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Journal of Women's Health. 2011 Nov; 20(11):1655-1661.Background: The practice of female genital cutting (FGC) is widespread in Nigeria and varies from one ethnic group to another. In 1994, Nigeria joined members of the 47th World Health Assembly in a resolution to eliminate the practice, and since then, several steps has been taken to achieve this objective. Methods: Nigeria joined members of the 47th World Health Assembly sixteen years ago in a resolution to eliminate female genital mutilation. This study uses data from 420 women aged 15-49 years who had at least one surviving daughter to investigate changes in FGC prevalence among mothers and daughters. The sample was systematically selected through stratified random sampling across the six states of southwest Nigeria. Focus group discussion, and an in-depth interview with fourteen women considered to be specialist in FGC were also held to compliment data generated from the interview. Results: The analysis indicated an FGC prevalence rate of 75% and 71% for mothers and daughters, respectively. It further indicated that the practice is rooted in tradition despite the fact that 52% of the respondents are aware of the health hazards of FGC. Educated mothers were found to be less likely to favor the cutting of their daughters. Conclusions: It is suggested that educational campaigns aimed toward parents should be intensified. Legal recourse, prohibition of operations, improvement in women's status, and sex education are also suggested as means of eradicating the practice.
Reliability of self reported form of female genital mutilation and WHO classification: cross sectional study.
BMJ. British Medical Journal. 2006 Jul 15; 333(7559):124.The objective was to assess the reliability of self reported form of female genital mutilation (FGM) and to compare the extent of cutting verified by clinical examination with the corresponding World Health Organization classification. Design: Cross sectional study. Settings: One paediatric hospital and one gynaecological outpatient clinic in Khartoum, Sudan, 2003-4. Participants: 255 girls aged 4-9 and 282 women aged 17-35. Main outcome measures: The women's reports of FGM the actual anatomical extent of the mutilation, and the corresponding types according to the WHO classification. All girls and women reported to have undergone FGM had this verified by genital inspection. None of those who said they had not undergone FGM were found to have it. Many said to have undergone "sunna circumcision" (excision of prepuce and part or all of clitoris, equivalent to WHO type I) had a form of FGM extending beyond the clitoris (10/23 (43%) girls and 20/35 (57%) women). Of those who said they had undergone this form, nine girls (39%) and 19 women (54%) actually had WHO type III (infibulation and excision of part or all of external genitalia). The anatomical extent of forms classified as WHO type III varies widely. In 12/32 girls (38%) and 27/245 women (11%) classified as having WHO type III, the labia majora were not involved. Thus there is a substantial overlap, in an anatomical sense, between WHO types II and III. The reliability of reported form of FGM is low. There is considerable under-reporting of the extent. The WHO classification fails to relate the defined forms to the severity of the operation. It is important to be aware of these aspects in the conduct and interpretation of epidemiological and clinical studies. WHO should revise its classification. (author's)
New York, New York, UNICEF, 2005 Nov.  p.FGM/C is a fundamental violation of human rights. In the absence of any perceived medical necessity, it subjects girls and women to health risks and has life-threatening consequences. Among those rights violated are the right to the highest attainable standard of health and to bodily integrity. Furthermore, it could be argued that girls (under 18) cannot be said to give informed consent to such a potentially damaging practice as FGM/C. FGM/C is, further, an extreme example of discrimination based on sex. The Convention on the Elimination of All Forms of Discrimination against Women defines discrimination as "any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field." Used as a way to control women's sexuality, FGM/C is a main manifestation of gender inequality and discrimination "related to the historical suppression and subjugation of women," denying girls and women the full enjoyment of their rights and liberties. (excerpt)
International Journal of Gynecology and Obstetrics. 2006; 92:5-9.The April 2005 edition of Population Reports provides a detailed summary of the different contraceptive choices that are currently available. The report focuses on effective, less costly, easier to deliver contraceptive innovations that have fewer side effects. While some of the new contraceptives discussed are already available in some countries, others are on the brink of introduction. Some of the new methods covered include vaginal rings, transdermal patches, spray-on contraceptives and new implants. Two new variations on fertility awareness-based methods -- the Standard Days Method and the Two-Day method -- are described. The Standard Days Method is reported to be as effective as barrier methods for women with regular cycles between 26 and 32 days long. The Two-Day method can be used by women with cycles of any length regardless of regularity. It however produces best results in couples who can avoid unprotected intercourse for about 10--15 days per cycle. (excerpt)
Testing the effectiveness of integrating community-based approaches for encouraging abandonment of female genital cutting into CARE's reproductive health programs in Ethiopia and Kenya.
