Ackah Josephine Akua, Ayerakwah Patience Ansomah, Boakye Kingsley, Owusu Bernard Afriyie, Bediako Vincent Bio, Gyesi Millicent, Ameyaw Edward Kwabena, Appiah Francis
Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
PLOS Glob Public Health. 2022 Nov 18;2(11):e0000660. doi: 10.1371/journal.pgph.0000660. eCollection 2022.
Education has been adjudged as an important behavioural change intervention and a key player in combating Female Genital Mutilation/Cutting (FGM/C). An assumed pathway is that it influences FGM/C attitudes. However, empirical evidence that explores this assumption is scarce. Hence, our study examines whether the associative effect of FGM/C continuation attitudes on circumcision of daughters is influenced by the level of a mother's education in Nigeria. We extracted data from the 2018 Nigeria Demographic and Health Survey (NDHS). The study focused on youngest daughters that were born in the last five years preceding the survey. A sample of 5,039 children with complete data on variables of interest to the study were analysed. The main outcome variable for this study is "circumcision among youngest daughters". The key explanatory variables were maternal "FGM/C continuation attitudes" and "education". At 95% confidence interval, we conducted a two-level logistic regression modelling and introduced interaction between the key independent variables. In the study's sample, the prevalence of FGM/C was 34%. It was lower for daughters whose mothers had higher education (12%) and believe FGM/C should discontinue (11.1%). Results from the multivariate analysis show statistically significant odds of circumcision for a daughter whose mother has had higher education and believes FGM/C should discontinue (OR-0.28, 95%CI: 0.08-0.98). For women who believe FGM/C should discontinue, the probability of daughter's circumcision reduced by 40% if the mother has attained higher education. Among those who believe FGM/C should continue, the probability of daughter's circumcision worsened if the mother had attained higher education (64%), however, this result was influenced by mothers' experience of circumcision. Education influences FGM/C attitudes, nonetheless, women's cutting experience can be a conduit for which the practice persists. Promoting female education should be accompanied by strong political commitment towards enforcing laws on FGM/C practice.
教育被视为一种重要的行为改变干预措施,也是打击女性生殖器切割(FGM/C)的关键因素。一种假设的途径是,它会影响对女性生殖器切割的态度。然而,探索这一假设的实证证据却很匮乏。因此,我们的研究考察了在尼日利亚,母亲的教育水平是否会影响女性生殖器切割持续态度与女儿割礼之间的关联效应。我们从2018年尼日利亚人口与健康调查(NDHS)中提取了数据。该研究聚焦于调查前最后五年出生的最小女儿。对5039名拥有本研究感兴趣变量完整数据的儿童样本进行了分析。本研究的主要结果变量是“最小女儿的割礼情况”。关键解释变量是母亲的“女性生殖器切割持续态度”和“教育程度”。在95%置信区间下,我们进行了两级逻辑回归建模,并引入了关键自变量之间的交互作用。在该研究样本中,女性生殖器切割的发生率为34%。母亲受教育程度较高的女儿(12%)以及认为女性生殖器切割应停止的女儿(11.1%)的发生率较低。多变量分析结果显示,母亲受教育程度较高且认为女性生殖器切割应停止的女儿接受割礼的统计学显著几率(OR-0.28,95%CI:0.08-0.98)。对于认为女性生殖器切割应停止的女性,如果母亲获得了更高的教育,女儿接受割礼的概率会降低40%。在那些认为女性生殖器切割应继续的人中,如果母亲获得了更高的教育,女儿接受割礼的概率会增加(64%),然而,这一结果受到母亲割礼经历的影响。教育会影响对女性生殖器切割的态度,尽管如此,女性的切割经历可能是这种习俗持续存在的一个渠道。促进女性教育应伴随着对执行女性生殖器切割相关法律的坚定政治承诺。