The impact of health education on attitudes towards female genital mutilation (FGM) in a rural Nigerian community.

OBJECTIVES: To determine the level of practice of female genital mutilation (FGM) and the impact of a health education intervention in Shao community.
MATERIALS AND METHODS: Intervention study using a multistage sampling technique. The instrument was a pre-tested, structured questionnaire. The survey was supplemented by an in-depth interview of the traditional excisors.
RESULTS: Most respondents (88.0%) cited traditional excisors as operators of the procedure, while 7.8% mentioned health workers. Factors found to be statistically significantly associated with the practice of FGM are age, gender and educational status of respondents (p<0.05). The age at which FGM is usually performed was put at under one year old by 60.3% of respondents. All respondents cited type II FGM as the type practised in the community. Most (88.0%) of the female respondents were excised. A greater proportion of men than women did not want the practice of FGM stopped in the pre-intervention stage; however, there was a statistically significant decrease in the proportion of males who did not want the practice of FGM stopped in the post-intervention stage. Also, there was a statistically significant increase in the proportion of respondents who had no intention to excise future female children in the post-intervention stage (p<0.05). Legislation, female literacy and empowerment, educating men and provision of alternative vocation for excisors were means suggested by respondents for stopping the practice. CONCLUSION AND RECOMMENDATIONS: The health education intervention had a positive impact on the attitude of respondents towards FGM. However, for sustainable behavioural changes that will lead to elimination of FGM practice, we recommend placing FGM elimination efforts within a comprehensive development strategy and the larger context of reproductive health and gender education in Nigeria.