Female genital cutting (FGC) comprises all surgical procedures involving partial or total removal of the external genitalia and/ injury to the female genitalia organs whether for cultural or any other non-therapeutic reasons [1, 2]. An estimated 200 million girls and women have undergone FGC globally. The practice of FGC cuts across over 30 countries in Africa, Asia, and the Middle East [3]. In Africa, more than 101 million girls aged 10 years and above have undergone FGC [4], and an estimated 3 million girls have their genital cut annually [2, 5], as the practice is deeply entrenched in African culture [6]. The Practice of FGC is high in Nigeria with one-quarters of the global estimates occurring in the country, and it cuts across all socio-cultural and geo-political zones in the country [7]. The current national prevalence of FGC among women of reproductive age stood at 20 percent and 19 percent among daughters less than 14 years of age, with the highest prevalence among adult women (35%) found in the South East, followed by South West (30%) and lowest in the North East (6%) region of the country [8].
In Nigeria, the practice of FGC is performed during infancy especially within 8 days of delivery among some cultures, before marriage in some other societies most especially among the Ibo of the South of Nigeria, and sometimes before the birth of the first child in some other societies [3, 6, 9]. It is mostly performed by the traditional birth attendants and the local circumcisers with no medical training, using unsterilized instruments such as razor blades, scissors, and broken glasses [5, 10, 11], while some few health workers are also involved in the operation [3, 12, 13].
FGC is justified among the perpetuators on the premise that the procedure helps in preventing promiscuity, among women, initiates girls to womanhood, and promotes women’s chastity. It also increases male sexual pleasure, prevents infant and child deaths, enhances women’s fertility and child survival. Other reasons cited for the practice of FGC are cultural and religious beliefs even though the practice is independent of religion [7, 11, 14]. FGC has no health benefit but inflicts serious health complications which are irreversible on its victims; such as menstrual pain, excessive bleeding during delivery, infections (such HIV/Aids, hepatitis, urinary tract infections, abscesses, etc.), painful intercourse, and can also results into death of the victims through severe bleeding [11, 15]. It is also a major contributor to maternal and child deaths especially during delivery [16, 17]. The practice of FGC exerts social and psychological trauma on its victims [13, 14] and also constitutes the violation of fundamental human rights of both girls and women [18]. This is because it is commonly performed on infants when the individual consent is not given before it is performed [2, 19].
FGC is an unhealthy old cultural practice that must be unequivocally eradicated for the benefit of women and girls. The international agency and several governments have outrightly condemned the practice of FGC based on human rights violations and the associated health complications. The government of Nigeria has also joined some other parts of the world in making laws against the practice of FGC, for instance, the “Violence Against Persons Prohibition Act 2015” was passed in May 2015 [20]. The country was among the five countries calling for the eradication of FGC at the forty-sixth World Health Assembly [5]. Despite efforts aimed at eliminating the practice of FGC in Nigeria, the practice though has declined, is still unabatedly high beyond the expected target as emphasized by Sustainable Development Goals 3 and 5 [6]. There is, therefore, the need to investigate the contributory factors to the perpetuation of FGC in Nigeria so as to put an end to the practice.
Several studies have been done on the practice of FGC but some of these earlier studies [5, 20] were carried out on the prevalence of FGC while some examined intergenerational attitudes towards FGC [19, 21]. Other studies have combined both prevalence and intergenerational attitudes towards FGC [22, 23]. However, all of these studies focused on individual respondents rather than a cohort. Hence, we conceptualised this study with the view to providing a better understanding of socio-cultural mechanisms aimed at eradicating FGC in Nigeria. The specific objectives of this study are to carry out a cohort analysis of the state of the practice of FGC in the country; investigate the prevalence of FGC among daughters and mothers; and examine attitude towards its discontinuation of FGC between the years 2009 and 2018. The findings from this study will assist public health programmers and policymakers in designing prompt and appropriate interventional programmes targeting the eradication of FGC in Nigeria.
Theoretical framework: the theory of cultural relativism
The theory of cultural relativism postulates that no culture is superior to another and, therefore, every culture must be respected, preserved, and be independent of external influence. Cultural relativism is exhibited in Africa culture most especially in the practice of harmful traditional practices such as the practice of FGC. In Africa, FGC is protected by culture; it is a practice that is passed down from older generations to the younger ones for a cultural reason. In some societies in Africa, FGC is practiced as a rite of passage of girls to womanhood [24,25,26], while in other societies in Africa, it is practiced to protect women’s chastity and protect them from being promiscuous [2, 27]. Seeing FGC as an aspect of African culture that must be sustained is one of the reasons why the practice continues in most African societies; therefore, efforts to abolish FGC must be handled with extra care so that it is not seen as a deliberate attempt to enforce foreign culture on African women. While African traditional culture should be preserved, it is pertinent to note that harmful traditional practice (such as FGC) that violates women’s and girls’ rights should be discouraged.