AN ASSESSMENT OF THE EFFECTS OF FEMALE GENITAL

MUTILATION AMONG ADOLESCENTS IN AKWANTAKWARAM

WARD, BAKORI LOCAL GOVERNMENT AREA OF KATSINA
STATE

BY

ISAH ASHIRU

B18/074

A RESEARCH PROJECT SUBMITTED TO THE DEPARTMENT OF

COMMUNITY HEALTH EXTENSION WORKERS, COLLEGE OF

HEALTH TECHNOLOGY KANKIA IRO, KATSINA STATE

IN PARTIAL FULLFILLMENT FOR THE AWARD OF DIPLOMA

IN COMMUNITY HEALTH

AUGUST, 2021
 DECLARATION

I hereby certify that this project has been carried out solely by me under the

guidance of Malam Lawal Abdu Mashi of Department of Community Health

Kankia Iro School of Health Technology. The work embodied in the project

is original and has never been presented for any kind of award

........................................ …..........................
Isah Ashiru Date
B18/074

ii
 APPROVAL PAGE

This is to certify that this research work was carried out by Isah Ashiru with

Registration number B18/074 in partial fulfillment for the award of Diploma

in Community Health in the Department of Community Health Kankia Iro

School Of Health Technology Kankia, Katsina State

.................................................. ...................................
Malam Lawal Abdu Mashi Date
Supervisor

................................................... ..................................
Malam Jabir Muhammad Kurfi Date
Head of Department

................................................... ..................................
Date
External Examiner

iii
 DEDICATION

This research work is whole heartedly dedicated to my beloved parents also

dedicated to my beloved brother Abraham Abel.

iv
 ACKNOWLEDGEMENT

My special appreciation I return it to God my creator who makes it

accomplished to reach the bus of my successful journey in Jesus name amen.

I wish to prove out my special emotion of thanks to my lovely, amazing and

splendiferous parents for encouragement and financial support throughout
my Bio of existence from the start to date, and other members of my best
family in the world who play one or more role in taking me to higher
destination of my successful journey may Almighty God reward them
abundantly.

I also appreciate my humble, wonderful and worthy supervisor Malam Abdu

Lawal Mashi (Daddy) who took time to amend mistakes using his
knowledge and facial expressions and criticism to produce an excellence
task despite all his challenges and commitments may God reward him
abundantly.

I also wish to appreciate the following vital people for playing an important
role in this course of study the great and respectable School Director in
person of Dr. Bishir Ahmad and the Vice Director in person of Malam
Abubakar Iliya, my current HOD Dr. Jabir Muhammad Kurfi of Community
Health Department, and my respected Class Coordinator in person of Malam
Abdurrashid Abdullahi K/Soro and my special Primary Health Care
management lecturer in person of Malama Saratu Abdu Bawa (Mamar Yara)
and other lecturers of the Department like Malam Mustapha Aminu, Malama
Hauwa Idris may God reward you abundantly amen.

Most gratitude goes to the entire lecturers of community health Department

for their tireless work toward ensuring all necessary knowledge and skills
are impcted to us.

I will like to appreciate my brothers Abraham Abel (Baban Boy), Isah

Habila (Baban Aminu), Emmanuel Abel (Man Colour), Jude Abel, Ummaru
and sisters Mrs. Maryamu Elesha (Babbar Yaya), Mrs Hannatu Yusuf
(Mamar Lauwuka) Mrs Jemimah pastor Iliya Isya Elijah (Mamar Sophia and
Nissi), Aisha Habila (Auta), Hagar Abel for their support, prayers and

v
encouragement may God continue to rewards you abundantly and guide you
in Jesus name amen.

I also like to extend my gratitude to my sweetheart in person of Marvelous

Omodibo Omokhepue for her support, prayers and contributions in one way
or the other up to the success of my research project I really appreciate May
God reward you more amen.

I cannot conclude without delivering my sincerely appreciation to Trusted

friends Faisal Ayuba (FAM-C), Samaila Yusuf, Simon Shitu, Reuben
Suleman, Yusuf Adamu Roni, Yusuf Adamu Magawata, Eli prince,
Jayysmart, Bilyaminu Ibrahim, Jafar Muaxu, Ishaka Abdul (Fillo) and others
which time will not permit me to mention them all may God reward you
amen.

I also express my gratitude to my sons and daughters Benjamin (Boy) ,

Aminu, Musty, Suleiman, Babangida, Adamu, Najib, Samson, Rufa'i, Eli
Prince, Sophia, Nissi, Lauwuka, Abira, Kauna, Esther, Joy, Asiya, And
others for their support and prayers to me may God bless you all.

I wish to express my deepest and heartedly profound to my dearest beloved

course mate starting from Jafar, Fillo, Captain, Yan Biyu, Deputy, Mal Abu,
Smart, Albarka, Naim, Jigawa, Tutor, Sarfilus, Roni, Meenah Yusuf, Tajiri,
Safiyanu, Edy, Teema Chew, Aysher Lurwan, Asmau, Lubit, Ainat, Umit,
Kadyt, Sa A, Memxy, Bulka, Umar Auwal Najib, Sani, Ibrahim, Hanny,
Marasa, and the rest members of chew class of 2021 which time may not
permit me to mention them all , you are among the unforgettable people in
my life. May God reward you Abundantly Amen.

Finally I will like to express my feelings to my lovely Fellowship Of

Christian Health Students our struggles is never in vain, I encourage you that
anywhere God lead us, let us allow his light shine in us. I love you so much
for time we spent, may his love continue to guide us in Jesus name Amen.

vi
 TABLE OF CONTENTS

Title Page ………………………………………........................................... i

Approval ……………………………………................................................ ii
Declaration ……………………………………........................................... iii
Dedication ……………………………………............................................ iv
Acknowledgement ………………………………………............................. v
Table of Contents ………………………………………............................ vii
Abstract ….................................................................................................... xi
CHAPTER ONE
1.0 Introduction ………………………………………................................. 1
1.1-Background of the Study ………………………………………............ 1
1.2-Statement of the Problem......................................................................... 4
1.3-Objectives of the Study ………………………………………............... 5
1.4-Research Question …………………………………….......................... 5
1.5- Research Hypothesis ……………………………………….................. 6
1.6- Significance of the Study ………………………................................... 6
1.7- Scope and Limitation of the Study ......................................................... 7
1.8- Definition of the terms …………………………………....................... 8
1.9- Organization of the study ……………………………………............... 9
CHAPTER TWO
Review of related Literature ……………………………………................ 10
CHAPTER THREE
3.0- Research Methodology ........................................................................ 28
3.1- Research Design ……………………………………........................... 28
3.2- Area of the Study …............................................................................. 28
3.2.1- Major Ethnic Composition …………………………………............ 28
3.2.2- Population ……................................................................................. 29
3.2.3- Occupation of the People .................................................................. 29

