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      Prevalence of female genital mutilation among women in Ethiopia: A systematic review and meta-analysis

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          Abstract

          Background

          Female genital mutilation affects the social, psychological, spiritual and physical well-being of women. In Ethiopia, studies regarding the female genital mutilation were conducted in various settings and years.

          Objective

          This systematic review and meta-analysis was aimed to summarize the prevalence of female Genital Mutilation in Ethiopia.

          Methods

          A systematic search of articles was conducted in PubMed, African Journals Online (AJOL), Excerpta Medica database (EMBASE), SCOPUS, Web of Science, and JSTOR. Data were extracted using a standardized data extraction format prepared in Microsoft Excel. The data were analyzed using STATA version 11 software. Cochrane Q statistic was used to assess the presence of significant between-study heterogeneity. I 2 was used to quantify between-study heterogeneity. A leave-one-out sensitivity analysis and subgroup analysis based on a study period and setting were done. The funnel plot and Egger's regression tests were used to measure the presence of substantial publication bias. The pooled estimated prevalence of female genital mutilation was conducted using a DerSimonian and Laird random effects model.

          Results

          The pooled prevalence estimate of FGM was 77.28% (95% CI: 55.81, 98.76). The pooled prevalence was higher in studies conducted from 2013-2017 (78.39%, 95%CI: 48.24, 108.54) and studies conducted in Hospital (92.02: 95%CI: 55.81, 98.76).

          Conclusion

          The prevalence of Female Genital Mutilation is high. Therefore, interventions that are focused on health education, social support and advocacy are recommended.

          Abstract

          Quality of life; Epidemiology; Gynecology; Obstetrics; Reproductive system; Female genital mutilation, Cutting, Clitoridectomy, Infibulation.

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          Most cited references42

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          Female genital mutilation: prevalence, perceptions and effect on women’s health in Kersa district of Ethiopia

          Wondimu Shanko Yirga, Nega Assefa Kassa, Mengistu Gebremichael … (2012)
          Background Female genital mutilation (FGM) is nontherapeutic surgical modification of the female genitalia. It is an ancient tradition in large parts of Africa, including Ethiopia, especially in the eastern part of the country. This study aimed to identify the prevalence, perceptions, perpetuators, reasons for conducting FGM, and factors associated with this practice with regard to women’s health. Methods Community-based cross-sectional house-to-house interviews were conducted during 2008 among 858 females of reproductive age (15–49 years), in Kersa district, East Hararge, Oromia region, Ethiopia. Proportions and Chi-square tests were used to describe the data and logistic regression was used to describe statistical associations. Statistical significance was set at P < 0.05. Results FGM was reported to be known by 327 (38.5%) of the interviewees. The majority (n = 249, 76.1%) reported that local healers were the main performers of FGM, and 258 (78.9%) respondents stated that the clitoris was the part removed during circumcision. The main reason for the practice of FGM was reduction of female sexual hyperactivity (reported by 198 women [60.3%]). Circumcision of daughters was reported by 288 (88.1%) respondents, and this showed a statistically significant association with the Christian religion (P = 0.003), illiteracy (P = 0.01), and Amhara ethnicity (P = 0.012). The majority of the respondents (792, 92.3%) were themselves circumcised and 68.8% did not know of any health-related problems associated with FGM. Conclusion In spite of FGM being a common practice in the study area, only one third of the respondents stated that they knew about it. Local healers were the main performers of FGM. Some of the women knew about the negative reproductive health effects of FGM and some had also experienced these themselves. However, only a few had tried to stop the practice and the majority had taken no steps to do so. This may be attributable to the fear of becoming alienated from the cultural system and fear of isolation.
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            Mental health problems associated with female genital mutilation

            Jeroen Knipscheer, Erick Vloeberghs, Anke van der Kwaak … (2015)
            Aims and method To study the mental health status of 66 genitally mutilated immigrant women originating from Africa (i.e. Somalia, Sudan, Eritrea and Sierra Leone). Scores on standardised questionnaires (Harvard Trauma Questionnaire-30, Hopkins Symptom Checklist-25, COPE-Easy, Lowlands Acculturation Scale) and demographic and psychosocial correlates were analysed. Results A third of the respondents reported scores above the cut-off for affective or anxiety disorders; scores indicative for post-traumatic stress disorder were presented by 17.5% of women. Type of circumcision (infibulation), recollection of the event (a vivid memory), coping style (avoidance, in particular substance misuse) and employment status (lack of income) were significantly associated with psychopathology. Clinical implications A considerable minority group, characterised by infibulated women who have a vivid memory of the circumcision and cope with their symptoms in an avoidant way, reports to experience severe consequences of genital circumcision. In terms of public healthcare, interventions should target these groups as a priority.
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              Female genital mutilation/cutting in Africa

              Akin-tunde Odukogbe, Bosede Afolabi, Oluwasomidoyin O. Bello … (2017)
              Female genital mutilation/cutting (FGM/C) is a traditional practice in which the external female genitalia is partially or totally incised or excised for a non-therapeutic reason, usually without the consent of the individual. FGM/C is common in Africa with varying prevalence in different countries, though the incidence is reducing because it is considered a human rights issue with tremendous advocacy for its elimination by mainly nongovernmental organizations. It is mainly underreported in many countries in Africa especially where it has been declared illegal. FGM/C is often performed by a nonmedical practitioner with the aim of fulfilling religious or cultural rites and sometimes for economic benefits with the resultant acute, intermediate and late complications. It is sometimes performed by medical practitioners when it is speciously believed that its medicalization reduces the complications associated with the practice. The sensitivity of FGM/C is amplified when compared to male circumcision and voluntary alterations of the female external genitalia like piercing and tattooing as similar practices. The magnitude of the physical and psychosocial consequences of FGM/C outweighs the presumed benefits of the procedures highlighting the need for improvement of the multiple preventive measures by all the stakeholders and in all the sectors.
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                Author and article information

                Contributors
                Robera Olana Fite
                Journal
                Journal ID (nlm-ta): Heliyon
                Journal ID (iso-abbrev): Heliyon
                Title: Heliyon
                Publisher: Elsevier
                ISSN (Electronic): 2405-8440
                Publication date PMC-release: 24 July 2020
                Publication date Collection: July 2020
                Publication date (Electronic): 24 July 2020
                Volume: 6
                Issue: 7
                Electronic Location Identifier: e04403
                Affiliations
                [a ]Department of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, Ethiopia
                [b ]Department of Anesthesia, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
                Author notes
                [∗ ]Corresponding author. rolana2000@ 123456gmail.com
                Article
                Publisher ID: S2405-8440(20)31247-0 Publisher ID: e04403
                DOI: 10.1016/j.heliyon.2020.e04403
                PMC ID: 7385462
                SO-VID: 40c5a4b1-3ba0-4fb0-8e6c-27cfee95ab8a
                Copyright © © 2020 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 3 January 2020
                Date revision received : 7 May 2020
                Date accepted : 3 July 2020
                Categories
                Subject: Article

                Keywords: quality of life,epidemiology,gynecology,obstetrics,reproductive system,female genital mutilation,cutting,clitoridectomy,infibulation
                Data availability:
                Keywords: quality of life, epidemiology, gynecology, obstetrics, reproductive system, female genital mutilation, cutting, clitoridectomy, infibulation

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