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      Female genital cutting: current practices and beliefs in western Africa Translated title: Mutilations génitales féminines: pratiques et croyances actuelles en Afrique de l'ouest Translated title: Mutilación genital femenina: prácticas actuales y creencias en África occidental

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          Abstract

          OBJECTIVE: To conduct a cross-national comparative study of the prevalence and correlates of female genital cutting (FGC) practices and beliefs in western Africa. METHODS: Data from women who responded to the Multiple Indicator Cluster Surveys between 2005 and 2007 were used to estimate the frequencies of ever having been circumcised, having had a daughter circumcised, and believing that FGC practices should continue. Weighted logistic regression using data for each country was performed to determine the independent correlates of each outcome. FINDINGS: The prevalence of FGC was high overall but varied substantially across countries in western Africa. In Sierra Leone, Gambia, Burkina Faso and Mauritania, the prevalence of FGC was 94%, 79%, 74% and 72%, respectively, whereas in Ghana, Niger and Togo prevalence was less than 6%. Older age and being Muslim were generally associated with increased odds of FGC, and higher education was associated with lower odds of FGC. The association between FGC and wealth varied considerably. Burkina Faso was the only country in our study that experienced a dramatic reduction in FGC prevalence from women (74%) to their daughters (25%); only 14.2% of the women surveyed in that country said that they believe the practice should continue. CONCLUSION: The prevalence of FGC in western Africa remains high overall but varies substantially across countries. Given the broad range of experiences, successful strategies from countries where FGC is declining may provide useful examples for high-prevalence countries seeking to reduce their own FGC practices.

          Translated abstract

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          Translated abstract

          <img border=0 src="../../../../../img/revistas/bwho/v90n2/a12rs02.jpg">

          Translated abstract

          OBJECTIF: Réaliser une étude comparative transnationale de la prévalence et des indicateurs des pratiques et croyances en matière de mutilations génitales féminines (MGF) en Afrique de l'Ouest. MÉTHODES: Les données fournies par des femmes ayant répondu aux enquêtes en grappes à indicateurs multiples entre 2005 et 2007 ont servi à estimer la fréquence avec laquelle elles avaient été excisées, avaient fait exciser une ou plusieurs de leurs filles et pensaient que les pratiques de MGF devaient se poursuivre. Une régression logistique pondérée a été réalisée afin de déterminer les indicateurs autonomes de chaque résultat. RÉSULTATS: La prévalence des MGF était généralement élevée mais variait de manière significative d'un pays d'Afrique de l'Ouest à l'autre. En Sierra Leone, Gambie, Burkina Faso et Mauritanie, la prévalence des MGF était de 94%, 79%, 74% et 72%, respectivement, alors qu'au Ghana, Niger et Togo, cette prévalence était inférieure à 6%. Un âge plus avancé et le fait d'être musulmane constituaient des facteurs généralement associés à des risques accrus de MGF et un degré d'éducation plus élevé était associé à des risques plus faibles. L'association entre MGF et aisance financière variait considérablement. Le Burkina Faso était le seul pays de notre étude à avoir noté une diminution spectaculaire des MGF des femmes (74%) à leurs filles (25%); seules 14,2% des femmes interrogées dans ce pays ont déclaré penser que cette pratique devait se poursuivre. CONCLUSION: La prévalence des MGF en Afrique de l'Ouest reste généralement élevée mais varie de manière significative d'un pays à l'autre. Compte tenu du large éventail d'expériences, des stratégies réussies dans des pays où les MGF sont en baisse peuvent fournir des exemples utiles à des pays à forte prévalence désireux de diminuer leurs propres pratiques de MGF.

