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Strand PS, Maxwell PD, Trang J. Daughter circumcision and maternal life satisfaction: a cultural moderation effect revealed across two multicountry studies. BMJ Glob Health 2024; 9:e014200. [PMID: 38697655 PMCID: PMC11085712 DOI: 10.1136/bmjgh-2023-014200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/29/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION The present paper assessed the relationship between maternal life satisfaction (MLS) and the intergenerational transmission of female genital cutting (FGC, female circumcision). It was hypothesised that the association would be more strongly positive in countries in which FGC is more prevalent (ie, culturally normative), suggesting a practice that is socially reinforcing within sociocultural contexts in which it is common. METHODS Across two studies with more than 85 000 participants in 15 African and Asian countries, mothers completed surveys reporting on their own FGC experiences and those of their daughters' and on their educational history and socioeconomic status. RESULTS The association between MLS and daughter circumcision was weak but positive for the full sample. Contrary to predictions, in countries in which FGC is uncommon, it was more positively associated with MLS, and in countries in which it is common, it was weakly or negatively associated with MLS. CONCLUSION Results are contrary to the notion that the intergenerational transmission of FGC is a function of happiness deriving from its cultural normativity. They suggest, instead, a diversity of social motives depending on cultural context. Customised messaging to reduce the intergenerational transmission of FGC is discussed.
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Affiliation(s)
- Paul S Strand
- Psychology, Washington State University Tri-Cities, Richland, Washington, USA
| | | | - Justin Trang
- Psychology, Washington State University Tri-Cities, Richland, Washington, USA
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Ifechukwu Okpara P, Tekbaş S. Effect of Female Genital Mutilation on Sexual Function in Ibadan, Nigeria. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:167-176. [PMID: 38616797 PMCID: PMC11008539 DOI: 10.1080/19317611.2024.2328717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 03/04/2024] [Indexed: 04/16/2024]
Abstract
Objective: Female genital mutilation, which harms women physically and psychologically, also causes serious problems in sexual life that continue throughout life. This study aimed to determine the impact of female genital mutilation on sexual outcomes in Ibadan, Nigeria. Method: This is a cross-sectional descriptive study. A self-administered questionnaire was used to obtain data from 161 women who agreed to participate in the study. After the data were collected, the sample group was divided into two groups those with female genital mutilation (84) and those without (77), and they were compared in terms of sexual outcomes. Results: Type I (77.3%) and type II (22.7%) mutilations were found in women with female genital mutilation. It was determined that women with FGM experienced statistically significantly more pain and bleeding during vaginal penetration than uncircumcised women. At the same time, the orgasm rate was found to be statistically significantly lower in this group. Conclusions: Our study revealed that female genital mutilation and enlargement of the incision area negatively affect sexual health.
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Affiliation(s)
| | - Serap Tekbaş
- Nursing Faculty, Near East University, Nicosia, Turkey
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Ayenew AA, Mol BW, Bradford B, Abeje G. Prevalence of female genital mutilation and associated factors among women and girls in Africa: a systematic review and meta-analysis. Syst Rev 2024; 13:26. [PMID: 38217004 PMCID: PMC10785359 DOI: 10.1186/s13643-023-02428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/11/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Female genital mutilation (FGM) has zero health benefits. It can lead to short- and long-term risks and complications, including physical, sexual, and mental health and well-being of girls and women. It is a worldwide public health issue with more than 80% prevalence in Africa. It is a global imperative to strengthen work for the elimination, and the United Nations Sustainable Development Goal (SDG) strives to eliminate FGM and monitor the progress made. However, one of a challenge in tracking progress is establishing baseline prevalence data within