Feature: Female Genital Mutilation; showing its ugly face in modern era?

Female genital mutilation (FGM) involves the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons

FGM is practiced by several ethnic groups including the Kusasis, Frafras, Kassenas, Nankanis, Busangas, Wallas, Dagarbas, Builsas and Sisalas, who live mainly in the Upper East, Upper West and Northern regions of Ghana, and the migrant population in the south.

As a result, the Upper East and Upper West have the highest prevalence of FGM, at 13.0% and 32.5% respectively (of women aged 15-49), and all other regions have a prevalence of less than 3%.

The Volta region, along the east coast, has the lowest prevalence, at 0.3%.  Women aged 15-49 who live in rural areas are more likely to undergo FGM (3.6%) than those living in urban areas (1.2%).

The prevalence of FGM is inversely correlated with level of education and wealth, and 94.4% of women aged 15-49 who have heard of FGM believe the practice should be stopped.

It is imperative to protect women and girls from all violence and harmful practices because it is not only a moral issue but an infringement of their human rights as well. Ending FGM is critical to the economic and social progress of every nation.

FGM is recognized internationally 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 girls and women. It is nearly always carried out on minors and is a violation of the rights of children.

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, in instances when the procedure results in death.

FGM has no health benefits, and it harms girls and women in many ways.  Although all forms of FGM are associated with increased risk of health complications, the risk is greater with more severe forms of FGM.

FGC can have immediate and life-long health harms on the victim. The severity of health harms depends on the type of mutilation but includes immediate physical consequences such as excruciating pain, hemorrhage, localized and ascending genitourinary infection resulting from non-use of aseptic techniques during the cutting, and death.

Also, it is deeply rooted in cultural beliefs and social norms perpetuated over generations which are related to ideals of femininity and modesty including the notion that FGM/C will preserve virginity and reduce promiscuity, increasing girls’ marriage ability.

The decision-making process to perform FGM/C is therefore influenced by social norms and community beliefs and usually lies within the confines of households, involving more than one individual of the family—each one with different power over the decision.

In most countries, mother, grandmothers, and other women (e.g., aunties) are the key decision-makers with fathers and other men playing a limited role in the decision-making process.

The impacts of FGM occur at the time of the procedure and at adulthood, particularly motherhood. All forms of FGM have psychological effects, particularly related to female sexuality and sexual relationships.

According to Research, each year, not less than three million women are circumcised, and more hundred million females have already been circumcised.

In many African societies, the practice of female genital mutilation (FGM) is a serious cultural practice.

Several studies have demonstrated a significant association between FGM and various gynecological and pregnancy complications. Yet, women, who bear these consequences, continue with the FGM practice.

Many factors have shown a significant relationship with FGM practice, and among these include demographic factors such as age, educational background, religion, culture and economic status.

In sub-Saharan African nations, studies on economic status had a significant relation with FGM. Women from better economic homes were less likely to involve in FGM. And younger and well-educated women are negatively associated with FGM practice.

Additionally, a study in northern Ghana found a significant relationship between a woman’s demographic characteristics and FGM. Predictors’ factors were aged 35–49 years, no formal education or primary education, and married women.

It high time FGM is ended in the country. It is gradually damaging women in the rural areas or the less privileged who are forced to practice it.

In study report from the World Health Organization, the economic costs of treating health complications of FGM has found that the current costs for 27 countries where data were available totaled 1.4 billion USD during a one-year period (2018).

This amount is expected to rise to 2.3 billion in 30 years (2047) if FGM prevalence remains the same – corresponding to a 68% increase in the costs of inaction. However, if countries abandon FGM, these costs would decrease by 60% over the next 30 year.

Since 1997, great efforts have been made to counteract FGM, through research, work within communities, and changes in public policy. In 2007, UNFPA and UNICEF initiated the Joint Programme on Female Genital Mutilation/Cutting to accelerate the abandonment of the practice.

In 2008, WHO together with nine other United Nations partners, issued a statement on the elimination of FGM to support increased advocacy for its abandonment, called: “Eliminating female genital mutilation: an interagency statement”. This statement provided evidence collected over the previous decade about the practice of FGM.

In 2010, WHO published the “Global strategy to stop health care providers from performing female genital mutilation” in collaboration with other key UN agencies and international organizations.

WHO supports countries to implement this strategy? Also, in December 2012, the UN General Assembly adopted a resolution on the elimination of female genital mutilation.

In May 2016, WHO in collaboration with the UNFPA-UNICEF joint programme on FGM launched the first evidence-based guidelines on the management of health complications from FGM?

The guidelines were developed based on a systematic review of the best available evidence on health interventions for women living with FGM.

In 2018, WHO launched a clinical handbook on FGM to improve knowledge, attitudes, and skills of health care providers in preventing and managing the complications of FGM?

In 2021, UNICEF, with the support of WHO, UNFPA and Population Council outlined a research agenda for FGM. To complement this agenda, WHO developed ethical guidance for conducting FGM-related research?

The WHO will soon launch a training manual on person-centered communication (PCC), a counseling approach that encourages health care providers to challenge their FGM-related attitudes and build their communication skills to effectively provide FGM prevention counseling.

FGM should be abolished as soon as possible because it is gender-based violence, steals girls’ futures, extends poverty, force girls out of school, can be traumatizing and is a violation of girls’ and women’s rights.

By Florence Kissiwa

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