Knowledge and Attitude on Obstetric Effects of Female Genital Mutilation among Maasai Women in Maternity Ward at Loitokitok Sub-County Hospital, Kenya

Abstract

Background Female genital mutilation (FGM) is one of the most harmful traditions still practiced in many parts of the developing world, including Kenya. The practice leads to permanent and irreversible health damages; however, knowledge and attitude of women towards its obstetric effects is scarce. Aim The objective of this study was to determine knowledge and attitude of women towards obstetric effects of FGM among Maasai women. Methods A hospital-based cross-sectional study was conducted at Loitokitok Sub-County Hospital among 64 Maasai women who had undergone FGM. Systematic sampling was employed to identify the respondents. Data were collected using a pretested semistructured questionnaire and analyzed through Statistical Package for the Social Sciences (SPSS) version 20.0 based on frequencies and percentages. Qualitative data were coded and categorized and thematic analysis was done. Results Half of the women were knowledgeable on obstetric effects of FGM. Majority of them, 81% (n=52), sustained perineal tears during childbirth while 53% (n=34) had postpartum hemorrhage. Majority of the respondents, 81% (n=51), had negative attitude towards FGM and 87% (n=31) would not encourage their daughters to be circumcised. Most of them, 64% (n=23), disagreed that circumcision made one a respectable woman. Conclusion Obstetric effects of FGM were fairly known and there was negative attitude towards FGM practice.

Attitudes toward Female Genital Mutilation/Circumcision: A Systematic Review and Meta-Analysis

“…The articles were published between 1978 and 2021 (22 August), with only two studies before 2000 (one article was published in 1978, and one in 1997). With regard to the FGM/C participants of the 40 studies, ten studies were conducted among health care professionals [ 21 , 23 , 31 , 34 , 35 , 36 , 41 , 45 , 50 , 51 ], eight were conducted among women from the general population [ 20 , 22 , 24 , 27 , 29 , 47 , 49 , 52 ], nine were conducted among students [ 10 , 17 , 30 , 32 , 33 , 38 , 40 , 43 , 46 ], four were conducted among a general population in which no distinction was made between men and women [ 26 , 28 , 48 , 53 ], four were conducted among circumcised women [ 18 , 19 , 39 , 42 , 54 ], one was conducted among online users [ 44 ], one was conducted among pregnant women [ 25 ], one among patients in hospitals [ 37 ], and one study was conducted among school teachers [ 16 ]. The sample sizes of participants varied from 63 to 21,756, with a total sample size of 184,574 participants.…”

“…The age of the participants ranged between 15 and 60 years. The participants from the included studies were from 16 different countries or regions, including Egypt [ 10 , 18 , 19 , 24 , 29 , 32 , 43 , 47 , 53 ], Nigeria [ 16 , 17 , 20 , 25 , 40 , 41 , 50 ], Ethiopia [ 27 , 46 , 52 ], Sudan [ 21 , 28 , 30 , 38 , 48 ], Iraq [ 49 ], Australia [ 45 ], Kenya [ 37 , 42 , 54 ], USA [ 31 ], Yemen [ 22 ], Belgium [ 23 , 36 ], Gambia [ 33 , 34 ], Guinea [ 26 ], various African countries, [ 26 ] Middle East countries, [ 44 ], Iran [ 51 ], and Tanzania [ 39 ]. All studies used a cross-sectional design, and 11 of them were obtained from national Demographic and Health Survey (DHS) studies, like the Department of International Development Sudan Opinion Poll (DFIDSOP) dataset [ 28 ], Yemen Demographic and Health Survey (YDHS) [ 22 ], Egypt Demographic and Health Survey (EDHS) [ 19 , 24 , 47 ], Kenya...…”

“…Two statements were considered in the assessments of attitudes toward FGM/C: (a) negative attitudes toward the practice of FGM/C in general; and (b) negative attitudes toward the decision to circumcise daughters now or in the future (18 of the 48 studies). Examples of statements of having negative attitudes toward the practice of FGM/C are as follows: women with FGM/C are at risk for gynecological complications [ 40 ], FGM/C causes anxiety disorders [ 37 , 38 ], FGM/C causes infection [ 42 ], FGM/C is not a good practice [ 43 , 52 , 53 ], FGM/C should be stopped [ 17 , 34 ], FGM/C is an illegal practice [ 10 , 25 , 26 , 27 , 50 , 51 ], FGM/C should be discontinued [ 22 , 26 , 28 , 38 , 47 , 48 , 54 ], one should oppose FGM/C [ 18 , 19 , 43 ], FGM/C can lead to girls’ deaths [ 18 , 32 ], and it is important to abandon FGM/C [ 39 ].…”

“…The following statements were considered: (a) negative attitudes toward FGM/C, defined as FGM/C being harmful, having a negative impact on health, or causing complications, and (b) intentions to genitally mutilate daughters. Forty studies [ 10 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ] were selected for the systematic review. Studies with two or more independent strata were considered separate studies [ 22 , 26 , 35 , 47 ].…”

Tendencias teóricas y prácticas de la promoción de la salud en el ámbito escolar en Latinoamérica

“…Entre las consecuencias psicosociales prevalecen el síndrome de estrés postraumático, trastornos de ansiedad, pánico, supresión de la sensación y pensamiento y, a veces intento de suicidio 9 , adicionalmente, las personas encargadas de estas prácticas son usualmente mujeres parteras o abuelas que, sin tener conocimiento médico, realizan la mutilación genética, cargando con el peso social y un señalamiento como victimarias por parte de la sociedad que condena el mantenimiento de una práctica que se considera no solo arcaica, salvaje, sino además, por fuera de cualquier consideración o tolerancia desde el enfoque de los derechos humanos, los derechos de la niñez y los derechos de la mujer 10 , aunque sea una tradición ancestral y merezca, desde el relativismo cultural, una consideración especial que requiere un tratamiento específico puesto que no hay verdades universales 11 . En todo caso, más allá de las consideraciones formales sobre la legitimidad de las prácticas culturales y el derecho de los pueblos al ejercicio soberano de sus hábitos, las mujeres no desean mutilar mujeres, tampoco conocen los riesgos 12 , pero están bajo el mandato de una comunidad que las obliga, según el precepto social que mantiene este tipo de tradiciones.…”