regions and countries. Therefore, this review aimed to pool the prevalence of FGM in Africa and identify the promoting factors among women and girls. METHODS This review was conducted according to the PRISMA checklist guideline. Both published and unpublished studies conducted from 2012 onwards were eligible. Studies written in non-English languages were excluded. To retrieve relevant studies; PubMed/Medline, Google Scholar, Science Direct, African Journals Online databases, and African Index Medicus (AIM) were searched using a combination of searching terms. The Newcastle-Ottawa Assessment Scale (NOS) tool was used to assess the quality of each included study. The Cochran's Q chi-square and I2 statistical tests were used to evaluate the heterogeneity of the included studies. The Funnel plot and Egger's regression test (p value < 0.05) were used to evaluate meh publication bias. We used STATA for analysis and the overall and subgroup pooled effect size was estimated using the random effect model with DerSimonian and Laired pooled effect method. The overall prevalence of FGM and the adjusted odds ratio (AOR) with 95%CI (confidence interval) for contributing factors were calculated and presented using a forest plot. RESULT This study included 155 primary studies conducted on the prevalence and/or factors associated with FGM in Africa. The pooled prevalence of FGM was 56.4% (95%CI 49.7-63.6). The primary factors promoting the practice of FGM were family history of circumcision (AOR = 13.71, 95%CI 9.11-20.62), being a Muslim religion follower (AOR = 3.51, 95%CI 2.61-4.71), poor wealth index (AOR = 1.38, 95%CI1.27-1.51), higher age (AOR = 2.95, 95%CI 2.49-3.38), not attending formal education (AOR = 3.28, 95%CI 2.62-4.12), and rural residency (AOR = 2.27, 95%CI 1.84-2.80). CONCLUSION The prevalence of FGM in Africa was found to be high. This study also observed a variation in FGM prevalence across regions and countries and a slight temporal decline over the study period. As the global community enters the final decade dedicated to eliminating FGM, there remains much to be done to achieve the elimination goal.
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Affiliation(s)
- Asteray Assmie Ayenew
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
- Department of Midwifery, Bahir University College of Medicine and Health Science, Bahir Dar, Ethiopia.
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Billie Bradford
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Gedefaw Abeje
- Department of Reproductive Health, Bahir Dar University, Amhara, Ethiopia
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Gebeyehu AA, Anteneh RM, Dessie AM, Yenew C. Prevalence and determinants of female genital amputation among adolescent girls and young women in Ethiopia: multilevel analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:144. [PMID: 38102635 PMCID: PMC10725002 DOI: 10.1186/s41043-023-00484-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/02/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Female genital amputation is a harmful traditional practice that has adverse risks on health outcomes. Consequently, it affects girls and women's physical, psychological, and mental health conditions. However, evidence on female genital amputation factors among adolescent girls and young women in Ethiopia was limited. METHOD Secondary data analysis was conducted from the 2016 Ethiopian Demographic and Health Survey. A weighted sample size included in this study was 2961 adolescent girls and young women. Data management and further analysis were performed using Stata 14 software. An adjusted odds ratio with a 95% confidence interval was used for measuring a significant relationship between factors with the outcome variable. RESULT This study found that the prevalence of female genital amputation among adolescent girls and young women in Ethiopia was 53.4%. Among individual- and community-level variables included in the multivariable multilevel analysis: maternal age, religious status, marital status, maternal educational level, occupational status, residence areas, community uneducated level, and community mass media were significant factors for female genital amputation. CONCLUSION The prevalence of female genital amputation among adolescent girls and young women in Ethiopia remains high. Those individual- and community-level factors influence female genital amputation among adolescent girls and young women in Ethiopia. It requires health interventions on female genital amputation to improve behavioral changes and create awareness about harmful practices.
