I TITLE PAGE ASSESSMENT of the HARMFUL CULTURAL

TITLE PAGE

ASSESSMENT OF THE HARMFUL CULTURAL PRACTICES AFFECTING THE HEALTH OF RURAL WOMEN: A STUDY OF COMMUNITY BASED WOMEN ORGANISATIONS IN EBONYI STATE

MBAGWU, FELICIA ONYEJIUWA (Mrs.) PG/Ph.D/00/27897

BEING

A Ph.D THESIS PRESENTED TO THE DEPARTMENT OF ADULT EDUCATION AND EXTRA-MURAL STUDIES

UNIVERSITY OF NIGERIA, NSUKKA

FOR THE

DEGREE OF DOCTOR OF PHILOSOPHY IN COMMUNITY DEVELOPMENT

SUPERVISOR: PROF. (MRS.) C. I. OREH

MARCH, 2009

CERTIFICATION

MBAGWU, FELICIA ONYEJIUWANAKA, a postgraduate student in the Department of Adult Education And Extra-mural Studies with Registration number PG/Ph.D/00/27897, has satisfactorily completed the requirements for the course work and research for the degree of Doctor of Philosophy in Community Development Studies. The work embodied in this thesis is original and has not been submitted in part or in full for any other diploma or degree of this university or any other university.

------Supervisor Candidate

iii

APPROVAL PAGE

This thesis has been approved for the Department of Adult Education And Extra-mural Studies, University of Nigeria, Nsukka.

------Supervisor’s Name Internal Examiner’s Name

------External Examiner’s Name Head of Department’s Name

------Dean of Faculty’s Name

DEDICATION

This thesis is first dedicated to Almighty God for His enablement from the beginning to the completion of this work. It is also dedicated to my wonderful companion, late Prof J.S.C. Mbagwu who was always there for us, especially his uncompromised interest in our academics.To my first supervisor late Prof.(Mrs.) JDC Osuala, who assisted the researcher in laying the foundation of this work and all the women who have been traumatized by Harsh Cultural Practices meted out on them.

ACKNOWLEDGEMENTS

The researcher wishes to acknowledge all those who contributed in various ways to the successful completion of this work. First, she is sincerely grateful to her lecturer and supervisor Prof. (Mrs.) C. I. Oreh for her patience, guidance, moral support and interest in supervising all aspects of this work. The researcher’s thanks go to her family, my Children Obinna, Ikenna, Ezenwa, Chidera Uchechukwu and Ukamaka for their prayers and commitment to this work. She also wishes to express her appreciation to Prof. E. C. Osuala and Dr C. Eze for providing some materials to assist the researcher, in this work..To Prof.C.E.zedum, Dr S.C.Nwizu. Dr S,N.Obasi ,Dr U.Eze and Dr.R.E.Ozioko, the researcher is sincerely grateful to you for accepting to read this work and the useful contributions made at various stages. The researcher says a big thanks again to Prof.C.Ezedum, Dr.B.C.Madu, Dr P.Onwuasanya, and Dr K.O.Usman for validating the instruments used for this study.She expresses her profound appreciation to.Prof. (Mrs.) D. U. Egonu, Prof. T. A. Ume, Rev Canon C. A. Onyechi,and Prof. P. N. C. Ngwu, her lecturers,who nurtured her academically and supported her morally during this study. Similar thanks must go to Dr. (Mrs.) T Ogbuanya, who inspite of her thight schedule,contributed in no small measure to the success of this work. She read through this work with sustained interest and patience. To a host of others too numerous to mention here, she appreciates them for their encouragements. The researcher must thank the staff of the Ministry of Information and state orientation Ebonyi State for their various assistance which included providing the statistical data on the distribution of Community Based Organizations. A big thank you is extended to all the staff of U.N.N. Cyber café and the Nnamdi Azikiwe library U. N. N. especially to Mr. Vincent Ekwelem for the various literature materials that were made available to assist in this work. Similar thanks go to my field research assistants – Felicia Njoku, Uzorna Nwamini, Otah Chinyere and Uche Jasper. To the various community leaders and women executives, she says thank you.The researcher sends a warm thanks to Mr. Okoye of Ogueri Cyber café and Mr. Oruade for handling the statistical aspects of this work. The researcher also acknowledges Miss Chikaodili Nnamani and Helen Anazodo for typing this manuscript. Again, the researcher thanks the Almighty God for His infinite mercy wisdom, abundant grace, provisions, protection and many other blessings throughout the the duration of this work. I say thank you Daddy.

Mbagwu, Felicia Onyejiuwa

TABLE OF CONTENTS

Title page ------i Certification Page ------ii Approval Page ------iii Dedication ------iv Acknowledgement ------v Table of Contents ------vi List of Tables ------viii Abstract ------x

Chapter one: INTRODUCTION ------1 Background to the study ------1 Statement of the study ------5 Purpose of the study ------7 Significance of the study ------8 Research Questions ------9 Hypotheses ------10 Scope of the study ------10 Chapter two: REVIEW OF LITERATURE - - - - 11

A.Conceptual/theoretical background -

1.The concept of culture and women’s health------11 2Harmful cultural practices and women’s health------18 3.Manifestations of Harmful Cultural Practices - - - - - 26 4.Types of Harmful Cultural Practices that may Affect Women’s Health - 33 5.Why Harmful Cultural Practices Resist Change in Cotemporary Times - 62 6.Intervention Strategies to Eliminate Harmful Cultural Practices. - - - 67 7.Psychologically related theories------79 B. Review of Emperically Related Studies------81 C. Summary of Related Literature - - - - - 89

vii

Chapter Three: RESEARCH METHOD ------91

Research Design ------91 Area of study ------91 Population of the study ------92 Sample and Sampling Techniques ------92 Instrument for Data Collection ------93 Validity of the Instrument ------94 Reliability of the Instrument ------95 Procedure for Data Collection ------95 Method of Data Analysis ------96

Chapter Four: RESULTS ------97 Findings from the Focus Group Discussion - - - - - 105 Summary and Findings ------110

Chapter Five: DISCUSSIONS, RECOMMENDATIONS, CONCLUSION and SUMMARY ------111 Discussion of findings ------111 Implication of the Study for Adult Education/Community Development -120 Conclusion ------121 Recommendations ------122 Suggestions for Further Research ------123 References ------124

viii

Appendix A ------142 143 Frequency table of Respondent’s Bio-Data Appendix B ------144-147 Distribution of the Randomly Sampled Local Governments and Community Based Organizations using 40% Sample Interval. Appendix C ------148-158 Letter of Introduction from the Researcher and Questionnaire on the Assessment of Harmful Cultural Practices that May Affect the Health of Women in the Local Government Areas in Ebonyi State, used for the study. Appendix D ------159-161 Letter of Introduction from the Researcher and Focus Group Discussion Schedule. Appendix E ------162 A Letter for Validator (s) of Research Instrument. Appendix F ------163 Modifications on Questionnaire and Observation made on FGD Instrument. Appendix G ------164 - 168 Reliability of Instrument. Appendix H ------169 Mean and Standard Deviation of the reason for the existence of HCPs practices in the communities according to the respondents Appendix I ------170-172 ANOVA Summary for mean ratings of respondents on HCPs based on location Appendix J ------173-175 T-test analysis of the mean ratings of single and married parent on why the HCP exist in communities Appendix K ------176 Names of Primary Schools and Volunteered Teachers

LIST OF TABLES Table Page 1. Distribution of Community Based Women Organization in the thirteen Local Government Area of Ebonyi State - - - - - 92 2. Distribution of the radomlysampled local governments and Community Based Organizations using the 40% sample interval propounded by Osuala (2005) ------93 3. Mean and Standard deviation of the harmful cultural practices in the communities of the respondents - - - - - 97 4. Mean and Standard Deviation of the reason for the existence of HCPs practices in the communities according to the respondents - 98 5. Mean and Standard Deviation of the consequences of the HCPs on women’s health according to the respondents - - - - 99 6. Mean and Standard deviation of the reason why HCPs are resistant - 100 7. Mean and Standard deviation of the intervention strategies for eliminating HCPs ------101 8. ANOVA Summary for mean ratings of respondents on HCPs based on location ------102 9. t-test analysis of the mean ratings of single and married parent on why the HCP exist in communities------103 10. t-test analysis of mean ratings of educated and non-educated respondents on why HCPs resist change in contemporary times - - - 105

ABSTRACT

Harmful cultural practices have been identified as significant causes of disability and deaths particularly among women of reproductive age in developing countries. Hence, the researcher conducted this study on the assessment of harmful cultural practices (HCPs) affecting the health of women in Ebonyi State using community women organizations as target population. To guide this study,five research questions were posed and three null hypotheses were formulated and tested at 0.05 level of significance. Descriptive survey design was adopted in this study. The population for this study comprised 11,424 members of the three hundred and twenty seven registered communities based women organizations in the thirteen Local Government Areas that make up the three senatorial zones of Ebonyi State. The sample consisted of sixty-five purposively selected community based association which has 1,962 registered members drawn from six out of the thirteen LGA’S selected for the study. The study employed multi-staged sampling technique. The selection of the sample was based on 40 per cent of the entire population from the purposively selected local government Areas in Ebonyi State. For the qualitative data a systematic sample size of twelve women from each group of Community Based Organization were used for Focus Group Discussion (FGD). A one hundred and sixty two questionnaire items on the Assessment of Harmful Cultural Practices (AHCPs) arranged in five sections was developed, validated and used for quantitative data collection. A Focus Group Discussion guide (FGDG) based on the five research questions were constructed by the researcher for data collection. Data collected were analysed using percentages, weighted means and standard deviation. The Focus Group Discussions were qualitatively analyzed. Among the major findings were that majority of the respondents were educationally disadvantaged. (2) it was confirmed from the study that harmful cultural practices such as early marriage, female genital mutilation, widowhood practices and nutritional taboos existed and were practiced in their different locations. The opinions of respondents to the questionnaire were similar to those of the discussants during the ( F G D) sessions. It was recommended among other things that women should be educationally empowered. This would enable them to challenge those discriminatory attitudes and cultural practices which has held them captive, such as not participating in decision-making process in issues concerning their welfare which has hindered them from being integrated into the whole spectrum of community development programmes. Education empowerment of women will pave way to their social economic and political empowerment.

