Knowledge and Perceptions of Complications Associated With Female Genital Mutilation/cutting Among Somali Community in Wajir County, Kenya

Abstract

Introduction: Female Genital Mutilation/cutting (FGM/C), defined by the World Health Organization (WHO) as “all procedures that involve intentional partial or total removal of the external female genitalia or others injuries to female genital organs for non-medical reason”. The practice is usually done at birth, adolescent and even on adult women. FGM/C causes a wide range of immediate and long term obstetric, gynecological, psychological and sexual complications. The practice of FGM is common in Wajir County with prevalence of over 80 percent with infibulation and excision being the commonest forms practiced. Despite the concerted efforts that have been made by various stakeholders such as the government, NGOs, CBOs and other organizations to discourage the practice, it persists among the Somali community thus making it necessary to consider knowledge and attitudes of the community members towards FGM. Methodology: The study adopted cross sectional descriptive design. Mixed methods approach (Survey, FGDs and KIIs) was used to collect data for the study. In the quantitative survey the number of participant selected were 240, while there were 14 KII and 9 FGDs conducted in the qualitative study. Quantitative data collected was entered and cleaned using MS Excel spreadsheet package then imported into SPSS version 22 for analysis. Univariate analysis with basic frequencies, proportions and means was first conducted before bivariate analysis by cross tabulations was conducted. Chi square distribution was used to test for statistical significance which was calculated at p< 0.05. Result: Age, sex, education level, occupation or the nature of the settlement area are important socio demographic parameters that affect the knowledge and perceptions towards FGM. Women (mothers and grandmothers) – who have undergone FGM/C are still at the fore front in advocating for it. Men as decision makers at the household level support FGM/C. Both men and women have sufficient knowledge regarding the FGM/C related complications (85.4 %). This knowledge is however more among women than it is in men. Women are also more aware of the complications during and after FGM/C compared to males. More married women compared to single, divorced or widowed just like women from rural areas compared to those from urban and peri-urban areas. Young people are ready and willing to have their daughters undergo the practice though type 2 most preferably. Culture and religion contributes more towards shaping the community’s perception regarding FGM/C though the contribution of religion is still contestable. Religion (Islam) is quoted widely as advocating for the practice something that has no basis in the Quran, the prophetic saying, scholarly opinion and the analogical deduction. The practice persists partly because it is believed to maintain the sexual purity of a girl by containing her sexual desires until marriage. About 72.1% of the members of the community not aware of any interventions or campaigns against FGM/C in the area. Recommendations: Targeted awareness creation campaigns on the dangers of FGM/C on the young Somali girls by the local and International NGOs, CBOs and Human Rights groups in the County. This should target mainly older women, mothers, fathers, young girls and young boys who are future parents. Local radio stations, sermons in the mosques, school programs and during Maternal and Neonatal and Child health clinics (MNCH) in local health facilities; male involvement in campaigns against FGM/C are critical avenues for this. Finally, involvement of religious leaders such as sheikhs and Imams to help as knowledge, attitude and practice change agents within the community should be prioritized.