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Hemmeda L, Anwer L, Abbas M, Elfaki L, Omer M, Khalid M, Hassan M, Mostafa M, Hamza L, Mahmoud M, Osman MM, Mohamed M, Bakheet L, Omer AT. The unbroken chain of female genital mutilation: a qualitative assessment of high school girls' perspectives. BMC Womens Health 2024; 24:11. [PMID: 38172761 PMCID: PMC10765796 DOI: 10.1186/s12905-023-02843-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Female Genital Mutilation (FGM) is defined as any procedure that involves damage to the female external genitalia. This practice is majorly prevalent in Sudan, as it is estimated that over 12 million Sudanese women are circumcised. This study uncovers rural females' knowledge and insights about FGM domestically. METHODS A qualitative, deductive study with thematic analysis was conducted. A total of 42 female high school students were recruited and divided into five focus groups, each of which included girls from four different high school classes in the main school of the study area. A topic guide was prepared and used to lead the focus groups. Thematic analysis was used, and the study data had been categorized into four themes: knowledge, procedure and performance, experience, and practice. The condensed meaning units of each theme were identified, then classified to formulate sub-themes. RESULTS All the participants indicated that FGM is a traditional practice in the village. The vast majority have heard about it from family members, mainly mothers and grandmothers. Regarding the procedure, all the participants agreed that midwives perform FGM, but most of them don't know what exactly is being removed. According to all participants, mothers and grandmothers are the decision-makers for FGM. The majority of the participants stated that they do not discriminate between the circumcised and uncircumcised women and most of them agreed that circumcision has negative side effects. They have mentioned pain, difficult urination, and walking as early side effects, while psychological impacts and labor obstruction as late ones. Generally, the majority of the participants agreed that circumcision is not beneficial and should stop. CONCLUSION Knowledge regarding the dangers of FGM among high school girls is better than expected given the high prevalence of the practice. Generally, the process is well understood, the performers are known, the experience is universal, and the side effects are acknowledged. Nevertheless, a majority still showed an intent to circumcise their daughters in the future.
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Affiliation(s)
- Lina Hemmeda
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan.
| | - Lena Anwer
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Marwa Abbas
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Lina Elfaki
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Maram Omer
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Maab Khalid
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Mushrega Hassan
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Mihrab Mostafa
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Lina Hamza
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Maab Mahmoud
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Maram Mohamed Osman
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Mozan Mohamed
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Lamees Bakheet
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
| | - Alaa T Omer
- Faculty of Medicine, University of Khartoum, P. O. Box 11111, Khartoum, Khartoum, Sudan
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Connor JJ, Abdi C, Chen M, Salad M, Pergament S, Afey F, Hussein I, Robinson BBE. Our Body Our Health (Jirkeena, Caafimaadkeena): Somali Women's Narratives on Sexual Health. JOURNAL OF SEX RESEARCH 2023:1-15. [PMID: 38047877 PMCID: PMC11147957 DOI: 10.1080/00224499.2023.2288077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Women across the globe have been subject to female genital cutting (FGC), with the highest rates in Somalia. FGC can result in sexual concerns, especially sexual pain and lower pleasure. Due to ongoing civil war and climate disasters, there is a large number of Somali immigrants and refugees living in countries where healthcare providers may be unfamiliar with the impact of FGC. In this qualitative study, sixty Somali women between the ages 20 and 45 and living in the U.S. shared their perspectives on how FGC has affected their sexual lives, including how they have coped with any complications attributed to FGC. Participants were recruited through convenience sampling and interviewed by a bilingual community researcher in either Somali or English. Data were analyzed through a participatory analysis process by academic and community researchers. Themes included sexual desire, arousal, and pleasure; sexual satisfaction; sexual pain at first intercourse; coping with sexual pain at first intercourse; long-term sexual pain, coping with long-term sexual pain. Results are discussed with a focus on agency of the participants, role of partners, and implications for healthcare professionals.