Washington, D.C., Population Council, Frontiers in Reproductive Health, 2004 Dec.  p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00; USAID Cooperative Agreement No. HRN-A-00-98-00023-00)Between 2000 and 2002, CARE International, with technical support from the Frontiers in Reproductive Health Program of the Population Council, implemented an operations research (OR) project among the Afar people of Ethiopia and Somali refugees in Daadab camps in Kenya. The OR project aimed to assess the effectiveness of community-based female genital cutting (FGC) strategies in increasing the knowledge of harmful FGC effects and positive FGC related attitudes and intended behaviour among the intervention communities. Both communities are predominantly of Islamic faith and practice infibulation, the most severe form of FGC. In both Ethiopia and Kenya, CARE integrated FGC interventions into existing community-based reproductive and primary health care information and service delivery activities. The study in Ethiopia was designed to test the effectiveness of education activities using behaviour change communication (BCC) approaches and advocacy activities by religious and other key leaders in the intervention site. No interventions occurred in the control sites. In Kenya, both the intervention and comparison sites had education/BCC activities. The intervention site had advocacy activities in addition to education/BCC activities. The OR study assessed the effectiveness of BCC and advocacy activities versus no interventions in Ethiopia, while in Kenya the comparison was between BCC strategies alone and the combination of BCC and advocacy activities. (excerpt)
Geneva, Switzerland, WHO, 1997.  p.Violence against women and girls is a major health and human rights issue. At least one in five of the world’s female population has been physically or sexually abused by a man or men at some time in their life. Many, including pregnant women and young girls, are subject to severe, sustained or repeated attacks. Worldwide, it has been estimated that violence against women is as serious a cause of death and incapacity among women of reproductive age as cancer, and a greater cause of ill-health than traffic accidents and malaria combined. The abuse of women is effectively condoned in almost every society of the world. Prosecution and conviction of men who beat or rape women or girls is rare when compared to numbers of assaults. Violence therefore operates as a means to maintain and reinforce women’s subordination. (excerpt)
The Hague, Netherlands, Ministry of Foreign Affairs, Directorate General for International Cooperation, Development Cooperation Information Department, 1995. , 216,  p.The Netherlands Institute of Human Rights conducted an inventory of international, regional, and national documents, legislation, and rules on female genital mutilation (FGM) to generate an overview of existing FGM-related regulations. Chapter 2 of the study's report presents the various forms of FGM and the countries where FGM is practiced. It also examines religion, tradition, culture, and socioeconomic backgrounds. The chapter also presents the views and attitudes of various famous researchers and authors. The legal approach to FGM has been receiving increasing attention, reaching the level of considering FGM as a health issue. Chapter 3 reviews international and regional regulations as they apply to FGM. The views and initiatives of international and regional governmental and nongovernmental organizations, particularly those initiatives aiming to eradicate FGM, are addressed in chapter 4. Chapter 5 discusses the countries of origin (e.g., Somalia), while chapter 6 discusses those of destination (e.g., Canada). Specifically, these chapters cover these countries' national legislation and their government's views on FGM. These chapters also address initiatives and programs of those national nongovernmental organizations involved in the eradication of FGM. The report concludes with a summary of the findings and various conclusions.