|Year : 2018 | Volume
| Issue : 1 | Page : 33-36
Practice of girl child circumcision in Northwestern Nigeria
Garba D Gwarzo
Department of Paediatrics, Bayero University Kano, Nigeria
|Date of Web Publication||23-Mar-2018|
Dr. Garba D Gwarzo
Department of Paediatrics, Bayero University Kano
Source of Support: None, Conflict of Interest: None
Background: Female circumcision (FC) is still common in many developing countries including Nigeria despite its adverse health consequences. It is performed on women and young girls. This study examined the current awareness and practice of FC in northwestern Nigeria. Patients and Methods: This cross-sectional study was conducted among mothers at a paediatrics department of a tertiary hospital in Kano, northwestern Nigeria. A questionnaire seeking information on the awareness and practice of FC was administered to selected mothers by the researcher. The data was analyzed. Results: Awareness of FC was 93.6% among 234 mothers enrolled in the study. It was practiced by 135 (67.2%) of 201 mothers who had at least one daughter, and only 10.4% of them believed FC was harmful. It was decided by fathers (82.2%), done on babies in the first 7 days (95.6%), by traditional barber (97.0%) and at home (97.8%). Culture was the main reason (69.6%) for performing FC. Conclusion: FC is still commonly practiced. Knowledge of its adverse effects is scanty. More awareness campaigns and effective legislations are needed to curtail this harmful practice.
Keywords: Female circumcision, female genital cutting, girl child, Nigeria
|How to cite this article:|
Gwarzo GD. Practice of girl child circumcision in Northwestern Nigeria. Niger J Basic Clin Sci 2018;15:33-6
| Introduction|| |
Female circumcision (FC) is also called female genital mutilation (FGM) or female genital cutting (FGC). It is defined as procedures that involve partial or complete removal of the external female genitalia and/or injury to female genital organs for cultural or other nontherapeutic reasons., It is classified by the World Health Organization (WHO) into four types.
It is practiced in many developing countries for various reasons.,,,,, In Nigeria, FC is practiced in all the six geopolitical zones.,,,,, Considerable effort has been targeted toward eliminating this harmful practice, but there is no federal legislation against the practice of FC in Nigeria. There is, however, no recent data from the study area that show the current situation. Moreover, most reported researches evaluated the practice of FC in adults and adolescents. Therefore, there is a need to determine the current level of awareness of FC among mothers in the study area and how it is practiced among young girls.
| Patients and Methods|| |
The study was a descriptive cross-sectional study. It was conducted among consecutive mothers who brought their children to the paediatrics department of a tertiary health centre in Kano, northwestern Nigeria. Ethical clearance was obtained from the hospital's Research Ethics Committee.
Mothers living in the study area continuously for at least 6 months (6 months was considered long enough to be called a resident of the area where the study was conducted) and who gave informed consent to participate were included in the study. The study was conducted from January to June 2016. A questionnaire was administered to the selected mothers. Biodata, awareness, and conduct of FC were asked and recorded. Confidentiality of the participants was ensured. The data was entered in Excel 2016 software (Microsoft Office) and analyzed. Proportions (percentages) were calculated, and the result are presented as tables and charts.
| Results|| |
Two hundred and thirty-four mothers who brought their children to the paediatrics department of a tertiary health centre were enrolled and their data were analyzed. Majority of them were between the ages of 20 and 39 years, had at least primary school education, belonged to nuclear family, and resided in urban areas, as shown in [Table 1].
Awareness of female circumcision
Two hundred and nineteen (93.6%) mothers enrolled in the study knew about FC while the remaining 6.4% did not know. [Table 2] shows that, among the 201 mothers who had daughters, the awareness was similarly high.
|Table 2: Knowledge and practice of female circumcision among 201 mothers who had daughters|
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Knowledge that female circumcision is harmful and is discouraged
Knowledge of dangers of FC was very low. More than 80% of 201 mothers who had girls did not know that FC is harmful [Table 2].
Knowledge of problems that might arise from female circumcision
Less than 10% of the 201 mothers who had girls knew of problems that might arise from FC [Table 2]. The problems listed by 19 (9.5%) respondents who knew included bleeding from circumcision site, tetanus, human immunodeficiency virus infection acquired from the procedure, vesicovaginal fistula (VVF) acquired from the procedure, and death.
Practice of female circumcision
FC was practiced by 135 (67.2%) of 201 mothers who had at least one daughter. Details are shown in [Table 2]. Among 171 mothers with both boys and girls, 58 (33.9%) did circumcision for boys only.
Reasons for doing female circumcision
Culture was the main reason for performing circumcision in 94 (69.6%) of 135 mothers who performed FC, as shown in [Figure 1]. Included among other reasons were cosmetics, pressure by relations, and peers.
Decision to perform female circumcision
Overall, fathers took the final decision in the families of 111 (82.2%) of 132 respondents who performed FC. Mothers did not play a significant role in the final decision on FC, as shown in [Table 3].
