Female Genital Mutilation in Sierra Leone: who are the decision makers?
), Bailah Leigh(2), Grace Harman(3), Staffan Bergström(4), Lars Almroth(5),
(1) Nairawebs Design
(2)
(3)
(4)
(5)
Corresponding Author
Abstract
The objectives of this study were to identify decision makers for FGM and determine whether medicalization takes place in
Sierra Leone. Structured interviews were conducted with 310 randomly selected girls between 10 and 20 years in Bombali and Port Loko Districts in Northern Sierra Leone. The average age of the girls in this sample was 14 years, 61% had undergone FGM at an average age of 7.7 years (range 1-18). Generally, decisions to perform FGM were made by women, but father was mentioned as the one who decided by 28% of the respondents. The traditional excisors (Soweis) performed 80% of all operations, health professionals 13%, and traditional birth attendants 6%. Men may play a more important role in the decision making process in relation to FGM than previously known. Authorities and health professionals’ associations need to consider how to prevent further medicalization of the practice. (Afr J Reprod Health 2012; 16[4]: 119-131).
Résumé
Les objectifs de cette étude étaient d'identifier les décideurs à l’égard des mutilations génitales féminines et de déterminer si la médicalisation a lieu en Sierra Leone. Des entretiens structurés ont été menés avec 310 filles choisies au hasard entre 10 et 20 ans dans les Districts de Bombali et de Port Loko au nord de la Sierra Leone. L'âge moyen des filles dans cet échantillon était de 14 ans, 61% avaient subi des MGF à un âge moyen de 7,7 ans (entre 1-18ans). En règle générale, les décisions sur les mutilations sexuelles féminines ont été prises par les femmes, mais 28% des interviewés ont mentionné le père comme étant celui qui a décidé. Les exciseuses traditionnelles (Soweis) ont effectué 80% de toutes les opérations, les professionnels de santé 13%, et les accoucheuses traditionnelles 6%. Les hommes peuvent jouer un rôle plus important dans le processus de décision en ce qui concerne les mutilations génitales féminines que précédemment connu. Les autorités et les associations de professionnels de santé doivent tenir compte de la manière de prévenir la médicalisation de cette pratique (Afr J Reprod Health 2012; 16[4]: 119131).
Keywords: Female genital mutilation, Sierra Leone, decision makers, medicalization
References
UNAIDS, UNDP, UNECA, UNESCO, UNFPA,
UNHCHR, UNHCR, UNICEF, UNIFEM, WHO
(2008). Eliminating female genital mutilation: an interagency statement. Geneva: World Health Organisation, 2008.
Yoder PS, Khan S. Numbers of women circumcised in Africa: The production of a total. Maryland: Macro International Inc., 2007.
Yoder PS, Abderrahim N, Zhuzhuni A. Female genital cutting in the Demographic and Health Surveys: a critical and comparative analysis. Maryland: Macro International Inc., 2004.
World Health Organisation Study Group on Female Genital Mutilation. Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries. Lancet 2006; 367:1835–1841.
Utz-Billing I, Kentenich H. Female genital mutilation: an injury, physical and mental harm. J Psychosom Obstet Gynecol. 2008; 29(4):225-229.
Almroth L, Elmusharaf S, El Hadi N, Obeid A, El Sheikh MAA, Elfadil SM (2005b). Primary infertility after genital mutilation in girlhood in Sudan: a case−control study. Lancet, 366:385−391.
Almroth L, Bedri H, El Musharaf S, et al. Urogenital complications among girls with genital mutilation: a hospital based study in Khartoum. Afr J Reprod Health 2005; 9:118–24.
Morison L, Scherf C, Ekpo G, et al. The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey. Trop Med Int Health 2001; 6:643–53.
Dirie MA, Lindmark G. The risk of medical complications after female circumcision. East Afr Med J.1992; 62:479-182.
United Nations Children’s Fund. Legislative Reform To Support The Abandonment Of Female Genital Mutilation/Cutting. New York: United Nations Children’s Fund, 2010.
Statistics Sierra Leone and UNICEF-Sierra Leone. 2011. Sierra Leone Multiple Indicator Cluster Survey 2010, Final Report. Freetown, Sierra Leone: Statistics Sierra Leone and UNICEF-Sierra Leone.
Table derived from data provided by United Nations Children’s Fund (UNICEF) Child Info – Monitoring the situation of women and children [cited 25 April 2012]Available at:
http://www.unicef.org/infobycountry
Shell Duncan B, Hernlund Y, Wander K, Moreau A.
Contingency and Change in the Practice of Female Genital Cutting: Dynamics of Decision Making in
Senegambia. Summary Report. 2010.
UNDP/UNFPA/WHO/World Bank Special
Programme on Research, Development, and Training in Human Reproduction (through the World Health Organisation) and by National Science Foundation.