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Affiliation(s)
- Jennifer Jo Connor
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Cawo Abdi
- Department of Sociology, University of Minnesota
| | - Muzi Chen
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Munira Salad
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Shannon Pergament
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Foos Afey
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Intisar Hussein
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Beatrice Bean E Robinson
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
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Laleh SS, Roshanaei G, Soltani F, Mehran FG. Socio-economic disparities in female genital circumcision: finding from a case-control study in Mahabad, Iran. BMC Public Health 2022; 22:1877. [PMID: 36207728 PMCID: PMC9547433 DOI: 10.1186/s12889-022-14247-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/06/2022] [Accepted: 09/27/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Female genital circumcision (FGC) is still a challenge in reproductive health. This study investigated socioeconomic disparities in FGC in the Kurdish region of Mahabad, Iran. METHODS A case-control study was conducted in three comprehensive health centers on 130 circumcised girls as the case group and 130 girls without a history of circumcision as the control group, according to the residential area and the religious sect. The participants completed a previously validated demographic and circumcision information questionnaire. A multivariate logistic regression model with a backward method at a 95% confidence level was used to determine the relationship between socioeconomic variables and FGC. RESULTS Multivariate logistic regression showed that a family history of FGC (AOR 9.90; CI 95%: 5.03-19.50), age ranging between 20 and 30 years (AOR 8.55; CI 95%: 3.09-23.62), primary education (AOR 6.6; CI 95%: 1.34-33.22), and mothers with primary education (AOR 5.75; CI 95%: 1.23-26.76) increased the chance of FGC. CONCLUSION The present study provided evidence on socioeconomic factors related to FGC in girls. A family history of FGC, age ranging between 20 and 30 years, and girls' and their mothers' education level were strong predictors of FGC. The findings indicate the need to design effective interventions to address these factors to help eradicate FGC.
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Affiliation(s)
| | | | - Farzaneh Soltani
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Fahmideh Ave, 6517808836 Hamadan, Iran
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Adom-Aboagye NAA. Where are the African voices and perspectives of women in sport coaching? Front Sports Act Living 2022; 4:909965. [PMID: 36187709 PMCID: PMC9520905 DOI: 10.3389/fspor.2022.909965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
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Ahinkorah BO, Ameyaw EK, Seidu AA, Njue C. Effects of antenatal care visits and health facility delivery on women's choice to circumcise their daughters in sub-Saharan Africa: evidence from demographic and health surveys. Int Health 2022; 14:519-529. [PMID: 34614181 PMCID: PMC9450640 DOI: 10.1093/inthealth/ihab066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/28/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study examines the association between maternal healthcare service utilisation and circumcision of daughters in sub-Saharan Africa (SSA). METHODS This study is based on a cross-sectional study design that draws on analysis of pooled data from current demographic and health surveys conducted between 2010 and 2019 in 12 countries in SSA. Both bivariate and multivariable binary logistic regression models were employed. RESULTS Mothers who had four or more antenatal care visits were less likely to circumcise their daughters compared with those who had zero to three visits. Mothers who delivered at a health facility were less likely to circumcise their daughters than those who delivered at home. With the covariates, circumcision of daughters increased with increasing maternal age but decreased with increasing wealth quintile and level of education. Girls born to married women and women who had been circumcised were more likely to be circumcised. CONCLUSIONS This study established an association between maternal healthcare service utilisation and circumcision of girls from birth to age 14 y in SSA. The findings highlight the need to strengthen policies that promote maternal healthcare service utilisation (antenatal care and health facility delivery) by integrating female genital mutilation (FGM) information and education in countries studied.
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Affiliation(s)
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Australia
- L & E Research Consult Limited, Wa, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Department of Estate management, Takoradi Technical University, Takoradi, Ghana
| | - Carolyne Njue
- School of Public Health, Faculty of Health, University of Technology Sydney, Australia
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Obiora OL, Maree JE, Nkosi-Mafutha NG. Experiences of Girls Who Underwent Female Genital Mutilation/Cutting. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:283-296. [PMID: 38595739 PMCID: PMC10929576 DOI: 10.1080/19317611.2021.1908478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/17/2021] [Accepted: 03/20/2021] [Indexed: 04/11/2024]
Abstract
Objective To describe the experiences of girls who have undergone FGM/C, so that efforts toward ending this practice can be scaled up using evidence-based interventions. Method: A qualitative descriptive design with in-depth interviews conducted with 16 genitally mutilated girls, aged between 12 and 19 years. Results: Four themes and 10 sub-themes were identified. The themes were: it is the right thing to do; the cold circumcision morning; life after FGM/C; FGM/C is ongoing. They experienced fear, uncertainty, pain, and helplessness due to the practice. Conclusion: The FGM/C experiences of these girls could serve as evidence to scale up efforts toward ending FGM/C.
