ATTITUDE AND PERCEPTION TOWARDS FEMALE CIRCUMCISION: A STUDY OF VULNERABILITY AMONG WOMEN IN KENYA AND NIGERIA

Full text

Vol. 62, No.2, December 2016 35
IntroductIon
Female Genital Mutilation (FGM), also
known as Female Genital Cuing (FGC)
or infrequently as Female Circumcision,
refers to “all procedures involving partial
or total removal of the external female
genitalia or other injury to the female
genital organs whether for non-medical
reasons.”1,2 FGM/C is a geographically
circumscribed phenomenon, with the
highest concentration in the western,
eastern, and north-eastern regions of Africa.
It is also found in some countries in Asia
and the Middle East and among certain
immigrant communities from Africa and
South-West Asia living in North America
and Europe.1,3
FGM/C is, therefore, a global
concern. While the exact number of women
and girls worldwide, who have undergone
FGM/C remains unknown, it is estimated
that at least 20 million women and girls
in 30 countries have been subjected to the
Ankita Siddhanta and Atreyee Sinha, Doctoral Research Scholar, International Institute for
Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai- 400 088.
ATTITUDE AND PERCEPTION TOWARDS
FEMALE CIRCUMCISION: A STUDY OF
VULNERABILITY AMONG WOMEN IN
KENYA AND NIGERIA
ANKITA SIDDHANTA AND ATREYEE SINHA
practice.4 As the availability of national
level representative data increases, so does
the number of women and girls known to
have experienced the procedure. In most
countries, the majority of the girls are cut
before age ve years.5 FGM/C is markedly
different from the male circumcision
process; there are dierent types of genital
excision: Type 1 - clitoridectomy, Type
2 - excision, Type 3 - infibulation or
Pharaonic circumcision, which is the
riskiest, and Type 4 - all other harmful
practices like pricking, incising, scraping,
and cauterization. All these procedures
are irreversible and their eects last for
a lifetime. The most common form is
clitoridectomy accounting for 80 percent
of all cases. It is estimated that around
15 percent of all circumcised women
are infibulated; in Dijibouti, Somalia,
and northern-Sudan, the incidence of
Infibulation is widespread comprising
almost 80-90 percent.6-8

36 The Journal of Family Welfare
FGM/C is performed on girls aged
0-15 years and less frequently on adults
mostly by traditional practitioners in the
community with crude instruments.8,9
The event of circumcision is sometimes a
celebrated public event and somewhere it
is private family aair both bringing pain
and health risk to the life of a girl.10-13 The
practice is mostly carried out by traditional
circumcisers, without proper knowledge
of human anatomy and medicine. Female
circumcision possesses great risks for
women causing sexual and reproductive
health complications, psychosexual and
psychological morbidities often leading to
loss of life.8 Despite the graveness of the
issue, the practicing societies look on it
as an integral part of their tradition and
cultural identity. Opponents of the practice
have perceived FGM/C as a violation of
the human rights of girls and women. It
reflects deep-rooted inequality between
the sexes, and constitutes an extreme form
of discrimination against women. The
practice also violates a person’s rights to
health, security, and physical integrity,
the right to be free from torture and cruel,
inhuman or degrading treatment, and the
right to life when the procedure results
in death.1 The pervasiveness of this age
old traditional practice has driven world
scholars, policy makers from mid-twentieth
century to focus on its adversities through
a humanitarian lens. As a result, during
the ’90s it was re-conceptualized as a form
of violence against women (VAW) and
recognized as a violation of human rights
in the 1993 Vienna World Conference on
Human Rights.5 Despite several decades
of campaign and legislation against
circumcision, the practice still persists
owing to deep rooted local and traditional
beliefs.3,14 Any attempt to eradicate this
traditional malpractice therefore, calls for
detailed scrutiny of peoples’ perceptions
and aitude towards the issue.
