7% in rural schools. Educational levels of mother and father were negatively associated with FGC (P < 0.001). The mean age of the time of FGC was 10.1 +/- 2.3 years. FGC prevalence is lowering, yet more active education at the grass-roots level is needed to create change.

Methodological issues in measuring the impact of interventions against female genital cutting

With increasing efforts being made to introduce systematic interventions for encouraging abandonment of female genital cutting (FGC) comes the need to better understand how such interventions work and what effects they have. Many interventions are based on theoretical models of behaviour change and so studies to evaluate them should develop indicators appropriate to the type of behaviour change anticipated. Systematic evaluations need also to use some form of quasi‐experimental design to be able to attribute change to the intervention and not to any ‘natural’ change in FGC behaviour or other activities that may be concurrent. A sustained change in the prevalence of FGC is the ultimate indicator and there are several ways this can be measured, although with many limitations given the intimate nature of the practice. Moreover, appropriate sample sizes must be calculated and used to be able to draw valid conclusions. Many of those implementing FGC interventions are not familiar with such basic research principles and so there is an urgent need to ensure that projects are well designed so that valid conclusions concerning their effectiveness can be drawn.