Knowledge, Attitude And Practice Of Female Genital Mutilation Among Women In The Community

Project and Seminar Material for Public Health

Knowledge, Attitude And Practice Of Female Genital Mutilation Among Women In The Community


Abstract


This study was carried out to examine the knowledge, attitude and practice of women FGM in Ethiope west LGA of Delta state. The study was specifically carried out to measure the magnitude of FGM in daughters of women living in Ethiope west; assess the knowledge of women about harmful effects of FGM in Ethiope west; assess the attitude of women towards FGM in Ethiope west; and assess the practice of women in subjecting their daughters to FGM in Ethiope west. A descriptive survey study was conducted in the study area. A total of 384 sampled mothers were interviewed using a face to face interview. A systematic sampling technique was used to select the sampled households. The data processing was made by entering coded variables accordingly in to a computer SPSS version 16 and obtained the corresponding frequency counts for each variable. Finally, analysis was made by interpretation of frequencies, tables and graphs. Chi-square test was used to determine statistical association between variables. Three hundred twenty four (84.4%) of the mothers responded that FGM can lead to a health problem, while 58(15.1%) of the mothers said that FGM does not lead to any health problem. Among the mothers who know the possible problems that could occur as a complication of FGM 128(39.5%) responded that the problem occurs immediately after the procedure (bleeding) and during child birth. Among respondents 370(96.4%) claimed that the practice is abandoned by law and is punishable, while 12(3.1%) of the mothers responded it has no legal provision. Three hundred thirty five (87.2%) of respondents do not want their daughters to be circumcised and need to avoid FGM in the future, and 49(12.8%) want to continue with FGM. Maternal education has very significant association with mothers’ knowledge, attitude and practice about FGM with p-value of 0.000, 0.005 and 0.000, respectively. Mothers who had access to different kinds of mass media were more likely found having good knowledge, attitude and practice than mothers who had no access to any kind of mass media (p=0.001 for each). Maternal age was another variable which has very significant association with knowledge, attitude and practice of mothers with p-value of 0.001, 0.021 and 0.000, respectively. This study showed the magnitude of FGM to be 63.7%. The study showed that maternal education, access to different kinds of mass media and maternal age have significant effect on mothers’ knowledge, attitude and practice about FGM.


Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample Size Determination
  • 3.4 Sample Size Selection Technique and Procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Validity of the Study
  • 3.9 Reliability of the Study
  • 3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Demographic Analysis
  • 4.2 Answering Research Questions
  • 4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Backgroud of the Study

Female genital mutilation (FGM), by definition is the removal of female genitalia partially or completely for non-medical reason. Female genital mutilation (FGM) and female circumcision are two terms that refer to the practice of removing parts of the women’s genitalia. The former is used by World health organization (WHO), while the latter is used by the community where this custom is practiced. The practice of FGM and the type of operation are often specific to particular ethnic groups and thus the prevalence varies widely within and between countries.
According to WHO there are four types of FGM, these are: Type I FGM, which is excision of the prepuce with partial or total removal of the clitoris; Type II FGM, which is excision of the clitoris with partial or total removal of the labia minora; Type III FGM (infibulation), which is excision of the labia majora with stitching or sealing of the vaginal orifice, and Type IV FGM, is unclassified which includes, the range of practices as stretching of labia and clitoris, burning of the clitoris and adjacent tissues by cauterization.1 FGM exists primarily in Africa. It is practiced in 28 countries in Africa and at a rate of at least 50% in more than 60% of the countries. It is not well known when and where the tradition of FGM is originated, but some people believe the practice started in ancient Egypt. The highest incidence of FGM has been reported in Somalia (98%), Djibouti (98%), Eritrea (90%), Serra lion (90%), Sudan (85%), Egypt (80%), and Gambia (80%). It is estimated that between 100 and 400million girls and women have experienced FGM, respectively, and that at least 2million girls undergo some forms of such mutilation every year.2
Many harmful traditional practices (HTP) such as FGC are deeply entrenched in the society of Nigeria in general and the study area in particular, for which reason they are regarded as just and beneficial acts by many. Also in as much as the practices are harmful to the victim there are also pockets which benefit from it. Needless to say women are victims of harmful traditional practices in general and FGM in particular in the community. These practices violet their marital, reproductive health, physical and spiritual rights and wellbeing in a number of ways, as they are subject to different forms of FGM right from the date of their birth, all the way to the time of giving birth.3 Despite different constitutional provisions the hard reality on the ground reveals a shedding picture, some of the factors contributing for this discrepancy may be cultural and religious belief related factors such as gender inequality, an ill begotten attitude towards women’s reproductive organs, and the need to secure wife’s fidelity to husband. Moreover, socio economic factors as poor access to information, not educating women or legal related factors as poor enforcement of the law, and reluctantness of the law enforcement organs to regard FGC as an act that reveal bodily harm are other factors incriminated.1,3 There is a misconception that FGM is a religious obligation. However, FGM cannot be related to either Islamic or Christianity because of the following reasons: FGM is not practiced in all Islamic countries, It is not practiced in all Christian countries, there is strong historical evidence that it pre-dated the arrival of Islam in Africa, the Koran does not prescribe the performance of FGM, there is no reference to female circumcision in the old or new Testament of the Holy Bible. Because of the resulting physical and physiological hazards it brings to the life of the circumcised girl, Christianity rejects FGM.4 The statement by Islamic jurists also demonstrate that society is capable of emphasizing those religious believes which serve its economic interest. Female circumcision persists because of economic and political factors. Adewale contends that in an attempt to hide the true reasons for events, religious arguments are used to obscure the economic and political factors which actually shape history.