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Affiliation(s)
- Oluchukwu Loveth Obiora
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| | - Johanna Elizabeth Maree
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
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Ahinkorah BO. Factors associated with female genital mutilation among women of reproductive age and girls aged 0-14 in Chad: a mixed-effects multilevel analysis of the 2014-2015 Chad demographic and health survey data. BMC Public Health 2021; 21:286. [PMID: 33541311 PMCID: PMC7863379 DOI: 10.1186/s12889-021-10293-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chad is one of the African countries with high prevalence of female genital mutilation (FGM). The aim of this study was to examine the factors associated with FGM among women aged 15-49 and girls aged 0-14 in Chad. METHODS Data for the study were obtained from the 2014-2015 Chad Demographic and Health Survey. FGM among women aged 15-49 and girls aged 0-14 were the outcome variables. The prevalence of FGM among women and girls were presented using percentages while a mixed-effects multilevel multivariable logistic regression analysis was carried out to assess the factors associated with FGM. The results were presented using adjusted odds ratio with associated 95% confidence intervals. RESULTS The results indicate that more than half (50.2%) of the women and 12.9% of girls in Chad had been circumcised. Among women aged 15-49, level of education, employment status, ethnicity, religion, wealth quintile and community literacy level were significant predictors of FGM. Age, partner's level of education, marital status, employment status, ethnicity, religion and mother's FGM status were associated with FGM among girls aged 0-14. CONCLUSION This study has identified several individual and contextual factors as predictors of FGM among women and girls in Chad. The findings imply the need to adopt strategies aimed at addressing these factors in order to help eliminate the practice of FGM. Government and non-governmental organisations in Chad need to implement policies that enhance media advocacy and community dialogue to help deal with FGM in the country.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
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Obiora OL, Maree JE, Nkosi-Mafutha NG. Experiences of young women who underwent female genital mutilation/cutting. J Clin Nurs 2020; 29:4104-4115. [PMID: 33463831 DOI: 10.1111/jocn.15436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/21/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVES To describe the FGM/C experiences of young women living in Nigeria. BACKGROUND Globally, several activities have been targeted at ending female genital mutilation/cutting (FGM/C). However, the practice is ongoing, especially in countries such as Nigeria, which is reported to be having a population boom. Therefore, there is a need to investigate the FGM/C experiences of young women in such countries so that efforts towards ending it can be accelerated using evidence-based, community-led interventions. DESIGN A qualitative descriptive design. METHODS The study took place in two states of south-eastern Nigeria with a high prevalence of FGM/C. The snowball sampling method was used to recruit 22 women, aged 20-40, who had undergone FGM/C. Participant's experiences were explored through semi-structured interviews, and the qualitative content analysis was used for data analysis. The consolidated checklist for reporting of qualitative studies guided the reporting of this study. FINDINGS Three themes and seven subthemes emerged from the data. The themes were as follows: cultural issues, life as a circumcised woman and the future with FGM/C. Half of the participants could not recall their experiences on the day of their circumcision, as they were circumcised at infancy. However, those who were older when circumcised experienced it as a painful, traumatic experience forced upon them. Some of the participants experienced sexual and childbirth problems due to this procedure, and this was of great concern to them. CONCLUSION Female genital mutilation/cutting was a traumatic experience forced on the participants. They felt helpless as they could not choose and had to do the "right thing." Despite the trauma and complications caused by the cutting, some still supported the continuation of the practice. RELEVANCE TO CLINICAL PRACTICE Understanding the experiences of genitally mutilated women could assist healthcare practitioners in rendering quality, and contextualised services to these women.
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Affiliation(s)
- Oluchukwu Loveth Obiora
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| | - Johanna Elizabeth Maree
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
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