CHAPTER ONE INTRODUCTION Background to the Study

Traditional cultural practice reflects values and beliefs held by members of a community or social groupings for periods often spanning generations. Saba{1997) noted that social groupings in the world have specific cultural practices and beliefs; some are beneficial to all members while others are harmful to a specific group such as women and girls’ Hence, Kiragu sees culture as part of human environment and a product of history which forms strong images in the minds of the people concerned Ofonagoro(1996) viewed culture as the totality of the life of a people which could be assessed and comprehended in terms of how they create and re-create their lives both in the material and non-material sense of their social existence. Suffice it here to observe that culture represents the development of specific people in the society which is often equated with civilization. From the above interpretation of culture, it is glaring that the concept has many definitions as there are writers on the subject. Hernlund (2000) posits that culture is a totality of the way of life evolved by a people in their attempt to meet the challenges in their environment. In effect this is to say that culture embraces and includes challenges to social, political, economic, aesthetic and religious norms and mode of an organization, thus distinguishing a people from their neighbours. Also, from a different perspective Kisijia (2001) remarked that culture can be viewed as being complex and has a compelling nature which regulates all aspects of human life which include; for example, food, religion, dressing and language of the people, housing, marriage and family relations. Supporting, the above view, Seralgaldin (2002) noted that culture is a complex phenomena with distinctive spiritual, material, intellectual and emotional features that characterize a group or society. Hence, he maintained that the role of culture especially in traditional settings show that it is supreme and uncompromising, such as in discussing or sharing of lands (which excludes women) and women obtaining permission from their husbands before accepting or adopting any contraceptive method. Unfortunately, these old patriarchal systems are still maintained in some communities, to subjugate women and render them vulnerable to obnoxious cultural practices which violate the “rights” of girls/women. For example female circumcision, which is rooted in a whole set of beliefs, values, social and cultural behaviour pattern of some societies, is often culturally determined and incidentally

2 transmitted by women themselves simply because of cultural adherence and not that it serves any useful purpose to individual families or the society. However the most revealing thing in the society is that culture is not static. Every culture has a dual tendency: A tendency towards stability and a tendency to change. Culture changes perpetually because the individuals in the society or the cultural architects constantly modify their cultural plans, improve and adapt their behaviour to the caprices and exigencies of their physical, social, and ideological milieu (Gbotukama, 2002:17).

Hence, the definition of the essential elements of culture varies from time to time reflecting correct power structure and influences. The variety of culture bound practices harmful to women, otherwise, known as harmful traditional practices reasonably fall under the rubric of 89violence against women which has direct effect on their health (Heise, 1998). Health, according to United Nations Organization (UNO) (1995) is a fundamental human right and not merely a social good. It is an asset for individuals in the family, community and nation irrespective of age, sex, origin or race. It is sad to note that women are the foremost victims of old and die-hard traditional attitudes which militate against their health and well-being (Berhane, 1998). Women are arbitrarily deprived of their liberty to express and exercise their fundamental rights. For example, inspite of the high risk of maternal morbidity health and financial impact of traditional or too closely spaced birth; women often cannot exercise control over their own fertility.This is the reason why the United Nations International Children Education Fund (UNICEF) (1998) concluded that women were often deprived of good health right from birth.For example, in some traditional set up, pregnant and lactating mothers are made to abstain from nutritious foods such as eggs, snail which are regarded as taboo but are also necessary for the growth and development of the child. The issue of traditional practices adversely affecting the health of women have been the focus for discussions at several international and national conferences, workshops and seminars where intervention approaches to eliminating harmful practices meted on women were extensively deliberated on. Notable among the legal interventions to eliminate harmful cultural practices were the Viennia 1993 World Conference on Human Rights pioneered by women’s health and women’s Rights Advocates who declared that women’s Rights are Human right; the International Conference on Population and Development 1994

3 maintained that women have the right to control all aspects of their health and matters of sexual relations and reproduction; the Fourth World Conference on Women Beijing 1995 was another pointer where women activists worldwide vehemently reacted to the plight of women and in collaboration with the United Nations mandated Governments in various countries to make legislations and policies against harmful cultural practices affecting the health of women/girls. The article of the Convention on the Elimination of All forms of Discrimination Against women stressed on the need to promote women’s access to better health care and family planning services. Others include the AIDS Conference 2000 where it was resolved that women/girls should have access to the use of contraceptives and reproductive health counselling and the widows without Rights Conference 2001 which affirmed the right entitled every individual to be free from any form of inhuman treatment or discrimination. Nigeria is not left out in this struggle to eliminate harmful cultural practices. It appears the impact of the resolutions at both international and national conferences to eliminate all harmful cultural practices have been particularly unevenly felt in most developing countries of Africa (Fredrick, 1996). For example, in Nigeria the National Population Council (2000) record showed that female genital circumcision is prevalent in Imo, Osun, Ondo, Delta and Cross River States. The practice of FGM is less prevalent in the North with 77 per cent in Kaduna. Likewise, the practice of FGM has not been given up by excissors in Ebonyi State. The National Base Line Survey (2004) revealed that Ebonyi State ranked 76 per cent score for FGM. Also, in July 2004 a widow from Iseke village in Enonyi State (televised) was brutally murdered in cold blood by the brother in-law for refusing to hand over the late husbands piece of land to him. The efforts made by different interest groups towards elimination of harmful cultural practices affecting the health of women does not seem to have made much impact. This may be due to lack of necessary information on the harmful cultural practices.Hence, the concern of the researcher on the need for an assessment of the problem. Such an assessment will provide information on the nature and dimensions of the problem. This will give direction or guide forwards the solution of the problem. Assessment, according to Okoro (2002) is an appraisal of situations and problems and using it in making appropriate decisions. It also involves the collection of data, judging the worth of the issue under study and the use such data to map out course of action towards enhancement or otherwise of the issue. An assessment of HCP is very necessary to obtain information that will lead to its elimination. Okoro (1991) explained that, information from assessment is used for planning decision making and improvement. Improvements in elimination of HCP affecting the

4 health of women constitute functions of assessment that could be used by various interest groups with a view to redeeming dwindling fortunes, images and revitalizing worthwhile practices through necessary inputs, special grants and education/sensitization activities. Akpan (1989) explained that in carrying out assessment, the necessary aspects of the issue under study or all the components that constitute the issue need to be assessed. It is imperative to study important aspects of HCP affecting the health of women in Ebonyi state in order to come up with necessary information that will aid its elimination. In Nigeria, indigenous organizations such as Human Rights Activists Nigeria, Children’s Right Advocacy Group, Child Life Line and the Convention on the Elimination of All forms of Discrimination Against Women are working in different communities sensitizing and educating women on the dangers of some traditional practices such as widows rites and female genital mutilation (Akpala, 1998). It is of interest to note that countries like Ethiopia, Belgium, France, Sweden, United Kingdom and Ghana have outlawed female circumcision (Akinola, 2001).This may be due to the fact that such practice has no relevance to development. Hence, the concern of the researcher for women in developing countries like those in traditional rural communities of Ebonyi State under study is very instructive. Harmful cultural practices are obviously widespread in Ebonyi where women are seen as backward and least literate, some must obtain permission to attend ante-natal clinics or even can not take imitative to go to the hospital during labour in the absence of their husbands (Akumadu, 2001). Also, literature showed that the educational background of women is important in women related studies. This is because of the belief that educated women have greater respect and recognition than non-educated. It is therefore important in this study of this nature to critically examine the response of educated and non educated women so as to decipher if there are discrepancies in the HCPs meted out on them. Educated women in this study refer to any women who can read and write in the communities under study. Some women may be affected by HCP more than others because of the educational/ marital status. In some communities in Igbo land married women are treated with more respect more than their unmarried counterpart. Again, even among communities within a LGA or state may differ in their belief or culture especially as it concerns the rights of women. It is amazing but very sad to note that such inhuman and dehumanizing attitudes towards women have never been challenged by policy makers. Could it be that policy makers have thought about the serious implications of these HCPs because they have their origin in the history of

5 the people long ago? And so, no legislation has been passed to eliminate harmful cultural practices even when Nigeria has been signatory to decisions taken at workshops and conferences at various levels. The truth is that all hands (both the affected and unaffected) must be on deck to kill these man-made dragons especially at the grassroots levels, if a change is so desired. This is because in the words of Kisija (2001 ) for any meaningful change in attitudes or behaviour to be achieved, the people themselves should be involved in the change process. And that is to say that the women whose health status are threatened by harmful cultural practices meted on them should be involved in this struggle to enable them assert their fundamental rights which include freedom of choice and existence among others. Even among different communities in Ebonyi state, cultural practices differs. That is the intensity or extent of HCP affecting the health of women which may differ from community to community For instance there are certain cultural practices that can be meted to married women but not to single mothers or widows.

Statement of the Problem In spite of the National and International affirmations on improving the lot of women in human society there still exist tenacious harmful cultural practices, which are yet to be done away with particularly as they adversely affect the health of the women/girl-child. Till date high premium is still placed on the males while females are regarded as a household property, which can be used and manipulated at will For example, the traditional bride price confers a property identify on a woman and also awards the husband with the implicit ownership of the wife (Obianyo, 2000). As it is typical of most patriarchal societies throughout the world, Nigeria inclusive; women are usually expected to be submissive, obedient and respectful to their husbands no matter how educated they may appear to be. Women were never heard but only seen even on issues concerning their sexuality and reproductive rights. Hence women face complex health issues particularly those arising from pregnancy. Information from World Fertility Survey, (1999) revealed that in countries like Nigeria, gender-based disparity in health care received are largely the result of the girl-child being undervalued by their family. Women’s vulnerability to maltreatment in diverse forms are deeply rooted in the culture and traditions of their communities. Kamara (1991) observed that culturally prescribed traditions such as female-female marriage and male health providers not attending to pregnant mothers may have serious health consequences on women. Unfortunately, many of these harmful practices still prevail in some societies. For example HCPs like widowhood rites is prevalent

