Abstract
Background: Female
genital mutilation/cutting (FGM/C) is a harmful traditional practice with
severe consequences for the health and well-being of girls and women. Health
care professionals are therefore
expected to be aware of how to identify and manage these consequences in order
to ensure that those affected by the practice receive quality health care.
Moreover, their integration and legitimacy within the communities allow them to
play a key role in the prevention of the practice. Nevertheless, the perception
of health care professionals on FGM/C has been barely explored in African
contexts. This study seeks to contribute to this field of knowledge by
examining the knowledge, attitudes, and practices regarding FGM/C among health
care professionals working in rural settings in The Nigeria.
Methods: A
cross-sectional descriptive study was designed through a quantitative
methodology, following a multiethnic approach. A pre-tested questionnaire with
open and closed-ended questions was created. Forty medical students from the
Community-based Medical Programme were trained to administer the questionnaire,
face to face, at village health facilities in rural areas of The Edo state. A
final sample of 468 health care professionals included all nurse cadres and
midwives.
Results: A significant
proportion of Nigerian health care professionals working in rural areas
embraced the continuation of FGM/C (42.5%), intended to subject their own
daughters to it (47.2%), and reported having already performed it during their
medical practice (7.6%). However, their knowledge, attitudes, and practices
were shaped by sex and ethnic identity. Women showed less approval for
continuation of FGM/C and higher endorsement of the proposed strategies to
prevent it than men. However, it was among ethnic groups that differences were
more substantial. health care professionals belonging to traditionally
practicing groups were more favourable to the perpetuation and medicalisation of
FGM/C, suggesting that ethnicity prevails over professional identity.
Conclusions: These
findings demonstrate an urgent need to build HCP’s capacities for FGM/C-related
complications, through strategies adapted to their specific characteristics in
terms of sex and ethnicity. A culturally and gender sensitive training
programme might contribute to social change, promoting the abandonment of FGM/
C, avoiding medicalisation, and ensuring accurate management of its health
consequences.
CHAPTER ONE
INTRODUCTION
1.1
Background
of the study
According to the World
Health Organization (WHO), Female genital mutilation (FGM) is defined as all
procedures which involve partial or total removal of the external female
genitalia and/or injury to the female genital organs, whether for cultural or
any other nontherapeutic reasons (World Health Organization 1998). Worldwide,
government and non- governmental organizations frown at FGM having seen it as
an infringement on the physical and psychosexual integrity of the female child.
Nigeria was said to have the highest absolute number of cases of FGM in the
world, accounting for about one-quarter of the estimated 115– 130 million
circumcised women worldwide (UNICEF 2001). The prevalence rate of FGM was put
at 41% among adult Nigerian women (Okeke 2012). Nigeria is a country in West
Africa bordering the Gulf of Guinea between Benin and Cameroon. It has an area
of 923,768.00 sq kilometers with a population of 140,431,790 according to the
2006 National Population census (National Bureau of Statistics 2006). The male
constituted 71,345,488 while the female were 69,086,302 (National Bureau of
Statistics 2006). This study was donein a tertiary hospital in Edo State, one
of the 36 states of Nigeria. Edo State has a population of 2,398,957with the female
being 1,215,487and the male 69,086,302 (National Bureau of Statistics 2006). It
is majorly inhabited by the Edo’s who are noted for high level of literacy in
terms of formal education and is reputed to have produced the reasonable number
of professors in Nigeria (Adesina 2008).The 2008 Nigeria Demographic and Health
Survey showed that 30% of female surveyed between ages 15- 40years had
undergone female circumcision with the Yoruba and igbo ethnic groups having the
highest percentage (58.4% and 51.4% respectively) (National Population
Commission 2009).Olamijulo et al., reported the prevalence of FGM among
children examined at the child welfare clinic, Wesley Guild Hospital, Ilesha,
Nigeria to be 66.3%.The following states in Nigeria have prohibited this act
since 1999;Abia, Bayelsa, Cross River, Delta, Edo, Ogun, Osun and Rivers.
However, with increasing awareness of the complication of FGM, there is a
recent ban on the practice in Nigeria as a nation in year 2015. The prevalence
rate is therefore expected to progressively decline in the younger age groups.
FGM practiced in Nigeria is classified into four typesas follows;
clitoridectomy or Type I, this involves the removal of the prepuce or the hood
of the clitoris and all or part of the clitoris. Type II or “sunna” is a more
severe practice that involves the removal of the clitoris along with partial or
total excision of the labia minora. Type III (infibulation), involves the
removal of the clitoris, the labia minora and adjacent medial part of the labia
majora and the stitching of the vaginal orifice, leaving an opening of the size
of a pin head to allow for menstrual flow or urine. Type IV or other
unclassified types include introcision and gishiri cuts, hymenectomy, scraping
and/or cutting of the vagina, the introduction of corrosive substances and
herbs in the vagina, and other forms. Consequences of female genital mutilation
include increased risks of urinary tract infections, bleeding, bacterial
vaginosis, dyspareunia, obstetric complications, psychological problems such as
depression, anxiety, post-traumatic stress disorder, low self-esteem, etc
(Behrendt and Moritz, 2005), Abdulcadir and Dällenbach, 2013), Amin et al.,.,
2013), Andersson et al.,., 2012), Andro et al.Female genital mutilation is
classified into four major types (WHO, 1996). The most common type of the
female genital mutilation is type 2 which account for up to 80% of all cases
while the most extreme form which is type 3 constitutes about 15% of the total
procedures(WHO, 1996; Oduro et al., 2006). Types 1 and 4 of FGM constitute the
remaining 5%. The consequences vary according to the type of FGM and severity
of the procedure (Onuh et al., 2006; Oduro et al., 2006). The practice of FGM
has diverse repercussions on the physical, psychological, sexual and
reproductive health of women, severely deteriorating their current and future
quality of life (Oduro et al., 2006; Larsen, 2002). The immediate complications
include: severe pain, shock, haemorrhage, urinary complications, injury to
adjacent tissue and even death (Onuh et al., 2006; Oduro et al., 2006; Larsen,
2002). The long term complications include: urinary incontinence, painful
sexual intercourse, sexual dysfunction, fistula formation, infertility,
menstrual dysfunctions, and difficulty with child birth (Akpuaka, 1998;
Okonofua et al., 2002; Oguguo and Egwuatu, 1982). The physical and
psychological sequelae of female genital mutilation have been well highlighted
in many literatures (Onuh et al., 2006; Oduro et al., 2006; Badejo, 1983;
Klouman et al., 2005; ACHPR, 2003; Ibekwe, 2004). Recently, there has been
serious concern on the increased rate of transmission of Human Immunodeficiency
Virus (HIV) following this practice (WHO, 1996; Klouman et al., 2005). The
practice is also a violation of the human rights of the women and girl child.