vii
3.2.4- Transportation ………………………………................................... 29
3.2.5- Health Facilities ………………………………................................ 29
3.3- Population of the Study ........................................................................ 29
3.4- Sample Size and Sampling Techniques ……………………………... 29
3.5- Instrument for Data Collection ………………………….................... 30
3.6- Validity and reliability of the instrument ………………………......... 30
3.7- Method of Data Collection ………………………............................... 30
3.8- Method of Data Analysis ……………………..................................... 30
CHAPTER FOUR
4.0- Introduction ……………………......................................................... 31
4.1- Data Presentation and Analysis ........................................................... 31
CHAPTER FIVE
5.0- Introduction …………………….......................................................... 37
5.1- Summary .............................................................................................. 37
5.2- Discussion of Finding …………………….......................................... 38
5.3- Suggestions for Further Study ............................................................. 40
5.4- Conclusion ……………………........................................................... 40
5.5- Recommendations ................................................................................ 41
5.6- Limitation of the Study ........................................................................ 41
Reference .......................................................................................... 42
Appendix I ….……………………………………............................ 45

viii
 ABSTRACT

This project focuses on Assessment of the effects of female genital mutilation

among adolescents in Kwantakwaram Ward Bakori Local Government Area
of Katsina State. The data collection procedure was designed through
questionnaires distribution, a 50 pieces was distributed to the respondents
and the 50 pieces has return intact to me which are expressing the views of
different types of people experience on the study and also the result was very
effective and clear. Suggestion and recommendations were made to maintain
the success achieved.

ix
 CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

According to the World Health Organization (WHO), female genital

mutilation (FGM) is defined as all procedures which involve partial or total

removal of the external female genitalia and/or injury to the female genital

organs, whether for cultural or any other non-therapeutic reasons (World

Health Organization 1998). Worldwide, government and non- governmental

organizations frown at FGM having seen it as an infringement on the

physical and psychosexual integrity of the female child. Nigeria was said to

have the highest absolute number of cases of FGM in the world, accounting

for about one-quarter of the estimated 115– 130 million circumcised women

worldwide (UNICEF 2001). The prevalence rate of FGM was put at 41%

among adult Nigerian women (Okeke 2012). Nigeria is a country in West

Africa bordering the Gulf of Guinea between Benin and Cameroon. It has an

area of 923,768.00 sq kilometers with a population of 140,431,790

according to the 2006 National Population census (National Bureau of

Statistics 2006). The male constituted 71,345,488 while the female were

69,086,302 (National Bureau of Statistics 2006). This study was done in a

tertiary hospital in Edo State, one of the 36 states of Nigeria. Edo State has a

population of 2,398,957 with the female being 1,215,487and the male

1
69,086,302 (National Bureau of Statistics 2006). The following states in

Nigeria have prohibited this act since 1999; Abia, Bayelsa, Cross River,

Delta, Edo, Ogun, Osun and Rivers. However, with increasing awareness of

the complication of FGM, there is a recent ban on the practice in Nigeria as

a nation in year 2015. The prevalence rate is therefore expected to

progressively decline in the younger age groups. FGM practiced in Nigeria

is classified into four types as follows; clitoridectomy or Type I, this

involves the removal of the prepuce or the hood of the clitoris and all or part

of the clitoris. Type II or “sunna” is a more severe practice that involves the

removal of the clitoris along with partial or total excision of the labia

minora. Type III (infibulation), involves the removal of the clitoris, the labia

minora and adjacent medial part of the labia majora and the stitching of the

vaginal orifice, leaving an opening of the size of a pin head to allow for

menstrual flow or urine. Type IV or other unclassified types include

introcision and gishiri cuts, hymenectomy, scraping and/or cutting of the

vagina, the introduction of corrosive substances and herbs in the vagina, and

other forms. Consequences of female genital mutilation include increased

risks of urinary tract infections, bleeding, bacterial vaginosis, dyspareunia,

obstetric complications, psychological problems such as depression, anxiety,

post-traumatic stress disorder, low self-esteem, etc (Behrendt and Moritz,

2005), Abdulcadir and Dällenbach, 2013), Amin et-al.,., 2013), Andersson

2
et-al.,., 2012), Andro et-al. Female genital mutilation is classified into four

major types (WHO, 1996). The most common type of the female genital

mutilation is type 2 which account for up to 80% of all cases while the most

extreme form which is type 3 constitutes about 15% of the total procedures

(WHO, 1996; Oduro et-al., 2006). Types 1 and 4 of FGM constitute the

remaining 5%. The consequences vary according to the type of FGM and

severity of the procedure (Onuh et-al., 2006; Oduro et-al., 2006). The

practice of FGM has diverse repercussions on the physical, psychological,

sexual and reproductive health of women, severely deteriorating their

current and future quality of life (Oduro et-al., 2006; Larsen, 2002). The

immediate complications include: severe pain, shock, haemorrhage, urinary

complications, injury to adjacent tissue and even death (Onuh et-al., 2006;

Oduro et-al., 2006; Larsen, 2002). The long term complications include:

urinary incontinence, painful sexual intercourse, sexual dysfunction, fistula

formation, infertility, menstrual dysfunctions, and difficulty with child birth

(Akpuaka, 1998; Okonofua et-al., 2002; Oguguo and Egwuatu, 1982). The

physical and psychological sequelae of female genital mutilation have been

well highlighted in many literatures (Onuh et-al., 2006; Oduro et-al., 2006;

Badejo, 1983; Klouman et-al., 2005; ACHPR, 2003; Ibekwe, 2004).

Recently, there has been serious concern on the increased rate of

transmission of Human Immunodeficiency Virus (HIV) following this

3
practice (WHO, 1996; Klouman et-al., 2005). The practice is also a violation

of the human rights of the women and girl child. FGM categorically violates

the right to health, security and physical integrity, freedom from torture and

cruelty, inhuman or degrading treatment and the right to life when the

procedure results in death. It constitutes an extreme form of violation,

intimidation and discrimination. Despite its numerous complications, this

harmful practice has continued unabated, notwithstanding that Nigeria

ratified the Maputo Protocols and was one of the countries that sponsored a

resolution at the 46th World Health Assembly calling for the eradication of

female genital mutilation in all nations (Klouman et-al., 2005; ACHPR,

2003; Idowu, 2008).

1.2 STATEMENT OF THE PROBLEM

The practice of Female Genital Mutilation (FGM) is regrettably persistent in

many parts of the world. This occurs commonly in developing countries

where it is firmly anchored on culture and tradition, not minding many

decades of campaign and legislation against the practice (Onuh et-al., 2006;

WHO, 2008). Female genital mutilation comprises any procedure involving

partial or total removal of the external female genitalia or other injury to the

female genital organs for cultural, religious or other non-therapeutic reason

(WHO, 2008; WHO, 1996). The World Health Organization (WHO)

4
estimates that between 100 and 140 million girls and women worldwide are

presently living with female genital mutilation and every year about three

million girls are at risk (WHO, 2008). It is in view of this that the researcher

intends to assess the effect of female genital mutilation.

