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Martínez‐Linares JM, López‐Entrambasaguas OM, Fernández‐Medina IM, Berthe‐Kone O, Fernández‐Sola C, Jiménez‐Lasserrotte MDM, Hernández‐Padilla JM, Canet‐Vélez O. Lived experiences and opinions of women of sub‐Saharan origin on female genital mutilation: A phenomenological study. J Clin Nurs 2022; 32:2547-2558. [PMID: 35312126 DOI: 10.1111/jocn.16294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to describe and understand the lived experiences and opinions of sub-Saharan women living in Spain in relation to female genital mutilation. BACKGROUND Female genital mutilation is a bloody procedure with serious consequences for the health of women and girls. Understanding mutilated women's lived experiences plays a crucial role in the management of health consequences and could help healthcare professionals to provide assistance to these women. DESIGN A descriptive phenomenological study was carried out. The COREQ checklist was followed as guidance to write the manuscript. METHODS A total of 12 in-depth interviews were conducted. Interviews were recorded, transcribed and analysed using ATLAS.ti 9.0. RESULTS Two themes with four subthemes were identified from the data analysis: 1) 'The traumatic experience of female circumcision' with the subthemes 'Female mutilation is a physical and psychological torture procedure' and 'recognising and coping with negative emotions'; 2) 'The fight for the eradication of female genital mutilation' which contains the subthemes 'the need for a real sociocultural change at the origin' and '"I want to be the last": Personal development leads to sociocultural change'. CONCLUSIONS Female genital mutilation was experienced by women as a very aggressive and traumatic event. It causes considerable negative emotions that last over time. Although there is a tendency to reject the practice, in women's countries of origin, there is social pressure for girls to be mutilated. RELEVANCE TO CLINICAL PRACTICE Caring for women who have suffered from female genital mutilation requires awareness of the traumatic experience they underwent when they were girls. Healthcare professionals play a crucial role in eradicating female genital mutilation. Apart from education, preventive measures may include specific recommendations when girls are travelling to the country of origin and participatory action research.
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Affiliation(s)
| | | | | | - Ousmane Berthe‐Kone
- Surgical Critical Resuscitation Ward Torrecárdenas University Hospital Almeria Spain
| | - Cayetano Fernández‐Sola
- Nursing, Physiotherapy and Medicine Department University of Almería Almería Spain
- Faculty of Health Sciences Autonomous University of Chile Santiago Chile
| | | | | | - Olga Canet‐Vélez
- Nursing Department Faculty of Health Sciences Blanquerna University Ramon Llull Barcelona Spain
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Rundasa DN, Wolde TF, Ayana KB, Worke AF. Awareness of obstetric fistula and associated factors among women in reproductive age group attending public hospitals in southwest Ethiopia, 2021. Reprod Health 2021; 18:183. [PMID: 34526056 PMCID: PMC8442366 DOI: 10.1186/s12978-021-01228-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obstetric fistula occurs in all developing countries but it is confined to the "fistula belt" across the northern half of Sub-Saharan Africa from Mauritania to Eritrea and in the developing countries of the Middle East and Asia. Ending obstetric fistula is critical to achieving Sustainable Development by 2030. So creating awareness on obstetrics fistula among women in the reproductive age group have a crucial role in reducing morbidity, mortality, and social stigma. OBJECTIVE To assess awareness on obstetric fistula and its associated factors among reproductive-age women attending governmental hospitals in southwest Ethiopia, 2021. METHODS An Institutional based cross-sectional study design was conducted among 413 women. The sample size was estimated by using a single population proportion formula. The collected data were coded and entered into EPI-data version 3.1 then exported to SPSS version 24 for descriptive and inferential analysis. Adjusted odds ratio (AOR) along with 95% confidence level was estimated to assess the strength of the association and variables with a p-value < 0.05 were considered to declare the statistical significance in the multivariable analysis in this study. RESULTS In this study, a total of 400 clients have participated in the study. The mean ages of participants were 30.26 (SD ± 8.525) years old. Education of women who cannot read and write are 85% less likely to have good awareness than women who are above the secondary level of education [AOR = 0.162; 95% CI (0.081-0.364)]. While Women who have primary education level are 83% less likely to have good awareness than women who are above the secondary level of education [AOR = 0.170; 95% CI (0.085-0.446)]. In addition, This study shows women who have not heard about obstetric complications are 54% less likely to have awareness of obstetric fistula than those who heard about obstetric complications [AOR = 0.458; 95% CI (0.368-0.643)]. CONCLUSION This study identifies that the educational level of women, history of pregnancy, distance to the nearby health institution, and awareness of obstetrics complications were the factors associated with awareness of reproductive age women on obstetrics fistula. Hence, increasing awareness on obstetric fistula plays a key role in averting this problem.