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Affiliation(s)
- Asaye Alamneh Gebeyehu
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Rahel Mulatie Anteneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anteneh Mengist Dessie
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Chalachew Yenew
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Ayenew AA, Mol BW, Bradford B, Abeje G. Prevalence of female genital mutilation and associated factors among daughters aged 0-14 years in sub-Saharan Africa: a multilevel analysis of recent demographic health surveys. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1105666. [PMID: 37779639 PMCID: PMC10536250 DOI: 10.3389/frph.2023.1105666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 08/10/2023] [Indexed: 10/03/2023] Open
Abstract
Background Female genital mutilation (FGM) is a harmful traditional practice involving the partial or total removal of external genitalia for non-medical reasons. Despite efforts to eliminate it, more than 200 million women and girls have undergone FGM, and 3 million more undergo this practice annually. Tracking the prevalence of FGM and identifying associated factors are crucial to eliminating the practice. This study aimed to determine the prevalence of FGM and associated factors among daughters aged 0-14 years. Methods The most recent Demographic Health Survey Data (DHS) datasets from sub-Saharan African countries were used for analysis. A multilevel modified Poisson regression analysis model was applied to identify factors associated with FGM. Data management and analysis were performed using STATA-17 software, and the pooled prevalence and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported. Statistical significance was set at p ≤ 0.05. Results The study included a weighted sample of 123,362 participants. The pooled prevalence of FGM among daughters aged 0-14 years in sub-Saharan Africa was found to be 22.9% (95% CI: 16.2-29.6). The daughter's place of birth (AOR = 0.54, 95% CI: 0.48-0.62), mother's age (AOR = 1.72, 95% CI: 1.4-2.11), father's education (AOR = 0.92, 95% CI: 0.87-0.98), mother's perception about FGM (AOR = 0.42, 95% CI: 0.35-0.48), FGM as a religious requirement (AOR = 1.23, 95% CI: 1.12-1.35), mother's age at circumcision (AOR = 1.11, 95% CI: 1.01-1.23), residing in rural areas (AOR = 1.12, 95% CI: 1.05-1.19), and community literacy level (AOR = 0.90, 95% CI: 0.83-0.98) were factors associated with FGM. Conclusion The high prevalence of FGM among daughters aged 0-14 years in sub-Saharan Africa indicates the need for intensified efforts to curb this practice. Addressing the associated factors identified in this study through targeted interventions and policy implementation is crucial to eradicate FGM and protect the rights and well-being of girls.
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Affiliation(s)
| | - Ben W. Mol
- Department of Obstetrics and Gynecology, Monash University, Clayton, VIC, Australia
- Aberdeen Centre for Women’s Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Billie Bradford
- Department of Obstetrics and Gynecology, Monash University, Clayton, VIC, Australia
| | - Gedefaw Abeje
- Department of Reproductive Health, College of Medicine and Health Sciences, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
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Mwanja CH, Herman PZ, Millanzi WC. Prevalence, knowledge, attitude, motivators and intentional practice of female genital mutilation among women of reproductive age: a community-based analytical cross-sectional study in Tanzania. BMC Womens Health 2023; 23:226. [PMID: 37138247 PMCID: PMC10158332 DOI: 10.1186/s12905-023-02356-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/14/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND To harmonize and enhance economic growth at the individual, family, community, and national levels, healthy women embody the guardian of family health and a healthy world. They are anticipated to have the freedom to choose their identity in opposition to female genital mutilation in a thoughtful, responsible, and informed manner. Despite restrictive traditions and culture, it is unclear from the available information what exactly would be the drivers of FGM practices in Tanzania from an individual or social perspective. The purpose of this study was to evaluate female genital mutilation among women of reproductive age in terms of its frequency, knowledge, attitudes, and purposeful practice. METHODS Three hundred twenty-four randomly selected Tanzanian women of reproductive age were studied using a community-based analytical cross-sectional study design quantitatively. Structured questionnaires from earlier studies that were delivered by interviewers were utilized to gather information from the study participants. The statistical software package Statistical Packages for Social Science was used to examine the data. (SPSS v.23). A 5% significance threshold was used with a 95% confidence interval. RESULT A total of 324 women of reproductive age participated in the study with a 100% response rate with a mean age of 25 ± 7.481 years. Findings revealed that 81.8% (n = 265) of study participants were mutilated. 85.6% (n = 277) of women had inadequate knowledge about FGM, and 75.9% (n = 246) had a negative attitude toward it. However, 68.8% (n = 223) of them were willing to practice FGM. Their age (36-49 years) (AOR = 2.053; p < 0.014; 95%CI: 0.704, 4.325), single women (AOR = 2.443; p < 0.029; 95%CI: 1.376, 4.572), never go to school (AOR = 2.042; p < 0.011; 95%CI: 1.726, 4.937), housewives (AOR = 1.236; p < 0.012; 95%CI: 0.583, 3.826), extended family (AOR = 1.436; p < 0.015; 95%CI: 0.762, 3.658), inadequate knowledge (AOR = 2.041; p < 0.038; 95%CI: 0.734, 4.358) and negative attitude (AOR = 2.241; p < 0.042;95%CI: 1.008, 4.503) were significantly associated to practice female genital mutilation. CONCLUSION The study observed that the rate of female genital mutilation was significantly high and still, women demonstrated the intention to continue practicing it. However, their sociodemographic characteristic profiles, inadequate knowledge, and negative attitude towards FGM were significantly linked with the prevalence. The private agencies, local organizations, the Ministry of Health, and community health workers are alerted to the findings of the current study to design and develop interventions and awareness-raising campaigns for women of reproductive age against female genital mutilation.