          Translated abstract

          <img border=0 src="../../../../../img/revistas/bwho/v90n2/a12rs03.jpg">

          Translated abstract

          OBJETIVO: Llevar a cabo un estudio comparativo entre países de África occidental sobre la prevalencia y correlación de las prácticas de mutilación genital femenina (MGF) y las creencias relacionadas. MÉTODOS: Se emplearon los datos procedentes de las mujeres que respondieron a las Encuestas de Indicadores Múltiples por Conglomerados entre 2005 y 2007 para calcular el porcentaje de mujeres que habían sido sometidas a una ablación, el de hijas de dichas mujeres que habían sido sometidas a una ablación y la creencia de que las prácticas de MGF deberían mantenerse. Se realizó una regresión logística ponderada empleando los datos procedentes de cada país para determinar las correlaciones independientes de cada resultado. RESULTADOS: La prevalencia de la MGF fue alta en general, si bien variaba de manera sustancial en los diversos países de África occidental. En Sierra Leona, Gambia, Burkina Faso y Mauritania, la prevalencia de la MGF fue de un 94%, 79%, 74% y 72%, respectivamente, mientras que en Ghana, Níger y Togo la prevalencia fue inferior al 6%. Una edad más avanzada y la condición de musulmana se asociaron generalmente a una mayor probabilidad de haber sufrido una MGF, mientras que se asoció una educación superior a una menor probabilidad de MGF. La asociación entre MGF y riqueza variaba ostensiblemente. Burkina Faso fue el único país dentro del estudio que experimentó una reducción drástica en la prevalencia de la MGF entre las madres (74%) y las hijas (25%). Solo el 14,2% de las mujeres encuestadas en dicho país afirmaron considerar que debía continuarse con dicha práctica. CONCLUSIÓN: La prevalencia de la MGF en África occidental sigue siendo elevada en general, si bien varía sustancialmente entre los diversos países. Teniendo en consideración la amplia variedad de experiencias, las estrategias fructíferas en países donde la MGF está descendiendo podrían servir de ejemplo útil a los países con una mayor prevalencia que deseen reducir sus prácticas de MGF.

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          Most cited references64

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          Ending Footbinding and Infibulation: A Convention Account

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            Female circumcision as a public health issue.

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              Reliability of self reported form of female genital mutilation and WHO classification: cross sectional study.

              To assess the reliability of self reported form of female genital mutilation (FGM) and to compare the extent of cutting verified by clinical examination with the corresponding World Health Organization classification. Cross sectional study. One paediatric hospital and one gynaecological outpatient clinic in Khartoum, Sudan, 2003-4. 255 girls aged 4-9 and 282 women aged 17-35. The women's reports of FGMthe actual anatomical extent of the mutilation, and the corresponding types according to the WHO classification. All girls and women reported to have undergone FGM had this verified by genital inspection. None of those who said they had not undergone FGM were found to have it. Many said to have undergone "sunna circumcision" (excision of prepuce and part or all of clitoris, equivalent to WHO type I) had a form of FGM extending beyond the clitoris (10/23 (43%) girls and 20/35 (57%) women). Of those who said they had undergone this form, nine girls (39%) and 19 women (54%) actually had WHO type III (infibulation and excision of part or all of external genitalia). The anatomical extent of forms classified as WHO type III varies widely. In 12/32 girls (38%) and 27/245 women (11%) classified as having WHO type III, the labia majora were not involved. Thus there is a substantial overlap, in an anatomical sense, between WHO types II and III. The reliability of reported form of FGM is low. There is considerable under-reporting of the extent. The WHO classification fails to relate the defined forms to the severity of the operation. It is important to be aware of these aspects in the conduct and interpretation of epidemiological and clinical studies. WHO should revise its classification.

                Author and article information

                Journal
                bwho
                Bulletin of the World Health Organization
                Bull World Health Organ
                World Health Organization (Genebra, Genebra, Switzerland )
                0042-9686
                February 2012
                : 90
                : 2
                : 120-127
                Affiliations
                [02] Accra orgnameUniversity of Ghana Medical School orgdiv1Department of Psychiatry Ghana
                [04] Ouagadougou orgnameOuagadougou University School of Medicine orgdiv1Department of Psychiatry Burkina Faso
                [03] San Francisco orgnameUniversity of California orgdiv1Helen Diller Family Comprehensive Cancer Center USA
                [01] New Haven CT orgnameYale University orgdiv1School of Public Health orgdiv2Department of Health Policy and Administration United States of America
                Article
                S0042-96862012000200012 S0042-9686(12)09000212
                2d5f39cd-4317-464b-a2b1-f5bf36c10e9e

                History
                : 26 May 2011
                : 11 October 2011
                : 12 October 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 39, Pages: 8
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                SciELO Public Health

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