Alo, Olubunmi Akinsanya (Ph.D)
Department of Sociology, Adekunle Ajasin University
Akungba Akoko, Ondo State-Nigeria.
E mail: email@example.com
Department of Demography, Joseph Ayo Babalola University
Ikeji Arakeji, Osun State-Nigeria.
E mail: firstname.lastname@example.org
The practice of female genital cutting 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 have been taken to achieve this objective. Sixteen years later, this study uses data from 420 women aged 15-49 years, who had at least one living daughter and who were systematically selected through stratified random sampling across the six states of southwest Nigeria. There were seven focused group discussions and in-depth interviews with fourteen women considered as specialist in female genital cutting to investigate the changes in female genital cutting prevalence among daughters and mothers; attitudes and beliefs of mothers towards female genital cutting and how the menace can be eradicated. The analysis indicated a 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 female genital cutting. Educated mothers were found to be less likely to favour the cutting of their daughters. It is suggested that educational campaigns towards parents should be intensified. Legal recourse, prohibition of operations, improvement in women's status and sex education is also suggested as means of eradicating the practice
Female genital cutting (FGC) is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between sexes, and constitutes an extreme form of discrimination against women. The practice also violates a person’s rights to be free from torture, cruel, inhuman or degrading treatment and the right to life when the procedures result in death (WHO, 2010). Female genital cutting has been widely condemned by International Organizations and Feminist Groups all over the world due to the health outcomes it has for women, and because it is an abuse of the women’s Fundamental Human Rights (Alo and Adetula, 2005). A worldwide consensus was reached at the International Conference on Women and Development (ICWD) held in Cairo in 1994 where the practice was recognized as a set back on women’s rights and major life long risk to women’s heath.
Female genital cutting consists of all procedure that involve partial or total removal of the external genitalia, or other injury to the female genital organs for non-medical reasons. It is estimated that between 100-140 million girls and women worldwide are currently living with the consequences, while in Africa an estimated 92 million girls and women have undergone female genital cutting (WHO, 2010). The practice is most common in the western, eastern and north eastern regions of Africa, in some countries in Asia and the Middle East and among certain immigrant communities in North America and Europe (Okumepira, 2010). It has also been reported to occur in individual tribes in South America and Australia (WHO, 1999). To a lesser degree female genital cutting is practiced in Indonesia, Malaysia, Pakistan, India, New Zealand and United States (WHO, 2009).
In the mid 1990’s, World Health Organization and many other groups adopted the term genital mutilation to describe the cutting of female genitalia. Some other interventionist groups have adopted female genital surgeries (Obermeyer, 1999). A number of specialists have objected to the term mutilation, because the term is judgmental and implies disrespect (Elias, 1996), USAID recommended a neutral term ‘Female genital cutting’ and this is preferred by an increasing number of researchers. This is the position adopted in this article. Female genital cutting (FGC) is used in this article to refer to all forms of female circumcision, female genital mutilation and the removal of any part of the female genitals at whatever age.
The types of FGC vary from a simple pricking of the clitoris, to removal of all the female genitalia, and almost complete closure of the virginal area (infibulations). Based on the classification of Toubia (1994), WHO categorized the practice into the following four types:
FGC is carried out using various types of unsterilized instrument which include special knives, scissors, scalpels, and pieces of glass or razor blades. The procedures are usually carried out by an elderly woman of the village who has been specially designated for this task or by traditional attendants. It has been documented that FGC has very serious health implications on the reproductive, physical and emotional health of girls and women. The immediate physical health consequences include: severe pain, heavy bleeding, shock, acute urinary infection, pelvic inflammatory diseases, risk of contacting HIV and Hepatitis B; while the long term consequences include difficulty passing urine, recurrent urinary tract infection, and infertility, loss of normal sex function, cysts and abscess on genitals, painful intercourse, problems in child birth, painful and difficult labour, etc. (Alo and Adetula, 2005).
