Linking Female Genital Mutilation (FGM) to Obstetric Fistula

Abuja, Nigeria. May 23rd, 2017 – Today marks the United Nations Day to End Obstetric Fistula worldwide. The day is meant to raise awareness on obstetric fistula and mobilize support around the globe. This year's theme is “hope, healing, and dignity for all”. Although Obstetric Fistula, a hole between the birth canal and the bladder or rectum, is mainly caused by prolonged obstructed labour; it could also be a long-term health risk caused by types 1, 2 and 3Female Genital Mutilation (FGM)[1]. While a direct association between FGM and obstetric fistula is yet to be established, given the causal relationship between prolonged and obstructed labour and fistula, and the fact that FGM is also associated with prolonged and obstructed labour it is reasonable to presume that both conditions could be linked in women living with FGM. 

In view of the above and the 2017 Day commemoration, NOIPolls presents a throwback from itsFemale Genital Mutilation (FGM) poll conducted in February, 2017,which basically assessed the knowledge, attitudes, and perceptions of Nigerians towards the practice of Female Genital Mutilation (FGM) in Nigeria.  

The poll showed that 64 percent of respondent nationwide established that FGM was not prevalent in their locality while 36 percent disclosed that there are various degrees of prevalence within their communities; with a high level of prevalence experienced across Ondo, Kwara, Enugu, Delta, Adamawa, Ebonyi, Ondo, Cross-River, Anambra and Niger states. While this was deemed as a low number (36 percent) in comparison with results from other countries such as; Somalia (98 percent), Guinea (96 percent), Djibouti (93 percent), Egypt (91 percent), Eritrea and Mali (88 percent each) and Sierra Leone and Sudan (88 percent each) which reported higher prevalence of FGM[2], as revealed by a study undertaken by UNICEF, it still highlights the need for a call to action to completely eradicate this practice in Nigeria.  

Furthermore, the poll also revealed that while 88 percent of respondents nationwide were not in support of the practice, 12 percent were in support of the practice of FGM and residents from the south-west zone accounted for the largest proportion of respondents whom were in support of the practice.  Additionally, the poll revealed that 48 percent of Nigerians supported the practice on the grounds that it helped to prevent promiscuity in women, while another 33 percent supported the practice of FGM because it is traditional and its practice protects their tradition from going extinct.

Finally, the poll revealed that 22 percent of the respondents did not support FGM practice because it led to health complications, while 18 percent had regarded the practice as unethical. These were some of the key findings from the Female Genital Mutilation (FGM) poll conducted in the week commencing February 13th, 2017.  

Brief Background

Female Genital Mutilation (FGM) otherwise known as female circumcision is a tradition whose origins would be difficult to trace as it is practiced all over the African continent. FGM is the partial or complete removal of the external part of the female genitalia for non-medical reasons. There have been widespread interventions aimed at reducing and changing the perception of the world about FGM, yet, the practice still lingers. According to a United Nations International Children’s Fund (UNICEF) report, in Sub Saharan Africa; Nigeria, Sudan, Mali and Ghana have been labelled as practicing the worst type of FGM. Various reasons were given by those who practice it ranging from culture, religion to superstition.[3] 

According to the United Nation Population Fund, an estimated 200 million girls and women alive today are believed to have been subjected to FGM and those who have experienced FGM live predominately in Sub-Saharan Africa and the Arab States. In Africa, FGM is practiced among certain communities in 29 countries namely Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d'Ivoire, Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda and Zambia.A few years ago, there were public sensitization campaigns against the practice of FGM which gained momentum and attracted global interest after the World Health Organization (WHO) study which associated the practice of FGM with increased risk of adverse obstetrics outcome.[4]  

Despite the various campaigns to discourage the act, it continues to be widespread in many parts of the world. According to health experts, the instant health consequences of FGM are infection and excessive bleeding also known as hemorrhage which can have a drastic effect enough to threaten life. Long term effects such as sexual dysfunction, menstrual and fertility problems, difficulties with childbirth and psychological damage are also reported.[5] In many countries, there are laws that forbid the practice of FGM, yet studies have shown that the practice is still persist despite an increased awareness and increased general negative attitude towards it. Against this background, NOIPolls conducted its latest poll to assess the knowledge, attitudes, and perceptions of Nigerians towards the practice of Female Genital Mutilation (FGM).  

Excerpts of Findings from the NOIPolls survey on FGM

Findings from the poll revealed that the majority of respondents (64 percent) affirmed that the practice of FGM was not at all prevalent within their communities and localities. Residents from the North-West (79 percent) and the North-Central (78 percent) zones had the highest percentage in this category while the South-South zone with 39 percent had the least.  In addition, the poll also revealed that 65 percent of respondents aged between 18 – 35 years formed the largest proportion of those who confirmed that the practice of FGM was not at all prevalent in their vicinities and this could be an indication of a gradual phasing out of the practice.  

Furthermore, 29 percent stated that the practice was somewhat prevalent while 5 percent and 2 percent of the respondents stated that the practice of FGM was very prevalent and extremely prevalent in their localities respectively. The South-South (54 percent), North-East (32 percent), South-East and South-West zones (30 percent each) had the largest proportion of Nigerians who reported that the act is somewhat prevalent and some of the specific states in these zones includes Cross-River, Delta, Adamawa, Borno, Ebonyi, Anambra, Ondo and Ogun states respectively. Some of the L.G.As where this practice is particularly prevalent are; Moro, Ilorin-south, Ilorin-north in Kwara state and  Akure-North and Akure-South in Ondo state. Others are Ika-south, Ughelli, Warri-south, Sapele and Aniocha-south all in Delta state. 