6 in six geopolitical zones in Nigeria, Ebonyi state inclusive (Akumadu, 2000). For example in the year 2003, a widow from Okwuato Ibeku in Aboh Mbaise LGA was alleged to have been stripped of everything she had including her children; by her in-laws (Daily Sun, October 2003). Also, sometime in the year 2004, in Isieke (Ebonyi state) a widow was brutally murdered by her brother in-law over the deceased husband’s piece of land. Likewise the practice of FGM has not been given up by excissors in Ebonyi state which ranked highest in the South-East geopolitical zone with a 76% score. It is also a cruel irony that women themselves in the name of tradition perpetuate some of the harmful cultural practices like FGM, widowhood practices, female-female marriage. Perhaps these people put up a crafty defense mechanism, feel justified and even seek social legitimacy for their conduct while the victims may not openly report/discuss their experiences. This culture of silence of the abused or oppressed may have been the reason why literature on various dimensions of HCPs is yet evolving. Moreover, information on these practices may be concealed for myriad reasons such as fear-induced restrictions, ignorance, low literacy level/development, backwardness of the people and women’s subordinate positions imposed on them by the society. Women also teach, practice and uphold traditional practices surrounding differential feeding and food taboos harmful to their girl-child as is the practice in Igboland, ( Okafor 2005). Certainly, practices sanctioned by culture that may have threatened the health and well being of women; seem to have recurrent health problems, (Chukwuezi, 2000). Such health problems could be those associated with their culture, sexual and reproductive tract infections. For example Ezumah, (2002) observed that women are stigmatized as disease carriers and not the men. According to her, among the Igbos, reproductive tract infection called “Nsi-Nwanyi” or women’s disease have not only debased women but has encouraged male permissiveness and absolved them of their responsibility for disease transmission. Such perception will certainly affect women’s health in various ways. Despite outrage by human rights group, international courts and feminist groups at both national and local levels; all efforts to eradicate harmful cultural practices in contemporary societies have often been met with hostility from the implementers, coupled with a number of reasons given for its persistence. Other reasons why harmful cultural practices still exist may be attributed to issues such as delayed pregnancy, sex-preference in the family; as the male child is valued more than the female. Policy makers have never challenged the serious implication of these practices either because these practices have their origin in the history of the people long ago, and also ostracization from ones group because of their tradition is not possible. It may

7 also be possible that mothers adhere to traditional harmful practices because of their religious belief, ancestral attachments; their loyalty to their deity, their husbands, limited access to education, information and essential services;renderd them powerless to boldly assert their rights even when they are maltreated. This is the reason why IkejIani (2001) suggests the need for education of the rural population especially the secluded, invisible poor and powerless women on pertinent gender issues. Hence, the researcher was interested in establishing whether HCPs exist in the communities under study; their impact on women’s health, reasons why these HCPs resisted change and intervention strategies needed to eliminate them.

Purpose of the Study The main purpose of the study was to assess the harmful cultural practices affecting the health of rural women in Ebonyi state. Specifically, the study sought to: (1) find out those harmful cultural practices which are practiced in the study areas in Ebonyi State. (2) determine why these HCPs exist in the study areas (3) ascertain the consequences of these harmful cultural practices on women’s health (4) establish reasons why harmful cultural practices resist change in contemporary times. (5) determine intervention strategies for eliminating the identified harmful cultural practices affecting the health of women. Significance of the Study The subjugation of women to harmful cultural practices even in contemporary times calls for urgent attention so as to adopt measures to alleviate or eliminate predominant authoritarian traditions imposed on women, which affects their health. On this note, this study will be useful not only to mothers who are members of community based organizations in the study areas but also to all mothers in Nigeria, NGOs, faith based organization and other interest groups on types of HCPs in Ebonyi state, why they exist and how they can be curbed. From the findings of the work, more light will be shed on the terrible effect of harmful cultural practices on women’s physical, psychological, social, emotional, and mental well-being. The changing times demands that a more aggressive approach be adopted on these inhuman traditions as the surest way to eradicating them. Information on their consequences will sensitize all concerned and help to quicken them to take immediate action towards its extinction.

There is no doubt that the findings of this work will make significant contributions to knowledge as not much study has been done in the area of assesment/ community based intervention strategies for eradicating harmful cultural practices affecting women’s health in Nigeria. The findings of this study will stimulate the interest of future researchers in this direction or other related issues on women. Also, to adult educators and community development workers, the findings of this study will equip them with information, which will, be used as a motivational tool for illiterate mothers to embrace literacy education. Education is the best ‘key’ to unlock illiteracy for better tomorrow, better family life, better nutrition/balanced diet for the child, pregnant and lactating mothers, better child care and better knowledge about reproductive health information. When mothers are well informed, they will be more relaxed, willing to accept innovations and take decisive actions as it affects them. Women in Nigeria particularly those in Igboland where die-hard cultural practices has been so persistent will be free to enjoy their liberty and drop their false humility/blind submissiveness to their husbands. The findings of this work if published and implemented will certainly boost media sensitization of the general public condemnation of all kinds of HCPS against women. The findings of this study will be most relevant to traditional rulers who are in charge of communities where such harmful practices prevail. The finding of this study will convict the traditional rulers to see the need/seriousness to improving traditional values status of females and to forgo all harmful cultural practices that may be detrimental to women’s health Additionally, the findings of this work will be of immense importance to religious bodies like churches that are known for soul winning, use the word of God to preach righteousness, justice, love, peace, equality and equity. The findings will also reveal to the churches that women are still subjected to harmful cultural practices in the name of tradition of the people. The findings of this study will be relevant to non-governmental organizations that are into serious efforts of empowering women to start addressing their various areas of denial in the society and to fight all forms of discrimination against womanhood and urgently possess their fundamental rights for the challenges ahead. This by extension will help in the achievement of the Millennium Development Goal (MDG) as it relates to gender and women empowerment.

Furthermore, to policy and law makers, the findings of this work will provide specific information on the present situation of women and the need to reassess the status of women in contemporary times so that women/health status will be given a prominent place in their research process. Policy makers will also see the need to involve women in the design, defining strategies, implementing process on how to improve the health of women and also eradicating harmful cultural practices in our communities This in line with the fact that” Health For All” remains an elusive goal especially in developing countries like Nigeria. Therefore, the findings of this study will provide useful information that will be relevant to actualizing the anticipated millennium development goal, which includes health promoting, gender equality and empowerment of women.

Research Questions 1. What harmful cultural practices are practiced in Ebonyi state? 2. Why do these HCPs exist in Ebonyi state? 3. What are the consequences of these harmful cultural practices on women’s health? 4. Why do these harmful cultural practices resist change in contemporary times? 5. What strategies can be adopted in eliminating these harmful cultural practices? Hypotheses The following null hypotheses were tested at (0.05) level of significance.

HO1: There is no significant difference in the mean ratings of respondents on harmful cultural practices practiced based on location

HO2: There is no significant difference between the mean ratings of single and married parents respondents on why harmful cultural practices exist in their communities.

HO3: There will be no significant difference between the mean rating of educated and non- educated respondents on why harmful cultural practices resist change in contemporary times.

Scope of the Study The study was limited to investigating harmful cultural practices affecting the health of women in the communities under studied in Ebonyi State. Furthermore, the study recommended intervention strategies to eliminate such practices that adversely affect the health of women. In this study, an educated women refer to those who went beyond primary school. While non-educated ones are those who stopped at primary six and below.

CHAPTER TWO REVIEW OF LITERATURE The researcher consulted reference materials containing various works by researchers, which relate to the topic of her study. From these journals textbooks and reports that dealt with similar topics she could have insights into the problem(s) that were investigated. The literature relevant to this study was reviewed under the following sub-headings: A. Conceptual /Theoretical framework 1 The concept of culture and women’s health. 2 Harmful cultural practices and women’s health. 3 Manifestation of harmful cultural practices. - Types of harmful cultural practices. - Why harmful cultural practices resist change. - Interventions to harmful cultural practices. - Psychological related theories. - B: Review of Empirical Related Study C: Summary of Related Reviewed litereture

Conceptual/Theoretical background and Psychological related theories Culture and Women’s Health Culture has many definitions, probably the definitions are as many as there are writers on the subject. Often times based on the perception of individuals, there has been misconceived notion of culture. However, culture according to Kisija (1994) connotes a true representation and level of development of specific people in society, which is often associated with civilization. Culture as defined by Ofonagoro (1996) is the totality of life of a people, which could be assessed and comprehended in terms of how they create and recreate their lives both in the material and non-material sense of their social existence. Surprisingly, Sani (1996) observed that culture is not only fundamental to our way of life, how we relate to one another and socialize among ourselves; rather it is central to our corporate entity as a people. In general terms, She continued by saying that culture may refer to an inherited, cherished and treasured values which help cement the bond of friendship, cooperation and understanding among people. Nevertheless, Gbotokuma (2002: 17) opined that culture is a product of history, which reflects a people way of life, their adaptation to physical, social and ideological milieu. As a matter of fact, his view agrees with the cultural policy of Nigeria (1988), which clearly spelt out the definition of culture as:

The totality of the way of life evolved by a people in their attempts to meet the challenges of living in their environment which gives order and meaning to their social, political and economic aesthetic and religious norms and modes of organization, thus distinguishing a people from their neighbours p7.

It is significant to note here that the cultural policy, underscores culture as dynamic hence its ability to meet the challenges that confront man in space. These challenges include mans innovative initiative as well as his adaptability. And so, one can deduce from the above definitions of culture that if culture is the distinctive characteristics of a people, it means that there is no community/nation without a culture of its own. Little wonder did Gbotokuma (2002) contend that people should not allow their cultural worldview to erode their well-being. This is because, according to him, the adaptation to cultural practice particularly the enshrined harsh practices, pose constraints which affects adversely the physical, mental, social, emotional, psychological health and integrity of individuals particularly women. Supporting the above view, Koso-Thomes (1998) had earlier expressed concern about cultural factors such as restrictions on women being treated by male health care providers, which may pose serious health risks for women. Such health risks according to him include delayed diagnosis/medical treatment and preventable deaths. It is for this reason and many other strong evidence of gender difference that gave rise to arguments for adequate provision of accelerating investment in women’s health. The Fourth World Conference on Women, Beijing (1995) identified “women and health” as one critical area of concern in the platform for action which had five strategic objectives. The objectives covered a range of cultural and traditional practices, which affect women/girls negatively, prevention of these practices harmful to the health of women, promoting positive health practices including delayed childbearing, safe sex, adequate nutrition and ways to eliminate such negative practices affecting the health of women. The term health is often used to mean different things to various people. It can be referred to as people’s health status i.e. people being in good or bad health. It can be referred to the environment, natural and human-made and its impact on human beings. However, health according to WHO (1998) means peoples well-being, which is a basic human right, a vital social goal and the key component of human development. It is an end in itself, and it is a means, an asset that allows people to access a series of other opportunities including benefiting from information and new knowledge that ought to breed positive change in ones behaviour.