In Nigeria, specifically Ethiope west in Delta state, where majority of the community are dependent on farming for their life. As the other rural communities of the local government, it is the male who is the decision maker of the family and women are dependent on the male in their life, even they need their husbands to decide on their health related issues. Mothers in those communities are not well educated and have little access to information about reproductive health and other health related issues. Thus assessing the Knowledge, attitude and practice (KAP) of mothers towards FGC is the get point to fight against the practice.


1.2 Statement of the Problem

The practice of Female Genital Mutilation (FGM) is regrettably persistent in many parts of the world. This occurs commonly in developing countries where it is firmly anchored on culture and tradition, not minding many decades of campaign and legislation against the practice (WHO, 2018). Female genital mutilation comprises any procedure involving partial or total removal of the external female genitalia or other injury to the female genital organs for cultural, religious or other non-therapeutic reason (WHO, 2018; WHO, 2016). The World Health Organization (WHO) estimates that between 100 and 140 million girls and women worldwide are presently living with female genital mutilation and every year about three million girls are at risk (WHO, 2018).

Mothers in our study shared the opinion of FGM having no benefits for females because of the ongoing campaigns against the practice, as well as the fact that they were being interviewed by healthcare professionals, who are seen to be among the groups involved in championing the fight against FGM in the country. They also likely reported that uncircumcised females will become sexually promiscuous because this is a widely held perception in the community where our study was carried out.


1.3 Objectives of the study

Generally, this study seek to assess the knowledge, attitude and practice of women FGM in Ethiope west LGA of Delta state. Specific objectives are stated below.

  1. Measure the magnitude of FGM in daughters of women living in Ethiope west.
  2. Assess the knowledge of women about harmful effects of FGM in Ethiope west.
  3. Assess the attitude of women towards FGM in Ethiope west.
  4. Assess the practice of women in subjecting their daughters to FGM in Ethiope west.

1.4 Research Question

The following research questions were raised;

  1. What is the magnitude of FGM in daughters of women living in Ethiope west?
  2. What is the knowledge of women about harmful effects of FGM in Ethiope west?
  3. What is the attitude of women towards FGM in Ethiope west?
  4. What are the practice of women in subjecting their daughters to FGM in Ethiope west?

1.5 Research Hypothesis

  • Ho: Women in Ethiope west do not have adequate knowledage of FGM.
  • Ha: Women in Ethiope west have adequate knowledage of FGM.