1.3 OBJECTIVE OF THE STUDY

- To assess the knowledge of adolescent towards female genital mutilation

- To find out the effects of female genital mutilation

- To ascertain major reasons for female genital mutilation

- To identify the health implications of female genital mutilation

- To find out the roles of the government in prohibiting female genital

mutilation

1.4 RESEARCH QUESTIONS

- What are the level of knowledge of adolescent towards female genital

mutilation

- What are the effects of female genital mutilation

- What are the major reasons for female genital mutilation

- What are the health implications of female genital mutilation

- What are the roles of government in prohibiting female genital mutilation

5
1.5 RESEARCH HYPOTHESIS

To aid the completion of the study, the following research hypotheses were

formulated by the researcher

- H0: Female genital mutilation does not have any effect on the sexual
habit of the girl child

- H1: Female genital mutilation does have a significant effect on the sexual
habit of the girl child

- H0: Government does not play any significant role in prohibiting female
genital mutilation

- H2: Government does play a significant role in prohibiting female genital

mutilation

1.6 SIGNIFICANCE OF THE STUDY

At the completion of the study, it is believed that the study will be of great

important to the federal ministry of women affair and the house committee

on women affairs as the study will help them formulate policy that will help

prohibit or eliminate the archaic and orthodox practice of female genital

mutilation, the study will also be of great importance to every parent as the

study seek to expose the dangers of female genital mutilation among female.

The study will also be of great importance to student who intends to embark

on a study in similar topic as the findings of the study will serve as a

pathfinder to them. Finally the study will be of great importance to students,

6
teachers and the general public as the finding will add to the pool of existing

literature.

1.7 SCOPE AND LIMITATION OF THE STUDY

The scope of the study covers an assessment on female genital mutilation

among adolescent girls in Kwantakwaram ward with emphasis on Katsina

State. But in the cause of the study, there were some factors which limited

the scope of the study

a) AVAILABILITY OF RESEARCH MATERIAL: The research material

available to the researcher is insufficient, thereby limiting the study.

b) TIME: The time frame allocated to the study does not enhance wider
coverage as the researcher has to combine other academic activities and
examinations with the study.

c) FINANCE: The finance available for the research work does not allow
for wider coverage as resources are very limited as the researcher has
other academic bills to cover

7
1.8 DEFINITION OF TERMS

1.8.1 FEMALE

Female is the sex of an organism, or a part of an organism, that produces

non-mobile ova (egg cells). Barring rare medical conditions, most female

mammals, including female humans, have two X chromosomes.

1.8.2 FEMALE GENITAL MUTILATION

Female genital mutilation (FGM), also known as female genital cutting and

female circumcision, is the ritual cutting or removal of some or all of the

external female genitalia. The practice is found in Africa, Asia and the

Middle East, and within communities from countries in which FGM is

common

1.8.3 REPRODUCTIVE HEALTH

Within the framework of the World Health Organization’s (WHO) definition

of health as a state of complete physical, mental and social well-being, and

not merely the absence of disease or infirmity, reproductive health, or sexual

health/hygiene, addresses the reproductive processes, functions and system

at all stages of life. Reproductive health implies that people are able to have

a responsible, satisfying and safer sex life and that they have the capability

to reproduce and the freedom to decide if, when and how often to do so. One

8
interpretation of this implies that men and women ought to be informed of

and to have access to safe, effective, affordable and acceptable methods of

birth control; also access to appropriate health care services of sexual,

reproductive medicine and implementation of health education programs to

stress the importance of women to go safely through pregnancy and

childbirth could provide couples with the best chance of having a healthy

infant.

1.9 ORGANIZATION OF THE STUDY

This research work is organized in five chapters, for easy understanding, as

follows. Chapter one is concern with the introduction, which consist of the

(background of the study), statement of the problem, objective of the study,

research questions, research hypotheses, significance of the study, scope of

the study etc. Chapter two being the review of the related literature presents

the theoretical framework, conceptual framework and other areas concerning

the subject matter. Chapter three is a research methodology covers deals on

the research design and methods adopted in the study. Chapter four

concentrate on the data collection and analysis and presentation of finding.

Chapter five gives summary, conclusion, and recommendations made of the

study.

9
 CHAPTER TWO

2.0 REVIEW OF RELATED LITERATURE

2.1 INTRODUCTION

Female circumcision (FC) or female genital mutilation (FGM) describes

practices that manipulates, alter, or remove the external genital organs in

young girls and women (W.S Yirga, N.A. Kassa, M.A. Gebremichael and A.

R Aro 2012). The procedure is performed using a blade or shard of glass by

a religious leader, town elder, or a medical professional with limited

training. In about 15% of cases, infibulation, the most common and severe

form of FGM, involves the removal of the vulva; this practice may place the

victims life at risk (W.S Yirga, N.A. Kassa, M.A Gebremichael, and A.R

Aro 2012). In contrast to male circumcision, the procedure produces no

known health benefits and is not performed for medical reasons (M.

Donohoe 2006). FGM is widely recognized as a procedure that violates a

person’s human rights, as well as increasing their risk for health

complications (M. Donohoe 2006). The aim of the present study was to

compare literature sources regarding the practice and negative outcomes of

FGM as well as explore the phenomena perpetuating the custom.

2.2 METHODS

PRISMA guidelines were followed according to the studies of Moher et-al.

(D. Moher, L. Shamseer, Clarke et-al.., 2015) and Shamseer et-al. (L.
10
Shamseer. D. Moher, M. Clarke et-al., 2015). Our review question sought to

investigate the consequences of FGM, its cultural and social dynamics, and

possible approaches and obstructions to eradication. 42 articles published

between the years 1994 and 2017 were reviewed. Database searches

included PubMed, MEDLINE, Google Scholar, Web of Science, and

EBSCO host. In addition, the data from four international organizations that

address FGM were reviewed for relevant information: specifically, the

Population Reference Bureau (PRB), the United Nations Children’s Fund,

the United Nations Population Fund, and the World Health Organization

(WHO).

No date restrictions were imposed, and all study types were explored

including systematic reviews, cohort studies, case-control studies, case

series, cross-sectional studies, case reports, and randomized controlled

studies to encompass qualitative research and the qualitative element of

diversified methods. As FGM is not an overtly researched field, especially

within the United States, it was important to explore all sources of

information in order to generate the best understanding of FGM procedures.

Searches were refined to articles written in English and published in a peer-

reviewed or organizational journal in order to retain the integrity of the

informational sources. The search strategy incorporated subject headings and

11
text words relating to FGM. We included the four alternative classifications

for the procedure, including mutilation, circumcision, excision, and cutting.

We did not apply any methodological search filters in order to maximize

sensitivity. This strategy was applied to all databases reported above.

Results from database searches underwent titles and abstracts screening by

two separate reviewers for relevance and inclusion. Any discrepancies were

submitted and resolved by a third reviewer who examined the pertinence and

concerns of the two initial reviewers. Studies considered for inclusion were

then retrieved as full-text articles. Final decisions about inclusion were made

by the authors, and reasons for exclusion were documented. Using a

specifically developed piloted data extraction form, information from all

reports was recorded (e.g., details of the phenomenon of interest, population,

context, study methodology, methods, and outcomes of significance). For

each outcome, we aimed to extract the relevant statistical results, which

included prevalence incidence rates, relative risk, odds ratio, and chi-squared

goodness-of-fit tests. No assumptions or simplifications were made other

than those listed by the authors in their original studies.