World Bank (1999) report revealed that evidence around the world has demonstrated that investment in women’s health is fundamental to improving a country’s general welfare and economy. An adage says that a healthy nation is a wealthy nation. This is simply because when a large proportion of people including woman avail themselves of the use of health facilities, there will be reduced gender discrimination, social and cultural factors influencing women’s health. Thus, the general well being of women/girl-child will be ensured for better and sustained human development and economic growth. Regrettably, the socio-economic position of women often places them in a vulnerable position with serious health consequences (Minder, 1993). Continuing, he noted that low socio-economic status is known to be associated with health, especially mortality and morbidity roles that rub women of their notable contributions in development. Quedraogo (2001) succinctly observed that if women are to be economically empowered the impediments they face as children and young adults have to be reduced. Traditionally, women lack autonomy because generally they are under considerable inhibition even in issues concerning their life style, their own health, their sexuality and fertility control. Such inhibition called harmful traditional/cultural practices have over the years been used as weapons to deny women their rights to freedom of expression and to attain the highest standard of health opportunities among others (Chukwuekere, 1998). For example traditionally, in the past a male birth attendant never attends to a pregnant woman. According to Economist (1996: 45), a pregnant woman does not take the initiative to going to seek medical attention even when she is in labour and perhaps the husband travelled outside the home and the man’s relations have no right to hold brief for the husband. In such circumstance, the pregnant women may end up with pregnancy related complications like Uterine Inertia, Uterine rupture, and Intra-Uterine death of the foetus, profuse hemorrhage or death of the woman. Chukwukere (1998) observed that the absence of a gender sensitive attitude towards women’s issues especially long and medium term strategies for development in general, has further heightened the persistent, unjust inequality and discrimination against women. This discrimination could be seen also in the religious, nutritional and other socio-cultural taboos, which have continually, drew women back and endorsed male superiority in all spheres of life. Similarly, Obianyo (2000) noted that most traditional practices are harmful to women as they invariably confer a property identity on women who have been purchased and so should be regarded as mere tools that should be manipulated and used at will. Continuing, she emphasized that the same women are usually pregnant and bear children till they attain menopause. Most of them end up

13 with one health or pregnancy related problems or another even before menopause and without care or assistance from their husbands. Also UNDP (1995:92), Duetz (2003) noted that women in Africa face difficult conditions even when pregnant. These conditions include hewing wood, serious farm work, cooking, providing health care for their family and rearing the children all alone. These activities take a toll on women’s health. Cultural values however they may appear from cultural and personal standpoint tend to fulfill some useful purposes, but in most cases the harmful effect out rights or outweighs the supposed benefits. For example the prevalence of health issues among women resulting from their experience of negative cultural attitudes, violence, limited power and lack of influence in decision-making and social realities have devastating effect on women (World Bank, 1998). WHO, (1998) confirm; that in every culture, some practices celebrate life-cycle traditions which perpetrate community cohesion or transmit traditional values to subsequent generations, while many traditions also promote social cohesion and unity. Prominent among practices classified as traditional and harmful attitudes include female genital mutilation, widowhood practices, female-female marriage, teenage-surrogate motherhood, male-child preference, violence, stigmatization and discrimination against women in all its forms. Unfortunately, women are the foremost victims of these old die-hard traditional attitudes which militate against their health (Berhame, 1998). These negative cultural/traditional practices are accompanied by all the severe medical consequences that affect the physical, emotional, mental and psychological health of women, which are a fundamental human right and not just a social food (Machara, 2004). A woman’s body and health is her only asset; one that is vital for her own’ her families and community livelihood. The physical, psychological and mental development, the capacity of the individual to learn, work and perform desired responsibility in the family, community or nation depends on good health. Evidence from around the world has shown that investing on people’s health (women inclusive) is fundamental to improving a country’s general welfare and economic growth as well as reducing poverty (World Bank, 1998). Health, according to Fashel and Bush (1997) is a composite of current state and prognosis and thus not only to function now but the outlook for future functionality ability. This life-course definition justifies health indicators since they measure the lifetime spent in different health states. Hence, health is viewed as a fundamental human right and a priceless treasure, which should be appreciated and enjoyed by all “irrespective of sex, age or race. Yet most of Africa’s forty-five

14 countries lag far behind other developing countries in the vital task of improving their health. For example,according to World Bank,(1994), infant mortality rate is 55 percent higher and average life expectancy is eleven years less in Africa than in the rest of the World’s low income developing countries. Moreover, maternal mortality at 700 women per 100,000 live births is almost double that of other low and middle-income developing countries and more than forty times greater than in the industrial nations (World Bank, 1994). In many developing countries, the lack of data on women’s health coupled with the lack of understanding of the importance of gender issues may have rendered women’s health problems particularly those associated with harmful cultural practices invisible. Although women’s health is critical to the well-being of communities, there is still a huge unmet challenge to respecting women’s sexual rights and providing health services. Women and adolescent girls particularly those in desperately poor communities continue to face overwhelming sexual and reproductive health problems. These include malnutrition, early marriage/early child-bearing, unwanted pregnancies, unregulated fertility,sexually transmitted diseases and infertility which are in alarming rate.(Robine and Tagger, 2003). These infections have caused a significant increase in infertility among young women and men. But it is unbelievable that IAC (1999) data show that only women are usually assumed to be infertile and they pay a heavy price ranging from divorce, abandonment by husbands relations or being devalued by their husbands In addition, in the absence of the husband, she has no right to leave the family compound even in extreme emergencies that may involve the loss of her life. Such delays in medical intervention are better imagined than described. The situation is even worse with traditionally caged or secluded women such as those in Purdah (in Moslem communities), which adds to the reluctance of household members to send their females outside for treatment of illness or childbirth under a male birth supervisor or attendant. It is the increased stress of these women’s multiple harmful cultural practices that has led to the horrendous levels of ill-being of women who are the main household careers and informal producers of health care (Kim, 2000). Also, research carried out in Ghana, Nigeria and Sierra Leone have shown that various cultural and societal factors negatively influence the utilization of health services available to women. There is also evidence from WHO,(1998) report that the introduction of fees has increased

15 discrimination against women given the gender differences in the household level health expenditure. Standing, (1999) confirmed that when users charges where introduced, maternal deaths in the Zaria region of Nigeria rose by 56 percent along with a 46 percent decline in the use of health facilities and the number of deliveries in the main hospital. Low socio-economic status of women is a serious factor, which is known to be associated with the ill health of women especially with mortality and morbidity rates as was revealed by WHO (1998).As a follow up WHO (2000)record show that in Africa in particular, pregnancy and child birth-related mortality and morbidity rates are high. The reason being that from the time the girl becomes biologically able to bear children she is more at risk for certain gender-specific health problems.The same Globally too,the same record showed that over 600,000 women die each year following child birth and 99 percent of these deaths occur in developing countries. For each woman who dies, at least 30 to 100 women survive child bearint suffer from serious disease, disability or physical damage, which may have been overlooked during pre-natal care. Pre-natal care is a central component of maternity care, which is accepted as beneficial to maternal, and child health. Thus, providing adequate pre-natal care may prevent immediate cause of pregnancy-related complications, promote healthy behaviour including post-partum contraceptive use and infant care (Kogan, Alexander). The right to control one’s fertility through contraceptive use is now widely recognized as a basic human right. The importance of family planning to women’s general well-being and health is widely accepted for women with good social, health and financial support, the timing, spacing and number of pregnancies can be unproblematic for low-income women with limited access to health care (O’Cornell 1994). Women who give birth to more than 4 children and with less than 2 years between births are more at risk to maternal mortality and morbidity. But most of these deaths are preventable (UNO, 1995). Poor nutrition also contributes to three major causes of maternal mortality, pregnancy induced hypertension, hemorrhage and septiciaemia (UNFPA, 1994), cultural factors such as inequitable intra-household food distribution and taboos tend to affect the nutrition and health of adolescent girls and pregnant women. This group of people needs iron particularly in developing countries where infectious diseases like malaria contribute fourth to anaemia, Radhike, (1994)

16 recognized that throughout developing world where nutritional taboos are observed by pregnant and lactating mothers they suffer from iron (fe) and protein deficiencies because of deprivation of these essential nutrients in their diets. Other health consequences on women resulting from negative cultural practices include extreme pregnancy related health conditions such as uterine rupture due to prolonged labour resulting from malposition or malpresentation of the foetus (Bledsoe and Cohen, 1999). According to them these obstetrical and gynecological abnormalities are worse in girls who marry early, elderly primips and those who have been pregnant so many times. These gynaecological health problems may even aggravate to cervical and perinial lacerations, vesico-vagina or recto-vaginal fistulas; with complications like urine incontinence, urethral strictures, profuse haemorrhage, psychological and mental trauma and death. Commenting on the issue of cultural practices adversely affecting the health of women, Khafagi, (2001) noted that female genital mutilation(FGM) can be seen in some countries as a deeply rooted tradition inseparable from the peoples way of life.FGM usually takes place before or just as a girl reaches puberty. The reasons deduced for the practice of FGM include to moderate female sexuality, assure a girl’s marriageability and to prepare her for the pain of child birth. According to Toubia, (1994) this negative cultural practice is still widespread in male-dominated societies in Africa, like Sudan, Chad and Ethiopia. He affirmed that the percentage of the adult female population affected by this practice ranges from 90% in most of the horn of Africa and few in some of the other countries. Undoubtedly, according to Obianyo (2000) women occupy a special place in efforts to improve health because they participate in, and often manage many activities that affect the health and well-being of their families. Therefore harmful cultural practices affecting the health of women is a human insecurity issue, and one of health inequality which requires a holistic approach to ensuring gender equity and right to health; thus ultimately will lead to fairer and more just development.

