Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-04T21:32:16.708Z Has data issue: false hasContentIssue false

Empirical linkages between female genital mutilation and multiple sexual partnership: evidence from the 2018 Mali and 2013 Sierra Leone Demographic and Health Surveys

Published online by Cambridge University Press:  19 March 2021

Bright Opoku Ahinkorah
Affiliation:
School of Public Health, Faculty of Health, University of Technology Sydney, Australia
John Elvis Hagan Jr
Affiliation:
Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
Abdul-Aziz Seidu
Affiliation:
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
Eugene Budu
Affiliation:
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
Ebenezer Kwesi Armah-Ansah
Affiliation:
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
Collins Adu
Affiliation:
Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Edward Kwabena Ameyaw
Affiliation:
School of Public Health, Faculty of Health, University of Technology Sydney, Australia
Sanni Yaya*
Affiliation:
School of International Development and Global Studies, University of Ottawa, Ottawa, Canada The George Institute for Global Health, Imperial College London, London, UK
*
*Corresponding author. Email: [email protected]

Abstract

Female genital mutilation (FGM) is very pervasive in Africa, with significant regional variations in the prevalence of this traditional practice. This study examined the linkages between FGM and multiple sexual partnership in Mali and Sierra Leone – two African countries with a high prevalence of FGM. Data were from the 2018 Mali and 2013 Sierra Leone Demographic and Health Surveys, and the study sample comprised 4750 women from Mali and 16,614 from Sierra Leone. Multilevel logistic regression was used for the data analysis, with reported adjusted odds ratios (aOR) and associated 95% confidence intervals. In Mali, women who had not undergone FGM were less likely to have multiple sexual partners (aOR=0.60, CI=0.38–0.96) compared with those who had undergone FGM. In Sierra Leone, women who had undergone FGM (aOR=1.15, CI=1.02–1.30) were more likely to have multiple sexual partners compared with those who had not undergone FGM. Age, level of education, wealth quintile, sex of household head, community socioeconomic status, mass media exposure, and community literacy level were found to be associated with the likelihood of multiple sexual partnership among women in Mali and Sierra Leone. Comprehensive, age-group-based risk-reduction strategies, such as abstinence education and decision-making skills (assertiveness) training, are needed to reduce girls’ and young women’s engagement in multiple sexual partnerships. Policy interventions, such as anti-FGM legislation and initiatives like the ‘Schooling for the Female Child’ initiative aimed at reducing social inequality among girls and women, might help decrease FGM and the likelihood of health-compromising behaviours like multiple sexual partnership.

Type
Research Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abeya, SG, Chuluko, BG and Gemeda, DD (2017) Factors associated with female genital mutilation among women of reproductive age in Gewane Woreda, Afar National Regional State, Ethiopia. Remedy Open Access 2, 1051.Google Scholar
Ahinkorah, BO, Hagan, JE, Ameyaw, EK, Seidu, AA, Budu, E, Sambah, F and Schack, T (2020a) Socio-economic and demographic determinants of female genital mutilation in sub-Saharan Africa: analysis of data from demographic and health surveys. Reproductive Health 17(1), 114.CrossRefGoogle ScholarPubMed
Ahinkorah, BO, Hagan, JE Jr, Seidu, AA, Torgbenu, E, Budu, E and Schack, T (2020b) Understanding the linkages between male circumcision and multiple sexual partnership among married Ghanaian men: analysis of data from the 2014 Ghana Demographic and Health Survey. SSM-Population Health 11, 100622.CrossRefGoogle ScholarPubMed
Aliaga, A and Ruilin, R (2006) Cluster optimal sample size for Demographic and Health Surveys. In 7th International Conference on Teaching Statistics–ICOTS, Vol. 7, pp. 2–7.Google Scholar
