RESEARCH

 

Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria

 

 

A S Adeniran^I; M A Ijaiya^II; A A Fawole^II; O R Balogun^II; K T Adesina^I; A W O Olatinwo^II; A O Olarinoye^II; I P Adeniran^III

^IFWACS, FMCOG; Department of Obstetrics and Gynecology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
^IIFWACS; Department of Obstetrics and Gynecology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
^IIIRPN Nursing Services Department, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

Correspondence

 

 

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ABSTRACT

BACKGROUND. The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C).
OBJECTIVES. To determine knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it.
Methods. A cross-sectional survey among male adolescent students in Ilorin, Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM, USA). A p-value of <0.05 was taken as significant.
RESULTS. Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years, range 14 - 19), 1 184 (77.1%) were aware of FGM/C, 514 (33.5%) supported female circumcision, 362 (23.6%) would circumcise their future daughters, 420 (27.3%) were of the opinion that FGM/C had benefits, mostly as a necessity for womanhood (109, 7.1%), and 627 (40.8%) perceived it as wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C, and 42.2% recommended education as the most important intervention to achieve this.
CONCLUSION. Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C.

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Female genital mutilation/cutting (FGM/C) or female circumcision has received attention because of its health complications and the recognition that it represents human rights abuse and violence against females. However, it remains endemic in some countries in Africa, the Middle East and Asia,^[1,2] with reports of new cases.^[3] Decisions regarding FGM/C involve multiple stakeholders, including males (fathers, uncles or community leaders).^[1] Women who are unwilling to circumcise their daughters often lose against in-laws who support FGM/C if the husband is indifferent or not on the mother's side.^[1,3] Focusing on male adolescents, who are tomorrow's fathers, will indicate what interventions are necessary to transform them into advocates of eradication of FGM/C.

 

Objective

To evaluate knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it.

 

Methods

A cross-sectional survey was done among male senior secondary school students aged 14 - 19 years in 18 secondary schools in Ilorin, Nigeria, between October and November 2014. Participating schools and individuals were selected by multistaged sampling, informed consent was obtained from the students or their parents, and each participant completed a self-administered questionnaire. The inclusion criteria were male gender, current enrolment in the senior secondary school class, age 14 - 19 years, and informed consent.

Sample size determination

The sample size was calculated using an appropriate formula^[4] and a 25% prevalence of FGM/C in Nigeria.^[5] The information collected included demographic parameters and level of knowledge about, perceptions and views of and attitudes to FGM/C.

Statistical analysis

Statistical analysis was performed with SPSS version 20.0 (IBM, USA). A p-value of <0.05 was taken as significant.

Ethical considerations

The ethical committee of the University of Ilorin Teaching Hospital (NHREC/02/05/2010) and the State Ministry of Education and Human Capital Development (MOEHCD/CD/PLAN/RS/2/1/17) approved the study.

 

Results

Of 1 536 participants (mean age 15.09 (standard deviation 1.84) years, range 11 - 19), 1 184 (77.1%) were aware of FGM/C. The major sources of information were parents (mothers 29.8%, fathers 24.3%), teachers (39.6%) and friends (24.4%). Five hundred and fourteen (33.5%) supported FGM/C, 420 (27.3%) thought it had benefits, mostly as a necessity for womanhood (109, 7.1%), and 292 (19.0%) had the perception that FGM/C makes a female a 'real woman'. Conversely, 532 (34.6%) opposed FGM/C, 1 174 (76.4%) would not circumcise their future daughters, and 627 (40.8%) perceived FGM/C as wickedness against females. On seeing a girl who was about to be circumcised, 489 (31.8%) would report this to the police and 470 (30.6%) would appeal to the parents not to continue with the act; 648 (42.2%) viewed education as the best approach to stop the practice (Table 1).

 

 

Significant positive predictors of the attitude of the male adolescents in the study to the discontinuation of FGM/C included seeing a victim of the act (odds ratio (OR) 0.540, 95% confidence interval (CI) 0.424 - 0.687; p<0.001), attitude to circumcision of a future daughter (OR 0.442, 95% CI 0.321 - 0.608; p<0.001) and awareness of government policy on FGM/C (OR 1.656, 95% CI 1.306 - 2.099; p<0.001).