Person who performed female circumcision
Traditional barbers performed 131 (97.0%) of all 135 FC in the area, as shown in [Table 3]. No FC was performed by a health worker.
Place where female circumcision was conducted
Circumcision was conducted at home in 132 (97.8%) of 135 families who did FC. In the remaining 2.2%, the circumcision was done in traditional barber's environment. No FC was done in a health facility.
Reason for choosing the place for conducting female circumcision
The main reason for choosing the venue for FC among 135 responders was culture (91.8%), as shown in [Table 3].
Age at female circumcision
One hundred and twenty-nine (95.6%) of all 135 reported FC were done in the first 7 days of baby's life. The remaining 4.4% circumcisions were done in the first month (but after 7 days) of life.
Season when female circumcision was conducted
There is no seasonal variation in conducting FC. One hundred and thirty (96.3%) of the reported 135 FC were done at any time of the year depending on when the baby was born.
Complications of female circumcision
Only 30 (22.2%) of 135 mothers provided information about complications of FC in their children. These complications were excessive bleeding from the circumcision site (5), infection at the circumcision site (8), and no any complication noticed (17).
Outcome of female circumcision
The reported outcome for FC was good in 131 (97.0%) of them and fair in 3 (2.2%). No poor outcome was reported.
| Discussion|| |
Awareness of FC among the interviewed mothers was very high. Up to 93.6% mothers knew about FC. This is not surprising owing to various campaigns, especially in the electronic media, aimed at discouraging the harmful practice. However, very few (10.4%) knew about its complications. This may be due to limited disclosure of these complications in the community as the victims of the complications may be stigmatized.
The practice of FC is still common (67.2%) in the area despite awareness campaigns against it. It is more prevalent than 27% that was found earlier in children in another part of northwestern Nigeria. However, the prevalence is still less common than 90% in women in Sudan  and in many other developing countries. These studies with higher prevalence were conducted several years ago. Therefore, reduced prevalence in the present study may be due to sustained enlightenment campaign against the harmful practice as also observed earlier in southern Nigeria  and in Nigeria as a whole.
Culture remained the main reason for performing circumcision in girls in the present study. The cultural beliefs in FC include reduction in female sex drive, promiscuity, and adultery as in other cultures., However, in the present study, the contribution of each of the individual cultural beliefs were not studied separately. Religion was reported as an important reason for performing FC in northcentral Nigeria  and northern Sudan. However, FC was reported in many countries in Africa and Asia that have diverse religious beliefs including Islam, Christianity, and traditional religions. Religious leaders are still important in the fight against the practice because they help in moulding the opinion of many people in developing countries. In this respect for instance, United Nation Fund for Population Activities (UNFPA) engaged religious leaders to sensitize people regarding the dangers of FC in Nigeria.
Fathers were the main final decisionmakers of FC in the present study. The roles of mothers and grandmothers in taking the final decision were negligible. This may be due to increasing nuclear family setting where grandparents have little influence, as well as the dominant nature of men in the families in this area. Similar trend was found in southern  and northcentral  Nigeria where fathers were the main final decisionmakers in circumcising their daughters. In Sudan, grandmothers had strong influence on FC.
Traditional barbers performed FC in 97% of the cases. In this area, in addition to cutting men's hair, barbers commonly perform surgical procedures such as circumcision (for both boys and girls), incision of abscesses, and wound care. They have no formal medical training but are trusted by people in the area. There was no report of a healthcare worker (HCW) performing FC in this study. Similarly, untrained people performed FC in 89% of the cases in southwestern Nigeria. This contrasts with a trend in some parts of the world where FC is “medicalized” whereby it is performed by a trained healthcare worker sometimes in a health facility. In northcentral Nigeria for instance, HCWs including doctors did the mutilation in 32.1% of the cases in a study by Adeniran et al in 2015. However, even in a northcentral Nigerian study, majority of the procedures were done by traditional circumcisers. In the present study, FC was done mostly (97.8%) at home probably for convenience and secrecy. In a study by Adeniran et al., 22 of 61 respondents did the cutting in hospitals.
Daughters were circumcised mostly (95.6%) in the first week of the neonatal period. This may be an attempt to avoid resistance in adolescent or adult women. It may also be due to the belief in the area that the younger the girl is the faster is the healing of the inflicted wound. In other places, the cutting was done in adolescent and adult women,, sometimes even in pregnant women.
Few women who did FC reported complications in their daughters. There may be under-reporting due to secrecy and feelings of guilt. Complication are expected because the procedure was conducted by untrained people. Complications of FC were reported in up to 67% of the cases. These complications included severe bleeding, psychosocial, sexual, and complications affecting babies born to circumcised women such as still birth.,,,,,,
| Conclusion|| |
Female circumcision is still commonly practiced in Kano, northwestern Nigeria. Knowledge of its adverse effects is scanty.
More awareness campaign against the practice, and effective legislation are needed to curtail this harmful practice.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]