Attitude and Perception on the Impact of Female Genital Mutilation on Health and Sex Drive among Married Women in Ebenebe, Awka North L.G.A., Anambra State

Research Article

Austin J Public Health Epidemiol. 2016; 3(4): 1047.

Attitude and Perception on the Impact of Female Genital Mutilation on Health and Sex Drive among Married Women in Ebenebe, Awka North L.G.A., Anambra State

Nwaokoro JC¹*, Ede AO¹, Dozie IJ¹, Onwuliri CD³, Nwaokoro AA² and Ebiriekwe SC4

¹Department of Public Health Technology, Federal University of Technology Owerri, Nigeria

²Department of Family Medicine, Lagos University Teaching Hospital (LUTH), Nigeria

³Department of Community Medicine, University of Nigeria Teaching Hospital, Nigeria

4Raw Materials Research and Development Council (RMRDC), University of Nigeria Teaching Hospital, Nigeria

*Corresponding author: Nwaokoro JC, Department of Public Health Technology, Federal University of Technology Owerri, Imo State, Nigeria

Received: July 29, 2016; Accepted: September 06, 2016; Published: September 14, 2016


Background: Female Genital Mutilation (FGM) is a kind of practice which involves the partial or complete removal of female genitalia for non-medical reasons and it leads to so many health problems like infection, keloid formation, difficulty in delivery, shock, etc.

Objective: This study therefore, aimed to investigate the attitude and perception of Female Genital Mutilation in Ebenebe, Awka North L.G.A., Anambra State, Southeastern Nigeria.

Materials and Methods: A cross-sectional descriptive survey was employed in the study and well-structured questionnaires were developed and administered on the respondents. Data obtained were analyzed using descriptive and chi-square statistical analysis.

Results: The result obtained showed that 189 (94.03%) of the interviewed women were aware of the practice of female circumcision in their community. Majority 102 (51.52%) of them reported that FGM practice usually carried out at their native homes and 176 (89.34%) were aware of the health implications of female circumcision. And 68.2% of respondents perceived that FGM is a bad practice and the practice should be abolished. In conclusion, women perceived that FGM is a bad practice because its health implications were relatively high. Therefore, efforts should be made by relevant bodies to encourage policies and programs relating to FGM in terms of abolition, awareness campaign and possible sensitization of the female folks.

Keywords: Attitude; Perception; Female genital mutilation; Traditional birth attendant and knowledge


Female Genital Mutilation or circumcision (FGM) or female genital cutting is defined as a partial or total removal of some or all external female genitalia, or other injury on the female genital organs for non-therapeutic reasons [1]. The female circumcision is typically carried out by a traditional circumciser or Traditional Birth Attendant (TBA) using a blade, with or without anaesthesia. Female genital mutilation, which involves the partial or complete removal of female genitalia for non-medical reasons, considered illegal in the UK since 1985 and has been banned in most countries. There are no health benefits rather than harm the female’s genital organs. FGM is mostly carried out on girls between the ages of 0 and 15 years. However, adult and married women are also subjected to the female genital mutilation procedure. The age at which female genital mutilation is performed varies with local traditions and circumstances, but is decreasing in some countries [2].

The World Health Organization estimates that between 100 and 140 million girls and women have been genitally mutilated and that every year 3 million girls are at risk of being subjected to FGM (WHO, 2008). Currently, FGM continues to be practiced in 28 countries and in several Asian countries [3,4].

In some African countries and the Middle East where FGM is widely performed, poor hygiene is recorded. There is no anaesthesia, no sterilised equipment to replace rusting blades, which can lead to haemorrhage, shock, septicaemia and tetanus. If the victim survives, she may be left infertile, or suffer complications during childbirth, cysts and recurrent urinary tract infections may always be observed. The FGM was classified into four types depending on the extent of tissue removed. Type I (Clitoridectomy) which is the partial or total removal of the clitoris and in very rare cases only the prepuce (the fold of the skin surrounding the clitoris). Type II (Excision) is the partial or total removal of the clitoris and the ‘labia minora’ with or without excision of the ‘labia majora’.