A recent study by WHO (2010) has shown that women who have had FGC are significantly more likely to experience difficult child birth and that their babies are more likely to die as a result of the practice. Serious complications during child birth include the need to have caesarian section, dangerously heavy bleeding after the birth of the baby and prolonged hospitalization after the birth. The psychological effects of FGC are less easily measured than medical complications. Among the effects documented by researchers are: anxiety, depression, trauma, frigidity, and marital conflict (WHO, 1996a). FGC sharply reduces a woman’s capacity for sexual fulfillment (Toubia, 1995:16), and it may also leave a woman with damaged nerve and scar tissue that makes intercourse extremely painful (WHO, 1996b). World Health Organization has compiled a list of possible health consequences of FGC and divided them into three categories; short term medical, long term medical, and sexual, marital and social consequences (WHO, 1996c).
FGC is a common practice in many societies of Africa. In a few societies, the procedure is carried out when a girl is a few weeks old and in some others, it occurs latter in childhood or adolescence. In the case of the later, FGC is often part of a ritual initiation into womanhood that includes a period of seclusion and education about the rights and duties of a wife. The practice of FGC is wide spread in Nigeria and varies from one cultural setting to another. A 1996 United Nations Development Systems Study reported that 32.7 million women have undergone FGC in Nigeria; the average reported rate for southwest Nigeria is 66 percent (United Nations, 1996). Toubia (1994) provided an estimate of 50% prevalence rate for Nigeria. This estimate prompted Gruebaun (2001:8) to postulate that nearly 1/3 of the cases in Africa are in Nigeria, not because of high prevalence but because of the large population; Nigeria accounts for 30.6 million of the 114.3 million cases for Africa as a whole. DHS estimated for Nigeria a prevalence rate of 25% for 1999 (NPC, 2000), 19% for 2003 (NPC, 2004) and 30% for 2008 (NPC, 2009). DHS (2003) further reported that about 60% of females have undergone that procedure in all the six geopolitical zones in the country, and that Southwest Nigeria is ahead in the practice with 56.9% prevalence rate. In 1999 Snow et al conducted a cross sectional study of reproductive health among woman aged 15-49 attending antenatal and family planning clinic in three hospitals in Edo state of Nigeria and reported a prevalence rate of 46% (Snow et al, 2002).
In 1994, Nigeria joined other members of the 47th World Health Assembly in a resolution to eliminate FGC-WHA 47.10 (Mandara, 2004). Steps taken so far to achieve this include establishment of Multicultural Technical Working Group on Harmful Traditional Practices (HTPS), conduct of various studies and national surveys on HTPS, launching of a regional plan of action, formulation of national policy and plan of action which was approved for the elimination of FGC in Nigeria by the federal executive council. In 1997, WHO issued a joint statement with the United Nations Children Fund (UNICEF), and the United Nation Population Fund against the practice of FGC (WHO, 1998). A new statement with wider United Nations support was issued in February 2008 to support increased advocacy for the elimination of FGC (UNFPA, 2010). The United Nations declares February 6 of every year as International day of zero tolerance to female genital cutting. The Nigeria National Assembly, Nurses and Mid Wives Association of Nigeria, the Nigerian Medical Association, and Nigerian Female Medical Association have all made concerted efforts towards the elimination of a FGC in Nigeria. The Houses of Assembly in Edo, Ogun, Cross-River, Osun, Rivers and Bayelsa have all passed into law bills prohibiting the practice of FGC in their respective states since 1999.
However, despite these concerted efforts from Local and International agencies towards the elimination of this practice, there are indications that the practice is rather on the increase (Alo, 2005 and Adetula; Shell-Duncan and Hernlum, 2000:71). Caldwell, Orubuloye and Caldwell (2000) reported that there are relatively few accounts of female genital cutting in Nigerian ethnographic literature. Therefore, this study investigated the prevalence of FGC, the correlates of FGC, why the practice still continue and how best and how quickly to eliminating the practice within the study population. Information about FGC is critical to understanding how FGC has been carried out and how the practice is distributed in a population. Data on distribution of FGC and how it is practiced can be useful to guide strategies for interventions against the practice. Figures on the prevalence of FGC are important for estimating the extent of the phenomena and the number of women at risk. These figures can then be used to publicize the threat that FGC poses to women’s health and human right (Yoder et al, 2004). It is important to get accurate estimate of FGC prevalence for judging the relative importance of adverse health consequences and for the allocation of resources for planning interventions. Knowing what was done to a girl or a woman at circumcision is important for anticipating possible health consequences in the long and short terms; consequences that may range from psychological distress to death.
