Nigeria is ranked third highest in Female Genital Mutilation/Cutting (FGM/C) prevalence in the world. It estimated that 25percent or 19.9 million Nigerian girls and women 15 to 49 years old underwent FGM/C between 2004 and 2015. These absolute numbers are only behind Egypt with 27.2 million victims and Ethiopia with 23.8 million victims respectively (UNICEF 2016a). The Nigerian estimate is consistent with prevalence rates derived from the analysis of the 2013 Nigeria Demographic and Health Survey (NDHS) data (NPC Nigeria and ICF International 2014). According to the US Department of State (2001) report,

Types of FGM/C

Type I (commonly referred to as clitoridectomy), Type II (commonly referred to as excision), and Type III (commonly referred to as infibulation) are historically the most common forms of FGM/C in Nigeria. Type IV is practiced to a much lesser extent (US Department of State 2001, Mandara 2004). It is important to note, however, that analysis of current data shows a high level of prevalence of Type IV across Nigeria, with a total national prevalence of up to 30percent, a level unusually high for Sub-Saharan Africa and not often emphasized by practitioners and campaigners in the country.

FGM/C remains a recognised and accepted practice in many Nigerian cultures, performed any time from a few days after birth until after death, considered important for women’s socialisation, curbing their sexual appetites and preparing them for marriage (NPC and ICF 2014). In each survey year (1999, 2003, 2008, 2013), the highest prevalence of FGM/C was found in the South West and South East geopolitical zones, among the Yoruba and Igbo ethnic groups, respectively. Similarly, for 2008 and 2013, where data are available, the three States with the highest prevalence rates were Ebonyi (83%), Osun (83%), and Oyo (84%), in 2008, and Ebonyi (74%), Ekiti (72.3%), and Osun (77%) in 2013. Although few women in the North have been circumcised, Type IV forms of FGM/C, which constitutes 30percent of national FGM/C prevalence, are more prevalent in the region, vis-à-vis the greater prevalence of Type I, II, and III are in the South. For instance, 76percent of women who underwent scraping of tissues surrounding the vaginal orifice (angurya cuts) (Type IV) were in three Northern States: Jigawa, Kano, and Kaduna, with 48percent of the cuts in Kano alone. Among women who underwent vaginal cutting (gishiri cuts), the State of highest prevalence is Kaduna (25%).

Despite the cultural justifications for the practice, as in many other countries, evidence in Nigeria of declining levels of FGM/C is supported by almost monotonic decrease in the proportion of women circumcised, from oldest to youngest age cohorts. The proportion of circumcised women decreased from 35.8percent among women ages 45 to 49 to 15.3percent (NPC Nigeria and ICF International 2014). Despite decreasing support for the practice, however, millions of girls remain in considerable danger of being circumcised. The UNICEF report reveals that a majority of people in most countries where the practice is concentrated oppose it, yet about 30 million girls are still at risk of being cut in the next decade (UNICEF 2013a).

FGM/C has drawn considerable criticism, particularly because of its potential short- and long term medical complications, harm to victims’ reproductive health, and infringement on women’s rights (Toubia 1995). Despite the medical implications of FGM/C, it persists, as it is deeply rooted in culture (Yerima and Atidoga 2014), and its eradication by government and other stakeholders is challenging. A 1985-1986 national study by the National Association of Nigerian Nurses and Midwives found FGM/C practiced in all States, and in five States at least 90percent of women had been cut. FGM/C prevalence from 1999 to 2013 remained relatively constant, around 25percent, or one out every four women of reproductive age (NPC Nigeria and ORC Macro 2000, NPC Nigeria and ICF International 2014). Several FGM/C eradication efforts in the last two decades have emphasized the health and psychological consequences suffered by women, although Babalola and Adebajo (1996) found that FGM/C in Nigeria is a cultural practice persisting despite its social and health detriments.