Culture in play
FGM/C has been practiced traditionally
for centuries in different parts of sub-
Saharan Africa. In the communities that
follow excision of female genitalia, FGM/C
is associated with ethnicity, culture,
prevailing social norms, and sometimes as
religious obligations. In some communities,
it is followed as a coming of age ritual for
preparing young girls for womanhood
and marriage.6,15,16 The custom includes
festivity, celebration, and rewards for girls
who are going through this procedure.
Associated with it is a sense of pride, social
cohesion, acceptance, and inclusion in the
secret societies of adult women, which is
necessary to become a responsible member
of the society.3
There is a cultural aesthetics in play for
some ethnic groups practicing circumcision.
FGM is associated with cultural ideals of
femininity and modesty, which include the
notion that girls are clean and beautiful
after removal of body parts that are
considered unclean, unfeminine or male.8
Circumcision is often considered to make
girls clean and beautiful by smoothening
the ‘masculine’ part i.e. clitoris in their
body.17,18,19 A belief sometimes recognized
by women is that female circumcision
increases sexual pleasure among men.8,20,21
Another belief is that FGM/C increases
women’s fertility, ability to procreate, and
child’s survival.8,22
In many communities this particular
practice is upheld as a religious
requirement. FGM/C is performed by
Muslims, Christians, and Jews. However, it
is carried out in some Muslim communities
with the belief that it is demanded by
Islamic faith. In reality, though, there is
no documentation of this practice in the
holy texts of these religions. Moreover, the
historical origin of the practice asserts that
it predates the advent of all major religions
of the world including Islam.3,8,23
Why does it continue?
In most societies, where FGM is
practiced, it is considered a cultural

Vol. 62, No.2, December 2016 37
tradition, which is often used as an
argument for its continuation. Female
circumcision is an integral part of the
societies characterized by patriarchal
authority and control over female sexuality.
In communities where female circumcision
is practiced, both men and women support
it without questioning. In some countries
like Sudan, men were found to be more
likely to favour circumcision than women.24
FGM/C is referred as the manifestation
of gender inequality that represents
society’s control over women by WHO3
and is deeply entrenched in people’s non-
egalitarian attitude towards normative
gender roles which permeate through
generations.6
Where it is believed that being cut
increases marriageability, FGM is more
likely to be carried out. There is often
an expectation that men will marry only
women who have undergone the practice.
The desire for a proper marriage, which
is often essential for economic and social
security as well as for fulfilling local
ideals of womanhood and femininity, may
account for the persistence of the practice.3
Where FGM is a social norm, the social
pressure to conform to what others are
doing, as well as the need to be accepted
socially and the fear of being rejected by
the community, are strong motivational
factors to perpetuate the practice. In some
communities, FGM is almost universally
performed unquestioned.1
FGM/C is associated with a series
of permanent and irreversible adverse
health consequences for the victims
in varying intensities. The immediate
consequences like pain, heavy bleeding,
and infections often remain unreported
until they seek hospital treatment.25 Long-
term consequences can include chronic
pain, infections, decreased sexual desire,
or painful intercourse.26 Female genital
mutilation is also highly linked with
increased risk of acquiring HIV.27 There
are several psychological consequences,
such as anxiety, depression, and post-
traumatic stress disorder. Findings from a
WHO multi-country study in which more
than 28,000 women participated, conrm
that women who had undergone genital
mutilation had significantly increased
risk for adverse events during childbirth,
sometimes even leading to death of the
child. Higher incidences of caesarean
section and post-partum haemorrhage were
found in women with genital mutilation
compared to those who had not undergone
genital mutilation. Striking new nding
from the study is that genital mutilation
of mothers has negative eects on their
newborn babies. Most seriously, death rates
among babies during and immediately after
birth were higher for those born to mothers
who had undergone genital mutilation
compared to those who had not.2
FGM/C has been practiced as a form of
oppression of women and the signicance
of the culture is much more profound in the
practicing societies. Hence, understanding
people’s attitude towards the practice
under cultural influence is crucial to
formulate strategies to combat this social
peril. This study was undertaken as an
endeavour to fill a crucial gap in the
research of circumcision of women in the
African context by analysing two distinct
countries, namely Nigeria, which accounts
for the highest number of cut women and
Kenya, a country which has the history of
early propagation against the banning of
circumcision of women. The primary reason
for selecting the two countries for analysis
was that both are low economy countries
with a prevalence of circumcision and its
similar historical origin.