Harmful Cultural Practices and Women’s Health There is a compelling reason for investing in women’s health. Such an investment will ensure women equality in social, economic and political efficacy for their own development, that of their community and the nation. Unfortunately, women viocelessness, disproportionate poverty, low social status, harmful cultural practices meted out on them coupled with their reproductive roles expose them to

17 severe health hazards, risks and premature deaths which are largely preventable. Women’s health simply put is the complete physical, mental and personal fitness of women for fruitful and quality living. The fourth World Conference on women Beijing (1995) defined the concept ‘women and health as one critical area of concern in the platform for Action with five strategic objectives established to include the fight against severe persistent, discrimination and violation of the girl- child and improvement of the welfare of the girl child/women especially with regard to health (World Bank, 1998), Within the past ten years, women’s health has evolved too many issues concerning their paradigm of reproduction but recently it refers to the prevention, diagnosis and management of the conditions or of the reproductive system that may be unique to women such as pregnancy. For example, women spend a lot of their active years bearing and rearing children especially when married early. In order words, a life cycle approach to women’s health could be traced back to their childhood and adolescent period which takes into cognizance the specific and cumulative effects of poverty and cultural influence. According to Economic Community of Africa (ECA) (1997) health of women emanating from some discriminatory harmful cultural practices, especially in developing countries include, discriminatory food taboos for the girl child, pregnant and lactating mothers, early marriage, and female-female marriage among others. According to Gachiri (2000) harmful cultural practices in relation to women can be defined as those traditional practices that are harmful to the health and well-being of women. The concept harmful cultural practices connotes ‘hurting someone’, or an accepted life style of a people’s behaviour, which causes pain to someone else (Carr, 1997). It could also mean an un-natural/abnormal behaviour of a people which hurts (College Dictionary, 1987). Prominent among practices that are classified as cultural or traditional and harmful that may affect the health of women include female initiation rituals known as female circumcision or female genital mutilation. Female genital mutilation was defined in a joint statement issued by WHO, UNICEF and UNFPA in 1977 that: female genital mutilation comprises all procedures involving part or total removal of the external female genitalia or other injury to female

genital organs whether for cultural or other non- therapeutic reasons.

This inhuman female genital cutting has received growing attention from governmental and international organizations like the Advancement of women, (1994) and Beijing (1995) among others. The plight of women/girl child with regard to female genital mutilation is commonly considered a human rights violation .According to Kiragu,(1995) those subjected to this harmful cultural practice were never given any form of anaesthesia or the use of sterile instruments The use of unsterile instrument is also risky for the girls/women because of possible transmission of human immune Deficiency Virrus(HIV) and infective hepatitis B through reusing of unsterile equipment which have been in contact with the blood of numerous girls/women(Klasen and Wink,2002) .Moreover, Ascadi (1993) earlier expressed the fear that genitally-mutilated girls/women may die suddenly because of pain and anaphylactic shock Their deaths also may be as a result of profuse bleeding, tetanus and recurrent severe infection. Long term consequences of female genital mutilation include inertia of the female external/internal genitalia during labour and childbirth due to scar tissue formation, urethral stricture, prolonged labour with lacerated vagina, urethral and perineal walls; especially where the foetus is large (Mandara, 1995: 31) and Kun, (1997: 153). Moreover, it has been documented historically on all continent today, that the practice of female genital circumcision appears limited to 28 African countries forming a continent belt across the northern sub-Saharan region; from Sudan to Senegal and along the nile valley from Egypt down to East Africa, (TijaniSlanger, 1998). In the overwhelmingly male-dominated societies of Africa males dictate the standards of marriageability and so see women genital mutilation as the best way of preparing them for pain of labour/childbirth. However, depending on where FGM is practiced, it is justified on the basis of tradition, religious assurance of virginity before marriage and marital fidelity which is an inseparable part of a culture .According to Khafegi, (2001) the practice of female circumcision is a reflection of a girl’s social position within her family and community. No wonder each year an estimated 2 million girls are mutilated (World Bank, 2000). In Nigeria,according to National Population Commission,(2000) the prevalence of this harmful cultural practice is 25 percent for the whole country and

19 ranges from 2 percent in the North east to 48 percent in the South west. Also, the study earlier conducted by the International Reproductive Rights Research action Group (IRRAG.1995: 113) revealed that in Nigeria, women/girls who are uncircumcised are stigmatized while young uncircumcised girls are sexually too active as was perceived among the Binis. This was why respondents used for that study opined that females submit to circumcision in order not to be stigmatized or ostracized. Similarly, another research carried out in Sierra Leone revealed that 86 percent subscribed to female circumcision on the basis of their tradition, 35 percent was for social identity while 17 per cent was because of their religion (WHO, 1998). Toubia (1994:48) confirmed that almost 33 percent of women who have undergone female genital mutilation eventually develop extreme complications like prolapse of the cervix /vagina. Continuing, he observed that girls and women who become victims of these health consequences are often abandoned, by their relations as these complications may be for life; especially during pregnancy, childbirth and the post-partum period when they desired intimate care (Ras-work, 2001: 104). Such information is sometimes qualified with the statement that health consequences vary by type. According to her, it is assuring that international pressure, has continued to be exerted on governments, communities and individuals to eliminate the practice. Hence, it is not surprising that there has been increased interest by researchers is growing rapidly to document the prevalence, determinants and health effects of genital cutting as well as developing appropriate intervention strategies with proven effectiveness. Although some review and advocacy literature on female circumcision are based on generalization but prescribed as empirical facts. For example, evidence has shown that in a place like Egypt, the declining rates of female circumcision, though slight, prove that the concerted efforts of many groups in Egypt to eliminate this practice have started to show positive impact (Khafagi 2001). However, it is sad to note that domestic and sexual violence are now visible and recognized as having been endemic for centuries in many cultures in almost every society (UN Campaign for the Human Rights of Women and Girls Against Violence 1998; WHO/PAHO, 2000). Violence against women encompasses various forms of physical and mental trauma, exploitation, humiliation, general maltreatment and degradation of women. Violence of women in any form, be it physical, psychological trauma or sexual is a significant cause of maternal

20 morbidity and mortality (World Bank, 1993 ). This is the re why the move for the prevention of violence against women is increasingly being addressed in the training activities of NGO’s such as Planned Parenthood Association of South Africa whose primary purpose is for reduction in unwanted/unprotected sex behaviour and HIV transmission (Heise, 1994). It is interesting to note that South Africa provides a good record of a country where the issue of gender based violence, forced prostitution and early girl-child marriage has been made relatively a high national priority. The cultural practice of subjecting a girl child to early marriage and in some cases to men old enough to be their fathers constitute a health risk to these girls. Obviously the girl will start bearing children immediately she is betrothed to the man and she might die in the process because she is not physically/biologically and psychologically matured for marriage. She may also have some other pregnancy related complications like pelvic disproportion and dislocation resulting from incompatibility of the foetus and the immature pelvic bones, extensive laceration of the reproductive organs, the perineum and fistulas (urethral, vagina or recto-vaginal) among others (Obianyo, 2000). Regrettably,these health problems of women constitute a significant drain on health resources, as most women die because of their low economic status which reflects on the type of food they eat, poor response to health care services which results to,poor health condition which deprives them from effectively participating in any meaningful development in their community (UNDP, 1995:92). In various communities throughout Africa social and cultural factors have a strong impact on dietary practice. There exist taboos/myths which dictate specific foods which may not be eaten by girls/women, pregnant and lactating mothers. Such foods include snail, grass cutter, squirrel, crab and eggs etc. According to Amadiume (1997) reasons for abstinence from these foods include the following; that pregnant mothers who eat snail, their babies will be salivating indefinitely; the eating of grass cutter will precipitate prolong labour; for eating squirrel, the baby will be small and very crafty and for eggs/milk, the baby will be a cleptomania. Such stories were mere fallacy because they were not subjected to any proof. Women who are denied these food components often suffer from calcium deficiencies and protein malnutrition. According to economic commission for Africa( ECA 1997) many of these foods are highly nutritious and depriving one’s body of them often result, in anaemia or even malnutrition for

21 women and poor development for infants. Adequate nutrition is essential for reproductive health, iron (fe) deficiency (anaemia) and stunting caused by calcium, protein-energy malnutrition which can contribute to pregnancy related deaths. Severe anaemia plays a part in up to 40% of the maternal deaths each year in developing countries (WHO and UNICEF, 1992, UNFPA 1998). Also, most maternal deaths in developing countries are associated with sexuality and reproduction. As indicated by Economic Commission for Africa (1997) a wife wishing to practice family planning to delay or space childbearing may be met with violence and accusations of infidelity from the husband. Cultural norms often make it difficult for women to seek for medical care away from home. Young girls are increasingly sought out for sexual relations by older men who believe that the risk of contracting HIV will be lowered (Parkin, 1999). Unfortunately such speculations are and still not true because as these young girls are indirectly forced into prostitution they are undoubtedly exposed to deaths, unwanted pregnancy and sexually transmitted diseases including HIV/AIDS. In many societies the social stigma of unwanted pregnancy by unmarried girls/women and HIV/AIDS leads to ostracism, murder or suicide (UNDP, 1995).Whereas, in some Igbo societies unwanted pregnancy is never a crime especially for parents who have no children or male child at all. For instance, marriage like female-female marriage and marriage for the deceased husband is usually arranged and accepted culturally and practiced because of the emphasis placed on male children or son preference and perpetuation of the male lineage. Definitely, these cultural practices have serious health consequences on women because of their involvement in sexual relationship with multiple partners (Nyamele and Mwabu, 1991) Supporting their views Lestharge,(1998) maintained that the spread of reproductive tract infections HIV/AIDS from infected persons associated with polygamy or female-female marriage; constitutes a serious health problem for women in rural and urban areas in Nigeria. Ever since the global panic around HIV/AIDS started, Panos, institute (1999) noted that Africa of which Nigeria is inclusive has been represented in extremely catastrophic terms as the lost continent where HIV infection is increasing more rapidly among females than males. As a matter of fact UNFPA (2000) report confirmed the presence of STD’s associated with increase risk of HIV transmission to have caused a significant increase in infertility among young women and men. Unfortunately only women are

22 assumed to be infertile and they pay a heavy price ranging from abandonment to divorce by their husbands and they are also devalued by their community. Holland, (1994) lamented that women’s lack of voice and power and the coercive gender relations existing in most of Africa’s communities predispose most women to infections. If women will have the power to say no to unwanted and unsafe sex, the HIV/AIDS saga would dramatically decline in Africa. Thus, more women would realize greater social and economic goals (Machera, 2004). Another issue about harmful cultural practices affecting the health of women is the widowhood inheritance which means the adoption of the widow by the deceased husbands close relation in some communities especially in Igbo speaking areas in Nigeria. This cultural process of protecting a widow could pose some health dangers to the woman. The new relationship may facilitate her demise as she may experience lack of care, sexual exploits, physical, psychological mental and emotional trauma. She may be exploited sexually (because of poverty by multiple sex partners, which exposes her to sexually transmitted diseases which will put her in a terrible condition as the man/men who had promised to assist her meet her domestic, child-rearing and economic responsibility will not only abandon her but will cause her being ostracized from the family/house with or without her children. However, Oberneyer (2001) observed that there is a growing acceptance in many quarters now for increased rigor in documenting the specific health effects of harmful cultural practices on women’s health and the intervention strategies to end them. At this juncture the specific harmful cultural practices which may affect the health of women will now be discussed beginning with their manifestations.

