BREAKING THE CHAINS OF FEMALE GENITAL MUTILATION IN NIGERIA: A Policy Report

Female Genital Mutilation/Cutting (FGM/C) refers to all forms of procedures involving the partial or total removal of a part of the female genitalia for non-medical reasons. Statistics have shown that over 20 million women and girls have undergone FGM/C, and this comprise of 10% of the global population of women[1]. In Nigeria, the South-eastern and south-western zones have the highest prevalence of FGM[2]. Out of the four types of female genital mutilation, excision and clitoridectomy are the most practiced mutilation done in Nigeria[3]. A total of 82% of women aged 15 – 49 and have undergone FGM, had their cutting before the age of five[4]. Statistics have shown that 20% of girls and women aged 15-49 have undergone female genital mutilation and 14% of girls in their adolescent ages of 15-19 years have undergone female genital mutilation.  Additionally, it is worth noting that 67% of women believe that female genital mutilation needs to be discontinued[5].

Female genital mutilation is a harmful practice that has both short term and long-term impact on the victims. These practices are done in all parts of the country and a large proportion of all the FGM done are by traditional circumcisers. The medicalization of FGM is when the mutilation is done by a healthcare professional with the intention of reducing the harm caused, however this negates the Hippocratic oath of ‘First do no harm’. Medicalised FGM not only violate the medical ethics by causing harm, but it also poses both long term and short-term health complications. The short-term complications include pain, haemorrhage, shock, urinary retention, infections including HIV transmission. Additionally, some of the long-term complications that victims are exposed to, are scar formation as a result of the cutting, pains while sitting and walking, childbirth risks[6]. Several reasons have alluded to the sustenance of this die-hard violation spanning from tradition, religion and politics. From the economic point of view, this is a source of income for the traditional practitioners and in some societies, the practice increases the marriage prospects of the victims and serves as a form of social stratification where daughters mutilated are considered to be in high class than their counterparts[7].

The costs and complications of practicing FGM outweighs the benefits in any society practicing it. It is important to note that the cost of FGM encompasses both the cost of the service and the cost of medical complications that arise from the practice whether short or long-term[8]. However, the psychosocial, emotional effects and consequences to the family of the victims are unquantifiable. Various studies have demonstrated that some types of FGM end up removing the sexually sensitive structures, scarring the affected area, thereby leading to a reduction in sexual response and sexual dissatisfaction[9]. Some practitioners try to manage the complications through immediate administration of pain killers and other medications, depending on the extent of the complications. There is no doubt that the best management of FGM complication is prevention of its occurrence[10].

The Federal Government of Nigeria recognised FGM as a discriminatory practice in the year 2002, therefore acknowledging the fact that FGM requires policy and legal interventions, and this brought about the first National FGM policy and plan of action in Nigeria between 2-13 to 2017. Subsequently, this National policy (2021-2025) was introduced with the aim eliminating the practice of FGM in Nigeria in order to improve the health and quality of life of girls and women in Nigeria. The violence against prohibited persons act (VAPP) is a comprehensive law that

promotes the safety of women and girls in Nigeria. The VAPP act was introduced by the federal government of Nigeria in the year, 2015 which is to be adopted by all the states in Nigeria[11]. This VAPP Act attracted various stakeholders simply because of it is the only law in Nigeria that criminalises a long-standing discriminatory act with cultural justification. Currently, there are a total of eight states in Nigeria that are yet to adopt the VAPP act. When the states do not adopt the act, it means that the state government does not recognise the law and hence the violation can linger on. International communities have called for all countries including Nigeria to eliminate the practice and ensure zero tolerance of female genital mutilation from the national level down to the grassroots.

While statistics from Demographic health survey (DHS) in Nigeria show a slow decline in the practice of FGM among girls and women between the ages of 15-49 from 24.8% in 2013 to 19.5% in 2018, its prevalence among 0-14 years have increased from 16.9% in 2013 to 19.2% in 2018. Data from DHS across 2007, 2011, 2016 and 2021 showed no significant difference in FGM prevalence across these years even with the institution of the VAPP act. Based on these posed risks and negative impact of female genital mutilation. Due to this infringement, thousands of girls are deprived of their health, education, and childhood ambitions[12]. The FGM goes a long way in impacting negatively the self esteem of the women which impact the kind of women and girls we raise in the society. Additionally, increased migration makes it a global issue. It is worth noting that during the 2020 commemoration of the international day of zero tolerance to FGM, the WHO launched the FGM cost Calculator that shows that if FGM were abandoned now the associated savings in health costs would be more than 60% by 2050; therefore, as a country, eliminating FGM/C will go a long way in reducing amount spent on FGM complications[13].