Methods and Data
Area of study
The study is located in the South western part of Nigeria. Nigeria is located on the West coast of Africa, north of the Atlantic Ocean and south of Niger Republic and Chad. It boarders Cameroon in the east and Republic of Benin in the west. The history and geography of the country have combined to create a complex mosaic of diverse ethnic groups. However, there are three large, relatively homogenous groups, Hausa/Fulani, Igbo and Yoruba. The Hausa/Fulani predominates the Northern Nigeria, the Igbo in the Eastern Nigeria and the Yoruba in the South western part of Nigeria. Aside from these three ethnic groups, anthropological evidence indicated that the country is populated by more than 200 other smaller ethnic groups (Collins, 1975: 301). The practice of FGC tends to follow ethnic groupings; therefore, political lines and national boundaries are not particularly useful in understanding the phenomenon of FGC (Yoder and Mahy, 2001). Ethnicity provides a better explanation of the distribution of FGC within countries than other variables (Yoder et al, 2004). In line with the above therefore, this study is situated among the Yoruba speaking ethnic group of Southwest Nigeria.
The field work for this study lasted from March 2010 to August 2010. As preparation for the study, 12 interviewers and 3 supervisors participated in a 10-day workshop on the principle of qualitative research, the logic underlying the study and the best ways to ask questions. Guides for the individual interview with women were developed in Yoruba language, the dominant language of the people of Southwest Nigeria. At the end of the training there were three research teams, each comprised of four interviewers and one supervisor. Because of the sensitive nature of the questions, all interviewers and supervisors were female undergraduates in the social sciences.
DHS collected data on FGC for the first time in a 1989/90 survey in northern Sudan (Alo and Adetula, 2005). In that survey, women were asked whether they had ever been circumcised, type of circumcision, who performed the operation etc. This pattern of questioning has been followed to a large extent in this study. However, there were small modifications. The methods of data collection include; individual interview with women of child bearing age, facilitated group discussions, in-depth interviews with clinical and traditional practioners of FGC. The group discussion focused on opinions about the practice of FGC in general. All the interviews and discussions were recorded and analysed. A total of 420 women participated in the individual interview segment of the study. It is sufficient to state that southwest Nigeria is comprised of six states- Ondo, Oyo, Ogun, Ekiti, Osun and Lagos states. Seventy respondents were systematically selected through stratified random sampling technique from each of the 6 states. As parts of the qualitative segment, fourteen women considered to be specialists in FGC – traditional circumcisers, traditional birth attendants, nurses and midwives were also interviewed indepth. The interview of specialist on FGC was also on the basis of 2 per state. Group discussions were held with 6 groups of women, also on the basis of one group of women per state. Each group consists of 8 participants who are homogeneous in socioeconomic characteristics. To select the individual sample of 70 per state, the enumeration areas (EA’s) from the 2006 census of Nigeria was used. Ten EA’s were randomly selected from each state and 7 women who had at least one surviving daughter from 7 households were systematically selected for the interview. Quantitative analysis involves frequency distribution and much of the analysis was done using information from the qualitative source because of its robustness and flexibility.
Results and Discussion
Female genital cutting is practiced in all the states of the southwest of Nigeria. It has been documented that FGC is recognized and considered important for the socialization of women, curbing their sexual appetite and preparing them for marriage (Alo and Adetula, 2005). It is with this background that this study investigated the prevalence of FGC in the study area. In this study, women who had at least one living daughter were asked if any of their daughters had been circumcised and if the respondents themselves were circumcised.
Table 1: Prevalence (%) of FGC by states of the Southwest Nigeria
The prevalence rate of FGC among daughters and mothers in each of the 6 states in Southwest Nigeria is presented in Table 1. Oyo state had the highest prevalence rate of 88% for daughters and 91% for mothers while Lagos had the least prevalence rate of 56% and 64% for daughters and mothers respectively. It is sufficient to note that Lagos state faired better regarding all the indices of modernization than any other state in the country being the former federal capital territory. Lagos state, however, had the highest intergenerational difference of 8%; this is followed closely by Ekiti State with an intergenerational difference of 5%. It is important to state that DHS (2003 & 2008) has reported that the prevalence of FGC is greatest in the southwest zone of the country (NPC, 2004 and 2009). However, the prevalence rate recorded in this study is higher than the DHS reported rates of 61% and 58% for DHS 2003 and 2008 respectively for the Yoruba speaking ethnic group of south west Nigeria. This study reported average prevalence rates of 71% and 75% for daughters and mothers respectively with an intergenerational difference of 4%. This report is contrary to the finding of Caldwell et al (2000) which reported a decline in the prevalence of FGC among the Yoruba of Southwest Nigeria.