 

Discussion

Knowledge of FGM/C among male adolescents in this study was higher than the national average of 68% for males in Nigeria.^[5] This may be because participants were senior secondary school students with access to education materials, social networks and information.^[6]

Some participants were of the opinion that FGM/C is good for girls, with perceived benefits, and wished to circumcise their future daughters. This emphasises the role of men in perpetuating FGM/C. It is perceived by some men as a method of controlling female sexuality, guaranteeing female virginity until marriage and heightening male sexual satisfaction and fertility during coitus through the narrow vaginal opening created^[7-9] Some perceive it as a social custom enhancing marriage prospects for circumcised females.^[10] Some men prefer to marry mutilated women,^[8,9] believing that they are not sexually overactive and are likely to be faithful in marriage. Conversely, a study in Sudan among men with one infibulated and one uncircumcised wife reported that 89% preferred uncircumcised or mildy infibulated women sexually.^[12] In a study among schoolteachers, men as fathers were proponents of FGM/C in their daughters (40.9%).^[13]

Male adolescents who opposed FGM/C in this study considered it an old-fashioned cultural act of wickedness against females. In a report, 72.9% of men supported abolition of FGM/C because of its negative consequences with regard to the woman's health.^[1] Much of the collaboration for abolition of FGM/C has stemmed from the recognition that it represents human rights abuse, with potential for health complications in its victims.^[6] However, only women with life-threatening acute complications usually present to hospital, others seeking medical attention in later life when the woman's health is significantly affected.^[3]

Participants in this study suggested education and advocacy as principal interventions to encourage the discontinuation of FGM/C, while legislation ranked low. There have been suggestions that legislation to eradicate FGM/C should be accompanied by other measures to influence the cultural and social norms.^[6,13]

 

Conclusion

Education and advocacy among male adolescents about FGM/C through formal and informal forums are central in correcting the misconceptions about the act. Available opportunities include enlightenment about harmful traditional practices in schools, and encouraging anti-FGM/C clubs among adolescents in schools, communities and religious settings. Expressions in the performing arts may also be useful.

Funding/conflict of interest. The study was funded by the researchers.

There was no conflict of interest.

 

References

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2. Onyago MA, Owoko S, Oguttu M. Factors that influence male involvement in sexual and reproductive health in western Kenya: A qualitative study. Afr J Reprod Health 2010;14(4):33-43.         [ Links ]

3. Adeniran AS, Aboyeji AP, Balogun OR, Ijaiya MA. Eradicating female genital mutilation: Case series evaluating the effects of interventions. Univ Mauritius Res J 2014;20:248-254.         [ Links ]

4. Araoye MO. Research Methodology with Statistics for Health and Social Sciences. Ilorin: Nathadex Press, 2003:115-121.         [ Links ]

5. National Population Commission (Nigeria). Nigeria Demographic and Health Survey (2013). Abuja NPC, 2014.         [ Links ]

6. UNICEF. Female Genital Mutilation/Cutting: A Statistical Overview and Exploration of the Dynamics of Change. New York: UNICEF, 2013. http://www.unicwf.org/publications/index_69875.html (accessed 10 October 2014).         [ Links ]

7. World Health Organization. Female Genital Mutilation. WHO Fact Sheet No. 241. Geneva: WHO Press, 2016.         [ Links ]

8. Sakeah E, Beke A, Doctor HV, Hodgson AV. Male's preference for circumcised women in Northern Ghana. Afr J Reprod Health 2006;10(2):37-47.         [ Links ]

9. Almroth L, Almroth-Berggren V, Hassanein OM. Male complications of female genital mutilation in Sudan. Soc Sci Med 20001;53(11):1455-1460. DOI:10.1016/S0277-9536(00)00428-7        [ Links ]

10. Islam MM, Uddin MM. Female circumcision in Sudan: Future prospects and strategies for eradication. Int Fam Plan Perspect 2001;27(2):71-76. DOI:10.2307/2673817        [ Links ]

11. Missailidis K, Gebre-Medihin M. Female genital mutilation in Eastern Ethiopia. Lancet 2000;356(9224):137-189. DOI:10.1016/S0140-6736(00)02453-3        [ Links ]

12. Dorkenoo E. Cutting the Rose, Female Genital Mutilation: The Practice and its Prevention. London: Minority Rights Publications, 1994.         [ Links ]

13. Adeniran AS, Fawole AA, Balogun OR, Ijaiya MA, Adesina KT, Adeniran IP. Female genital mutilation/ cutting: Knowledge, practice and experiences of secondary schoolteachers in North Central Nigeria. S Afr J Obstet Gynaecol 2015;21(2):39-43. DOI:10.7196.SAJOG.1047        [ Links ]

 

 

Correspondence:
A S Adeniran
acrowncord@hotmail.com

Accepted 31 May 2016.