The main objective of study was to
understand the perception and aitude of
women towards FGM/C in two selected
African countries - Kenya and Nigeria.
Methodology
For empirical analysis, the Demographic

38 The Journal of Family Welfare
Health Survey (DHS-2008) data of
Kenya(KDHS) and Nigeria (NDHS)
were used. The analysis was based on a
national sample of 8,444 women in Kenya
and 20,396 women in Nigeria in their
reproductive age group of 15-49 years.
The main outcome of interest in the
present study was perception of women
about the continuation of circumcision.
Women were asked about their opinion
whether circumcision should be continued or
not. Those who said ‘yes’ were coded as ‘1’
and ‘0’ as otherwise.
In the present study, a range of socio-
economic and demographic factors
that were likely to be associated with
women’s perception on FGM/C, were
controlled. Background characteristics of
the respondents included age of women
(categorized into three groups: <25 years,
25-35 years and >35 years), place of
residence (rural and urban), educational
aainment of the respondents (categorized
into three groups: no education, primary,
secondary, and higher), religion of the
respondents (categorized into three groups;
Christian, Muslim and Others), ethnicity of
the Nigerian women (Ekoi, Fulani, Hausa,
Ibibio, Igala, Igbo, Ijaw/Izon, Beriberi, Tiv,
Yoruba, and others), ethnicity of the Kenyan
women (Embu, Kalenjin, Kamba, Kikuyu,
Kisii, Luhya, Luo, Maasai, Meru, Swahili,
Somali, Taita, and others), wealth quintile
(categorized into ve groups: poorest, poor,
middle, richer, and richest) and exposure
to any mass media (categorize into two
groups: had exposure and no exposure).
Other variables used in the study were
– circumcised women (grouped into two
categories: ‘yes’ and ‘no’), circumcision was
performed by whom (grouped into four
categories: trained doctors/nurse/midwives,
traditional circumciser, traditional birth
aendant, and others); age of respondent
during circumcision (grouped into three
categories: infancy, <15 years, >=15 years);
percentage of women circumcised after
marriage (categorized as: ‘yes’ and ‘no’),
number of daughters circumcised (grouped
into three categories: none, <3 and >=3). The
variable for determining the perception
of the women regarding circumcision
were: circumcision should be stopped
or continued (continued, discontinued),
benets of circumcision (categorized as:
cleanliness/hygiene, social acceptance,
better marriage prospects, prevent pre-
marital sex/ensure virginity, more sexual
pleasure for men, religious approval, and
other benets), circumcision is required by
religion (categorized as: ‘yes’ and ‘no’).
Analyses were performed separately
for Nigeria and Kenya. Both bivariate and
multivariate techniques were applied to
accomplish the objectives of the present
study.
Descriptive statistics presented the
prevalence of circumcision in the two
countries, detailed scenario regarding the
experience of circumcision by women and
perception of women about circumcision
and its continuation. Secondly, bivariate
associations between the aitude of women
towards female circumcision (support for
the continuation of FGC, whether FGC
had any benets or not, whether mothers
want their daughters’ circumcision or
not, whether they believed that ‘female
circumcision is required by their religion’ or
not) and various background characteristics
(i.e. demographic and socio-cultural
characteristics) have been presented.
Lastly, binary logistic regression model was
applied to examine the factors determining
women’s aitude towards continuation of
circumcision in Kenya and Nigeria. Two
separate models were run for each country.
The rst model depicted the eects of religion
and ethnicity related variables. Whereas, in
the second model various socio-economic
and demographic variables were controlled
and the adjusted eects of various factors
were explored. All statistical analyses were
performed using SPSS-version 21.