Manifestations of Harmful Cultural Practices Affecting Women’s Health Many factors have been incriminated in the poor health status and general well-being of women. Among such factors include obnoxious cultural practices regarded as traditions which are directed at women. These traditions reflect norms, care and behaviour based on age, life style and social class. Many traditions according to UNFPA(1998) promote social cohesion and unity,while others erode the well-being of individuals particularly girls and women. Human behaviours and cultural values, however, irrelevant and inhuman they may appear from the personal and cultural stand point of others may have meaning and fulfill a function for those who practice them. Definitely, people are bound to change their

23 behaviour when they realize the hazards and indignity of harm projected. Then they may device means and the possibility of giving up such practices without giving up meaningful aspects of their culture. Harmful cultures exist in many different forms but they share origins in the historically unequal social and economic relationships between men and women. Previous studies by Hansson (1991), Onyeulor (1997) show that harmful traditional practices like female genital mutilation and widowhood practices are dehumanizing and has received global attention due to their severe negative impact on the health and well-being of females and several efforts to eradicate these practices are often met with hostility from the various communities practicing them. UNFPA, (1998) and Eze, (2000) asserts that harmful traditional practices meted on women are also violation of the fundamental human rights of women. The slogan “Women’s Rights are Human Rights”, adopted at the World Conference on Human Rights in Vienna in 1993, as well as the Declaration on the elimination of violence against women adopted by the general assembly the same year captured the reality of the status accorded to women (WHO, UNICEF, 1992). Ras-work (2001) observed also that for better control by male dominated societies so many myths and taboos are built around women. Thus harmful traditional practices against women are manifestations of the historically unequal power relation between men and women which have continued to erode the society and have led to men’s domination and discrimination against women. Although the degree of domination and its manifestations vary from country to country; but the subordinate status reserved for women is a long standing reality (Ahonsi and Awasanye,1997). Continuing, they noted that women’s subordination is not dependent on their education, social or economic status and well-being. It could be recalled that traditionally, women are regarded as weaker sex and inferior beings who cannot take initiative on what to do or how to do it.. Supporting the above view Fagbolu (2001) noted that women were thought to be mentally socially and psychologically inferior to men; therefore had little or nothing to contribute when it comes to decision making. To buttress this assertion, Amadiume (1997:35) posits that the most enduring enemies of a woman’s dignity and security are cultural forces aimed at preserving male dominance and female subjugation often defended in the name of venerable tradition. The word tradition according to Iman (1998:34) constitutes the ideology of the dominant group in a society as it is used

24 to maintain existing relations of inequality; and to make the subordinate groups to believe and accept as normal the prevailing structures of inequality. However, in conclusion on this issue, Akubue (2002) posits that women subordination knows no boundaries. Elaborating on the manifestations of harmful traditions Amadiume (1997) pointed out that women, particularly those in developing countries like Nigeria suffer discrimination and violation of their rights which unfortunately begins at or even before birth when a preference for sons may put baby girls at risk. Continuing, she noted that in igboland and precisely in Nnobi, a male child is preferred to the female, as the atmosphere is usually charged with songs and dances. Male children were regarded as those who would remain in the natal home and later inherit the property and responsibilities of their parents (that is, if there is anything to inherit) while the females are regarded as source of wealth to parents because, it is believed that they will surely leave home someday for somebody else’s family. Thus, the female-child is reserved for ‘trade by barter’ as she is not celebrated at birth. The psychological and emotional effect of these attitudes towards women can be traumatic particularly on the health of women who are barren, or those who have consistently given birth to female children or those who have lost all their children to disaster (Amadiume, 1997). In a similar view Shirima and Kisija (2001) reported that in the Rambo district of Tanzania a woman who gave birth to a baby girl got no attention from the husband or his relations but if a baby boy, a big goat (Nlafu) is slaughtered to announce his birth. The mother also got excellent care.Contrarily, in the Sukuma district of Tanzania, as was observed by the authors, female children were more valued than the males. The reason being that the family is assured of wealth from bride price; although males traditionally are considered heirs to the family name. In Nigeria particularly among the Igbo tribe as was observed by Amaduime (1997) the male child is preferred to the female, because men in particularly, and families in general will not be happy with all female children. In a contrary view, Onah, (1992) remarked that the female child is regarded as a bonafide member of her family but the reality remains however, that she is considered a passers-by. The effect of this particularly practice on women has psychological effect as it creates a lot of anxiety, tension insecurity and fear for their husband who may take another wife who will give him the elusive male child.

The traditional bride price is yet another form of derogatory action harmful to the girl-child which insinuates that women are mere products/articles for sale. The purchasing party takes possession of the woman as his personal property (Mgboh, 2000). Supporting this statement Obianyo, (2000:1) stated that: the bride price is partly responsible for the insults and injuries women receive in their matrimonial homes. When so purchased, she must obey without questioning… even husbands relatives view the wife as their property; a situation that is clearly demonstrated at the death of the husband.

It is worthy-mentioning that the bride price issue was never part of the biblical injunction about marriage as stated in Genesis 218-24 (RSV) that: it is not good for a man to be alone, I will make him a helper fit for him. Therefore, a man leaves his father and mother and cling to his wife and they become one flesh.

In essence, women are helpers to men and so the bride price embedded into the culture of our people by the society is a way to devalue the girl-child. Hence, Craft, (1998) posits that dowry/bride price often leads to physical abuse of women, wife battering as men who beat their wives boast, and assert their rights that they are dealing with their property. Such beatings atimes leave indelible mark injuries on the woman and if she is unfortunate, she may loose her life. Commenting on the attitude of men towards women, Obianyo (2000) still maintained that the bride price instituted by the society is a way of controlling and suppressing women to assuming second class citizenship and passive roles in marriage, whereas this is not suppose to be so. IRRAG 1995: 25-26); Craft, (1998) records that women are not allowed to participate in any decision-making process; even in issues concerning their sexuality and health. Continuing, Craft noted that women have often been beaten, physically abused and intimidated on issues concerning sexuality and fertility. The United Nations Development Programme Report (UNDP) (1995:92) also revealed that; for girls and women, sexuality and reproduction are all too often a source of pain, violence, disease death and even murder; are very much tied to differentials in power and decision-making within relationship and society at large.

In fact, the saying that women should be seen and not heard describes the lots of women in Africa and particularly those in rural communities in Nigeria; although some places may be worse than others in enforcing this common saying. Women like every other person have their rights to exercise. Such rights include the right to live,have control over there lives, adopt liberated mind to express themselves and right to enjoying good health/other privilage. Good health, according to WHO (1998) is essential to leading a productive and fulfilling life, and the right of all women to control all aspects of their health is basic for their empowerment. For example in a typical African society, wives wishing to practice family planning to delay or space childbearing may be met with violence and accusations of infidelity from their husbands (UNDP report, 1997). Men on the other hand are given greater leverage over decision making than women. This is because women in developing countries like Nigeria continue to be socialized into believing that their value is attached to the men either as their fathers, husbands, brothers and sons. This could have been the reason why Fagbolu (2001) affirmed that men do not subjugate women or relegate them to insignificance, rather women are their own problems as they have decided to cosily assign themselves second- class citizenship. For example, the traditional widowhood practice is supportive of her assertion because it is women and not men who have consistently perpetrated the evils associated with obnoxious widowhood practices meted out on widows Still elaborating on the above issue, the most highly valued female virginity and fecundity tests which are common practices in many societies in Africa (Zimbabwe, Uganda, Ghana and Nigeria etc) are performed by women. Young girls and women are subjected to virginity tests which are not only humiliating but also traumatic and yet may not be accurate. For example, according to Ubah (2005) young girls in Odegbolu local government area of Ogun State are being subjected to virginity test as a precondition for scholarship award; but this practice was condemned by the national coalition on violence against women’s rights organization because it is a way of debasing women/girls. Also the procedure for virginity test is traumatic, if it is forcefully done, the female hymen may be lacerated, there may be excessive bleeding, there may be ascending infection and perhaps scar tissue formation which may pose serious problems for the girl-child later in life.

In this way, women suffer severe consequences of men’s perceived need to control girls/women’s sexuality. Awasanye (1997) contends that such perception about women not only result to male domination and female subjugation but also endangers the lives of women. Still speaking on the issue about females having control over their sexuality Ezumah (2002) viewed that inequality in gender power relation is one of the factor that has influenced issues like sexuality and sexual behaviour, hence c0ommunication about sexuality has been very limited for discussion simply because such issues have been enshrouded in a culture of silence particularly for the girl-child. Also due to the gender-role socialization, girls’ and women are not suppose to know or discuss sexuality or express sexual desires (IRRAG, 1995:25). The issue of chastity and culture of silence imposed on women, even in issues affecting their well being has compounded their problems and status in the society. Akubue,(2002) observed that chastity is upheld for girls’ and women and not usually for boys and men. This may be the reason why many groups in Africa highly encourage early marriage of the girl child just to ensure her chastity,remarked, (Lestheage, 1998). Furthermore,he noted that the bride-price paid in some African communities normally vary according to whether the girl is a virgin or not. In other words, a women’s value is based on her virginity. It is very sad to believe that early marriage for a girl-child before the age of 18 years is just because her parents want to ensure her virginity. There is also need to consider the health consequences associated with such marriage as most life threatening complications occur during labour and delivery. Some of the outcome of pregnancy, labour and delivery considered as health risks include anaemia prolonged and obstructed labour particularly among malnourished girls. These health consequences are due to the general belief that a girl married soon after her menarche has not developed fully. She has about 5% more height and 10 – 20% more pelvic growth to attain (inter Africa Committee on Traditional Practices Affecting the Health of Women and Children (IAC) 1999:48.) Also, WHO (1998) confirmed that; As the body of an adolescent is undergoing a growth spurt, additional nutrients are required by her body…, the younger the girl, the higher the risk and this may lead to death of the mother and/or baby and often leads to recto-vaginal or vesico- vaginal fistulas.