Approval of FGC
Attitudes and prevalence more often than not go together. In this study respondents were asked if they approve the practice and whether or not the practice should continue. The result is presented in Table 2.
Table 2: Distribution of respondents who approved of FGC either on self or on daughter
Table 2 indicated that about 86% of the respondents believe that the practice should continue while 11.4% disapprove of the practice. Only 2.9% are unsure of whether the practice should continue or not. This result indicated a very high approval for the practice of FGC among the study population. Some of the reasons for approval as reported in the qualitative session are as follows:
“The clitoris will continue to grow as a girl gets older and so it must be removed.”
“The clitoris is dangerous; it can cause the death of an infant during delivery.”
“Female genital cutting is performed to keep a woman’s virginity by limiting her sexual behaviour. It stops woman’s sexual desire.”
A female medical doctor describes FGC as follows: “What is removed is the prepuce – a small piece of sheath that extends from clitoris. That sheath has no sexual function. It is the same sheath that is removed in males.” When it was later pointed out to her that what she has described is genital mutilation. She flared up and responded thus: “That term mutilation is mischievous and hypocritical. Why is anybody not talking about male genital mutilation, this is our custom, our tradition and nothing can stop it.”
A member of a group of young women said “The external genital is unclean and if left uncut will become unsightly”. Another discussant from the same group said “cutting instills calm, submissiveness and other traits associated with ideal feminity.”
Another discussant still from the same group said “cutting ensures a modest and faithful wife and it keeps women from becoming too sexually demanding…”
Another one of them: “…female genital cutting will empower our daughters, ensure the girls get married and protect the family good name.”
The following excerpts clearly present other dominant expressions in the focus group discussion.
“People believe that the clitoris is the cap of prostitution which the vagina wears from heaven so it must be removed.”
“The presence of the clitoris in a woman makes her husband to demand sex always.”
"The female organ is ugly and the offending part is the clitoris, so FGC is therefore needed to beautify it.”
“Clitoris causes itching in women so it should be removed.”
“Women’s genitals are ugly and bulky and can grow to become wild and it will be hanging down between her legs if not cut.”
“l am circumcised so do my parents and grand parents, so why would I not circumcise my daughters. This is our custom; the Holy Bible approves the practice…”
"An old woman stated that “we are circumcised and we insist on circumcising our daughters, the practice is to prevent young girls and later women from being promiscuous. This is our tradition and nothing can change it.”
The opinion of the old women in the group discussion can be summarized in this way. Female genital cutting is motivated by belief about what is considered proper sexual behaviour, linking it to premarital virginity and marital fidelity. It is believed to reduce a woman’s libido and help her to resist illicit sexual behaviours.
The approval of FGC cuts across age and education. It is based on deep rooted tradition which every member of the Yoruba society respects and observes. However, it was discovered during the discussion sessions that most of the respondents who disapprove the practice still cut their daughters. A probing session later disclosed that non-approval is not the same as not practicing the act. One of them responded thus: “I do not approve of the practice but I circumcise all my daughters because that is the demand of our tradition and culture. My husband makes decision regarding every issue like this at home.” This position confirms the patriarchal nature of Yoruba society where most families are male dominated and women/wives are only recipients of instructions.
On the rationale behind the cutting, as revealed in the in-depth interview, the findings can be summarized as follows on the order of prominence: custom and traditions, gender identification, control of women's sexuality, reproductive functions, health consideration and religion.
Background Characteristics of Respondents and FGC status of Respondents
Research on female genital cutting often compares women’s FGC status with their background characteristics (Carr, 1997: 16; Locoh, 1998). This correlation may not be completely correct. This is because the background variables in question may no longer be relevant at the point in which the FGC status of the woman is being established. In the present analysis, the background characteristics of the respondents is compared with the FGC status of their daughters. This is because most of the cuttings in Yoruba land are performed before the girl’s first birthday. Therefore the background characteristics of the surveyed women are not directly applicable to the woman’s situation at the time she was cut.