Vol. 62, No.2, December 2016 39
results
The study examined the overall
prevalence of circumcision, women’s
perception about circumcision, and
presented a comparative picture between
Nigeria and Kenya. Table 1 reveals that
the prevalence of circumcised women
was more in Nigeria; while nearly half
(48.8%) of the Nigerian women were
circumcised, it was less than one third of
Kenyan women (28.2%). Awareness about
the process of circumcision was markedly
high among the Kenyan women; while an
overwhelming majority (around 95%) of the
women in Kenya heard about circumcision,
correspondingly it was less for Nigerian
women (59.9%). There was a substantial
difference in age of the women when
they were circumcised. A large number of
women (85%), in Nigeria were circumcised
during infancy, around nine percent
were below 15 years of age and around
six percent women were circumcised
on or after aaining 15 years of age. In
contrast to Nigeria, nearly 70 percent of the
Kenyan women were circumcised below
the age of 15 years and one third of them
were circumcised on or after aaining 15
years of age. Only 1.7 percent of Kenyan
women were circumcised during infancy.
Surprisingly, 17 percent of women in
Kenya and 25 percent of women in Nigeria
experienced circumcision even after their
marriage. In both the countries, a majority
of the women reported geing circumcised
in risky conditions by traditional
circumcisers (64% Nigerian women; 75%
Kenyan women). While around 20 percent
of Kenyan women were circumcised by
trained doctors/nurses/midwives, it was
8.8 percent among Nigerian women. It
was found that nine percent of Nigerian
women and three percent of Kenyan
women were circumcised by traditional
birth aendants. An interesting nding of
this study was that more than 90 percent
of the Kenyan women reported that none
of their daughters were circumcised, while
it was 68 percent among Nigerian women.
Thus, indicating the continuation of the
process to the next generation. This was
relatively higher in Nigeria than in Kenya.
In Nigeria 22 percent women had less than
three circumcised daughters and 10 percent
had three or more circumcised daughters.
In Nigeria, 92 percent of their daughters
were circumcised in infancy similar to their
mothers and circumcision at older ages was
rare. On the other hand, majority (82%),
of the daughters of Kenyan women were
circumcised before they aained 16 years
of age and a few (17%) after aaining age
15 years of age; circumcision during infancy
was negligible similar to the experiences of
their mothers.
table 1
Experience, perception and attitude towards
circumcision among women aged 15-49 years in
Nigeria and Kenya
Nigeria
(%)
Kenya
(%)
Circumcised women 48.8 28.2
Women who heard about
circumcision 59.9 94.5
Circumcision performed by
Trained doctors /nurse
midwives 08.8 19.4
Traditional circumciser 63.7 74.7
Traditional birth attendant 09.4 03.4
Don't know/Don't remember 18.2 02.5
Respondent’s age when circumcised
Infancy 08.5 01.7
Less than 15 years 08.7 68.1
15 years or more 06.3 30.2
Circumcised After Marriage 25.2 17.1
Daughters circumcised
None 68.1 91.1
Less than 3 21.7 06.3
3 or more 10.2 01.8
Daughter’s Age When Circumcised
Infancy 092.2 01.1
<15 years 06.0 81.8
15 years or more 01.8 17.1

40 The Journal of Family Welfare
Nigeria
(%)
Kenya
(%)
Perception and Attitude
Continuation/discontinuation of circumcision
Circumcision should be
continued 25.7 10.3
Circumcision should be
discontinued 74.3 89.7
Benets of circumcision
Cleanliness/hygiene 5.9 2.6
Social acceptance 8.4 8.3
Better marriage prospects 8.1 3
Prevents pre-marital sex/
virginity 10.4 5.6
More sexual pleasure for men 4.2 1
Religious approval 2.5 1.8
Other benefits 3 0.6
Religious requirement
Yes 19.4 7.8
No 80.6 92.2
Table 2 presents the perception of
women regarding the practice of
circumcision. Although a majority of the
women from both the countries opined
that the practice of circumcision should
be discontinued, there was a substantial
number of women who said that it should
be continued. More Nigerian women (26%)
than Kenyan women (10%) believed that
circumcision should continue. The higher
majority of the women in Kenya were
of the opinion that this process should
be discontinued compared to women in
Nigeria. Around 20 percent women in
Nigeria perceived that circumcision was a
religious requirement compared to less than
ten percent (7.8%) women in Kenya. When
they were enquired about the benets of
the process of circumcision, one tenth of
Nigerian women believed that it would
prevent pre-marital sex, ensuring virginity
compared to only six percent women in
Kenya. Around eight percent of the women
in both the countries perceived circumcision
as a means to get social acceptance. Another
eight percent of Nigerian women believed
that circumcised women would have beer
marriage prospects, while it was only three
percent among women in Kenya. The other
benefits deemed important by Nigerian
women were cleanliness/hygiene (5.9%)
and more sexual pleasure for men (4.2%),
correspondingly these perceptions were
found to be less among Kenyan women.