Almroth, L, Almroth-Berggren, V, Hassanein, OM, El Hadi, N, AlSaid, SSE, Hasan, SSA et al. (2001) A community-based study on the change of practice of female genital mutilation in a Sudanese village. International Journal of Gynecology & Obstetrics 74, 179185.CrossRefGoogle Scholar
Ameyaw, EK, Tetteh, JK, Armah-Ansah, EK et al. (2020) Female genital mutilation/cutting in Sierra Leone: are educated women intending to circumcise their daughters? BMC International Health and Human Rights 20, 19.CrossRefGoogle ScholarPubMed
Amo-Adjei, J and Tuoyire, DA (2018) Timing of sexual debut among unmarried youths aged 15–24 years in sub-Saharan Africa. Journal of Biosocial Science 50(2), 161177.CrossRefGoogle ScholarPubMed
Andro, A, Lesclingand, M, Grieve, M and Reeve, P (2016) Female genital mutilation: overview and current knowledge. Population 71(2), 217296.Google Scholar
Berg, RC and Denison, E (2013) A tradition in transition: factors perpetuating and hindering the continuance of female genital mutilation/cutting (FGM/C) summarized in a systematic review. Health Care for Women International 34(10), 837859.CrossRefGoogle ScholarPubMed
Bjälkander, O, Grant, DS, Berggren, B, Bathija, H and Almroth, B (2013) Female Genital Mutilation in Sierra Leone: forms, reliability of reported status, and accuracy of related Demographic and Health Survey questions. Obstetrics and Gynecology International 2013, 680926. URL: http://doi.org/10.1155/2013/680926 CrossRefGoogle ScholarPubMed
Bogale, D, Markos, D and Kaso, M (2014) Prevalence of female genital mutilation and its effect on women’s health in Bale zone, Ethiopia: a cross-sectional study. BMC Public Health 14, 1076.CrossRefGoogle ScholarPubMed
Cetorelli, V, Wilson, B, Batyra, E and Coast, E (2020) Female genital mutilation/cutting in Mali and Mauritania: understanding trends and evaluating policies. Studies in Family Planning 51(1), 5169.CrossRefGoogle ScholarPubMed
Corrêa, S and Jolly, S (2008) Development with a body: making the connections between sexuality, human rights and development. In Cornwall, A et al. (eds) Development With a Body: Sexuality, Human Rights and Development. Zed Books, London, pp. 121.Google Scholar
Corsi, DJ, Neuman, M, Finlay, JE and Subramanian, SV (2012) Demographic and health surveys: a profile. International Journal of Epidemiology 41(6), 16021613.CrossRefGoogle ScholarPubMed
Doyle, AM, Mavedzenge, SN, Plummer, ML and Ross, DA (2012) The sexual behaviour of adolescents in sub-Saharan Africa: patterns and trends from national surveys. Tropical Medicine & International Health 17(7), 796807.CrossRefGoogle ScholarPubMed
Evans, R (2020) Teaching about Female Genital Mutilation/Cutting in Africa: complex questions of culture, ‘development’ and human rights. Journal of Geography in Higher Education 44(2), 230247.CrossRefGoogle Scholar
Exavery, A, Kanté, AM, Tani, K, Hingora, A and Phillips, JF (2015) Sociodemographic drivers of multiple sexual partnerships among women in three rural districts of Tanzania. HIV/AIDS (Auckland, NZ) 7, 105.Google ScholarPubMed
Fiaveh, DY (2011) Male perspective(s) on condom use: context of STI/HIV prevention in the University of Ghana community. Journal of Public Health and Epidemiology 3(1), 1727.Google Scholar
Freymeyer, RH and Johnson, BE (2007) An exploration of attitudes toward female genital cutting in Nigeria. Population Research and Policy Review 26(1), 6983.CrossRefGoogle Scholar
Gaffoor, Z, Wand, H, Street, RA, Abbai, N and Ramjee, G (2016) Predictors of perceived male partner concurrency among women at risk for HIV and STI acquisition in Durban, South Africa. AIDS Research and Therapy 13(1), 14.CrossRefGoogle ScholarPubMed
Groeneveld, AE (2013) Female genital mutilation: tradition versus human rights. African Journal of Urology 19(3), 134135.CrossRefGoogle Scholar
Gruenbaum, E (2001) The Female Circumcision Controversy: An Anthropological Perspective. University of Pennsylvania Press, Philadelphia, PA.CrossRefGoogle Scholar