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Affiliation(s)
- Charlotte H Mwanja
- School of Nursing and Public Health, Department of Nursing Management and Education, The University of Dodoma, Dodoma, Tanzania
| | - Patricia Z Herman
- School of Nursing and Public Health, Department of Nursing Management and Education, The University of Dodoma, Dodoma, Tanzania.
| | - Walter C Millanzi
- School of Nursing and Public Health, Department of Nursing Management and Education, The University of Dodoma, Dodoma, Tanzania
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Sabi Boun S, Otu A, Yaya S. Fighting female genital mutilation/cutting (FGM/C): towards the endgame and beyond. Reprod Health 2023; 20:51. [PMID: 36991436 DOI: 10.1186/s12978-023-01601-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023] Open
Abstract
Despite the criminalization of the practice by numerous laws and international treaties in most countries concerned, female genital mutilation/cutting (FGM/C), although on the decline overall, is stagnating or tending to increase in some parts Africa. This relative failure in the fight against FGM/C could be explained from an institutional perspective. Although these struggles affect the regulatory mechanisms, which include laws, they hardly touch the normative mechanisms, which constitute the set of values deemed socially acceptable by a society, and the cultural and cognitive mechanisms, which are the manifestations of the ideologies or beliefs of a group. The naming of FGM/C among certain ethnic groups, which is part of the normative character of the social institution, rather valorizes them and makes uncut girls/women feel "dirty" or "unfit". In these communities, women who have undergone FGM/C are viewed by society as women of honour while uncut girls are perceived as promiscuous and victims of mockery, rejection, or exclusion by the community. In addition, since excision ceremonies and rituals are exclusively reserved for women, many see them as a way of freeing themselves from the rules of patriarchy and male domination that are omnipresent in the societies concerned. Informal mechanisms such as the use of witchcraft, gossip, and beliefs related to the supernatural power of the excisors underpin the cultural-cognitive nature of FGM/C practice. As a result, many families are reluctant to challenge the cutters. The fight against FGM/C can be more effective by addressing the normative and cultural-cognitive roots that form the basis for its perpetuation. This can be achieved by avoiding moralizing the practice, involving those who resist the practice in a context of high prevalence, known as "positive deviants," and using productive methods from the societies concerned. This will create a social environment in which FGM/C is increasingly perceived as less favourable and will ultimately allow for a gradual reform of the normative and cultural-cognitive character of societies that practice FGM/C. Education of women and social mobilisation are critical tools which can act as powerful levers in shifting attitudes about FGM/C.
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Affiliation(s)
- Saidou Sabi Boun
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada
| | - Akaninyene Otu
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada.
- The George Institute for Global Health, Imperial College London, London, UK.
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Adu C. Socio-economic inequalities in intimate partner violence justification among women in Ghana: analysis of the 2014 Ghana Demographic and Health Survey data. Int Health 2023; 15:182-188. [PMID: 35640232 PMCID: PMC9977217 DOI: 10.1093/inthealth/ihac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 04/21/2022] [Accepted: 05/06/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND One of the key reasons for the high prevalence of intimate partner violence among women is the justification of intimate partner violence. Socio-economic status of women plays a key role in intimate partner violence justification. This study investigated the socio-economic inequalities in the justification of intimate partner violence among Ghanaian women. METHODS Data from the 2014 Ghana Demographic and Health Survey were used in this study. The study involved a total of 9267 women. A binary logistic regression analysis was performed to examine the socio-economic disparities in intimate partner violence justification. The findings were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs) demonstrating precision. Statistical significance was set at p<0.05. RESULTS The prevalence of intimate partner violence justification among women in Ghana was 28.2%. Compared with women with no formal of education, those with a higher level of education (aOR 0.17 [95% CI 0.10 to 0.30]) were less likely to justify intimate partner violence. In terms of wealth status, women in the richest quintile had lower odds of justifying intimate partner violence compared with women in the poorest wealth quintile (aOR 0.44 [95% CI 0.28 to 0.67]). CONCLUSIONS Interventions, policies, strategies and programs such as women's equitable access to formal education, formation of stronger social networks to improve women's socio-economic status, advocacy to stop intimate partner violence and empowerment interventions among women should be focused toward contextualizing intimate partner violence in terms of the acceptance of this behaviour, since this can play a significant role in victimization and perpetration.