table 2
Perception and attitude towards female circumcision of women aged 15-49 years and selected background
characteristics
Characteristic
Circumcision should be
continued (%)
Circumcision has got
benefits (%)
Intends daughter to get
circumcised (%)
Nigeria Kenya Nigeria Kenya Nigeria Kenya
Education
No Education 33.9 41.6 51.5 40.8 7.3 30.6
Primary 28.9 8.2 43.7 13.8 11.9 5.3
Secondary 23.8 7.7 37.4 14.2 6.6 3.6
Higher 14.0 2.3 29.3 8.3 2.2 1.2
Religion
Christian 20.1 7.3 34.1 13.4 8.1 4.9
Islam 36.4 43.3 53.3 41.9 5.7 35.8
Others 37.5 27.1 50.0 25.3 26.2 19.2
Wealth Quintile
Poorest 27.7 20.8 45.9 23.5 7.3 17.5

Vol. 62, No.2, December 2016 41
Characteristic
Circumcision should be
continued (%)
Circumcision has got
benefits (%)
Intends daughter to get
circumcised (%)
Nigeria Kenya Nigeria Kenya Nigeria Kenya
Poorer 33.3 10.3 47.0 17.6 10.5 7.6
Middle 27.2 10.1 41.9 15.6 9.9 6.1
Richer 27.3 7.1 42.7 14.8 7.7 4.6
Richest 20.0 7.0 34.8 10.7 5.0 2.6
Woman’s Age
Less than 25 26.1 10.3 40.4 15.4 10.2 11.8
25-35 24.6 9.9 39.2 15.4 7.7 7.8
More than 35 26.6 10.7 43.7 16.6 7.1 4.7
Figure 1 presents the trends in
prevalence and women’s aitude towards
the practice of FGM/C as shown in
consecutive District Health Surveys in both
the countries. It was observed that there
was a decline since 2008 in the prevalence
of circumcision of both women and their
daughters in both the countries; however,
the decrease was faster in Nigeria than
in Kenya as is evident by the proportion
of circumcised women and daughters
became almost half in 2013 in Nigeria the
corresponding decline was around seven
percentage points in Kenya. There was also
a slight change since 2008 in the percentage
of women who believed that circumcision
should continue in future as it was a
religious requirement in both the countries.
However, the overall prevalence and
women’s supportive aitude towards the
practice was found to be more in Nigeria
than in Kenya.
FIgure 1
Trends in the prevalence and women’s attitude towards FGM/C in Nigeria and Kenya (%)

42 The Journal of Family Welfare
Table 3 presents the bivariate
association of women’s perception and
aitude towards circumcision with their
background characteristics. The results
revealed that educational aainment of the
women had significant association with
women’s opinion about the continuation
of circumcision in both the countries. With
the increasing level of education, it was
found that women were less agreeable for
the continuation of the practice of female
genital circumcision. However, the eect
of education in Kenya was more prominent
than Nigeria. Similarly, an increase in the
education level decreased the perception
that ‘circumcision has got benefits’ and
the intention to get daughters circumcised;
again, the eect of education was more
prominent in Kenya than in Nigeria.
