Described by WHO as a violation of the human rights of girls and women, FGM is still practiced in some communities in Nigeria, and sadly, evidence from the National Demographic Health Survey (NDHS) has shown that some parents go as far as engaging the services of health-workers to conduct FGM on their female children; previously nearly all FGM acts were carried out by traditional circumcisers.
“You’d be surprised that some parents pay health workers as much as US$100 to circumcise their female child”, says Dr Chris Aimakhu an obstetrician and gynaecologist (OB/GYN) and the Secretary General of Society of Gynaecology and Obstetrics of Nigeria (SOGON).
“To the best of my knowledge, there are absolutely no health benefits of FGM. It is humiliating, excruciating, barbaric and actually poses serious health threats such as tetanus, excessive bleeding, urinary problems and in worst case scenarios, death. We need to unite and speak in one voice to stop these barbaric acts”, he reiterates.
At least 20% of Nigerian women age 15-49 have been circumcised
In Nigeria, data from the 2018 (NDHS) shows that 20% of women age 15-49 have been circumcised. The most common type of FGM in Nigeria is Type II (some flesh removed), with 41% of women who had FGM while undergoing the procedure. Meanwhile, 10% percent of women underwent a Type I procedure (clitoris stitched, no flesh removed) and 6% underwent a Type III procedure (also known as infibulation).
The NDHS 2018 also indicates that 7.0% of circumcisions carried out on girls age 0-14 and 8.6% of women age 15-49 were carried out by medical professionals with majority of female circumcisions carried out by traditional circumcisers.
Speaking further on the topic, Dr Christopher Ugboko, the Division Head of Gender, Adolescent/School Health and Elderly Care (GASHE) unit, Federal Ministry of Health said,
“The revised National Policy on the elimination of FGM (2020 – 2024) has mapped out roles for health workers, health regulatory bodies, professional health associations and other stakeholders to prevent FGM in Nigeria.”
He added, “Specific strategies include wide sensitization and awareness creation, capacity building of health workers as well as setting up of surveillance systems to detect such practices amongst medical personnel. The Violence Against Persons Prohibition (VAPP) law has prescribed sanctions against persons implicated in FGM and its medicalization.”
Currently, in addressing this menace, the Nigerian Government developed the first National Policy and Plan of Action for the Elimination of Female Genital Mutilation in Nigeria, 2013 – 2017; which was revised in 2018. Significant milestones were recorded in the implementation of the policy over the past six years which includes the enactment of legislation outlawing FGM. However, implementation of this legislative framework remains low across the states in Nigeria.
Canvassing for an end to FGM through Universal health Coverage
The context of universal health coverage and respect for human rights under the 2030 sustainable development agenda mandate that stakeholders address FGM regardless of individual circumstances, cultural or social norms. In Nigeria, WHO works closely with the Government of Nigeria to promote good health and wellbeing through various interventions, one of which includes advocacy and canvassing for the end of FGM.
“Currently, WHO Nigeria is working with Government and professional associations of health workers to stop medicalization of FGM. National guidelines and clinical handbooks have also been adapted in line with WHO recommendations to build the capacity of health workers to treat complications associated with FGM”.
Dr Ojo buttressed that the policies will also address the sexual and reproductive health needs of women and girls who suffer from its consequences. Furthermore, political commitment from governments and policy makers is needed to translate efforts into concrete actions at the national and grassroots level to reach the goal of zero tolerance to female genital mutilation by 2030.