ABSTRACT
Background. Despite global efforts at eradicating female genital mutilation/cutting (FGM/C), the act continues to be performed globally. Objective. To determine the experience of schoolteachers about FGM/C and their possible role in contributing to its eradication. Methods. A prospective cross-sectional survey involving secondary schoolteachers from 18 secondary schools in Ilorin, North Central Nigeria, was undertaken during October and November 2014. All consenting participants completed a self-administered questionnaire on FGM/C. Statistical analysis was with SPSS version 20.0 with Ï2 and logistic regression; a p-value of <0.05 was considered significant. Results. There were 371 participants (113 males (30.5%) and 258 females (69.5%)). More females than males were aware of FGM/C (205 v. 94; Ï2 41.2; p=0.001); 180 women (69.8%) and 81 men (71.7%) wanted awareness and the implications of FGM/C to be taught in schools, while 46 women (17.8%) and 23 men (20.4%) had previously educated students about FGM/C. Also, 109 (42.3%) of the female teachers had been mutilated (mean (standard deviation) age 4.76 (4.86) years), and 49 mutilations (45.0%) had been performed by traditional circumcisers. Of the teachers, 44.0% of men and 24.5% of women had subjected their daughters to FGM/C (p=0.029), mostly for religious reasons. The men initiated the majority of their daughters' mutilations, while the mothers-in-law were the main initiators among the women; 44 (17.0%) women and 23 (20.4%) men held the opinion that females should be circumcised, while the majority considered education and legislation to be the most important interventions to encourage its eradication. Predictors of the likelihood to support discontinuation of FGM/C include awareness of government policy about FGM/C and having a mutilated daughter. Conclusion. Education, reorientation and motivation of teachers will position them as agents for eradicating FGM/C
Subject(s)
Circumcision, Female , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Nigeria , SchoolsABSTRACT
BACKGROUND: Vesicovaginal fistula is a preventable calamity; which has been an age-long menace in developing countries. OBJECTIVE: To review the causes; complications; and outcome of vesicovaginal fistula in Nigeria. METHODS: Studies on vesicovaginal fistula were searched on the internet. Information was obtained on Pubmed (medline); WHO website; Bioline Innternational; African Journal on Line; Google scholar; Yahoo; Medscape and e Medicine. RESULTS: Many Nigerian women are living with vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria than southern Nigeria. Obstetric fistula accounts for 84.1-100of the vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9-96.5) in all the series. Other common causes include caesarean section; advanced cervical cancer; uterine rupture; and Gishiri cut. The identified predisposing factors were early marriage and pregnancy; which were rampant in northern Nigeria; while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance were poverty; illiteracy; ignorance; restriction of women's movement; non-permission from husband; and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87-91.7. Stigmatization; divorce and social exclusion were common complications. Overall fistula repair success rate was between 75and 92in a few centres that offer such services. CONCLUSION: Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern