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Amirah Abdallah Elmadani Ibrahim MBBS, Omdurman Islamic

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Amirah Abdallah Elmadani Ibrahim MBBS, Omdurman Islamic بسم اهلل الرحمن الرحيم Knowledge, Attitudes and Practice Among Women in Reproductive Age Towards Female Circumcision in Arkaweet Quarter, Wad Medani, Gezira State, Sudan (2017) Amirah AbdAllah Elmadani Ibrahim MBBS, Omdurman Islamic University(2010) A Dissertation Submitted to the University of Gezira in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science In Family Medicine Family and Community Medicine Department Faculty of Medicine May (2018) Knowledge, Attitudes and Practice Among Women in Reproductive Age Towards Female Circumcision in Arkaweet Quarter, Wad Medani, Gezira State, Sudan (2017) Amirah AbdAllah Elmadani Ibrahim Supervision committee: Name Position Signature Prof. Magda Elhadi Ahmed Main Supervisor …………... Prof. Salwa Elsanousi Hussein Co-supervisor …………... i Knowledge, Attitudes and Practice Among Women in Reproductive Age Towards Female Circumcision in Arkaweet Quarter, Wad Medani, Gezira State, Sudan (2017) AmirahAbd Allah Elmadani Ibrahim Examination Committee: Name Position Signature Prof. Magda Elhadi Ahmed Chairperson ………………….……… Dr.Abderrhman Ahmed Ismeil External Examiner …………………….…… Dr .ImadEldin Eljack Suleiman Internal Examiner ………………………….. Date of Examination: 13/ 5 /2018 ii Dedication To my family members especially my Father, my mother ,my husband and children, my friends, who show me the light when it gets dark…. Amira iii Acknowledgement I would like to express my deepest appreciation to Gezira University, Family medicine program and its supportive staff members. A special gratitude I give to all those who provided me the possibility to complete this research. Furthermore, I would like also to acknowledge with much appreciation the crucial role of my supervisor, Prof: Magda Elhadi Ahmed appreciating the guidance given by her that has improved my skills. Thanks to your comments and advices. Finally, yet importantly, I would like also to acknowledge the staff of Arkaweet Health Center and the community of Arkweet especially the women who helped me to collect the data and to complete my task. iv Knowledge, Attitudes and Practice Among Women in Reproductive Age Towards Female Circumcision in Arkaweet Quarter, Wad Medani, Gezira State, Sudan (2017) AmirahAbd Allah Elmadani Ibrahim Abstract Female genital mutilation/ cutting, is the ritual cutting or removal of some or all of the external female genitalia It is practiced mainly in Africa and in some Asian countries. A cross sectional descriptive and community-based study conducted in Arkaweet area, Gezira State, Sudan, during the period from September 2017 to December 2017, aiming at studying knowledge, attitudes and practice among women in reproductive age (15-49)toward female circumcision. Two -hundred-and-eighty -eight - questionnaires were distributed. they were aging from 17 to 49 years with mean age 33.98 years and SD 9.35 years, 176 (61.1%) were completed secondary education or higher,(96.2%)were Muslim, and(76.7%)of them were married. All participant know female circumcision, with(79.2%) of them were circumcised,(36.1%) of them affirmed that Female Circumcision is still practiced in the area, with presence of complication among circumcised daughters in (6.9%).The significant reasons why Female Circumcision persistent practice were; to insure virginity, avoid social stigma, for religious causes, with proportion of (16.3%), (10.1%), and (8.3%) respectively. The majority of participant were known its health consequences and (26%) stated that FC has health benefit according to their knowledge like reducing inflammations in (17.0%) and sexual hygiene in (6.2%), The attitude of participant towards (FC) was negative attitude in (33.0%) i.e. encouraging it. The negative attitudes were associated with social tradition (13.9%) marriage prospective (3.5%), safeguard virginity (4.5%), religious instruction (8.0%), removal of genitalia dirtiness (3.1%). Whereas Type I, clitoridectomy (Suuna) the most preferred type by (20.1%). And (31.9%)of the participant had intention to practice FC to their future daughters. All participating in the study aware about FC While, the practice and negative attitudes is still persistent, supported by social, tradition, religious and misconceptions. Keywords: FC, Knowledge, Attitudes, Practice v اميره عبداهلل المدنى ابراهيم ملخص الدراسة تشويه اﻷعضاء التناسلية لﻹناث، المعروف أيضا باسم قطع اﻷعضاء التناسلية لﻹناث وختان اﻹناث، هو طقس قطع أو إزالة بعض أو جميع اﻷعضاء التناسلية الخارجية لﻹناث. وتوجد هذه الممارسة في أفريقيا وآسيا والشرق اﻷوسط. هذه دراسة وصفية مقطعية ومجتمعية أجريت في منطقة أركويت، مدينة ود مدني في وﻻية الجزيرة بالسودان، خﻻل الفترة من سبتمبر 2017 إلى ديسمبر 2017، بهدف دراسة المعرفة والمواقف والممارسة بين النساء في سن اﻹنجاب نحو ختان اﻹناث في المنطقة. مع عينة 288 امرأة في سن اﻹنجاب )49-15( تم الحصول على النتائج التالية، كان المدى العمري من 15 إلى 49 سنة مع متوسط العمر 33.98 ± 9.350 سنة‘ كانت معظم المشاركات فى الدراسة نحو 176 )%61.1( قد حصلن على التعليم الثانوى فما فوق، وكان معظمهن من المتزوجات 221 )76.7٪(، وكان معظم المشاركات من المسلمين 277 )%96.2(. على الرغم من أن جميع المشاركين على دراية بختان اﻹناث، كان 228 )%79.2( من المشاركات قد ختن، و(%36.1) من هن اكدن انه ﻻيزال يمارس المنطقة، مع ظهور المضاعفات بين الفتيات المختونات بنسبة (%6.9).وكانت اﻷسباب التي ساعدت على استمرار هذه العادة هى لتجنب الوصمة اﻻجتماعية للبنت غير المختونة بنسبة (%10.1)،ولحفظ عذرية البنت بنسبة (%16.3)،وﻷسباب دينية بنسبة(%8.3)كانت اغلب المشاركات عرفن المضاعفات الصحية له، بينما (%26)اكدن ان لختان اﻻناث فوائد مثل تقليل اﻻلتهابات(%17.0)ومن النظافة(%6.2)،كما كان الموقف السلبي تجاه الختان بنسبة(%33.0)لدى أولئك الﻻئي يعتقدن أنه تقليد اجتماعي بنسبة )%13.9(والﻻتي يعتقدن انه من الدين بنسبة (%8.0). والﻻئى يعتقدن انه يحفظ العذرية فى)4.5%( والﻻتي يعتقدنه ﻹزالة اﻻجزاء المتسخة فى )%3.1(.كما ان النوع اﻻول السنة هو النوع المفضل بنسبة (%20.1). بينما (31.9%) لديهن الرغبة لختان بناتهن فى المستقبل.بالرغم من المعرفة الجيدة للختان اﻻ ان الممارسة واﻻتجاهات السلبية مستمرة مدعمة بالعادات اﻻجتماعية واﻷسباب الدينية والمفاهيم الخاطئة. vi Table of Contents Dedication .................................................................................................................................... iii Acknowledgement........................................................................................................................ iv Abstract ........................................................................................................................................ v Arabic Abstract ............................................................................................................................ vi Table of Contents ......................................................................................................................... vii List of Tables ............................................................................................................................... ix List of Figures .............................................................................................................................. xi List of abbreviations ..................................................................................................................... xii Chapter One Introduction .................................................................................................................................. 1 Problem Statement: ...................................................................................................................... 6 Justification…………………………………………………………………………………….. 7 Objectives………...…………………………………………………………………………… 8 Chapter Two Literature Review ......................................................................................................................... 9 Introduction: ................................................................................................................................. 9 Terminology………………………………………………………………...………… 9 Origin of the practice ................................................................................................................... 10 The operation .............................................................................................................................. 11 AGE at which circumcision done ................................................................................................ 12 Decision to circumcise …………………………………………………………….…….. 12 Medicalization of the practice ...................................................................................................... 12 Classification .............................................................................................................................. 14 Type I ........................................................................................................................................... 14 Type II .......................................................................................................................................... 14 Type III ........................................................................................................................................ 14 vii Type VI ....................................................................................................................................... 15 Secondary FGM /C in Sudan (Re- - infibulation ) ....................................................................... 16 Clitoral Hood reduction ............................................................................................................... 16 Simulation of female sexual
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