The risk of bias was assessed in all studies by three independent review

authors. Each reviewer then recorded his or her findings on a separate “Bias

Assessment Form.” Overlapping concerns of bias were then selected for

12
final review and incorporated into the literature review. The concerns wholly

addressed bias at the study level. For any conflicting information found

within sources, data from organizations conducting research “on the ground”

(i.e., UNICEF, WHO, and PBR) took precedence as their data were assumed

to be more recent and accurate. No combining of results was performed, and

all data were portrayed independently.

2.3. RESULTS: STUDY SELECTION AND CHARACTERISTICS

2.3.1. SOCIETAL IMPORTANCE

FGM is performed in developing countries with the most occurrences

reported in sub-Saharan Africa, the Middle East, and Asia. These countries

have many FGM victims, as the procedure produces a three-pronged

platform that makes eradication difficult. FGM has deep sociological roots

that create societal norms in order for families to be accepted by the

communities. The social conventions place pressure on parents to perform

FGM on their daughters in order to prepare them for marriage and

adulthood. Its cultural significance leads to the notion that it maintains girls’

chastity, preserves fertility, improves hygiene, and enhances sexual pleasure

for men. FGM is utilized as an initiation rite of passage to womanhood and

aims to ensure premarital virginity and marital fidelity by reducing her

desire for extramarital sexual acts. When the vaginal opening is altered to

13
create a smaller orifice, the fear of opening it further discourages

extramarital sexual intercourse (World health organization FGM 2016).

Parents and religious leaders enforce circumcision throughout their

communities in order to ensure the next generations of children maintain

tradition. The combination of these aforementioned factors creates a

dynamic that renders FGM a public health concern that requires cultural

competence to address (B.I. Odemerho and M.Baier, FGM 2012).

2.3.2. CULTURAL SIGNIFICANCE

The cultural and traditional components of FGM vary between ethnic

enclaves M.M. Islam and M.M. Uddin, 2001).The procedure is routinely

carried out between the ages of six and eight with a few cultures preferring

to cut at birth, menarche, or before marriage (L.A Morison, A. Dirir, S.

Elmi, J. Warsame, and S.Dirir, 2004). Mutilation is more often undergone

alone, but can occur in groups, using same instruments on more than 40

women (A.A. Odukogbe, B.B Afolabi, O.O Bello and A.S Adeyanju 2017).

The procedure is almost always performed in a ceremonial manner

accompanied by music, food, and gifts. The operators can range from

“circumcisers” (religious leaders) with no medical training to midwives and

birth attendants. The tools used include knives, clippers, scissors, or hot

objects (N. Nour, FGM 2015). A sterile environment is not feasible to attain

14
in the cast majority of cases, and no medical anesthetics are available; the

wound is sewed with crude instruments such as thorns. When infibulation

takes place, thorns or stitches may be used to hold the two sides of the labia

majora together and the legs may be bound together for up to forty days

(population Reference Bureau, women and girls at risk of female genital

mutilation in the US 2013), (J. Abu Dai 2000).The healing process is aided

by ointments and compounds made of herbs, milk, eggs, ashes, sugar, or

animal excrement, which is thought to facilitate healing.

Girls undergoing the procedure have varying degrees of knowledge about

what will happen to them. Girls are encouraged to be brave and not to cry

during the procedure lest it will bring shame onto their family (L. Morison,

C, Scherf, G. Ekpo et-al., 2001). Only women are allowed to be present at

the ceremony. In some cultures, girls will be told to sit beforehand in cold

water to numb the area and reduce the likelihood of severe bleeding.

However, no steps are taken to reduce the pain.

2.3.3. RAMIFICATIONS OF FGM

Currently, female circumcision is practiced in 30 countries throughout

Africa and the Middle East with an estimated 200 million women worldwide

currently infibulated (World health organization FGM 2016). Despite global

and regional attempts at ending genital mutilation by law and intervention

15
methods, the custom has persisted through the ages. Although it is

recognized internationally as an infringement on human rights, the

multifaceted dynamic makes it difficult to eradicate (World health

organization 2008).The ramifications of FGM affect the girl for the rest of

her life and result in many health problems (i.e., extended bleeding,

problems with urination, cysts, infections, and complications during

childbirth). Aside from health-related, ethical, and moral consequences of

FGM, it has been estimated by the World Health Organization (WHO) that

the annual cost of obstetric complications is more than $3.7 million

(K.Naguib.2012). However, rationalization of genitalia mutilation persists;

the people conducting the procedure do not believe they are doing harm. The

eradication of FGM as a public health initiative is imperative to ensuring

that newborn females and youth do not undergo this traumatic ordeal.

Moreover, immigrant populations arriving in developed countries,

particularly the United States (U.S.), present a particular obstacle in the full-

global abolition of female genital mutation as many seek to continue their

cultural traditions (H. Goldberg, P. Stupp, E. Okoroh, G. Besesa, D.

Goodman and I. Daniel. 2016), (New York governor signs Ban on female

genital mutilation October 1997).

16
Since 1997, conducting or practicing female circumcision on a minor in the

U.S. is considered a Class E felony (New York governor signs Ban on

female genital mutilation October 1997). Despite the obvious efforts to

prevent FGM from occurring in the U.S., it remains a significant injurious

tradition that may be carried out by family members in obscure locations. In

some instances, parents fly their daughters back to their homeland to have

the procedure before returning to seek better medical care. Most American

girls and women at risk of having a FGM procedure live in cities or suburbs

of large metropolitan areas (population Reference Bureau, women and girls

at risk of female genital mutilation in the US 2013).In particular, the tri-state

New York City area has an estimated 65,893 women who are at risk with

more than 21,737 of them under the age of 18. Additionally, girls and

women who have had the procedure prior to migrating may later present

with varying degrees of complications. Many of these complications arise

during pregnancy and childbirth. A third category of women seek out

medical care in order to have the circumcision process reversed in a surgical

procedure known as defibulation (E. Kause, S. Brandner, M.D. Mueller, and

A. Kuhn, 2011).

The complexity of FGM in its relation to urban and immigrant health is

comprised of a combination of concerns that center on gender equality,

17
religious freedom, cultural traditions, and societal norms R. Khosla, J.

Banerjee, D. Chou, L. Say and S.T, Fried 2017).Therefore, maintaining this

tradition remains of utmost importance to many individuals whose region

once practiced it. These issues form a dynamic that thrives within immigrant

communities that make it increasingly difficult to eradicate the procedure R.

Khosla, J. Banerjee, D. Chou, L. Say, and S.T, Fried 2017).

2.3.4. CLASSIFICATIONS OF FGM

The World Health Organization (WHO) classifies the mutilation of the

female genital into four distinct categories (World health organization FGM

2016). Three of the four categories are further broken down into

subcategories that classify the specific type of mutilation that was

performed. Type I is known as clitorodectomy and includes any procedure

that totally removes the clitoris and/or the prepuce (B.I Odemorho and M.