1.6 Significance of the Study

Assessing the KAP of the main victims of FGM is a very important measure towards the movement of discharging this long held tradition from the society which is suffering from its immediate as well long-term consequences. It has a great significance in the preparation for bringing an attitude change in mothers and to empower them above all by understanding that most common reasons for the practice of FGM stem from direct or indirect attitude of down grading women and looking at them as beings created to serve the other sex and it is this social attitude which is playing an important role that needs to be destroyed in order to achieve at behavioral change. Improvement of maternal health is incorporated in the millennium development goals (MDG) as one of the prerequisites for development and poverty reduction. Therefore, it is essential to describe their KAP before all actions that will be forwarded for improvement of maternal health. The study results will be used at all levels that are hoped to play a part in the improvement of maternal health ranging from the healthcare planners to those working in the periphery and by others who want to use the study result for their study in related topics in the future.


1.7 Scope of the Study

This study is focused on the knowledge, attitude and practice of women FGM in Ethiope west LGA of Delta state. Hence, this study will be carried out in Ethiope west LGA of Delta state.


1.8 Limitations of the Study

As with any human endeavor, the researcher experienced small impediments while performing the study. Due to the scarcity of literature on the subject as a result of the discourse’s nature, the researcher incurred additional financial expenses and spent additional time sourcing for relevant materials, literature, or information, as well as during the data collection process, which is why the researcher chose a small sample size. Additionally, the researcher conducted this inquiry in conjunction with other scholarly pursuits. Additionally, because only a small number of respondents were chosen to complete the research instrument, the results cannot be applied to other secondary schools outside the state. Regardless of the limits faced throughout the investigation, all aspects were reduced to ensure the best outcomes and the most productive research.


1.9 Definition of Terms

Female Genital Mutilation:

Female genital mutilation (FGM), also known as female genital cutting and female circumcision, is the ritual cutting or removal of some or all of the external female genitalia. The practice is found in Africa, Asia and the Middle East, and within communities from countries in which FGM is common.


1.10 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows.

  • Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
  • Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
  • Chapter three deals on the research design and methodology adopted in the study.
  • Chapter four concentrate on the data collection and analysis and presentation of finding.
  • Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five


Summary, Conclusions and Recommendations

5.1 Introduction

This chapter summarizes the findings on the knowledge, attitude and practice of women FGM in Ethiope west LGA of Delta state. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was on the knowledge, attitude and practice of women FGM in Ethiope west LGA of Delta state. The study is was specifically set to measure the magnitude of FGM in daughters of women living in Ethiope west; assess the knowledge of women about harmful effects of FGM in Ethiope west; assess the attitude of women towards FGM in Ethiope west; and assess the practice of women in subjecting their daughters to FGM in Ethiope west.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 384 responses were validated from the enrolled participants where all respondents are women residents in Ethiope west LGA of Delta state.


5.3 Conclusions

This study showed that: The magnitude of FGM was below the national prevalence of FGM by 8.8%., all of the circumcisions were performed by cutting the clitoris (Type I circumcision).Maternal education was found as determinant of mothers’ knowledge, attitude and practice about FGM. Literate (those who attended formal education) mothers were about two times more likely to have good knowledge about FGM and its complications than illiterate women (those who cannot read and write). Presence of mass media was another factor that strongly associated with mothers’ knowledge and attitude. Mothers who had access to different kinds of mass media were more likely found having good knowledge than mothers who had no access to any kind of mass media. Majority of the respondents have a positive response to eradicate FGM in the future. Majority of the circumcisions were undertaken by traditional circumcisers and some were by traditional healers and traditional birth attendants. Most of the mothers that circumcised their daughters know FGM could result health problems. It is not only lack of knowledge that make parents subject their daughters to FGM, cultural expectations and pressures that is exerted on them rather than because of personal convictions regarding the rationality or acceptability of the practice.


5.4 Recommendations

Even though the magnitude of FGM in the study area is below the national prevalence it The advocacies through different mass Medias need to be continued in organized and in a way the community at rural area get information in accessible manner, Teachers, religious leaders and health professionals need to continue in teaching the society about consequences of FGM. Proper sensitization of youth, fathers, religious leaders and legislators in order to put great pressure on the mothers, grandmothers and on those who perform the practice. It is also very important to identify and teach those traditional circumcisers about complications of FGM, and also to make them participate in the movement to discharge this long held tradition from the community. The law enforcement bodies need to take strong action in those who perform FGM and teach the community about the legal prohibition of FGM. Mothers who do not circumcised their daughters need to be encouraged and taken as model to teach other mothers.


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