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Affiliation(s)
| | | | - Kenbon Bayisa Ayana
- Department of Midwifery, College of Health Sciences, Mettu University, Metu, Ethiopia
| | - Abeya Fufa Worke
- Department of Midwifery, College of Health Sciences, Mettu University, Metu, Ethiopia
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Abdoli S, Masoumi SZ, Jenabi E. Investigation of Prevalence and Complications of Female Genital Circumcision: A Systematic and Meta-analytic Review Study. Curr Pediatr Rev 2021; 17:145-160. [PMID: 33655839 DOI: 10.2174/1573396317666210224143714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/03/2020] [Accepted: 12/16/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The present study was conducted to investigate the complications of circumcision and determine its prevalence in the studied areas. METHODS In this study, the electronic databases of Scopus, PubMed, SID, Web of Science and Magiran were selected to search the total population of observational studies published in Persian and English on the prevalence and circumcision complications in girls. The keywords searched for this purpose were as follows: female genital mutilation, Infibulations, Epidemiologic Methods, Clitorectomies, Female Circumcision, Clitorectomy, Clitoridectomy Complications, Prevalence, associated disease, coexistent conditions, and sequels associated with concomitant conditions, and coexistent disease and their Persian equivalent words. Prevalence estimates of all studies were pooled using a random-effects model at a confidence level of 95%. The bias in the published results of the studies and any reporting errors were examined using Begg and Egger's statistical tests. Out of 3756 studies, 45 articles were included in the study after excluding irrelevant and repetitive articles. RESULTS After reviewing the articles in this field, it was determined that female genital mutilation has sexual complications, problems during childbirth, physical and psychological complications. The prevalence of female genital circumcision in the world and Iran in the study areas was obtained using the random effect model, which was estimated to be 61% (95%, CI = 0.49, 0.73) and 61% (95%, CI = 0.52, 0.70), respectively. In other areas, the prevalence was reported to be close to zero. In total, among different countries of the world, of the 207,709 participants surveyed, 110,596 had undergone female genital circumcision (110,596 of 207,709). CONCLUSION The effects of female genital mutilation on girls are high and require government intervention in various countries.
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Affiliation(s)
- Sara Abdoli
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Mother and Child Care Research Center, Midwifery Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ensiyeh Jenabi
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Suuron VM, Mwanri L, Tsourtos G, Owusu-Addo E. An exploratory study of the acceptability of indoor residual spraying for malaria control in upper western Ghana. BMC Public Health 2020; 20:465. [PMID: 32252714 PMCID: PMC7137190 DOI: 10.1186/s12889-020-08505-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/11/2020] [Indexed: 12/03/2022] Open
Abstract
Background Despite the implementation of the World Health Organisation’s recommended indoor residual spraying (IRS) intervention in the upper west region of Ghana to reduce malaria morbidity and mortality, the uptake of this intervention remains low. This study explores the facilitators and barriers to the acceptability and community uptake of indoor residual spraying in a highly endemic region of Ghana. Methods The health belief model (HBM) and realist evaluation framework were used to inform the study. A qualitative enquiry was conducted between April to October 2016. Data were collected through focus group discussions and semi-structured interviews with program stakeholders including community members, AngloGold Ashanti malaria control (AGA Mal) spray operators, and AGA Mal officials. Results A total of 101 people participated in the study. Considerable barriers to community acceptance of indoor residual spraying (IRS) were found, including, dislike of spray insecticides, inadequate information, religious and cultural beliefs, perceived low efficacy of IRS, difficulties with packing, unprofessional conduct of IRS spray operators, and other operational barriers to spraying. Facilitators of IRS uptake included a perceived effectiveness of IRS in preventing malaria and reducing mosquito bites, incidental benefits, respect for authority, training and capacity building, and sensitization activities. Conclusion The numerous barriers to indoor residual spraying acceptance and implications show that acceptance levels could be improved. However, measures are required to address householders’ concerns and streamline operational barriers to increase community uptake of indoor residual spraying.
