TABLE OF CONTENTS

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Title page    …      …      …      …      …      …      …      …      …      i

Approval    …      …      …      …      …      …      …      …      …      ii

Certification         …      …      …      …      …      …      …      …      iii

Dedication            …      …      …      …      …      …      …      …      iv

Acknowledgment …      …      …      …      …      …      …      …      v

Table of Contents …     …      …      …      …      …      …      …      vi

List of Tables       …      …      …      …      …      …      …      …      viii 

List of Figure        …      …      …      …      …      …      …      …      ix

Abstract      …      …      …      …      …      …      …      …      …      x

CHAPTER ONE: INTRODUCTION

Background to the Study        …      …      …      …      …      …      …      1

Statement of the Problem        …      …      …      …      …      …      …      3

Purpose of the Study     …      …      …      …      …      …      …      4

Objective of the Study   …      …      …      …      …      …      …      4

Research Question         …      …      …      …      …      …      …      …      5

Significance of the Study         …      …      …      …      …      …      …      6

Scope of the Study        …      …      …      …      …      …      …      …      7

Operational Definition   …      …      …      …      …      …      …      7

CHAPTER TWO: LITERATURE REVIEW

Conceptual Review        …      …      …      …      …      …      …      8

Concept of Female Genital Mutilation        …      …      …      …      8

Types of Female Genital Mutilation …      …      …      …      …      10

Reasons for Female Genital Mutilation      …      …      …      …      13

Theoretical Review…    …      …      …      …      …      …      …      17

Empirical Review …      …      …      …      …      …      …      …      21

Summary of Literature Review         …      …      …      …      …      …      29

CHAPTER THREE: RESEARCH METHODS

Research Design            …      …      …      …      …      …      …      31

Study Area …      …      …      …      …      …      …      …      …      31

Population of Study      …      …      …      …      …      …      …      32

Sample       …      …      …      …      …      …      …      …      …      32

Sampling Procedure       …      …      …      …      …      …      …      33

Inclusion Criteria …      …      …      …      …      …      …      …      34

Instrument for Data Collection…     …      …      …      …      …      34

Validity of Instrument …        …      …      …      …      …      …      …      35

Reliability of Instrument         …      …      …      …      …      …      …      35

Ethical Consideration    …      …      …      …      …      …      …      35

Procedure for Data Collection           …      …      …      …      …      …      36

Method of Data Analysis                  …      …      …      …      …      37

CHAPTER FOUR: RESULTS

Results        …      …      …      …      …      …      …      …      …      38

Summary of Results      …      …      …      …      …      …      …      48

CHAPTER FIVE: DISCUSSION OF FINDINGS     

Discussion of Major Findings …      …      …      …      …      …      49

Summary of the Study   …      …      …      …      …      …      …      54

Implication of the Study for Nursing Practice      …      …      …      56

Conclusion …      …      …      …      …      …      …      …      …      57

Recommendations         …      …      …      …      …      …      …      …      59

Limitation of the Study  …      …      …      …      …      …      …      60

Suggestions for Further Studies        …      …      …      …      …      61

Reference    …      …      …      …      …      …      …      …      …      62

Appendix I …      …      …      …      …      …      …      …      …      68

Appendix II          …      …      …      …      …      …      …      …      …      73

LIST OF TABLES

Table 1:          Socio-demographic characteristics of the respondents             …        39

Table 2:          Social factors that still preserve FGM practice   …        …        41

Table 3:          Social structures that still preserve FGM practice…     …        42

Table 4:          Cultural factors that still preserve FGM practice …        44

Table 5:          Association between social structures and continued

practice of FGM       …        …        …        …        …        …        46

Table 6:          Relationship between cultural beliefs and continued practice

of FGM          …        …        …        …        …        …        …        47

LIST OF FIGURE

Fig. 1          Female Genital Mutilation flow diagram using

Rosenstock Stretcher and Becker (1988)

