Do educated women in Sierra Leone support discontinuation of female genital mutilation/cutting? Evidence from the 2013 Demographic and Health Survey

Abstract

Introduction Female genital mutilation/cutting (FGM/C) comprises all procedures that involve the total or partial elimination of the external genitalia or any injury to the female genital organ for non-medical purposes. More than 200 million females have undergone the procedure globally, with a prevalence of 89.6% in Sierra Leone. Education is acknowledged as a fundamental strategy to end FGM/C. This study aims to assess women's educational attainment and how this impacts their views on whether FGM/C should be discontinued in Sierra Leone. Methods We used data from the 2013 Sierra Leone Demographic and Health Survey. A total of 15,228 women were included in the study. We carried out a descriptive analysis, followed by Binary Logistic Regression analyses. We presented the results of the Binary Logistic Regression as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with 95% confidence intervals (CIs). Results Most of the women with formal education (65.5%) and 15.6% of those without formal education indicated that FGM/C should be discontinued. Similarly, 35% of those aged 15–19 indicated that FGM/C should be discontinued. Women with a higher education level had a higher likelihood of reporting that FGM/C should be discontinued [AOR 4.02; CI 3.00–5.41]. Christian women [AOR 1.72; CI 1.44–2.04], those who reported that FGM/C is not required by religion [AOR 8.68; CI 7.29–10.34], wealthier women [AOR 1.37; CI 1.03–1.83] and those residing in the western part of Sierra Leone [AOR 1.61; CI 1.16–2.23] were more likely to state that FGM/C should be discontinued. In contrast, women in union [AOR 0.75; CI 0.62–0.91], circumcised women [AOR 0.41; CI 0.33–0.52], residents of the northern region [AOR 0.63; CI 0.46–0.85] and women aged 45–49 [AOR 0.66; CI 0.48–0.89] were less likely to report that FGM/C should be discontinued in Sierra Leone. Conclusion This study supports the argument that education is crucial to end FGM/C. Age, religion and religious support for FGM/C, marital status, wealth status, region, place of residence, mothers' experience of FGM/C and having a daughter at home are key influences on the discontinuation of FGM/C in Sierra Leone. The study demonstrates the need to pay critical attention to uneducated women, older women and women who have been circumcised to help Sierra Leone end FGM/C and increase its prospects of achieving Sustainable Development Goals (SDG) three and five.

Rural and Urban Correlates of Stunting Among Under-Five Children in Sierra Leone: A 2019 Nationwide Cross-Sectional Survey

“… 27 , 37 , 38 , 59 - 61 Differences were observed with fathers’ level of education being significant in urban areas while mothers’ level of education being significant in rural areas. In predominantly patriarchal African societies, 62 fathers are the main sources of household income and have the highest decision making on food purchases. Given that rural communities are more likely to grow their own food unlike urban areas where most of the food is purchased, 40 , 63 fathers’ level of education in this context is translates to a higher household income, better understanding of health and nutrition information, hence making informed decisions regarding food choices for improved nutrition of their children.…”

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Rural–urban correlates of skilled birth attendance utilisation in Sierra Leone: evidence from the 2019 Sierra Leone Demographic Health Survey

“… 6 9 Furthermore, higher levels of education have an influence on women’s positive interpretation of mass media messages leading to positive healthcare seeking behaviour change. 48 In predominantly patriarchal African societies and mainly in rural areas, 57 men are the main providers with the highest decision making powers. 58 Women in rural areas are usually less empowered due to the more conservative societies in rural areas hence factors such as education that might increase women’s status and decision making are more likely to have an impact on healthcare seeking.…”

Disentangling rural-urban modern contraceptive utilization disparity among sexually active women of reproductive age in Sierra Leone: a Blinder-Oaxaca decomposition analysis

“…Women who got a big problem in getting permission to seek treatment were less likely to use modern contraceptives , and this disfavoured the rural dwellers. In patriarchal African societies (35), men regard themselves as the head of the household, support their wives and children financially, as well as being responsible for making reproductive health decisions and their decisions take precedence over any other family member or friend's approval or disapproval (18). According to a study conducted in the Democratic Republic of the Congo, rural women reported that their male partner's resistance to modern contraceptive use was a major barrier to modern contraceptive use (18).…”