Table 3: Distribution of respondents according to the FGC status of at least one of their daughters and background characteristics
No Daughter Cut
Some Daughters Cut
All Daughters Cut
|ii. State of residence
|iii. Age of respondents
|v. Socio-economic status
Table 3 shows the distribution of respondents according to the FGC status of at least one of their daughters and background characteristics. Panel i of the table indicated that education of mothers varies inversely with FGC status of daughters. Respondents with post secondary education are least likely to have their daughter cut as 44% and 56% had some of their daughters cut and all their daughter(s) cut respectively. Forty eight percent of them had none of their daughters cut against 20% of respondents who had no formal education.
In Panel ii, Ekiti state has the least proportion of none of their daughters cut (11%), this is closely followed by Oyo state with 12%. Lagos had the highest proportion of 32% of the respondents with none of their daughters cut. This report is consistent with the report in Table 1. Oyo state had the highest proportion of respondents with some of their daughters cut with 41% and all of their daughters cut with 66%. Lagos state had the least proportion (36%) of respondents with all of their daughters cut. Age of the respondents in relation to the FGC status of their daughters is presented in Panel iii. The oldest age group (45-49 years) had only 10% of their daughters not cut; this is compared to the youngest age group (15-24 years) who had 42% of their daughters not cut. In a similar vein, 75% of the women in the oldest age group had all their daughters cut and 74% had some of their daughter cut. The practice of FGC crosses religious barriers, no religious text requires or even supports female genital cutting. Despite the lack of doctrinal support both in the Holy Quran and Holy Bible, prevalence levels are generally high among the two religions as shown in Panel iv of Table 3. Eighty percent of Christian’s respondents and 81% of Muslim respondents had all their daughters cut. This is compared to 98% of respondents who are adherents of traditional religion. This finding reflects the strength of culture and tradition over the two western religions.
Panel v shows the distribution of respondents according to the FGC status of their daughters and their socio-economic status. Socio-economic status was classified into high, medium and low. This classification was based on an index of 10 household amenities. These include; electric lighting, television, radio, refrigerator, indoor toilet, car, gas or electric stove, access to internet, availability of three or more bedrooms and indoor plumbing. Availability of seven or more of the amenities was rated as high, possession of between four and six was rated as medium, while availability of less than four was rated as low on socio-economic scale. Generally speaking, respondents in the high socio-economic status are least likely to have their daughters cut as 26% of respondents in this category did not cut their daughter and 50% of them had all their daughters cut. This is against 88% in the low category and 61% in the medium category that had all their daughters cut. There is therefore an inverse variation between socio-economic status of respondents and the circumcision of their daughters.
Awareness of Health Hazards
The high prevalence of FGC among the study population may be associated with ignorance of the health hazards which are associated with FGC. The respondents were asked if they are aware of the health problems associated with FGC.
Table 4: Percentage distribution of respondent’s awareness of Health hazard connected to FGC
Table 4 shows that about half (52%) of the women are aware of the health hazards associated with FGC, while 48% claimed they are not aware. The awareness is quite low, contrary to earlier reports. The qualitative session was more revealing where most of the discussants regard the associated health hazards as a calculated propaganda. In the words of a mid-wife: “There is no health risk involved, I was circumcised as an infant, I have four children today and I have been living a normal sex life; so what are you talking about”. Another one said: “provided it is properly done, circumcision these days are done in the hospital where any complication can be promptly attended to.” It can be deduced from the two responses above that circumcision is done mostly in the hospitals where doctors and nurses are involved. This is contrary to earlier findings that attendance of antenatal clinic and deliveries in the hospital has an inverse relationship with female circumcision (Toubia, 1995).
The prevalence rate of female genital cutting is still very high in southwest Nigeria with the average prevalence rate of 75% for mothers and 71% for their daughters. The intergenerational difference of 4% does not justify the efforts that have been put into the elimination of the practice by both Local and International agencies. It is evident from this study that the practice is on the increase with the recorded rates of 61% and 58% by DHS 2003 and 2008 respectively for the southwestern part of Nigeria. The reasons given to justify female genital cutting are numerous. They include: custom and tradition, purification, family honour, hygiene, aesthetic reasons, protection of virginity and prevention of promiscuity. Others include increased sexual pleasure of husband, enhancing fertility, giving a sense of belonging to a group and increased matrimonial opportunities. It is therefore hypothesized that the perceived benefits of FGC outweighs the health hazards associated with the practice among the study population. Efforts should be intensified by policy makers to correct this wrong impression and this can be one of the reasons for the increase that was earlier noted in the prevalence rate of the practice.