Health Belief Model       …      …      …      …      …      20

ABSTRACT

The study examined the socio-cultural factors that still preserve female genital mutilation practice among women in selected rural communities of Enugu State. Five objectives and two null hypotheses were raised to guide the study. The study adopted the descriptive survey design. A sample of 419 women aged 15-49 years were drawn from estimated 145,905 women in rural communities in Enugu East Local Government Area of Enugu State using convenient sampling technique. Data were collected using researcher-developed 36-item questionnaire. Statistical analysis was done using statistical package for social sciences (SPSS) Version 17. Major findings revealed that high percentage of women almost half of the women studied 46.3% still practice female genital mutilation in the studied rural communities. The strongest social factors that preserves the practice of female genital mutilation were the belief that it controls sexual desires and promiscuity among women – mean =3.23 and SD = 6.14); 157 (52.3%) strongly agreed. The most strongly agreed cultural factors preserving the practice of female genital mutilation were that it is done in order to initiate girls into womanhood strongly agreed by 138 (46%); mean = 3.02 SD = 4.72. The study concluded that many women still practice female genital mutilation in the rural communities studied and actually they encourage its continuity.  They study recommends more sensitization campaign on the social structures supporting the practice. Efforts of stakeholders in health should be geared towards planning and implementing aggressive programmes aimed at creating more awareness on the negative effects of female genital mutilation and its practice.

CHAPTER ONE

INTRODUCTION

Background to the Study

Female genital mutilation (FGM) commonly known as female circumcision comprises all procedures involving partial or total removal of the external female genitalia either for cultural or other non-therapeutic reasons (Wright, 2006). Whatever the purpose, FGM is a dangerous and potentially life-threatening procedure that causes unspeakable pain and suffering to the victim. According to Black (2000), it is declining in many western worlds but it is still being practiced in many African countries. It continues to be one of the most persistent, pervasive and silently endured human rights violations in the developing world.

An estimated 140 million females in the world today have undergone some form of female mutilation. At the current rates of population increase and with the slow decline in these procedures, it is estimated that each year a further 2 million girls are at risk from the practice, and the women and girls affected live in 28 African countries and a few in the Middle East and Asia (World Health Organization (WHO), 2002).

Recently, it has been identified as a very vital public health problem (Uwasomba, 2003). Referring to female genital mutilation as female circumcision is misleading because it implies that the procedure is similar to male circumcision, which is necessary and simply involves the removal of piece of the foreskin of the genital organ (WHO, 2004). The procedure is far more invasive and dangerous as a large portion of healthy sensitive tissues of the female external genital organs are normally excised.

In Africa, the practice exists today in about thirty two out of the forty eight African countries among them are Sudan, Egypt, Mali, Niger, Nigeria to mention but a few (Bashir, 1997).  In Nigeria, female genital mutilation is noted to be practiced among different tribes, for example the Igbos, Efiks, Ishans, Edo’s, Urhobos, Yorubas, Nupes, Hausas, Idomas and many others (Bardie, 1995).

There are 3 main types of female genital mutilation although some other forms have been identified. They are: Type 1 (Clitoridectomy), Type 2 (Excision) and Type 3 (Infibulations). Clitoridectomy involvesremoval of the tip of the prepuce, with or without excision of part or all of the clitoris, Excisioninvolves removal of the clitoris along with some part or all of the labia minora while in infibulationsmost of all the external genitalia is removed, and the vaginal opening is then stitched leaving only a small opening for the flow of urine and menstruation.The procedure can be carried out during infancy, about the eight day of delivery, childhood, at time of marriage or even during first pregnancy depending on the cultural dictates of the area. The operation is often performed by practitioners with little or no formal knowledge of human anatomy and physiology and in most cases under unhygienic conditions without the use of anaesthetic or sterile instruments. The immediate medical consequences according to Black (2000), include, difficulty in passing urine, urine retention, haemorrhage, infection, fever, stress, shock and damage to the genital organs.

Over time, circumcised women may also develop menstrual complications, urinary tract infections, chronic pelvic infection and low fertility or infertility. With all these medical complications prevalent among the circumcised female, the obnoxious practice is still common especially in some rural areas in most developing countries like Nigeria. A lot of campaigns by government and non-governmental organizations highlighting the risks associated with FGM have been mounted, yet the practice is still prevalent in some rural settings in Nigeria (Jerry, 2000). This raises the question, “what could be the factors that are still preserving the continuing practice of FGM?”

Seeking answer to the question prompted the need to examine the socio-cultural perspectives of FGM in rural communities of Enugu State in other to provide evidence-based health education information.

Statement of the Problem