Type III (Infibulations) is the narrowing of the vaginal opening through the creation of a covering seal formed by cutting and repositioning the inner or outer labia with or without removal of the clitoris and Type IV includes all other harmful procedures to the female genitalia for non-medical purposes such as pricking, piercing, incising, scraping, and cauterizing the genital area. The procedure of infibulation derives its name from the Roman word fibula (clasp), which was fastened through the prepuce of men and labia of women to enforce chastity. While a range of socio-religious issues foster the practice, to this day a conviction that FGM is necessary to control women’s sexuality exists in many practicing communities [5,6].

There are many reasons for FGM practice. These may be sexual and reproductive reasons which include; inhibiting women’s sexual desire and heightening that of men, to increase fertility and assist childbirth [7]. Also, to enhance hygiene and provide aesthetic condition on female purifying the female genitals and removing some part which serve as ugly to male, and they constitute a male organ in a female body; another one is socio-cultural reason social pressure, cultural identity, social status of the family [8] and lastly, religious or related to myths [religious ruling, the clitoris is home to an evil spirit which can grow and become dangerous to men or foetus at birth [9].

In the context of this study, attitude refers to women’s opinion or feelings about female genital mutilation, expressed through their behavior. Oxford dictionary [10], defines perception as an understanding and awareness of female genital mutilation, as opposed to practices relating to it or the customary, habitual or expected procedure or way of doing it.

The prevalence of female circumcision, there are relative increase in female genital mutilation in Europe, Australia, Canada and the USA, primarily among immigrants from these countries. According to Ofor and Ofole [11], Countries with high prevalence rates (>85%) are Somalia, Egypt and Mali. Low prevalence rates (< 30%) are found in Senegal, Central African Republic and Nigeria.

Female circumcision is widespread in Nigeria. In Nigeria, a study carried out by Onuh et al. [12] showed that medical knowledge on female genital mutilation/circumcision was limited in nurses and their tendency to support its continuation. It is estimated that more than 50% of Nigerian women have undergone the procedure which are being made to discourage the practice. It is performed among adherents of Islam in the North and among Christians in the South. For example, female genital cutting is rite among the urhobos of Delta State [13,14] and among the Owu Yoruba in Abeokuta [15].

According to World Health Organization [16], stated that female genital mutilation in some countries are usually practiced by trained and untrained personnel who perform the procedure of FGM and untrained personnel used unsterilized equipment such as razor blades and shards of glass. Places where anesthesia is unavailable, the pain is excruciating, it causes physical, psychosexual and sexual problems. The severity of health effects depends on the type of female genital mutilation performed and it is also dependent on the skill of the circumciser, the cleanliness of the tools and setting used, and the physical condition of the girl or woman [16]. According to Ofor and Ofole, [11] the immediate consequences of FGM include: severe pain and bleeding, shock, difficulty in passing urine, infections, injury to nearby genital tissue and sometimes death. In addition to the severe pain during and in the weeks following the cutting, women who have undergone FGM experience various long-term effects which may be physical, sexual and psychological.

Furthermore, FGM is practiced not only by Muslims but also by Christians and Jews [3,9]. FGM is not only a violation of the human right of women and girls, but is also a major health problem, with numerous physical and psychological consequences. Female circumcision has caused a lot of havoc by rendering most women infertile in their life time because of ascending infection following circumcision. Some get Vesico-Vaginal Fistula (VVF), an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vagina vault. FGM has increased the incidence of death among married women that practice it.

Indeed, studies have documented various gynaecological and sexual health implications associated with female genital cutting [17]. These relate mainly to the more severe form of female genital cutting (infibulations), in which there is severe narrowing and scarring of the vaginal introituses. There are many reports about the high incidence of severe dyspareunia, penetration problems, marital disharmony, dysmenorrhoea and various psychological problems in association with type III female genital cutting on the sexual and reproductive health of women [18,19].