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Affiliation(s)
- Vitalis Mwinyuri Suuron
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia. .,Bureau of Integrated Rural Development, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - George Tsourtos
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Ebenezer Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
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Matanda DJ, Sripad P, Ndwiga C. Is there a relationship between female genital mutilation/cutting and fistula? A statistical analysis using cross-sectional data from Demographic and Health Surveys in 10 sub-Saharan Africa countries. BMJ Open 2019; 9:e025355. [PMID: 31362960 PMCID: PMC6678015 DOI: 10.1136/bmjopen-2018-025355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Literature on associations between female genital mutilation/cutting (FGM/C) and fistula points to a common belief that FGM/C predisposes women to developing fistula. This study explores this association using nationally representative survey data. DESIGN A secondary statistical analysis of cross-sectional data from Demographic and Health Surveys was conducted to explore the association between FGM/C and fistula. SETTING Sub-Saharan Africa. PARTICIPANTS Women aged 15-49 years in Burkina Faso (n=17 087), Chad (n=17 719), Côte d'Ivoire (n=10 060), Ethiopia (n=14 070), Guinea (n=9142), Kenya (n=31 079), Mali (n=10 424), Nigeria (n=33 385), Senegal (n=15 688) and Sierra Leone (n=16 658). MAIN OUTCOME MEASURES Fistula symptoms. RESULTS Multivariate logit modelling using pooled data from 10 countries showed that the odds of reporting fistula symptoms were 1.5 times (CI 1.06 to 2.21) higher for women whose genitals were cut and sewn closed than those who had undergone other types of FGM/C. Women who attended antenatal care (ANC) (adjusted odds ratio (AOR) 0.51, CI 0.36 to 0.71) and those who lived in urban areas (AOR 0.62, CI 0.44 to 0.89) were less likely to report fistula symptoms than those who did not attend ANC or lived in rural areas. CONCLUSIONS Severe forms of FGM/C (infibulation) may predispose women to fistula. Contextual and socioeconomic factors may increase the likelihood of fistula. Multisectoral interventions that concurrently address harmful traditional practices such as FGM/C and other contextual factors that drive the occurrence of fistula are warranted. Promotion of ANC utilisation could be a starting point in the prevention of fistulas.
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Affiliation(s)
| | - Pooja Sripad
- Department of Reproductive Health, Population Council, New York, New York, USA
| | - Charity Ndwiga
- Department of Reproductive Health, Population Council Kenya, Nairobi, Kenya
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Boyle EH, Svec J. Intergenerational Transmission of Female Genital Cutting: Community and Marriage Dynamics. JOURNAL OF MARRIAGE AND THE FAMILY 2019; 81:631-647. [PMID: 31741540 PMCID: PMC6860922 DOI: 10.1111/jomf.12560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE This study examined how characteristics of households and communities are linked with the intergenerational transmission of gender inequality and particularly female genital cutting (FGC). BACKGROUND Human capital perspectives suggest that socioeconomic inequality predicts FGC continuation. This study contributes to discussions of institutional change by examining the association of decisions to forego FGC with household decision-making patterns and community gender norms. METHOD Multilevel logistic regression was deployed to analyze a pooled sample (N = 12,144) of six Demographic and Health Surveys from Burkina Faso, Egypt, Guinea, Kenya, Mali and Nigeria. A series of models examined how decision-making styles, both at the household and community levels (2,524 DHS cluster aggregations), and community levels of FGC, correspond with the risk of having a daughter cut. RESULTS Results show that daughters are less likely to be cut when parents make key household decisions jointly. Autonomous decision-making by women at the community level was associated with lower odds of daughters being cut. However, at the community level, the impacts of women's household decision-making were attenuated when FGC was more prevalent. CONCLUSION The findings suggest that women's decision-making status is an important factor in FGC abandonment although that association is less robust when FGC is highly institutionalized. This study provides new insights into how women, families, and communities can disrupt the intergenerational transmission of behaviors associated with institutionalized gender inequality.
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Affiliation(s)
- Elizabeth Heger Boyle
- Sociology Department, University of Minnesota, 909 Social Sciences Building, 267 19 Avenue South, Minneapolis, MN 55455, , 612-624-3343
| | - Joseph Svec
- Human Development and Family Studies Department, Iowa State University, 4380 Palmer Building, 2222 Osborn Drive, Ames, IA 50011, , 515-294-6316
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Lange IL, Gherissi A, Chou D, Say L, Filippi V. What maternal morbidities are and what they mean for women: A thematic analysis of twenty years of qualitative research in low and lower-middle income countries. PLoS One 2019; 14:e0214199. [PMID: 30973883 PMCID: PMC6459473 DOI: 10.1371/journal.pone.0214199] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 03/08/2019] [Indexed: 11/18/2022] Open
Abstract
Background With an estimated 27 million annual incidents of maternal morbidity globally, how they are manifested or experienced is diverse and shaped by societal, cultural and personal influences. Using qualitative research to examine a woman's perception of her pregnancy, its complications, and potential long-term impact on her life can inform public health approaches and complement and inform biomedical classifications of maternal morbidities, historically considered a neglected dimension of safe motherhood. As part of the WHO’s Maternal Morbidity Working Group’s efforts to define and measure maternal morbidity, we carried out a thematic analysis of the qualitative literature published between 1998 and 2017 on how women experience maternal morbidity in low and lower-middle income countries. Results and conclusions Analysis of the 71 papers included in this study shows that women’s status, their marital relationships, cultural attitudes towards fertility and social responses to infertility and pregnancy trauma are fundamental to determining how they will experience morbidity in the pregnancy and postpartum periods. We explore the physical, economic, psychological and social repercussions pregnancy can produce for women, and how resource disadvantage (systemic, financial and contextual) can exacerbate these problems. In addition to an analysis of ten themes that emerged across the different contexts, this paper presents which morbidities have received attention in different regions and the trends in researching morbidities over time. We observed an increase in qualitative research on this topic, generally undertaken through interviews and focus groups. Our analysis calls for the pursuit of high quality qualitative research that includes repeat interviews, participant observation and triangulation of sources to inform and fuel critical advocacy and programmatic work on maternal morbidities that addresses their prevention and management, as well as the underlying systemic problems for women’s status in society.