Vesico-vaginal fistula or recto-vaginal fistula results from death of tissues of the birth canal, leading to a breakdown of the walls between the bladder or rectum and vagina. Fistulas can only be repaired surgically because they usually give rise to chronic problems (social and psychological) throughout the girls life. Certainly, the cultural attachment to social value of female virginity has adverse consequences on the girl-child/women. The same cultural practices seem to exonerate men from all the types of sexual behaviour they exhibit. Kisija (2001) remarked that most men see sexual behaviours like double standard on sexuality as a way to exhibiting their manhood and satisfying their sexual lust. This attitude of men predisposes them to having many concubines, marrying many wives and also indulging in discriminate extra-marital relationship. Cases abound where some men see nothing wrong with abandoning their wives and engage in extra-marital relationships with other women who are their concubines. For example, in most Igbo communities like Ngwa-land, a married man’s concubine is socially accepted and, recognized as “Ikom Nwanyi”. The same thing obtains in Arochukwu where a concubine is recognized as ‘Uzi” Kanu (1995). However, no matter how the society accepts or condones male’s promiscuity and sexual behaviours as a normal phenomenon, such unhealthy behaviours are fraught with dangers. As men/women keep multiple sex partners there is the possibility of contacting, acquiring and transmitting sexually transmitted diseases such as candidiasis, E- Coli and HIV/AIDS among others. Ngowi (2001) confirmed that sexually transmitted diseases such as AIDS caused by HIV virus is an illness of major concern all over the world but efforts to prevent or reduce the scourge through various health enlightenment programmes have not yielded much dividend. Simply because, according to O’malley (2002) no evidence of a translation into specific actions has been seen. She also observed that as individuals, most people in the world still do not see themselves personally threatened by AIDS because people deliberately resigned to infection by indulging in unguarded and casual sexual relationship especially when it involves multiple sex partners. It is also believed that the male condom was recognized as an important preventive technology to slow down the spread of sexually transmitted diseases/AIDS but unfortunately how many men would accept the use of condom. Moreover, the world also lacked female controlled preventive methods, easy diagnostic or treatment tools developed even for other sexually transmitted infection that facilitates HIV

29 transmission (World Bank, 2000). No wonder women and not men are the most vulnerable to HIV/AIDS because they lacked controlled protective gadgets like men. Although according to WHO (2000), out of the 10.8 million HIV/AIDS patients in Nigeria, no accurate number of women suffering from the pandemic diseases was established. In spite of this, the truth still remains that women with sexually transmitted disease have greater risk in contracting the diseases simply because women lack of voice and reproductive health decision. With reference to (World Bank 2000) report, the vulnerability of women to sexually transmitted disease is exacerbated by the ongoing oppression of women as well as by liberalizing sexual laws coupled with grinding poverty associated with women. Also the transmission of sexually transmitted disease are faster in women than from women to men because of their biological factor which places them at a higher risk to HIV/AIDS infection which is accelerating rapidly among women through their exposure to infected partners. Many are also susceptible to human papillomavirus infections resulting to cancer of the cervix, which accounts for more deaths yearly in developing countries (UNDP 1995, Parkin 1999). Similarly, Chukwuezi, (2000) opined that women are at greater risk than men of contacting HIV/AIDS simply because of their reproductive anatomy; and so they exhibit early signs and symptoms of any sexually transmitted disease before their infected male partners. Continuing, he stated that a woman would prefer keeping silent over any infection she acquired for fear and shyness of being first accused or interrogated as to ‘how’ and ‘when’ she contacted the disease. Such perceptions affect women’s health and well being in various ways. They may be traumatized psychologically if accused of promiscuity or stigmatized as disease carrier. Similarly, Adekunle and Ladipe (1992) opined that because of the prevailing culture of silence surrounding sexuality, women do not have courage to discuss this aspect of their health problems with their spouses or health personnel even when they visit the hospital in their very bad condition. This explains the limited use of health facilities by most women/girls and the delay/non-existence of adequate data on women’s health. Uzuegbunam (2003) observed that the language that stigmatizes women as disease carrier absolves men of the responsibility of transmission of diseases. Notably, the language that stigmatize women as disease carrier (simply because

30 they exhibit the manifestation of the signs or symptoms of disease first) not only debase women but also causes unnecessary delays to prompt treatment. Chukwuezi (2000) also remarked that health problems such as sexually transmitted disease(s) if not promptly addressed usually have adverse effects on both men and women/girls. In fact, according to him such delays in providing solutions to health problems particularly in developing countries have led to why many African countries have continued to record very high rates of death; and the current soaring rate of HIV/AID pandemic. Another factor that projects where manifestations of harmful cultural practices can adversely affect the health of women include the problems emanating from their physiological roles. According to Tijani (1998) it has been and still evident that women in Africa experience and also pass through various health problems arising from their physiological roles. The physiological roles of women include their domestic chores in the home, child bearing and child rearing. Unfortunately, most women deviate from (not by choice) their physiological roles to assuming complex responsibilities (even when the husband is still alive). The woman is a child producer, child-rearer, food producer, and sole breadwinner and also takes care of the schooling of the children; despite her limited resources and educational status. It is also pertinent that the society perceives women as potential producers of services for men, and active in pre and post harvest processes; working un-recognised to the detriment of their health. Regretably, the failure of the society to recognize women’s various contributions in any development process even when it is obvious that women have effectively participated is simply to ensure better control by male dominated society (Ahonsi and Awasanya, 1997).Continuing, they maintained that this attitude of the society has not only devalued the status of women but has continually denied women the opportunity for their empowerment, recognition of their human rights to boldly participate in decisions affecting them. In the same vein, Azikiwe (1992:30) reacted vehemently by saying that;

Tradition and culture have relegated women to inferior status and subordinate positions in the society; hence their contributions are generally un-recognised in development plans. Ethnographic and anthropological monographs such as the work of the Ottenbergs and Pitcher (1998) revealed that the African woman has a position and

31 status that is in many ways definitely inferior to that of men in spite of the fact that women do most of the hard work and supporting the family. Regrettably, the woman or women in question is/are the foremost victim of old and die-hard traditional attitudes that militate against their health and well being (Berhane, 1998). Still elaborating on the above issue, Ikejiani (2001) strongly refutes the perception about women as custodians of the social fabrics of the family and the marriage constitution creating stereotypes in which women are suppose to specialize in domestic chores while men on the other hand are saddled with the public duties and usually claim to have no time for household duties. On the contrary, Iman (1998:34) had earlier opined that men and women perform complementary roles and as such the inference about the perceived super or subordination of women should not arise. Similarly, Awasanya (1997: 141) opined that: the sharp contrast between the experiences of men and women in Nigeria with other societies do not only translate into complementality but inequality. In other words, there are still, obvious manifestations of discrimination and wide gap existing even in the roles played by men or women; which shows that women are discriminated against. Supporting this view, Burikhardt (2002) opined that generally women all over the world are facing various problems that are so deeply rooted in themselves and their culture. Most of these problems women face which affect their health and well being include those negative attitudes of women towards themselves. A good example is the harsh traditional burial customs practiced in most Igbo communities where the death of a man (husband) marks the end of the joy of a woman (wife). Embittered about such harsh cultural practice, Madu (2001) noted that the widow is subjected to chains of torment, debasement and subjugation that instantly affect the physical, emotional, mental and psychological health of the widow. Similarly, Amadiume (1997) observed that a widow is not supposed to see the corpse of her late husband, she will not bath or change her clothes till the expiration of six months after her husbands death.Such inhuman treatment make women more vulnerable to more health problem.In fact, the list of the examples of harmful cultural practices that may affect the health of women are inexhaustible but an attempt was made by the researcher to assess the types of harmfull cultural practices, why they exist, ,their consequencies and ,why they resist change in contemporary times. Moreover, the researcher also determined community-based

32 intervention strategies that may be adopted for the elimination of harmful cultural practices so that women all over the world will enjoy an enabling environment, have access to good health and health services and equality in all spheres of life because it is their fundamental human rights.

Types of Harmful Cultural Practices that May Affect Women’s Health: Marriage Practices (a) Early Marriage Marriage is a union between a man and woman traditionally and socially sanctioned to become partners for life for the purpose of procreation (Anyisi, 1979:7; Eze, 2000). Marriage itself, according to Nwanunobi (1997) is a good social union that is well contracted by people who are matured and have good understanding of what marriage is all about. But when marriage is contracted by teenagers and people who are not matured with or without the consent of the parents, it is called early marriage. Obilade (1998) sees early marriage as that: Marriage contracted before the full or average development of the economic social, educational and political potentials of the couple. In other words, couples who engage in such marriages are not groomed in knowledge and matured educationally to assume full responsibilities of maintaining a family that may also be due to prior lack of knowledge about each other. Early marriage is regarded as the violation of human rights. It could be recalled that the UN General Assembly 1956 approved an international treaty to prevent the practice of giving away young girls in marriage. This was followed by a supplementary convention on the issue of giving away women in marriage without their consent. Continuing, Obilade also remarked that the convention yet recommended a minimum age of 15 years for marriage and the registration of marriages that entered into force in December 1964. Still elaborating on the issue of girls rushing into marriage early, Obilade also noted that it is absolutely against the several legal instruments, resolutions and declarations drawn up by the Universal Declaration of Human Rights 1948 which stated vividly in the first two parts of Article 16 that:

1. Men and women of full age without any limitation due to race, nationality or religion have the right to marry and to found a family. They are entitled to equal rights as to marriage and at its dissolution.