The United Nations (UN) banned FGM/C worldwide in 2012. States in Nigeria: Bayelsa, Cross River, Edo, Ekiti, Enugu, Imo, Ogun, Osun, and Rivers each banned the practice, beginning in 1999. Although no federal law banned FGM/C in Nigeria until 2015, opponents of the practice relied on Section 34(1)(a) of the 1999 Constitution, “No person shall be subjected to torture or inhuman or degrading treatment,” as the basis for campaigning for its ban nationwide (US Department of State 2001). In 2015, however, Nigeria’s Federal Government passed a law criminalising FGM/C in the Violence Against Persons (Prohibition) Act 2015, making female circumcision or genital mutilation illegal, with several other forms of violence including forceful ejection from homes and harmful widowhood practices. This marks the first time that the entire country committed to stopping FGM/C through an Act of the National Assembly. Under Nigeria’s federal system, acts of the National Assembly such as the VAPP 2015 need to be ratified by each of the 36 State’s House of Assembly to apply in those respective States.

Despite all this progress, FGM/C is still actively practiced in six States (Nkwopara 2015), and prevalence rates have remained relatively stable over time. A gap in comprehensive knowledge of  FGM/C in Nigeria remains, even after the recent developments (Nigeria’s 2015 VAPP Act and the new UNFPA/UNICEF global target and call to eliminate FGM/C by 2030), with no rigorous review of the most recent literature and interventions in the country. No study or report has comprehensively examined the types, and effectiveness of abandonment interventions in the country.

In all survey years, a consistent differential by urban and rural residence is observed, with a larger proportion of urban than rural women circumcised. This reveals that FGM/C is more common among better educated women in each survey year, which seems counter-intuitive but reflects the fact that the Yoruba and Igbo, who traditionally reside in the Southwest and Southeast, are more urbanised and thus include more educated women in their populations than residing in the Northern regions. The dominance of FGM/C in the Southwest, South, and Southeast, the most educated regions in the country, continues to fuel the notion that cultural and customary beliefs in support of FGM/C remain strong and that education has been unable to reduce its prevalence. An overwhelming majority (82%) of circumcised women were cut before their fifth birthday, while about 10 percent were cut between the ages of five and 14 (NPC and ICF Macro 2014).

While educational attainment does not have a huge direct effect on women’s circumcision, the 2013 NDHS shows that education remains an important empowerment tool, with a positive intergenerational effect. Mothers with higher levels of education are less likely to have their daughters circumcised (NPC Nigeria and ICF International 2014). Data on the types of FGM/C practiced in each State were collected in an earlier study, in 1997 that covered 148,000 women and girls nationwide from 31 community samples. While the data are dated, and latest prevalence estimates suggest minor reductions, it confirms that, as far back as 20 years ago, all four forms of FGM/C were prevalent throughout the country, with Types I, II, and III more predominant in the south, and Type IV of higher incidence in the Northern States. Five States (Kwara, Ondo, Oyo, Osun, Delta) with the highest prevalence rates in 1997 remained among the 10 with highest prevalence rates in 2008 and 2013, respectively.

During the last 20 years, the Southwest region has had a continual higher prevalence, with three states (Ondo, Osun, Oyo) with highest prevalence rates in 2013, suggesting that little has actually changed. Although few women in the North have been cut, paradoxically Type IV is more prevalent there, with greater prevalence of Types I, II, and III in the south (UNICEF 2001, Adegoke 2005, NPC Nigeria and ICF International 2014). Angurya cuts scrape tissue surrounding the vaginal orifice, mostly common among the Islamic community (54%), the Fulani and Hausa ethnic groups (87% each), northwest residents (84%), and in Kano, Jigawa, and Kaduna states. Women with no education (70%) and those in the lowest wealth quintile (76%) are most likely to have angurya cuts (NPC Nigeria and ICF International 2014).

This question is, how far can government and stakeholders go to eradicate FGM/C in Nigeria? The next update will focus on the efforts being made in the recent time by governments and others stakeholders to eradicate FGM/C in Nigeria especially in the States with the highest prevalence rate.

Extract from:
Female Genital Mutilation/Cutting in Nigeria: A Scoping Review
May 2017

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