Approval of female genital cutting is almost universal among the study population. Eight six percent of the respondents approved the practice. The approval rate is a bit higher than the prevalence rate. The approval of the practice cut across age as revealed in the qualitative session as both old and young discussants approve the practice; though the prevalence rate for daughters is higher among the older respondents. The study also revealed that there is difference between non approval and non-practice because many of the respondents who claim they did not approve still practice the act. Approval also went across educational background as some doctors and mid-wives still approve the practice despite their educational background. The approval from this category of respondents further confirms the hospitalization of the practice. This is contrary to the campaign against FGC by their professional organizations. Several reasons which are similar to the ones earlier stated for prevalence rate were giving for the approval of the practice. Most of the reasons are rooted in tradition and belief system of the study population. There is no difference in the level of approval between the old and young cohorts of interviewed women. This can be an indication that the end of this practice is not at sight.
The study reveals an inverse variation between the educational level of mothers and the prevalence rate among their daughters. Education, socio-economic status and age are three variables which impact negatively on female genital cutting. This is expected because of the interlinkage between the three variables. Better educated women are likely to occupy high socio-economic status and they are likely to belong to the younger age cohort. About half of the daughters of respondents with post secondary education were never cut. State of residence is another variable in this study which is related to the FGC status. Thirty two percent of respondents from Lagos State did not circumcise their daughters; this is against 11%, 12% and 14% in Ekiti, Oyo and Ondo state respectively. It is noted earlier that Lagos is ahead of all other states in Nigeria in terms of indices of modernization/urbanization and that the city is the former federal capital territory of Nigeria. Findings from Lagos are therefore not surprising but it goes to suggest the negative impact of urbanization on tradition and other harmful practices. The patriarchal nature of the Yoruba society was again brought to bear in this study. Daughters still get cut whether or not their mother approve of the practice as long as the father approve the practice. The father is the head of the home and most decisions emanated from him without any input from the wife. In some places in Yoruba land, women are treated as objects that can only be seen and not heard. In some other instances, critical decisions are taken by grandmothers. In this regard, sensitization of the male gender becomes imperative. They should be involved in the whole process of eradication of this practice if meaningful result is desired. Any program of intervention that does not involve the men may not achieve the desired result.
Some socio-cultural determinants have been identified as supporting the avoidable practice of female genital cutting. In order to eliminate this practice in Nigeria, it is necessary to promote awareness of the problem by educating the policy makers, the general public, health workers and those who carry out the practice on all its health and psychological consequences. This call for the active involvement of political leaders, professionals, development workers, local communities and their leaders, women groups and organizations. The campaign against FGC should start from primary schools; this should be made a part of sex education which should form part of the curriculum of study for pupils at this level. Traditional rulers and community organization should be involved in this campaign.
Orthodox medical practioners who involve themselves in the practice of FGC should be adequately sanctioned and the activities of the traditional birth attendants and mid-wives should be closely monitored. The prohibition of the operation should be incorporated into the country’s criminal code where the penalty should be clearly stated. This is a serious violation of fundamental human rights and it should be treated as such. Later in life any woman who discovered that her right has been violated as an infant or a child should be free to take legal recourse against her parents and the person who performed the operation on her.
The position of this study is that better educated women are less likely to circumcise their daughters. There is therefore the need for massive female schooling on free basis in Southwest Nigeria. The efforts of the government of Lagos and Ondo state government in this regards are recognized. Lagos and Ondo state government introduced free primary and secondary education since 1999 and 2009 respectively. Generally speaking, the socio-economic status of women should be improved, this will enable them have a voice in decision making processes within and outside the family. The rapid urbanization of Nigerian societies is also suggested by this study. The urban status of Lagos state clearly reduced the prevalence of FGC in the state.
This study could not obtain information about the type of female genital cutting a woman underwent because it is impossible to obtain accurate information about this without a physical examination. It is therefore suggested that clinically based study on female genital cutting by health practioners should occupy the attention of future researchers on the subject matter.
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