A qualitative study of primary healthcare professionals’ knowledge, beliefs, and practices of female genital mutilation (FGM) in Delta State, Nigeria
Publication Date
July 16, 2024
Abstract
Background
Female genital mutilation (FGM) remains a global issue because of its high prevalence among infants, young girls and women, and the associated detrimental health implications. Nigeria has a high prevalence of FGM and rate of medicalisation, however there is a dearth of evidence regarding healthcare professionals’ (HCPs) understanding of FGM and the quality of care that is available for women living with FGM in Delta state Nigeria.
Purpose
To explore primary HCPs’ current knowledge, beliefs, and practices of FGM in Delta state, Nigeria.
Methodology and methods
This study followed the tenets of social constructivism and qualitative design. Purposive and snowball techniques was used to recruit 2 doctors, 15 nurse/midwives and 9 community health extension workers (CHEWs) that were practising in 11 primary healthcare (PHC) facilities in two local government areas (LGAs) in Delta state, Nigeria. A semi structured interview was conducted with the 26 HCPs and the recorded interviews were transcribed verbatim and exported onto NVivo12Pro data management software, where data construction was undertaken following Braun and Clark’s (2006) inductive thematic analytical approach.
Findings
Two main themes and five sub-themes were generated from the interview data. The main themes were “Knowledge of FGM: The influence of sociocultural system and professional practices” and “Encounters with FGM in the clinical setting: Experiences and challenges of providing care for women with FGM”. The five sub-themes include (i) sociocultural influence (ii) professional influence (iii) encountering FGM in clinical practice (iv) clinical service development for the care of FGM (v) beliefs and attitudes towards FGM practices.
Irrespective of the professional group, the HCPs had a good cultural understanding of FGM, but the professional knowledge about the concept of FGM and its typology was poor. Some of the HCPs had themselves undergone FGM procedures, some had been requested to perform FGM, while some had performed FGM in the past. Notwithstanding, almost all the HCPs had negative attitudes towards FGM and declared that they had a role to play in ending FGM practices. The majority of the HCPs had encountered and cared for women with FGM during parturition, and they described the experience as a ‘tug of war’. These HCPs identified lack of guidelines on FGM, lack of professional trainings, lack of specialist services and resources such as clinical instruments and staff as some of the challenges that they experienced when supporting women affected by FGM.
Conclusion
There is need for collaborative efforts by key stakeholders including the PHC system, the Nigerian healthcare system, and professional bodies to provide guidelines and procedures for the delivery of women with FGM and management of FGM complications. There is also a need to organise specialised training for HCPs, ensure a working referral pathway by establishing a specialist clinic for FGM cases, and provide adequate staffing and basic gynaecological and obstetric instruments.
Item Type
ethesis
Thesis Type
PhD
Subjects (LC)
Associated Schools / Departments
School of Health Sciences
eprints ID
77373
UoN Repository URI
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