Comparing the two religious communities
in the two countries, it was found that in
both the countries the proportion of women
saying circumcision should continue and
perceiving that ‘circumcision has got
benets, was higher among Muslims and
other religious groups followed by the
Christians. On the other hand, a higher
percent of Nigeria women from other
religious groups intended to get their
daughters circumcised than the Christians
and Muslims, while in Kenya it was higher
among the Muslims followed by other
religious groups. The economic status of
women showed similar eects as education.
Women from the upper wealth quintiles in
both the countries had less in agreement
for continuing the tradition of circumcising
their daughters and its benets. Age of
the women did not show a significant
relationship with women’s perception
regarding continuation of the practice and
the benets of circumcision, except for their
intention to circumcise daughters where
more women from the younger age groups
expressed agreement to this, compared to
older women in both the countries.
Binary logistic regression was applied
to explore the confounding factors for
women’s agreement about continuation
of the practice of circumcision. Model
1 and Model 3 presents the effects of
religion and ethnicity in Nigeria and
Kenya, respectively. It was found that in
Nigeria, women from Muslim and other

Vol. 62, No.2, December 2016 43
religious communities were signicantly
more likely to favour continuation of
circumcision as compared to Christians
(OR=1.91, p<0.001 and OR=2.89, p<0.001,
respectively). The results from ethnic
groups revealed that Hausa, Igbo, and
Yoruba communities were significantly
more likely to favour continuation of
circumcision (OR=1.63, p<0.01; OR=2.36,
p<0.001 and OR=3.40, p<0.001 respectively).
On the other hand, Ibibo, and Ijaw/Izon
communities were nearly 40 percent less
likely to favour circumcision; while Igala,
Beriberi and Tiv communities were >60
percent less likely to favour continuation
of circumcision. Similar results were found
in Kenya; Muslim and other religious
groups were significantly more likely
to favour continuation of circumcision
compared to the Christians (OR=5.02,
p<0.001 and OR=3.78, p<0.001, respectively).
The ethnic communities revealed that
Kisiis and Somalis favoured continuation
of circumcision most strongly; they were
nearly 6 and 17 times more likely to
favour circumcision (OR=5.40, p<0.001 and
OR=17.76, P<0.001, respectively). Among
the Massai community they were around
two times more likely to say that female
circumcision should continue (OR=1.85,
p<0.05). On the other hand, Kalenjin,
Kamba, Kikuyu, Luo, Meru, Swahili and
Taita communities were signicantly less
likely to favour continuation of female
circumcision than their counterparts.
Model 2 and Model 4 presented the
adjusted odds of favouring continuation
of circumcision after controlling for
various background characteristics of
the respondents. It was found that with
increasing age, women in both the countries
were signicantly less likely to opine that
circumcision should continue (P < 0.001).
Similarly, educational aainment among
women from both the countries also had
a signicant negative relationship with the
aitude towards circumcision; women who
had education up to primary, secondary,
or higher levels were significantly less
likely to favour the continuation of female
circumcision compared to those who had
no education (p<0.001). The effects of
education was more profound in Kenya
than Nigeria. Exposure to any mass media
also had a signicant pacifying eect for
Kenyan women; those having mass media
exposure were nearly 40 percent less likely
to say that female circumcision should
continue (p<0.001). Another important
nding was that circumcised women in
Nigerian and Kenyan were 21 times and
11 times, respectively, more likely to opine
that female circumcision should continue
in the future OR=21.61, P <0.001 and
OR=11.22, p<0.001, respectively). Wealth
quintiles and place of residence did not
show any significant relationship with
women’s attitude towards continuation
of female circumcision in future. It was
found that, even after controlling for
background characteristics, religion and
ethnicity emerged as signicant predictors
of women’s attitude towards female
circumcision. Muslims and other religious
groups were around two times more likely
in Nigeria (OR=1.62 and OR=2.27, p<0.001,
respectively) and around three times more
likely in Kenya (OR= 2.80 and OR=3.53,
p<0.001, respectively) than the Christians,
to say that the practice of circumcision
should continue in the future. In case of
ethnic origin, it was found that in Kenya,
the Kalenjin, Kamba, Kikuyu, Meruand
Swahili tribes were signicantly less likely
to favour continuation of this tradition
as compared to the Embu tribe. The Kissi
tribe showed around three times (OR=2.81,
p<0.001) and the Somali tribe was five
times more likely (5.37, p<0.001) to say
that female circumcision should continue.