FGM categorically violates the right to health, security and physical
integrity, freedom from torture and cruelty, inhuman or degrading treatment and
the right to life when the procedure results in death. It constitutes an
extreme form of violation, intimidation and discrimination. Despite its
numerous complications, this harmful practice has continued unabated,
notwithstanding that Nigeria ratified the Maputo Protocols and was one of the
countries that sponsored a resolution at the 46th World Health Assembly calling
for the eradication of female genital mutilation in all nation (Klouman et al.,
2005; ACHPR, 2003; Idowu, 2008).
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 (Onuh et al., 2006; WHO, 2008). 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, 2008; WHO, 1996). 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, 2008). It is in view of this
that the researcher intends to assess the effect of female genital mutilation.
1.3
OBJECTIVE
OF THE STUDY
The main objective of
the study is on an assessment of female genital mutilation in Nigeria with
emphasis on Edo state. But to aid the completion of the study, the researcher
intends to achieve the following sub-objective;
1.
To determine health care professionals’ awareness of female
genital mutilation and its health consequences
2.
To determine the Knowledge of FGM/C among Nigerian health care professionals
3.
To
examine the Attitudes of Nigerian health care professionals towards FGM/C
1.4
RESEARCH
QUESTIONS
To aid the completion
of the study, the following research hypotheses were formulated by the
researcher
1.
What is the level of health care professionals’ awareness of female
genital mutilation and its health consequences
2.
What is the level of Knowledge of FGM/C among Nigerian health care professionals
3.
What
is the Attitudes of Nigerian health care
professionals towards FGM/C
1.5
SIGNIFICANCE
OF THE STUDY
At the completion of
the study, it is believed that the study will be of great important to the
federal ministry of women affair and the house committee on women affairs as
the study will help them formulate policy that will help prohibit or eliminate
the archaic and orthodox practice of female genital mutilation, the study will
also be of great importance to every parent as the study seek to expose the
dangers of female genital mutilation among female. The study will also be of
great importance to student who intend to embark on a study in similar topic as
the findings of the study will serve as a pathfinder to them. Finally the study
will be of great importance to students, teachers and the general public as the
finding will add to the pool of existing literature.
1.6
SCOPE
AND LIMITATION OF THE STUDY
The scope of the study
covers an assessment on female genital mutilation in Nigeria, with emphasis on
Benin City. But in the cause of the study, there were some factors which
limited the scope of the study
a) AVAILABILITY OF RESEARCH MATERIAL:
The research material available to
the researcher is insufficient, thereby limiting the study.
b) TIME: The time frame
allocated to the study does not enhance wider coverage as the researcher has to
combine other academic activities
and examinations with the study.
c) FINANCE: The finance
available for the research work does not
allow for wider coverage as resources are very limited as the researcher has other academic bills to
cover
1.7
DEFINITION OF TERMS
Female
Female is the sex of
an organism,
or a part of an organism, that produces non-mobile ova (egg
cells). Barring rare medical conditions, most female mammals,
including female humans,
have two X chromosomes.
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
Reproductive
health
Within the framework of
the World Health Organization's
(WHO) definition of health as
a state of complete physical, mental and social well-being, and not merely the
absence of disease or infirmity, reproductive
health, or sexual health/hygiene, addresses the reproductive
processes, functions and system at all stages of life. Reproductive health
implies that people are able to have a responsible, satisfying and safer sex life and
that they have the capability to reproduce and the freedom to decide if,
when and how often to do so. One interpretation of this implies that men and
women ought to be informed of
and to have access to safe, effective, affordable and acceptable methods
of birth control; also access to
appropriate health care services of sexual, reproductive medicineand
implementation of health education programs to stress the importance of women to go safely through pregnancy and childbirthcould
provide couples with the best chance of having a healthy infant.
1.8
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 (background of the study),
statement of the problem, objectives of the study, research questions, research
hypotheses, significance of the study, scope of the study etc. Chapter two
being the review of the related literature presents the theoretical framework,
conceptual framework and other areas concerning the subject matter. Chapter three is a research methodology
covers deals on the research design and methods 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.
================================================================
Item Type: Project Material | Attribute: 54 pages | Chapters: 1-5
Format: MS Word | Price: N3,000 | Delivery: Within 30Mins.
================================================================
No comments:
Post a Comment