Guttmacher Institute (2012) Prevalence of female genital cutting varies greatly in Western Africa. International Perspective on Sexual and Reproductive Health 38(2), 110111.Google Scholar
Hernlund, Y and Shell-Duncan, B (2007) Transcultural Bodies Female Genital Cutting in Global Context. Rutgers University Press, New Brunswick, NJ.Google Scholar
Hicks, EK (1993) Infibulation: Female Mutilation in Islamic Northeastern Africa. Transaction, New Brunswick, NJ.Google Scholar
Hussein, M, Abdi, A and Mohammed, M (2013) Knowledge, attitude and practice of female genital mutilation among women in Jigjiga Town, Eastern Ethiopia. Gaziantep Med Journal 19(3), 164168.CrossRefGoogle Scholar
Ibekwe Perpetus, C, Onoh Robinson, C, Onyebuchi Azubike, K, Ezeonu Paul, O and Ibekwe Rosemary, O (2012) Female genital mutilation in Southeast Nigeria: a survey on the current knowledge and practice. Journal of Public Health and Epidemiology 4(5), 117122.CrossRefGoogle Scholar
Jang, SY (2015) The Causes of the Sierra Leone Civil War. E-International Relations Students. URL: https://www.e-ir.info/2012/10/25/the-causes-of-thesierra-leone-civil-war-underlying-grievances-and-the-role-of-the-revolutionaryunited-front (accessed 20th February 2021).Google Scholar
Jones, SD, Ehiri, J and Anyanwu, E (2004) Female genital mutilation in developing countries: an agenda for public health response. European Journal of Obstetrics and Gynecology and Reproductive Biology 116, 144151.CrossRefGoogle ScholarPubMed
Kim, J (2015) School socioeconomic composition and adolescent sexual initiation in Malawi. Studies in Family Planning 46(3), 263279.CrossRefGoogle ScholarPubMed
Makhlouf Obermeyer, C (2005) The consequences of female circumcision for health and sexuality: an update on the evidence. Culture, Health & Sexuality 7(5), 443461.CrossRefGoogle Scholar
Marks, SR (1974) Durkheim’s theory of anomie. American Journal of Sociology 80(2), 329363.CrossRefGoogle Scholar
Mitike, G and Deressa, W (2009) Prevalence and associated factors of female genital mutilation among Somali refugees in eastern Ethiopia: a cross-sectional study. BMC Public Health 9, 264.CrossRefGoogle ScholarPubMed
Mlambo, MG, Peltzer, K and Chirinda, W (2016) Predictors of multiple concurrent and multiple sexual partnerships among male and female youth aged 18–24 in South Africa. Journal of Psychology in Africa 26(2), 156163.CrossRefGoogle Scholar
Mmbaga, EJ, Leonard, F and Leyna, GH (2012) Incidence and predictors of adolescent’s early sexual debut after three decades of HIV interventions in Tanzania: a time to debut analysis. PLoS One 7(7), e41700.CrossRefGoogle ScholarPubMed
Mpofu, S, Odimegwu, C, De Wet, N, Adedini, S and Akinyemi, J (2017) The relation of female circumcision to sexual behavior in Kenya and Nigeria. Women & Health 57(7), 757774.CrossRefGoogle ScholarPubMed
Mulongo, P, McAndrew, S and Hollins Martin, C (2014) Crossing borders: discussing the evidence relating to the mental health needs of women exposed to female genital mutilation. International Journal of Mental Health Nursing 23(4), 296305.CrossRefGoogle Scholar
Njue, C, Karumbi, J, Esho, T, Varol, N and Dawson, A (2019) Preventing female genital mutilation in high income countries: a systematic review of the evidence. Reproductive Health 16(1), 113.CrossRefGoogle Scholar
Nnebue, CC, Chimah, UC, Duru, CB, Ilika, AL and Lawoyin, TO (2016) Determinants of age at sexual initiation among Nigerian adolescents: a study of secondary schools’ students in a military barracks in Nigeria. American Journal of Medical Sciences and Medicine 4(1), 17.Google Scholar
Oyefara, LJ (2014) Female genital mutilation (FGM) and theory of promiscuity: myths, realities and prospects for change in Oworonshoki Community, Lagos State, Nigeria. Genus 70(2–3), 733.Google Scholar
Pashael, T, Rahimi, A, Ardaian, A, Felah, A and Majiessi, F (2012) Related factors of Female Genital Mutilation (FGM) in Ravansar (Iran). Journal of Women’s Health Care 1(2), http://doi.org/10.4172/2167-0420.1000108 Google Scholar
Rajadurai, H and Igras, S (2005) CARE’s Experiences Working with Communities Toward Abandonment of Female Genital Cutting (FGC). CARE, Atlanta, GA.Google Scholar