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Affiliation(s)
- Isabelle L. Lange
- Maternal Adolescent Reproductive and Child Health Centre (MARCH), London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Doris Chou
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Lale Say
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Veronique Filippi
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Annandale E, Wiklund M, Hammarström A. Theorising women's health and health inequalities: shaping processes of the 'gender-biology nexus'. Glob Health Action 2018; 11:1669353. [PMID: 31587620 PMCID: PMC6792043 DOI: 10.1080/16549716.2019.1669353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Since the theoretical frameworks and conceptual tools we employ shape research outcomes by guiding research pathways, it is important that we subject them to ongoing critical reflection. A thoroughgoing analysis of the global production of women's health inequality calls for a comprehensive theorization of how social relations of gender and the biological body mutually interact in local contexts in a nexus with women's health. However, to date, the predominant concern of research has been to identify the biological effects of social relations of gender on the body, to the relative neglect of the co-constitutive role that these biological changes themselves may play in ongoing cycles of gendered health oppressions. Drawing on feminist and gender theoretical approaches, and with the health of women and girls as our focus, we seek to extend our understanding of this recursive process by discussing what we call the 'shaping processes' of the 'gender-biology nexus' which call attention to not only the 'gender-shaping of biology' but also the 'biologic-shaping of gender'. We consider female genital mutilation/cutting as an illustration of this process and conclude by proposing that a framework which attends to both the 'gender-shaping of biology' and the 'biologic-shaping of gender' as interweaving processes provides a fruitful approach to theorising the wider health inequalities experienced by women and girls.
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Affiliation(s)
- Ellen Annandale
- Department of Sociology, University of York , York , England
| | - Maria Wiklund
- Department of Community Medicine and Rehabilition, Physiotherapy, Umeå University , Umeå , Sweden
| | - Anne Hammarström
- Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden.,The Stress Research Institute, Stockholm University , Stockholm , Sweden
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Effectiveness of health education as an intervention designed to prevent female genital mutilation/cutting (FGM/C): a systematic review. Reprod Health 2018; 15:62. [PMID: 29650025 PMCID: PMC5897952 DOI: 10.1186/s12978-018-0503-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 04/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background Female Genital Mutilation/Cutting (FGM/C) is a harmful practice that violates the human rights of women and girls. Despite global efforts to restrict the practice, there have been few reports on major positive changes to the problem. Health education interventions have been successful in preventing various health conditions and promoting service use. They have also been regarded as promising interventions for preventing FGM/C. The objective of this systematic review is to synthesise findings of studies about effectiveness of health education as an intervention to prevent FGM/C. Methods The electronic databases searched were MEDLINE, EMBASE, Cochrane library, Web of Science, Psych INFO, CINAHL and ASSIA. Our search included papers published in the English language without date limits. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). A predesigned data recording form was used to extract data from the included studies which were summarised by comparing similar themes. Results Twelve out of 359 individual studies met our inclusion criteria. Seven studies were quantitative, three were qualitative and two used mixed methods. Six studies tested before and after the interventions, four studies assessed the effectiveness of previous interventions used by different research teams and two studies endorsed the intervention. Four main factors emerged and were associated with facilitating or hindering the effectiveness of health education interventions: sociodemographic factors; socioeconomic factors; traditions and beliefs; and intervention strategy, structure and delivery. Conclusions It is vital to target factors associated with facilitating or hindering the effectiveness of health education for FGM/C. This increases the possibility of effective, collective change in behaviour and attitude which leads to the sustainable prevention of FGM/C and ultimately the improved reproductive health and well-being of individuals and communities. Electronic supplementary material The online version of this article (10.1186/s12978-018-0503-x) contains supplementary material, which is available to authorized users.
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