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Affiliation(s)
- Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
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Abstract
Two commonly linked harmful practices that negatively impact the health of girls and women in sub-Saharan Africa, and threaten their development and quality of life, are female genital mutilation and girl-child marriage. The central focus of the study was to investigate the association between female genital mutilation and girl-child marriage in sub-Saharan Africa. Data from the most recent Demographic and Health Surveys of twelve sub-Sahara African countries were pooled. A total of 14,748 women aged 20-24 were included in the study. A multilevel logistic regression analysis was employed, with reported adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs). The overall prevalence of FGM in the twelve countries was 52.19%, with the highest prevalence in Guinea (97.17%). The overall prevalence of girl-child marriage in the twelve countries was 57.96%, with the highest prevalence in Chad (78.06%). Women who had never experienced female genital mutilation were less likely to experience girl-child marriage (aOR=0.76, CI=0.71-0.82) compared with those who had ever experienced female genital mutilation. Age 24 (aOR=0.47, CI=0.43-0.52), secondary/higher level of education (aOR=0.31, CI=0.28-0.35), richest wealth quintile (aOR=0.56, CI=0.47-0.66), exposure to mass media (aOR=0.81, CI=0.74-0.88) medium community literacy level (aOR=0.63, CI=0.57-0.69) and low community socioeconomic status (aOR=0.67, CI=0.49-0.92) were found to be protective against girl-child marriage. The findings reveal that female genital mutilation is associated with girl-child marriage in sub-Saharan Africa. The continued practice will adversely affect the reproductive health outcomes of girls in the sub-region. Policies aimed at eliminating female genital mutilation and girl-child marriage should focus on compulsory basic education, poverty alleviation and increasing access to mass media. Further, campaigns should cover more communities with lower literacy levels and medium socioeconomic status.
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Kalengo N, Isabirye A, Bukusuba J, Musinguzi LK, Twikirize JM. Psychosocial coping mechanisms among uncircumcised Pokot women in North-Eastern Uganda. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2121486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Noah Kalengo
- Department of Social Work and Social Administration, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
- Department of Social Work, Kyambogo University, Kampala, Uganda
| | - Alone Isabirye
- Department of Sociology, Anthropology and Population Studies (Demography), Kyambogo University, Kampala, Uganda
| | - John Bukusuba
- Department of Social Work and Social Administration, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - Laban K Musinguzi
- Department of Social Work and Social Administration, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - Janestic Mwende Twikirize
- Department of Social Work and Social Administration, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
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Kalengo N, Musinguzi LK, Twikirize JM. “You must cut that long and stinking thing”: uncovering the lived experiences of uncircumcised pokot women in North-Eastern Uganda. BMC Womens Health 2022; 22:433. [PMCID: PMC9636792 DOI: 10.1186/s12905-022-02005-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Female circumcision remains a dominant practice among the Pokot of North-Eastern Uganda. This paper explores the lived experiences of uncircumcised Pokot women, as they continue to live in a community, where the practice is cherished.
Methods
This qualitative study adopted an ethnographic research design. The study was based on thirty [30] serial interviews with 15 uncircumcised women in the Pokot local language between August and October 2021. Five [5] Key Informant Interviews were also conducted with key informants from Amudat District. A Focus Group Discussion with women, irrespective of their circumcision status, was organized as an entry point to identify the initial uncircumcised woman. Uncircumcised women were recruited using respondent-driven sampling while key informants were purposively selected. Data were analyzed thematically. Participants were allocated codes to ensure anonymity.