Baier 2012). Type Ia is the removal of the clitoris hood or prepuce only

while Type Ib includes the removal of both the clitoris and the prepuce.

Type II, or excision, is the partial or total removal of the labia minora

unrelated to any mutilation performed on the labia majora. Type IIa includes

the removal of the labia minora only. Type IIb is the removal of the labia

minora and the partial or total removal of the clitoris. Type IIc involves the

removal or the clitoris, labia minora, and labia majora. Infibulation, or Type

18
III, is the third category of mutilation procedures defined as the narrowing of

the vaginal orifice with the sealing of the perineum by cutting and

repositioning the labia minora and labia majora with or without the excision

of the clitoris. Type IIIa references specifically procedures done with the

removal and apposition of the labia minora, while Type IIIb includes

procedures done with only the labia majora. Type IV is a broad category that

includes all other harmful procedures done without medical purpose to the

female genitals. This includes any cutting, herbal treatments, or burns that

alter or harm the patient’s body (M. Lee and N the strong, female genital

mutilation 2015).

2.4. MAIN FINDING

2.4.1. PREVALENCE AND TRENDS

Female circumcision is practiced in many regions throughout Africa, Asia,

and the Middle East. However, the highest prevalence rates are found within

the Horn of Africa, the region containing the countries of Djibouti, Eritrea,

Ethiopia, and Somalia (M. Reyners,2004). Prevalence rates within this

province are estimated to be as high as 99% (M. Reyners, 2004). Other areas

throughout the African continent have varying prevalence rates ranging

between 2% and 95% (M. Reyners, 2004). In the Middle East, Egypt

contains the densest population of FGM victims with approximately 27.2

19
million women having undergone the procedure (UNICEF female genital

mutilation 2013). Within Asia, Malaysia, India, and Indonesia have

prevalence rates that exceed 90% in some regions (M. O. Ofor and N.M.

Ofole, 2015).Worldwide, it is estimated that more than 200 million women

have been cut and approximately 6,000 girls are circumcised every day.

More than 3 million girls are at risk for circumcision on the continent of

Africa (M. Reyners 2004). An estimated 3 million girls are subject to one of

the four types of mutilations each year with more than 85% eventually

having a medical complication, sometime in their life as a result (A. Gele, B.

Bo,and J. Sunby,2013) . The prevalence trends have shown mixed results

over the past two decades with little, if any, decline (population Reference

Bureau, female genital mutilation 2010). Figure 1 displays data collected by

the Population Reference Bureau (PBR) in which varied trends are seen for

the years 2000, 2005, and 2010 (population Reference Bureau, female

genital mutilation 2014). In some instances, prevalence rates have dropped

only to return to their previous levels.

2.4.2. CONSEQUENCES AND COMPLICATIONS OF FGM

The consequences of FGM have both physiological and psychological

complications, including short- and long-term complications. The method in

which the procedure is performed may determine the extent of the short-term

20
complications. If the process was completed using unsterile equipment, no

antiseptics, and no antibiotics, the victim may have increased risk of

complications. Primary infections include staphylococcus infections, urinary

tract infections, excessive and uncontrollable pain, and hemorrhaging.

Infections such as human immunodeficiency virus (HIV), Chlamydia

trachomatis, Clostridium tetani, herpes simplex virus (HSV) 2 are

significantly more common among women who underwent Type 3

mutilation compared with other categories. As the short-term complications

manifest, mortality risk increases because of the limited health care available

in low-income economies. While data on the mortality of girls who

underwent FGM are unknown and hard to procure, it is estimated that 1 in

every 500 circumcisions results in death. The belief that the procedure

produces protective factors against sexually transmitted infections (STIs),

much like male circumcision, was disproved in a case-control study

conducted in Sudan. After the area heals, victims suffer the long-term

consequences of the abuse through both physiological and psychological

complications and substantial complications during childbirth.

One of the most common long-term complications is the development of

keloid scar tissue over the area that has been cut. This disfiguring scar can be

a source of anxiety and shame to the women who had FGM. Neuromas may

21
develop because of entrapped nerves within the scar leading to severe pain

especially during intercourse. First sexual intercourse can only take place

after gradual and painful dilation of the opening left after mutilation. In a

study carried out in Sudan, 15% of women interviewed reported that cutting

was necessary before penetration could be achieved. Other side

complications include cysts, haematocolpos, dysuria and recurrent urinary

infections, and possible infertility. Childbirth for infibulated women presents

the greatest challenge, as maternal mortality rates are significantly higher

because of complications that arise during labor. During delivery, infibulated

women (i.e., genitals have been closed tightly) are cut in the perineum area

so that the baby can be delivered safely.

Posttraumatic stress disorder (PTSD), anxiety, depression, neuroses, and

psychoses are common delayed complications that are associated with FGM.

In developing countries, these conditions regularly go unrecognized and if

left untreated, may lead to mental concerns later in life.

4.3. IMPLICATIONS AND LIMITATIONS

The implications of FGM include both psychological and social factors.

Prior literature reported the association between female circumcision and

maternal morbidity and birth outcomes. Studies have shown maternal

prolonged maternal hospitalization, low birth weight, prolonged labor,

22
obstructed labor, and increased frequency of cesarean sections as outcome

variables in order to determine the consequences of FGM. IHr) from Kuwait

University Hospital, it was reported that the prevalence of FGM was 38%

(1842), with significant results found between Extended Maternal Hospital

Stay (OR = 1.5, CI 1.1–2.0), Prolonged Labor (OR = 3.4 CI 1.4–2.8),

increased frequency of C-sections (OR = 1.7, CI 1.2–2.0), Hep C infections

(OR = 1.6, CI 1.1–2.0), Obstructed Labor (OR = 2.3, CI 1.3–2.5), and Infant

Resuscitation (OR = 2.2, CI 1.0–3.3). Additionally, positive associations

between FGM and psychiatric sequelae that included flashbacks, psychiatric

disorders, anxiety disorders, and PTSD (OR = 24.6, CI 1.9–22.2) were

reported. These outcomes coincide with the existing literature that depicts

the relationship between FGM and a host of negative health effects including

obstetrical, gynecological, and fetal sequelae.

Nevertheless, several limitations exist within the study may explain large

confidence intervals and insignificant results in the outcomes analyzed. The

inclusion criterion for FGM patients was very broad and included any

marking or change that was performed on the female genital organs. This

allowed confounding variables such as self-impairment that had no impact

on the vaginal orifice (i.e., scratching and piercings) to be included and

lower the internal validity. Moreover, patients with FGM were given

23
preferential treatment (i.e., extended hospital stays and extra examination

time) that may have led to biases in the study.

4.3. PSYCHOLOGICAL LONG-TERM HEALTH CONSEQUENCES

In addition to the obstetrical, gynecological, and neonatal impacts of FGM,

other long-term health consequences include psychological and

psychosexual disorders. A study conducted at the University of Lagos,

Nigeria, analyzed the psychosocial aspects of FGM. The questionnaire

captured the socio-demographic aspects of respondents and included an

array of questions regarding the practice, belief, and eradication of FGM.