The likelihood of the Maasai tribe to
favour continuation of female circumcision
reduced significantly after controlling
for women’s background characteristics
(OR=0.39, p<0.05). In Nigeria consistently as
before, the Hausa, Igbo, and Yoruba tribes
were almost three times more likely to
have the aitude that circumcision should

44 The Journal of Family Welfare
continue (P < 0.001). In contrast to earlier
results, the adjusted odds revealed that
the Igala and Beriberi tribes became nearly
three times more likely (OR=2.84, p<0.05
and OR=3.03, p<0001 respectively) to have
a supportive aitude towards circumcision.
table 3
Results of binary logistic regression showing the odds of supporting the continuation of female circumcision
in future among women aged 15-49 years
Nigeria Kenya
Model-1 Model -2 Model-1 Model-2
Age
Less than 25
25-35 0.816*** 0.709**
More than 35 0.680*** 0.526***
Place of residence
Urban
Rural 1.033 0.693
Education
No education
Primary 0.904 0.326***
Secondary 0.792** 0.243***
Higher 0.506*** 0.125***
Religion
Christian
Islam 1.909*** 1.623*** 5.023*** 2.798***
Others 2.889*** 2.266*** 3.775*** 3.528***
Ethnicity (Nigeria)
Ekoi
Fulani 0.886 2.645***
Hausa 1.625** 3.492***
Ibibio 0.566* 1.207
Igala 0.398* 2.844*
Igbo 2.362*** 1.699***
Ijaw/Izon 0.639* 0.945
Beriberi 0.439*** 3.033***
Tiv 0.120*** 0.795
Yoruba 3.404*** 2.642***
Others 1.443* 2.698***
Ethnicity (Kenya)
Embu
Kalenjin 0.473* 0.295***
Kamba 0.716 0.983***
Kikuyu 0.415*** 0.763***
Kisii 5.402*** 2.811***
Luhya 0.124 0.549

Vol. 62, No.2, December 2016 45
Nigeria Kenya
Model-1 Model -2 Model-1 Model-2
Luo 0.515* 2.367*
Maasai 1.854* 0.391*
Meru 0.120*** 0.129***
Swahili 0.048*** 0.140***
Somali 17.758*** 5.370***
Taita 0.444* 0.623
Others 1.958* 1.261
Wealth Quintile
Poorest
Poor 1.207* 1.045
Middle 1.116 1.2
Richer 1.12 0.913
Richest 0.928 0.637
Mass media exposure
No
Yes 0.964 0.588***
Women Circumcised
No
Yes 21.608*** 11.224***
dIscussIon
The study revealed that the prevalence
and supportive aitude towards FGM/C
is still considerably high in both the
countries and the pace of decline has been
remarkably slow especially in Kenya even
after the resolution taken on the elimination
of female genital mutilation at the UN
General Assembly in 2012. It has been
predicted that if current trends continue,
the number of girls and women undergoing
FGM/C will rise signicantly over the next
15 years.4 It is argued that the law against
circumcision exists in most countries but
is rarely enforced. It is beyond doubt
that success in combating female genital
mutilation depends largely on government
mobilization.28 In terms of legal safeguards
and protection, Kenya has adopted various
approaches and strategies to abandon the
tradition of circumcision which was, by
and large successful; whereas, the eort
in Nigeria is met with diculties in spite
of a high degree of success in few pockets.
It was argued that in Kenya, half of the
adolescent girls were subjected to cuing
30 years ago, but the gure could be as low
as 10 percent by the end of this decade,
and with minimal acceleration the practice
could be eliminated within a generation
by the year 2030.29 In the year 1998, 38
percent of women were circumcised which
decreased to 32 percent in 2003, 28 percent
in 2008 and further to 21 percent in 2014.
