Baseline Survey on Knowledge, Attitudes and Practices About Female Genital Cutting in Eastern Nigeria

“Female genital cutting (FGC), like male circumcision, is an ancient practice that was mentioned in pharaonic writings. The World Health Organization (1997) classified FGC into four categories depending on the form of cutting. Type I involves the removal of the prepuce, with or without removal of all or part of the clitoris. Type II includes removal of the clitoris with partial or total excision of the labia minora (the inner vaginal lips). Type III is the most extreme form and it involves the partial or total removal of the external genitalia and infibulation (stitching or narrowing of the vaginal opening with small opening to allow for flow of urine and menstrual blood). Type IV involves the introduction of corrosive substances into the vagina.

Unlike male circumcision that involves the removal of the foreskin and that has been argued to have beneficial properties, there is overwhelming consensus that FGC is not beneficial to the victim. In contrast, even the mildest form of FGC, which involves the removal of the prepuce, could lead to serious medical complications and negative social consequences.

FGC is widely practiced in Nigeria: nationally, about 25 percent of girls and women have undergone one form of FGC (National Population Commission, 1999). Types I, II and III (mainly in the northern states) are the most common forms of FGC in Nigeria. Type IV is also practiced, although to a lesser extent. The practice cuts across ethnic and religious lines: Christians, Moslems and adherents of traditional religion alike practice it. Nonetheless, there are significant variations by ethnicity and geographical location in the form of FGC performed, the type of practitioner performing the procedure, the age at cutting and the overt reasons for the practice. FGC is performed on a girl a few days after birth in some communities, during adolescence in some, during the first pregnancy in some and even after death in others.

A recent survey shows that FGC prevalence varies considerably by state from 0% in places like Akwa Ibom and Kebbi States to more than 80% in Ekiti, Edo and Ondo States. Even within the same state, prevalence could vary between 0% in some communities and 100% in others (RMS, 1999).

In Enugu State, an estimated 59 percent of girls and women have undergone one form of FGC, typically Type I or Type II. Most of these girls and women underwent the procedure during infancy. The practice of FGC in Enugu State is fueled by a number of cultural factors and beliefs. For example, women who have not undergone FGC are generally believed to be unmarriageable, promiscuous and unclean. Moreover, it is believed that if the head of the male child touches the clitoris of the mother during child birth, the child will die. While the campaign against FGC has been going on in Enugu State for years, the support for the practice is still very strong in many parts of the state.

Against this background, the Health Communication Partnership (HCP), in collaboration with a number of Nigeria-based non-governmental organizations (NGOs), designed a multi-tier and multi-media program that aims to contribute to the abandonment of the practice in Enugu State. Funding for the program comes from the United States Agency for International Development (USAID).

The program has three components operational at three levels respectively: state, local government area (LGA) and hamlet. The hamlet-level component targets three villages selected from three LGAs: Uzo-Uwani, Isi-Uzo and Enugu South. The hamlet-level intervention relies on a community action cycle (CAC) that seeks to mobilize community members and groups around the issue of FGC.

One of the initial activities under the program was to conduct a household baseline survey. The baseline survey is expected to provide formative information for fine-tuning the design of program activities, and to yield data against which the impact of the program can be measured. The survey was conducted in Enugu and Ebonyi states in July/August 2003 based on a control-experimental design. In this document, we present findings from the baseline survey.”

Editor's note, May 1 2017: This document is no longer available online. Please contact the lead author (above) to inquire about accessing it.