76% (266) of respondents were circumcised with clitoridectomy being the

most prevalent mutilation type (83.1%). Additionally, 78.6% of women

reported that a nurse or a midwife was the operator of their FGM procedure.

Christianity (69.1%) appeared to be the most common religion practiced

although the presence of other religions was amongst those circumcised as

well. The most common perception on the commonality and acceptance of

circumcision was cultural significance (86.6%). Furthermore, respondents

indicated that the reduction of female sexuality (61.4%) followed by

tradition and customs (14.9%) were the reasons for practicing FGM. Only

7.7% of participants agreed that the practice should be continued. Although

76% of the responders were circumcised, 91.7% reported that they do not

24
plan to circumcise their own daughters. Sexual ramifications of FGM

provided that 62% of circumcised women reported pain during intercourse

when compared to 4% of those who did not (χ2 = 83.848). In addition,

60.5% of circumcised women reported fear when their spouse called for sex

compared to 2.4% of those who did not (χ2 = 86.742). Thus, the

psychosocial effects may impact the sexual experience of FGM victims and

affect their personal relationships.

4.4. TREATMENT

Few treatment options exist for victims of FGM. Psychological and

emotional support is available from therapist and support groups that

specialize in PTSD. These support groups are often located in urban areas or

near ethnic enclaves that have high risk of FGM. In addition, defibulation, a

surgical process that attempts to reconstruct the labia by undoing the initial

mutilation, is available at specialty hospitals throughout the world. However,

many times the procedure has mediocre results and can result in additional

complications. Additionally, the cost of the surgery is not always covered by

insurance, thereby causing a financial deterrent.

Foldès et-al. conducted a study at St. Germain Poissy Hospital, France, from

1998 to 2009, assessing the immediate and long-term outcomes of

reconstructive surgery. Employing a prospective cohort study design, they

25
followed 2938 women who had been operated on, from surgery to one-year

follow-up. Prior to surgery, all patients filled out a questionnaire about tier

demographic characteristics and preoperative pain at the mutilation site.

Subsequently, patients underwent surgery to restore both clitoral anatomy

and function. In addition, for infibulated patients, defibulation preceded

surgery in order to restore vaginal function. Patients were all discharged two

days following surgery, returned for a two-week follow-up, and told to

return in a year’s time; a follow-up rate of 29% was achieved.

4.5 DISCUSSION AND INTERPRETATION

The current review demonstrates that the practice of FGM remains prevalent

in certain countries, even though there may exist laws against FGM. The

elimination of FGM has made little progress over the past decade. This may

be due to the fact that developed countries have difficulties understanding

the cultural and religious dynamics that communities and ethnicities practice

FGM. Although activist movements are beginning to form throughout

Africa, utilization of an intervention method that understands the diverse

cultural dynamics can increase the results by introducing positive social

changes. Engaging community and religious leaders through helping them

understand the need for change is imperative in generating a transformation

26
within the culture. Communities need to develop, strengthen, and support

specific actions directed at ending FGM.

5.6 CONCLUSION

FGM has been associated with medical, socio-cultural, and economic

consequences. Elimination of FGM is possible through directing resources

in an efficient manner. Targeted interventions can include cultural and

ethnical proponents. Thus, future research should explore the effects of

intervention strategies to prevent FGM.

ABBREVIATIONS

FGM: Female genital mutilation

FC: Female circumcision

PRB: Population Reference Bureau.

CHAPTER THREE
27
3.0 RESEARCH METHODOLOGY

This chapter provide as necessary information required for the study

(research project), population used, research design, sample and sampling

techniques, procedures for collection of data and method of data analysis.

3.1 RESEARCH DESIGN

The descriptive research design was used for the study. The main aim is to

provide descriptive picture of the study.

3.2 AREA OF THE STUDY

Kwantakwaram is a ward in Bakori Local Government .Kwantakwaram is in

the Eastern senatorial ward of Bakori Local Government Area of Katsina

State otherwise known as Bakori east senatorial ward alongside Funtua,

Bakori town, Kafur, Danja, Malumfashi Local Government. Kwantakwaram

is bounded to the north by Malumfashi Local Government area, to the south

by Danja Local Government area, to the east by Kafur Local Government

area, and to the west Bakori town.

3.2.1 MAJOR ETHNIC COMPOSITION

Kwantakwaram ward is predominantly Hausa-Fulani. Most people speak

only Hausa. A great majority of the people are settled cultivators, farmers

28
and traders. But there are considerable numbers of nomadic settle Fulani's,

whose male rear livestock.

3.2.2 POPULATION

According to the 2006 national population census put the population of

Kwantakwaram ward at 516 with 214 males and 302 females.

3.2.3 OCCUPATION OF THE PEOPLE

The working populations of people In Kwantakwaram ward are farmers,

traders and cattle rearers.

3.2.4 TRANSPORTATION

Kwantakwaram is a ward in which they commonly use public system to

transport their farm products and other goods and services which operated
on established routes.

3.2.5 HEALTH FACILITIES

Kwantakwaram ward has primary health care with some dispensaries clinics
and some chemists.

3.3 POPULATION OF THE STUDY

The population of this study was 302 women in the entire ward.

3.4 SAMPLE SIZE AND SAMPLING TECHNIQUES

About 50 fifty respondents were selected for the purpose of the study out of

302. A simple random sampling technique was employed to select the

respondents, where everyone has equal chance of being selected.

29
3.5 INSTRUMENT FOR DATA COLLECTION

Self administered questionnaire with close ended were used to obtain the

information that can be accurately answered. The research questionnaire has

two sections that is section 'A' on personal data while section 'B' research

questions.

3.6 VALIDITY AND REABILITY OF THE INSTRUMENT

The instrument was validated by the project supervisor who correlated the

items in the questionnaire with the objectives of the study to justify the

relevance of the content in terms of clarity and appropriateness of the

language. The valid questionnaire is capable of answering the research

questions.

3.7 METHOD OF DATA COLLECTION

The data was collected through distributing questionnaire to the selected

respondents. The questionnaire was distributed and they were returned

complete with no invalid and none was lost.

3.8 METHOD OF DATA ANALYSIS

The method of data analysis is by frequency table (mean statistical) and

percentage distribution is used to analyze the information.

30
 CHAPTER FOUR

DATA PRESENTATION AND ANALYSIS

4.0 INTRODUCTION

This chapter deal with statistical analysis of data, which is the information

collected from various respondents is presented in percentage and frequency

table (statistical mean) in to four rating scale to draw conclusion

4.1 SECTION A: PERSONAL DATA

4.1.1 Table one (1): Age of the respondents

S/NO AGE FREQUENCY PERCENTAGE

1 15-25 30 60%
2 25-35 15 30%
3 35-45 5 10%
TOTAL 50 100%

The table above shows the age group distribution of the respondents where

60% of the respondents are within the age of 15-25 and those between 25-35

years are 30%, while those between 35-45 years are 10%. This implies that

majority of the respondents are those between 15-25 years old

4.1.2 Table two (2): Sex distribution of the respondents

S/NO SEX FREQUENCY PERCENTAGE

1 Famale 40 80%
2 Male 10 20%
TOTAL 50 100%

31
The table above shows the sex distribution of the respondents where 80% of

the respondents are female and 20% of them are male. this clearly shows

that majority of the respondents are female.