UNAIDS, UNDP, UNFPA, UNICEF, UNHCR, UNIFEM, WHO, FIGO, ICN, IOM, WCPT, WMA, MWIA. Global strategy to stop health-care providers from performing female genital mutilation. Geneva: World Health Organisation, 2010. #
Shell-Duncan B. The medicalization of female “circumcision”: harm reduction or promotion of a dangerous practice? Social Science and Medicine
; 52(7):1013–1028.
Refaat A. Medicalization of female genital cutting in Egypt. Eastern Mediterranean Health Journal 2009;
(6):1379.
Christoffersen-Deb A. “Taming tradition”: medicalized female genital practices in Western Kenya. Medical Anthropology Quarterly 2005; 19(4):402–418.
Njue C, Askew I. Medicalization of female genital cutting among the Abagusii in Nyanza Province, Kenya. Washington: Population Council, 2004. Statistics Sierra Leone (SSL) and ICF Macro, 2009 [Internet]. Sierra Leone Demographic and Health Survey 2008.
Maryland, USA: Statistics Sierra Leone (SSL) and ICF Macro; 2008 [cited 22 May 2011]. Available from: http://www.measuredhs.com/pubs/pdf/SR171/SR171. pdf
Koso-Thomas, Olayinka. Circumcision of women: a strategy for eradication. London: Zed Books, 1987.
Behrendt, A. Female Genital Cutting in the Moyamba and Bombali Districts of Sierra Leone. Final Report. Dakar: Plan West Africa Regional Office, 2005.
Kallon I, Dundes L. The Cultural Context of the Sierra Leonean Mende Woman as Patient. J Transcultural Nursing 2010; 21(3):228 – 236.
Statistics Sierra Leone (SSL), 2004 [Internet]. Sierra Leone Population and Housing Census [cited 22 May
. Available from: http://www.sierraleone.org/Census/ssl_final_results.pdf
United States of America – Department of State, Bureau of African Affairs, 2011 [Internet]. Background Note: Sierra Leone. [cited 4 Oct 2011] Available from: http://www.state.gov/r/pa/ei/bgn/5475.htm
Shell-Duncan B, Herniund Y. Are There “Stages of Change” in the Practice of Female Genital Cutting?
Qualitative Research Findings from Senegal and The Gambia. African J Reproductive Health 2006; 10 (2):
– 71.
Fanthorpe, R. Sierra Leone: the influence of the secret societies, with special reference to female genital mutilation. United Nations High Commissioner for Refugees, Status Determination and Protection Information Section (DIPS). [Internet]. 2007 [cited 10
August 2011]. Available from:
www.unhcr.org/refworld/pdfid/46cee3152.pdf
Nagar S, Pitamber, Nouh I. Synopsis of the female circumcision research findings. BabikerBadri Scientific Association for Women Studies; Undurman, Sudan, 1984.
Almroth L et al. A community based study on the change of practice of female genital mutilation in a Sudanese village. Int Journal of Gynecology and Obstetrics
; 74:179 – 185.
Asekun-Olarinmoye E, Amusan O. The impact of health education on attitudes towards female genital mutilation (FGM) in a rural Nigerian community.The European Journal of Contraception and Reproductive Health Care 2008; 13 (3): 289 – 297.
World Health Organisation (WHO). Men’s and women’s perceptions of the relationship between female genital mutilation and women’s sexuality in three communities in Egypt. Geneva: World Health
Organisation, 2010.
Myers R, Omorodion F, Isenalumhe A, Akenzu G. Circumcision: its nature and practice among some ethnic groups in southern Nigeria. Soc Sci Med1985; 21 (5):581 – 588.
Gruenbaum, E. Socio-cultural dynamics of female genital cutting: research findings, gaps and directions. Culture, Health & Sexuality 2005;7(5): 429 – 441.
Direction Nationale de la Statistique (DNS) (Guinée) et ORC Macro. 2006. Enquête Démographique et de Santé, Guinée 2005. Calverton, Maryland, U.S.A.: DNS et ORC Macro. [cited 25 April 2012]
Available from:
http://www.measuredhs.com/pubs/pdf/FR162/00Pa gesPréliminaires00.pdf
Cellule de Planification et de Statistique du Ministère de la Santé (CPS/MS), Direction Nationale de la Statistique et de l’Informatique du Ministère de l’Économie, de l’Industrieet du Commerce (DNSI/MEIC) et Macro International Inc. 2007. Enquête Démographique et de Santé du Mali 2006.
Calverton, Maryland, USA : CPS/DNSI et Macro
International Inc [cited 25 April 2012]
Available from:
http://www.measuredhs.com/pubs/pdf/FR199/FR19
National Population Commission (NPC) [Nigeria] and
ICF Macro. 2009. Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro [cited 25 April 2012]
Available from: http://www.measuredhs.com/pubs/pdf/FR222/FR222. pdf.
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