The poll also evaluated the support of Nigerians for Female Circumcision and the results show that most of the respondents surveyed (88 percent) say they are not in support of the practice in the country; and this also cuts across gender, geo-political zones and age-group. However, 12 percent expressed their firm support for the practice of FGM, particularly amongst respondents in some South-West (19 percent) and South-East (15 percent) states; as well as senior citizens aged 60 and above (19 percent).

 

Respondents who disclosed their support for female circumcision were further probed to state their reasons and 48 percent stated that ‘it prevents women from being promiscuous’, respondents from the North-west zone accounted for the largest proportion of Nigerians in this section with emphasis on Kano state.

This was followed by 33 percent who mentioned that ‘it is our tradition’ and respondents in this category would rather not abolish their tradition and Adamawa state had the highest percentage in the North-East. Additionally, 8 percent mentioned that ‘it has no health complications’ and the 7 percent ‘it aids easy child delivery’. However, on the flipside, the United Nation Population Fund believes that the practice of FGM has been medically proven to have serious implications for the sexual and reproductive health of girls and women, with attendant issues such as infibulation, severe pain, shock, hemorrhage, tetanus or other infections, urine retention, ulceration of the genital region and injury to adjacent tissues, wound infection, urinary infection, fever, anemia and septicemia among other complications during childbirth.

 

Similarly, respondents who did not support the practice justified their position with the following reasons: ‘It creates health complications’ (26 percent), ‘it is unethical and unnecessary’ (23 percent), ‘it is against our religious beliefs’ (14 percent) and ‘it is a harmful practice’ (13 percent) amongst other mentions.

In conclusion, the poll has shown that a significant proportion of the population (88 percent) did not support the practice, 12 percent of respondents polled were absolutely in support of the practice, with reasons to justify their positions on both sides of the divide. Additionally,36 percent of respondents acknowledged the prevalence of FGM in various parts of the country. 

The poll not only established that the practice of FGM still persists in states such as Ondo, Kwara, Enugu, Delta, Adamawa, Ebonyi, Cross-River, Anambra and Niger, it also revealed that at least 9 in 10 Nigerians would support any legislation that would seek to abolish the practice of FGM. Finally, with the findings from this poll, it can be deduced that more work needs to be done in the area of sensitization and enlightenment on the dangers and negative side-effects of this practice. Moreover, it was highlighted in the poll that there are deep-seated socio-cultural beliefs and innuendos that form the bedrock for the continued support of the practice in several communities, particularly in the rural and semi-urban areas. 

It was therefore recommended that a multi-stakeholder approach, involving medical practitioners, state & local government officials, federal & state ministries of health, traditional rulers, indigenous healthcare attendants, NGOs, CBOs, FBOs and the general public; be adopted to address the issue in a cross-cutting manner. The media, development partners and the third sector all have a huge role to play in designing, funding and implementing sensitization campaigns to get the message, especially to the grassroots, where the practice is mostly prevalent. 

 

Survey Methods

This opinion poll was conducted in the week of February 13th 2017. It involved telephone interviews of a random nationwide sample. 1,000 randomly selected phone-owning Nigerians aged 18 years and above, representing the six geo-political zones in the country, were interviewed. With a sample of this size, we can say with 95% confidence that the results obtained are statistically precise - within a range of plus or minus 3%. NOIPolls is the No1 for country specific polling services in West Africa. We conduct periodic opinion polls and studies on various socio-economic and political issues in Nigeria. More information is available at www.noi-polls.com, you can also download our mobile app NOIPolls on your smart phone.

 

Disclaimer

This press release has been produced by NOIPolls Limited to provide information on all issues which form the subject matter of the document. Kindly note that while we are willing to share results from our polls with the general public, we only request that NOIPolls be acknowledged as author whenever and wherever our poll results are used, cited or published. 

 

NOIPolls hereby certifies that all the views expressed in this document accurately reflect its views of respondents surveyed for the poll, and background information is based on information from various sources that it believes are reliable; however, no representation is made that it is accurate or complete. Whilst reasonable care has been taken in preparing this document, no responsibility or liability is accepted for errors or fact or for any views expressed herein by NOIPolls for actions taken as a result of information provided in this report. Any ratings, forecasts, estimates, opinions or views herein constitute a judgment as at the date of this document. If the date of this document is not current, the views and content may not reflect NOIPolls’ current findings and/or thinking. 

 

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[1] http://www.who.int/reproductivehealth/topics/fgm/health_consequences_fgm/en/

[2] https://www.theguardian.com/society/2014/feb/06/what-is-female-genital-mutilation-where-happen

[3] https://www.unicef.org/media/files/UNICEF_FGM_report_July_2013_Hi_res.pdf

[4] http://www.who.int/reproductivehealth/publications/fgm/fgm-obstetric-study-en.pdf

[5] http://www.who.int/reproductivehealth/topics/fgm/health_consequences_fgm/en