4.1 3 Table three (3): The marital status of the respondents

S/NO MARITAL STATUS FREQUENCY PERCENTAGE

1 Single 23 46%

2 Married 12 24%

3 Widows 8 16%

4 Divorced 7 14%

TOTAL 50 100%

The table above shows the marital status of the respondents where 46% of

the respondents are single, 24% of the respondents are married couples, 16%

are widows and 14% are divorced. This shows that majority of the

respondents are single

4.1.4 Table four (4): Tribe of the respondents

S/NO TRIBE FREQUENCY PERCENTAGE
1 Hausa 36 72%
2 Fulani 14 28%
TOTAL 50 100%

The table above shows the tribe of the respondents where 72% of the

respondents are Hausa, 28% of the respondents are Fulani. This shows that

majority of the respondents are Hausa by tribe.

32
 4.1.5 Table five (5): Level of education of the respondents
S/NO LEVEL OF EDUCATION FREQUENCY PERCENTAGE
1 Non-formal 12 24%
2 Primary 8 16%
3 Secondary 17 34%
4 Tertiary 13 26%
TOTAL 50 100%

The table above shows the educational level of the respondents where 24%
are non-formal, 16% are primary level of education 34% of the respondents
are secondary, 26% are tertiary level of education. This shows that majority
of the respondents are secondary level of education.

4.2 SECTION B

Decision rate

Any number that is above 2.5 is considered as agree and any number below
2.5 are consider to be disagree

4.2.1 Table Six: Research question one

What are the levels of knowledge of adolescents towards female genital

mutilation?
S/NO OPTION SA A D SD TOTAL MEAN REMARK
1 FGM is often considered as 15 25 6 4 50 3.2 Agreed
part of raising a girl
properly and preparing her
for marriage /Adulthood
2 FGM is social pressure to 20 9 17 4 50 3.08 Strongly
confirm a strong motivation Agreed
to continue the practice
3 FGM is often motivated by 26 5 10 9 50 2.96 Agreed
beliefs about what is
considered proper sexual
behaviour
33
4 FGM is associated with 10 8 17 15 50 2.3 Disagreed
cultural ideals of femininity
and modesty
5 FGM is often considered a 20 17 9 4 50 3.6 Strongly
cultural tradition which is Agreed
often used as an argument
for its continuation

The above table shows that the respondents strongly agreed with the option

number 2 and 5, respondents agreed with the option number 1 and 3 while

the respondents with the option number 4 respectively.

4.2.2 Table Seven (7): Research question two

What are the Effects of female genital mutilation?

S/NO OPTION SA A D SD TOTAL MEAN REMARK

1 Constant pain 16 18 6 10 50 2.9 Agreed

2 Pain and difficulty in having 15 25 5 5 50 3.0 Agreed
sex
3 Repeated infection which 8 30 2 10 50 2.8 Agreed
can lead to infertility
4 Problems during labour and 0 8 12 30 50 1.56 Disagreed
childbirth which can be life-
threatening
5 Bleeding, cyst and 25 15 9 1 50 3.3 Strongly
abscesses Disagreed

The above table shows that the respondents strongly agreed with the option

number 5, and the respondents agreed with the option number 1, 2, and 3,

while the respondents disagreed with the option 4 respectively.

34
 4.2.3 Table eight (8): Research question three

What are the major reasons for female genital mutilation?

S/NO OPTION SA A D SD TOTAL MEAN REMARK

1 For cleanliness and hygiene 25 16 9 0 50 3.3 Strongly

Agreed
2 For social acceptance 20 15 10 5 50 3.0 Strongly
Agreed
3 For fidelity /Virginity and 0 6 30 14 50 1.04 Disagreed
marriage prospects
4 For preservation of 20 27 3 0 50 3.3 Strongly
virginity and prevention of Agreed
pre-marital sex
5 For greater sexual pleasure 28 12 6 4 50 3.3 Strongly
for men and religious Agreed
approval

The above table shows that the respondents strongly agreed with the option

number 1, 2, 4 and 5 while the respondents disagreed with the option 3,

respectively

4.2.4 Table Nine (9): Research question four

What are the health implications of female genital mutilation?

S/NO OPTION SA A D SD TOTAL MEAN REMARK

1 Urinary problems (painful 26 10 10 4 50 3.2 Strongly

urination, urinary tract Agreed
infections)
2 Vaginal problems 0 5 25 20 50 1.7 Disagreed
(Discharge, itching,
bacterial vaginosis and
other infections
3 Menstrual 27 13 7 3 50 3.3 Strongly
35
 problems(painful Agreed
menstruation difficulty in
passing menstrual blood
4 Genital tissue swelling 26 13 9 2 50 3.3 Strongly
Agreed
5 Wound healing problems 30 11 7 2 50 3.4 Strongly
and injury to the Agreed
surrounding genital tissue

The above table shows that the respondents strongly agreed with the option
number 1, 3, 4 and 5 while the respondents disagreed with the option
number 2 respectively

4.2.5 Table Ten (10): Research question five

What are the roles of government in prohibiting female genital mutilation?

S/NO OPTION SA A D SD TOTAL MEAN REMARK

1 Speaks out the risk of 40 8 2 0 50 3.8 Strongly

female genital mutilation Agreed
2 Spread understanding that 0 0 35 15 50 1.74 Disagreed
religion does not demand
female genital mutilation
3 Tackle the secrecy that 27 10 10 3 50 3.9 Strongly
allows female genital Agreed
mutilation to continue
4 Keep pushing for female 10 30 5 5 50 2.9 Agreed
genital mutilation to be
banned
5 Educating girls on their 25 15 10 0 50 3.3 Strongly
right to decide what Agreed
happen to their body

The table above shows that the respondents strongly agreed with the option

number 1, 3 and 5 and the respondents agreed with the option number 4,

while the respondents disagreed with the option number 2 respectively

36
 CHAPTER FIVE

5.0 INTRODUCTION

This chapter is concerned with the summary, discussion of findings,

suggestions for further studies, conclusion, Recommendations and limitation

of the study.

5.1 SUMMARY

For easy and strategic conduction of the study, the process was divided into

stages as; introduction and background of the study, statement of the

problem, objectives of the study, research questions, significance of the

study, scope of the study, operational definition of terms and organization of

the study all were discussed in chapter one of the research study.

Literature review with discussion on Assessment of the effects of female

genital mutilation among adolescents girls includes the concept of female

genital mutilation, methods, societal importance, cultural significance,

Ramifications of FGM, classification, prevalence and trends, consequences

and complications, implications and limitations, psychological long-term

health consequences, treatment, discussion and interpretation, conclusion

were discussed in chapter two.

Descriptive research design were used for this study and systematic simple

random sampling techniques was used and one procedure were used during
37
the process that is self administered questionnaire and the finding of the

research question based on the respondents opinion were discussed in

chapter three.