Setegn, T, Lakew, Y and Deribe, K (2016) Geographic variation and factors associated with female genital mutilation among reproductive age women in Ethiopia: a national population-based survey. PloS One 11(1), e0145329.CrossRefGoogle ScholarPubMed
Shaaban, LM and Harbison, S (2005) Reaching the tipping point against female genital mutilation. Lancet 366, 347349.CrossRefGoogle ScholarPubMed
Shell-Duncan, B, Naik, R and Feldman-Jacobs, C (2016) A State-Of-The-Art Synthesis on Female Genital Mutilation/Cutting: What Do We Know Now? Population Council, New York.CrossRefGoogle Scholar
Shell-Duncan, B, Wander, K, Hernlund, Y and Moreau, A (2011) Dynamics of change in the practice of female genital cutting in Senegambia: testing predictions of social convention theory. Social Science & Medicine 73(8), 12751283.CrossRefGoogle ScholarPubMed
Sipsma, HL, Chen, GP, Ofori-Atta, A, Ilozumba, UO, Karfo, K and Bradley, EH (2012) Female genital multilation: current practices and beliefs in West Africa. Bulletin of the World Health Organization 80, 120127.CrossRefGoogle Scholar
Solanke, BL, Oyinlola, FF, Oyeleye, OJ and Ilesanmi, BB (2019) Maternal and community factors associated with unmet contraceptive need among childbearing women in Northern Nigeria. Contraception and Reproductive Medicine 4(1), 11.CrossRefGoogle ScholarPubMed
Solanke, BL and Rahman, SA (2018) Multilevel analysis of factors associated with assistance during delivery in rural Nigeria: implications for reducing rural-urban inequity in skilled care at delivery. BMC Pregnancy and Childbirth 18(1), 438.CrossRefGoogle ScholarPubMed
Steffenson, AE, Pettifor, AE, Seage, GR 3rd, Rees, HV and Cleary, PD (2011) Concurrent sexual partnerships and human immunodeficiency virus risk among South African youth. Sexually Transmitted Diseases 38(6), 459466.CrossRefGoogle ScholarPubMed
UNICEF (2013) Female Genital Mutilation/Cutting: A Statistical Overview and Exploration of the Dynamics of Change. UNICEF, New York.Google Scholar
UNICEF (2016) Female Genital Mutilation/Cutting: A Global Concern. UNICEF, New York.Google Scholar
UNICEF (2018) Female Genital Mutilation. URL: https://data.unicef.org/topic/child-protection/female-genital-mutilation/ (accessed 9th August 2020).Google Scholar
Van Rossem, R and Gage, AJ (2009) The effects of female genital mutilation on the onset of sexual activity and marriage in Guinea. Archives of Sexual Behavior 38(2), 178185.CrossRefGoogle ScholarPubMed
Van Rossem, R, Meekers, D and Gage, AJ (2015) Women’s position and attitudes towards female genital mutilation in Egypt: a secondary analysis of the Egypt demographic and health surveys, 1995–2014. BMC Public Health 15, 874.CrossRefGoogle ScholarPubMed
Wadesango, N, Rembe, S and Chabaya, O (2011) Violation of women’s rights by harmful traditional practices. Anthropologist 13(2), 121129.CrossRefGoogle Scholar
WHO (2008) Eliminating Female Genital Mutilation: An Interagency Statement. Technical Report, Department of Women’s Health, WHO, Geneva.Google Scholar
WHO (2013) Female Genital Mutilation. World Health Organization, Geneva. URL: http://who.int/mediacentre/factsheets/fs241/en (accessed 17th July 2020).Google Scholar
WHO (2020) Female Genital Mutilation. World Health Organization, Geneva. URL: http://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation (accessed 29th March 2020).Google Scholar
Williams-Breault, BD (2018) Eradicating female genital mutilation/cutting: human rights-based approaches of legislation, education, and community empowerment. Health and Human Rights Journal 20(2), 223233.Google ScholarPubMed
Yirga, WS, Kassa, NA, Gebremichael, MW and Aro, AR (2012) Female genital mutilation: prevalence, perceptions and effect on women’s health in Kersa district of Ethiopia. International Journal of Women’s Health 4, 4554.CrossRefGoogle ScholarPubMed
Yoder, PS, Camara, PO and Soumaoro, B (1999) Female Genital Cutting and Coming of Age in Guinea. Macro International Inc., Calverton, MD.Google Scholar