This is also evident from the fact that 97
percent of the daughters of the respondents
were not circumcised in Kenya as compared
to 83 percent in Nigeria. But the illiterate
and the poorest women in Kenya have
lesser positive perception and knowledge
than their Nigerian counterparts. Though
Nigeria is ahead of Kenya in certain
developmental indices like employment,
less prevalence of HIV/AIDS, and more
GDP per capita, the aforesaid results
clearly indicates that more Nigerian women
experience circumcision and conform to
socially constructed norms than women in
Kenya.

46 The Journal of Family Welfare
In Nigeria, female genital cutting is
till date practiced mostly during infancy.
Findings from the study suggests that a
substantially large number of women were
circumcised before their fifth birthday;
thus, indicating high-risk and vulnerability
of these young girls as they are too young
to be able to consent to the practice; the
chances of falling victim to this malpractice
gets enhanced manifold,30 and is, therefore
a violation of the rights of children.1
It was found that a considerable
proportion of women were circumcised
even after marriage, thus, contrary to the
popular belief that infibulated genitalia
before marriage is much preferred option.
Existing literature suggests that if the girl
is uncircumcised, the in-laws will ensure
that she delivers at home so that they cut
her while she is delivering.13
It was found that religion and ethnicity
were two strongest predictors for women’s
attitude towards the continuation of
female circumcision. According to Andro
and Lesclingand28 the main risk factor is
ethnicity and not religion and FGM is a
traditional component of the initiation of
rites associated with entry into adulthood.
Though no religious scripts prescribe the
practice, practitioners often believe the
practice has religious support.1
The ndings suggest that a substantial
proportion of women from both the
countries, especially from Nigeria,
supported the continuation of this harmful
practice in future. In certain societies
FGM/C is perceived to elevate a woman’s
prestige and social status from being a
mere sexual partner and servant to their
husband, to ‘mother of their children’
and thus, is staunchly supported by older
generation of women.13 In majority of the
cases it has been documented that their
own family members such as parents
mainly mothers, grand-parents, and grand-
mothers of the girls are the perpetrators
of this act. Ensuring daughter’s virginity
is a required task for them to arrange
for her marriage, receive proper bride-
price, and for family honour.6 Often older
women become the moral gatekeepers in
favour of this ritual to justify their own
experience of genital cuing and they tend
to see any eort to eliminate the practice
as a threat to their culture. FGM/C is also
propagated by traditional leaders, religious
leaders. It has become a social convention
associated with rewards and punishments;
and therefore, acts as a powerful force
behind its persistence. Due to immense
social pressure and fear of exclusion
from the community, families conform
to the tradition. Social benets received
after the ritual is deemed higher than its
disadvantages.31 In many societies, girls
who have not gone through FGM/C are
considered as unmarriageable, unclean and
it is a social taboo. Girls who remain uncut
may be teased or looked down upon in the
society. Most times, the girls themselves
desire to conform to peer as well as societal
pressure out of the fear of stigmatization
and rejection by their own community.
They accept the practice as a necessary and
normal part of life.6
recoMMendatIons
Expansion of reproductive health
policies, planning and programming
should include Female Circumcision
to address the health risks of women
associated with this tradition. There is a
need for interventions ranging from local,
regional, national, and international levels.
Local and regional interventions may
be focused on increasing awareness and
changing the belief system from which this
harmful practice arises. NGOs could be
involved in educating communities about
the negative health eects of circumcision.
At the national level, anti-circumcision laws
should be enforced and enacted which
may act as a legal deterrent to perform the
practice. Reconstructive surgery should
be promoted as it appears to reduce pain

Vol. 62, No.2, December 2016 47
and restores sexual pleasure in women.
Media campaigns and other forms of
communication should be organized and
implemented to support and publicize
abandonment of female circumcision.
Religious groups, organizations, and
institutions can also play a very important
role to decrease the vulnerability of the
women in these two countries. In recent
years, despite making female genital
mutilation illegal in both the countries,
circumcision is still prevalent. Systematic
cultural shift and change in aitude in these
populations required in both the countries
to end this harmful practice totally in the
coming years.
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