A simple frequency table and mean statistical method was used for data

analysis, interpretation and presentation were used in chapter four.

Summary of the study discussion of findings, suggestions for further studies

conclusion, recommendations and limitations of the study are discussed in

chapter five.

5.2 DISCUSSION OF FINDINDS

Research question one (what are the level of knowledge of adolescent

towards female genital mutilation)

As presented in table 4:6, the table shows that the respondents strongly

agreed with the following: FGM is social pressure to confirm a strong

motivation to continue the practice, FGM is often considered a cultural

tradition which is often used as an argument for its continuation. And the

respondents agreed with the following: FGM is often considered as part of

raising a girl properly and preparing her for marriage /adulthood, FGM is

often motivated by beliefs about what is considered proper sexual behaviour.

Research question two (what are the effects of female genital mutilation)

38
As presented in table 4:7, the table shows that the respondents strongly

agreed with the following: Bleeding, cyst and abscesses and the respondents

agreed with the following: constant pain, pain and difficulty in having sex,

repeated infection which can lead to infertility.

Research question three (what are the major reasons for female genital
mutilation)

As presented in table 4:8, the table shows that the respondents strongly

agreed with the following: for cleanliness and hygiene, for sexual

acceptance, for greater sexual pleasure for men and religious approval. And

the respondents agreed with the following: for preservation of virginity and

prevention of premarital sex.

Research question four (what are the health implications of female

genital mutilation)

As presented in table 4:9, the table shows that the respondents strongly

agreed with the following: urinary problems (painful urination, urinary tract

infection, menstrual problems (painful menstruation, difficulty in passing

menstrual blood, genital tissue swelling wound healing problems and injury

to the surrounding genital tissue.

Research question five (what are the roles of government in prohibiting

female genital mutilation)

39
As presented in table 4:10, the table shows that the respondents strongly

agreed with the following: speaks out the risk of Female genital mutilation,

tackle the secrecy that allows FGM to continue, educating girls on their right

to decide what happen to their body, and the respondents agreed with the

following: keep pushing for FGM to be banned.

5.3 SUGGESTION FOR FURTHER STUDY

The study "Assessment of the effects of female genital mutilation among

adolescents" Serve as beginning and should be replicated by other

researchers with a sample drawn in to study on related field, it is highly

suggested that further researchers work should be conducted on the

following areas:

- Prevalence of female genital mutilation

- Mother's perception on female genital mutilation
- Knowledge, Attitude and practice of female genital mutilation among
adolescents

5.4 CONCLUSION

This research study have shown various effects of female genital mutilation

among adolescents, this include constant pain, pain and difficulty in having

sex, repeated infection which can lead to infertility, problems during labour

and childbirth, which can be life threatening etc

40
All the above mentioned are effects of female genital mutilation among

adolescents, thus early diagnosis and adherence to the recommended

management is very important particularly in Kwantakwaram ward, Bakori

Local Government Area of Katsina State.

5.5 RECOMMENDATIONS

After obtaining enough information on female genital mutilation among

adolescents in the community, therefore, for us to find solutions to that

problem I hereby recommend the following:

- Health workers should speaks out the risk of female genital mutilation.
- Religious leaders should spread understanding that religion does not
demand female genital mutilation.
- Government should tackle the secrecy that allows female genital
mutilation to continue.
- Government should keep pushing for female genital mutilation to be
banned.
- Health workers should educate girls on their right to decide what happen
to their body.

5.6 LIMITATION OF THE STUDY

This research work is limited to Kwantakwaram ward, Bakori Local

Government Area of Katsina State due to financial constraints and

inadequate time.

41
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WHO (2018) Female genital mutilation- Fact Sheets (Detail). Geneva:

World Health Organization.

WHO (2018) Sexual and Reproductive Health. Female Genital Mutilation.

Geneva: World Health Organization.

Yasin K, Idris HA, Ali AA (2018) Characteristics of female sexual

dysfunctions and obstetric complications related to female genital
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Health 15: 7.
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 QUESTIONNAIRE

Katsina State College of Health

Science Technology,
Kankia Iro School of Health
Technology Kankia,
Community Health Department
Dear responder,
I am a finalist student of the above named school, conducting a research to
find out “The Assessment of the effects of female genital mutilation among
adolescents in Kwantakwaram ward Bakori Local Government Area of
Katsina State”. I will greatly appreciate your cooperation in responding to
the questions below as your contribution to this research. I assume you of
the greatest confidentiality and the information collected will be used for the
research purpose only.
Thanks for your cooperation.
Yours Faithfully,
Isah Ashiru
CHEW in training
INSTRUCTION:
Please tick in the appropriate space provided and give your opinion where
needed.
G – Good
F – Fair
P – Poor
SECTION A:
PERSONAL DATA
Age: 15 – 25 ( ) 26 – 35 years ( ) 36 – 45 years ( )
Sex: Male ( ) Female ( )
Marital status: Married ( ) Single ( ) Widow ( ) Divorced ( )
Tribe: Hausa ( ) Fulani ( )
Level of Education: Tertiary ( ) secondary ( ) Primary ( ) Non-
formal ( )

45
SECTION B

RESEARCH QUESTION 0NE:

What are the levels of knowledge of adolescents towards female genital

mutilation?

S/NO OPTIONS G F P

1 FGM is often considered as part of raising a girl

properly and preparing her for marriage /Adulthood
2 FGM is social pressure to confirm a strong motivation
to continue the practice
3 FGM is often motivated by beliefs about what is
considered a proper sexual behaviour
4 FGM is associated with cultural ideals of femininity
and modesty
5 FGM is often considered a cultural tradition which is
often used as an argument for its continuation

RESEARCH QUESTION TWO:

What are the effects of female genital mutilation?
S/NO OPTIONS G F P

1 Constant pain

2 Pain and difficulty in having sex

3 Repeated infection which can lead to infertility

4 Problems during labour and childbirth, which can be

life threatening

5 Bleeding, cysts and abscesses

46
RESEARCH QUESTION THREE:

What are the major reasons for female genital mutilation?

S/NO OPTIONS G F P

1 For cleanliness and hygiene

2 For social acceptance

3 For fidelity /virginity and marriage prospects

4 For preservation of virginity and prevention of

premarital sex

5 For greater sexual pleasure for men and religious

approval

RESEARCH QUESTION FOUR:

What are the health implications of female genital mutilation

S/NO OPTIONS G F P

1 Urinary problems (painful urination, urinary tract

infections)

2 Vaginal problems (Discharge, itching, bacterial vaginosis

and other infections)

3 Menstrual problems (Painful menstruation, difficulty in

passing menstrual blood etc)

4 Genital tissue swelling

5 Wound healing problems and injury to the surrounding

genital tissue

47
RESEARCH QUESTION FIVE:

What are the roles of government in prohibiting female genital mutilation?

S/NO OPTIONS G F P

1 Speaks out the risk of female genital mutilation

2 Spread understanding that religion does not demand

female genital mutilation

3 Tackle the secrecy that allows female genital mutilation to

continue

4 Keep pushing for female genital mutilation to be banned

5 Educating girls on their right to decide what happen to

their body

48