Available evidence suggest that type I and II female genital cutting are more common in Nigeria, and other West African countries [20]. Therefore, little is known about the direction of these effects, especially for women with mild and moderate types of female genital mutilation.

The present study was designed to investigate the attitude and perception of impact of female genital mutilation on health and sexual drive among married women in Ebenebe, Awka North LGA of Anambra State. The study is considered significant if it is able to highlight the truth and myth of desiring female genital mutilation. Consequently, the study will be viable to health practitioners, policy makers, the female folks as well as researchers generally. For the health practitioners, the problem associated with female genital mutilation in the cause of their medical practice will be reduced to the barest minimum. For policy makers, law making bodies will find the result of this study extremely important in drawing up policies and programmes relating to female genital mutilation in terms of abolition, awareness campaign and possible sensitization of the female folks. The female folks will no doubt be exposed to the hazards and health implications of female genital mutilation.

Materials and Methods

This study employed a descriptive study survey which describes the pattern of female genital mutilation among married women in Ebenebe, Awka North Local Government Area, of Anambra State Southeast Nigeria. The studied area comprises of 8 villages (Obuno, Uwani, Umuaba, Okpuno, Amagu, Umuji, Umuogbuefie and Ogolubo). The established health facilities located in four villages are health center in Umuji and Obuno, health maternity home in Amagu and Okpuno, then traditional birth attendants are found in many homes respectively. The population for the study consists of married women from 15 years and above who were living in Ebenebe town as at the time of the study. The study was conducted on 250 married women who gave their consent and they were interviewed with the use of well designed questionnaire. The random sampling methods were adopted in collecting data from the various villages in Ebenebe community. The questionnaire was designed to cover demographic data, attitude, health of the women, and perception of impact of female genital mutilation among married women in Ebenebe community. The questionnaire was administered to people of Ebenebe community on face-face basis and some of them were guided to complete the questionnaires especially those that were not properly educated. The validity of the instrument was reviewed by experts in reproductive health and health educator to ascertain that the contents of the questionnaire achieved the study objective. The reliability of the instrument was approved after a pilot test with 10% of the study population to minimize error due to data collection. The completed questionnaires were sorted out and put in tables that had frequencies and percentages. The generated data were plotted into charts, also analyzed using descriptive statistics and chi-square statistics.


The results of this study, “attitude and perception on the impact of female genital mutilation on health and sexual drive among married women in Ebenebe, Awka North Local Government Area of Anambra State”, are presented in the Tables and Charts below. In this study, five communities of Ebenebe were studied. The following sociodemographic characteristics were considered in this study. The age ranges were presented in (Table 1a & 1b) where 36-45 years accounted for the highest number of respondents with 116 (46.4%), while the least number of respondents was 6 (2.4%) for 66 years and above. A chi-square statistical test gave a value of 221.41 with a p-value of 0.001 which was very highly significant at p<0.001. The marital status of the respondents recorded least among single women with 4 (2.2%), divorced was 6 (2.4%), widowed 57 (22.9%) while married women had the highest 182 (73.1%) responses. A chi-square analysis of the marital status gave a value of 336.14 with a p-value of <0.001 which was significant at p<0.001 confidence level. Christianity accounted for the highest number of respondents with 223 (89.2%) followed by African Traditional Religion (ATR) with 24 (9.6%) and Islam had 3 (1.2%). The chi-square value was 353.77 with a p-value of <0.001. Majority of them had secondary education 142 (56.8%) followed by tertiary education 48 (19.2%), primary 37 (14.8%) and non-formal education recorded 23 (9.2%). The chi-square statistics gave a value of 139.86 with a p-value of <0.001. In terms of occupations, business had the highest number of respondents with 85 (34.1%), followed by the artisans 57 (22.9%), next was housewife 39 (15.7%), the least response came from retired civil servants with 12 (4.8%). The chi-square test showed a significant difference with 81.72 at p<0.001.