Results
Participants expressed understanding of female circumcision, and the procedure although they were not circumcised. Denial of participation in community and cultural functions, rejection by elders and relatives, difficulties in getting marriage partners, denial of conjugal rights and basic needs, refusal to give names to their children, and home desertion were the negative experiences reported by uncircumcised women. Sexual enjoyment during sexual intercourse, epitomized by the ease of reaching orgasms, fewer complications while giving birth as well as reduced risk of exposure to sexually transmitted diseases were mentioned by participants as their positive experiences.
Conclusion
Uncircumcised Pokot women continue to experience unbearable challenges since female circumcision is perceived as the only rite of passage to womanhood. This calls for intensified awareness of the population on the challenges associated with female circumcision refusal while demonstrating the positive experiences mentioned by uncircumcised women, that can be exploited as the beacon of hope.
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Contribution of between region and neighborhood variation of socioeconomic factors on the practice of female genital mutilation/cutting: a multilevel analysis of Tanzanian national surveys. J Biosoc Sci 2022:1-12. [DOI: 10.1017/s0021932022000293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
This study aimed to assess to what extent differences in socioeconomic factors between regions correlate to dramatic disparities in the prevalence of female genital mutilation/cutting (FGM/C) across Tanzania. The data from the 2004, 2010, and 2016 Tanzania Demographic Health Surveys were used in this analysis. The estimates from multilevel variance components for FGM/C were compared before and after adjusting for socioeconomic variables (residence, marital status, education, and wealth quintile) and age. The three-level structure of the sample sorted women into individual (level-1), neighborhood (level-2), and regional (level-3) categories. The pooled data included a total of 27587 women of reproductive age with a median age (IQR) of 29 (21–36) years. The random-effects results revealed that of the total age-adjusted variance in FGM/C, 76.7% was attributed to the between region and neighborhood differences. Despite the large between region variations, only 3.7% was explained by socioeconomic factors. Despite the large contribution of between region and neighborhood differences to variance in FGM/C prevalence, less of this variation was explained by socioeconomic factors. Therefore, it is possible that maternal and reproductive educational programs tailored to such neighborhood differences, beyond socioeconomic factors alone, could contribute to a radical shift in perspective for regions with high prevalence.
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Roy CM, Bukuluki P, Casey SE, Jagun MO, John NA, Mabhena N, Mwangi M, McGovern T. Impact of COVID-19 on Gender-Based Violence Prevention and Response Services in Kenya, Uganda, Nigeria, and South Africa: A Cross-Sectional Survey. Front Glob Womens Health 2022; 2:780771. [PMID: 35156086 PMCID: PMC8829509 DOI: 10.3389/fgwh.2021.780771] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundEpidemics and other complex emergencies historically have had a disproportionate impact on women and girls, increasing their vulnerability to gender-based violence (GBV). The COVID-19 pandemic has been no different, with reports of rising cases of GBV emerging worldwide. Already a significant problem in Kenya, Uganda, Nigeria, and South Africa, GBV in these countries has been exacerbated by government restrictions intended to contain the spread of COVID-19. The purpose of this study was to understand how the COVID-19 pandemic affected the availability of GBV prevention and response services from the perspective of the organizations that provide them.MethodsA cross-sectional online survey of people who work in GBV prevention and response in Kenya, Uganda, Nigeria, and South Africa was administered from July to October 2020. A convenience sample was identified through web search, contacts of in-country consultants, and relevant listservs and technical working groups. Descriptive analyses were completed using SPSS.ResultsA total of 187 respondents completed the survey. Nearly all (98.9%) survey respondents reported that COVID-19 impacted their work. The majority (77.9%) stated that work decreased due to government restrictions or GBV services being deemed non-essential. The types of service most impacted were community-based prevention, shelters, and legal services. Survey respondents overwhelmingly agreed (99.3%) that COVID-19 impacted GBV prevalence and identified adolescents and women with disabilities as particularly vulnerable groups.ConclusionsGBV prevention and response services in Kenya, Uganda, Nigeria, and South Africa were highly impacted by the COVID-19 pandemic, largely due to government restrictions and the failure of governments to deem GBV services as essential. Preparedness for future crises should ensure that GBV is adequately prioritized in the initial response in order to maintain service availability with special attention paid to at-risk populations.
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Affiliation(s)
- Charlotte M. Roy
- Global Health Justice and Governance Program, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, United States
- *Correspondence: Charlotte M. Roy
| | - Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Sara E. Casey
- Global Health Justice and Governance Program, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
| | | | - Neetu A. John
- Global Health Justice and Governance Program, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
| | | | | | - Terry McGovern
- Global Health Justice and Governance Program, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
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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 2021; 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] [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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15
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Ahinkorah BO, Hagan JE, Seidu AA, Budu E, Armah-Ansah EK, Adu C, Ameyaw EK, Yaya S. Empirical linkages between female genital mutilation and multiple sexual partnership: evidence from the 2018 Mali and 2013 Sierra Leone Demographic and Health Surveys. J Biosoc Sci 2021; 54:1-16. [PMID: 33736730 DOI: 10.1017/s0021932021000109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Female genital mutilation (FGM) is very pervasive in Africa, with significant regional variations in the prevalence of this traditional practice. This study examined the linkages between FGM and multiple sexual partnership in Mali and Sierra Leone - two African countries with a high prevalence of FGM. Data were from the 2018 Mali and 2013 Sierra Leone Demographic and Health Surveys, and the study sample comprised 4750 women from Mali and 16,614 from Sierra Leone. Multilevel logistic regression was used for the data analysis, with reported adjusted odds ratios (aOR) and associated 95% confidence intervals. In Mali, women who had not undergone FGM were less likely to have multiple sexual partners (aOR=0.60, CI=0.38-0.96) compared with those who had undergone FGM. In Sierra Leone, women who had undergone FGM (aOR=1.15, CI=1.02-1.30) were more likely to have multiple sexual partners compared with those who had not undergone FGM. Age, level of education, wealth quintile, sex of household head, community socioeconomic status, mass media exposure, and community literacy level were found to be associated with the likelihood of multiple sexual partnership among women in Mali and Sierra Leone. Comprehensive, age-group-based risk-reduction strategies, such as abstinence education and decision-making skills (assertiveness) training, are needed to reduce girls' and young women's engagement in multiple sexual partnerships. Policy interventions, such as anti-FGM legislation and initiatives like the 'Schooling for the Female Child' initiative aimed at reducing social inequality among girls and women, might help decrease FGM and the likelihood of health-compromising behaviours like multiple sexual partnership.
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Affiliation(s)
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - 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
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | | | - Collins Adu
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Australia
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Lugiai M, Shalabi Y, Racalbuto V, Pizzol D, Smith L. Female Genital Mutilation in Sudan: is a new era starting? SEXUALITY & CULTURE 2021; 25:1540-1545. [PMID: 33584090 PMCID: PMC7868303 DOI: 10.1007/s12119-021-09823-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/23/2021] [Indexed: 06/12/2023]
Abstract
The World Health Organisation (WHO) defines female genital mutilation or cutting (FGM/C) as a violation of human rights and includes all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. Sudan has one of the highest rates of FGM/C in the world with 86.6% girls and women aged between 15-49 years affected. Although FGM/C is still widely practiced across all of Sudan, social attitudes and norms towards the practice are changing, especially in urban areas. On 22 April 2020, the transitional Sudanese government criminalised FGM/C in Sudan when the Sovereign and Ministerial Councils endorsed the amendment to Criminal Law Article 141. Sudan is beginning a new era in terms of FGM/C. In order to achieve effective and long-lasting effects, efficient mechanisms, specifically allocated financial resources, and broader partnerships that include governmental bodies, civil society, community-based organisations, and international actors, must be put in place.
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Affiliation(s)
- Michela Lugiai
- Italian Agency for Development Cooperation, 33 Street, Amarat, Khartoum Sudan
| | | | - Vincenzo Racalbuto
- Italian Agency for Development Cooperation, 33 Street, Amarat, Khartoum Sudan
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, 33 Street, Amarat, Khartoum Sudan
| | - Lee Smith
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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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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