2. Marriage should be entered into only with the free and full consent of the intending spouses. Often times parents encourage their daughters to go into such marriage so that they can earn respect in the community and also be a grandparent early. Ladman (2000) opined that parents who are instrumental to the early marriage of their daughters may be to alleviate the economic hardship in their family. But it is sad to note that most girls who hurry into marriage instead of aspiring to be in school or complete their education; see marriage as a house of cards built by children because no sooner they become married than it is dissolved (Shyrock, 1993). On the contrary, Davies (2000) contends that teenagers are barely young people who are not physically, mentally and psychologically matured to take responsibilities of marriage and so should never be hurried into it. This is because; the physical, mental, psychological and health problems associated with failed marriages are better expressed than experienced. Among certain ethnic groups in Asia and America the practice of giving away teenage girls for marriage at the age of 11, 12 or 13 is very common. Lopez, (1993), Awogbade and Mu-azu (2000) described such marriage as cradle snatching. In most cases the girls in question are married before they attain puberty; as early as 10 years. However, the reason for rushing into this type of marriage cannot be justified by those who perpetuate it. In some societies the principle reason for early marriage is to ensure the virginity of the girl and the bride price is determined by her chastity (Strong and Bonilla, 1996). Nasara (2001) confirmed that in some societies in Africa early marriage of a girl is encouraged by parents so that their daughter remained a virgin until marriage to ensure the parents dignity, earn respect for parents who would wish to see their children married before old age and also to prevent girls from getting pregnant outside wedlock. Early marriage according to Awogbade (2000) is a common practice in Nigeria among both Christians and Moslems but notably with higher prevalence among the Hausa Moslems of Northern Nigeria. UNFPA (1998) report show that early marriage is a common practice all over the world with 50 percent for African women, 40 percent for Asian women and 30 percent for Latin American women who are married very young. For these categories of women childbearing starts early and may continue till late. Early births increases the risk of women dying from pregnancy due to underdeveloped

34 reproductive organs, too little spacing in between pregnancies as they are often not involved in decisions concerning timing of pregnancy and births. UNO (1995) database report show that in Africa 18 percent of girls aged 11 – 13 years become pregnant each year, adolescents account for nearly 25% of the currently high maternal mortality rate (MMR) of over 600 per 100,000 live births are found in many African Countries. Similarly WHO (1999) report revealed that adolescent girls have a 20 to 20 percent higher risk of dying from pregnancy-related causes than adult women; the younger the girl, the higher the risk. Although, the age at first marriage for females is not always the age at which they are exposed to the risk of childbearing because they could use contraceptives to prevent pregnancy till they are matured to take responsibility of pregnancy and childbearing. The trend towards early sexual experience combined with a lack of information and services increases the risk of unwanted and too early pregnancy Also, Inter-African Report (1999) revealed that childhood marriage robs a girl her childhood time necessary to develop physically, emotionally and psychologically. Certainly, early marriage inflicts great emotional, mental and psychological stress as the young teenage girl may be betrothed to a man as old as her grandfather. Kisija (2001) observed that in rural areas in particular where the practice of early marriages persists, girls as young as 9 -1 3 years were not often consulted as she does not decide on when or who to marry. This is the situation in most rural areas partly because of high population growth rate, poverty alleviation may be too slow for most people and if human development needs can not be provided for. Families do encourage their daughters to marry early as a means of survival. Such low socio-economic family status coupled with the present changing values can expose the girl-child to physical and sexual abuse, unequal power in sexual relationship, unbargained pregnancy leading to sexually- transmitted diseases. Unfortunately, girls who go into early marriage often do not stay with these elderly husbands. They elope because of the wide age difference, inability to cope with the sexual demands from their spouses who are as old as their father. Most of these child-brides run away to major cities to become commercial sex hawkers and in extreme cases such girls despite their objection to marry or attempts to run away may fail and may decide to commit suicide or hacked to death by their husbands (Akumadu, 2000). Apparently, most of these marriages are contracted between

35 men and girls who are 50 years younger, who she cohabits, develops an emotional and physical relationship with. If such marriage ends abruptly say by death of the man, as speculated by Boerma (2000) there will be increased likelihood of a woman becoming a widow at a very tender age with nobody to take responsibility of her welfare. It has been estimated by UNFPA (1998) that if a girl marries a man of 55, she has a one in two chances of being widowed by the time she is 50.such as in Cameroon there is one widowed man for every 19 widowed woman. And so, it is obvious that the list of health consequences associated with early marriage is inexhaustive. Of interest to most people, is why early marriage is practiced at all. Lestharge (1997) opined that there are many interactive social and economic structures and pressures that encourage a specific marriage timing that may differ from society to society. For example she observed that in Islamic agricultural societies where property can be passed on to women, girls tend to marry very early. Whereas, in the Islamic pastoralist societies with caste endogamy and preferential cousin marriage; property transmission produces exceptionally late age at marriage for women. Also in matrilineal societies women tend to marry late. Although late marriages are bad but early marriage as a cultural practice is not pleasant before the age of 18 for young girls who are not physically developed for child bearing. Early marriage is associated with early involvement in sexual relationship which invariable leads to early motherhood of a girl-child who is not physiologically matured to get married, get pregnant or go into labour. Hence, UNFPA (1998) stated that no girl should become pregnant before the age of 18 because she is not yet physically ready to bear children as there is a great risk to the young mother’s own health. Health consequences of early sexual relationship according to Tahzih (1995) include (dyspareunia) painful intercourse, lacerated hymen, profuse bleeding and severe infection which may delay healing. Similarly, Obianyo (2000) stated that because of the undeveloped pelvic bones there is usually an obstruction and delay in the descent of the baby through the birth canal leading to prolonged labour; with excessive pressure of the baby on the mothers bladder which is anatomically in front of the uterus. Prolonged pressure exercised on the bladder, vagina and rectum of the mother may lead to paralysis of the muscles, thus provoking unhealthy conditions such as vesico-vaginal or recto- vaginal fistulae especially when an untrained traditional birth attendant is

36 conducting the delivery. Vesico-vaginal fistula or recto-vaginal fistula are obstetrical conditions where a woman is incontinent of urine or feaces or both. Urine or feaces incontinence is/are dehumanizing because the victim lives with it for life. Awogbade (2000) noted that even where V.V.F. patients have been successfully treated, they often have problems of reproduction later. Other problems that could arise include wound breakage, recurrent infection and delayed healing of wounds.. Under terrible situations, Teachman (1983), Chick and Norton (1991) observed that sufferers of V.V.F. are socially discriminated against, firstly by her own husband and his relations. Cases abound where such victims of V.V.F. are forced out of their matrimonial homes by their husbands who are suppose to share of their wives present predicament. Also Awogbade and Mu’azu (2000) opined that when V.V.F. victims are thrown out of their homes many resort to begging as a means of sustenance. Some are compelled to sell their bodies in order to survive and in the process may contact sexually transmitted diseases and inevitably pregnant. The V.V.F. victims become visitors in their parent’s homes and also a permanent hospital obstetrical cases because of the frequent breakdown of their wounds especially where they involve in active sexual intercourse. Such people are atimes seen in our rural communities in their hopeless situation seeking for people’s assistance. UNO (1995) report revealed that risk following operative delivery, low weight and malnutrition are also associated with teenage pregnancy and lactation in the period of life when the young mothers are themselves growing. Norton and Moorman (1997) observed early marriage and teenage pregnancy are impediments to the education, economic empowerment, quality life and social status of these girls. However, if the political will of a country is strong, if their innovative approaches are tried and their resources are judiciously used for human capacity development by way of compulsorily enforcing completion of primary and secondary education by girls; the prevalence of early marriage may drop considerably.

(b) Polygamy Polygamy is a marriage in which a person of either sex may have more than one life partner at the same time. Al-Barwami (2001) posits that polygamy is a marriage system that involves a love relationship between two or more spouses. Aguene (1999) opined that polygamy is a marriage relationship that brings about social order in the community. He went further to say that by this, cases of

37 prostitution and cases of unwanted pregnancy among teenagers are not equally heard. Supporting the above view, Nze (1999) opined that polygamy helps in reducing the ratio of girls to men in the community, giving no room to prostitution or other social ills found among unmarried girls; thus every woman has a husband. Polygamy may be in the form of polygyny or polyandry. The former (polygyny) is the marriage of one man to more than one woman. Polyandry on the other hand connotes a woman having more than one husband at the same time. This means that a woman engages in marriage relationship with the number of men she regards as her husbands. According to Nwanunobi (1997), this marriage practice is common in many parts of Nigeria. Uzor (2005) also remarked that polyandry is a common practice in some parts of India where brothers from the same parents live in a single room with one wife. Kindiagau (1999) observed that polyandry is common in societies where there is shortage of girls, which could be as a result of female infanticide. And so the imbalance in sex ratio has to be balanced in order to have the girls married; hence it automatically favours the men. Ogbalu (1995) noted that polygamy owes its credence to the issue of extended family system especially among the Igbo communities in South Eastern Nigeria. He also remarked that marriage helps to unite families in Igboland hence they strongly believe in extended family system. Similarly, Uzor (2005) contends that more wives automatically bring about extending a family relationship to many in-laws who may help a man to bringing up his children socio- culturally and economically. Amadiuma(1997)opined that there have been various justifications for the popularity of this marriage practice. To some people, polygamy is seen as a normal way of life and a major means of production and reproduction. Polygamy in some societies signify wealth. According to Kisija (2001) men not only see it as a way of attracting dignity to themselves in the community but also a means of oppressing women, and satisfying their sexual lust. Continuing, he further stated that polygyny is an avenue for having more children who will support them at old age and for security purpose. For example, quoting Perdiata Houston message from the village 1936, a woman remarked that: “my husband says the more children he has, the more prestige he will have - - -; he will go off and marry another woman if I don’t have a child every year”. For polygamists many children especially the male children meant a lot; hence to increase their labour force, they marry many wives. Many wives meant

38 more economic advantage because there will be no need for hired labour force for food production and food processing. Moreover, a man’s wealth is measured by the number of wives, children, barns, of yam and farm animals he has. But often times, children from such homes are usually disadvantaged academically because they concentrate on extensive farm work, as they are the major labour force. Aguene (1999) disclosed that polygamy has been part of society’s customs and a practice that exists since ages and so could be regarded as a global affair. In a contrasting view, Nze (1999) observed that polygamy is only rampant in western part of Africa and in Nigeria records show that it is a marriage practice common in western, southern eastern and northern parts of the country. It has been and still an acceptable tradition in most northern states of Nigeria where this marriage practice is linked with religion. According to Al-Barwani (2001) the Moslem religion encourage their members to marry as many wives as they desire as stated in verse 3 of the Sura’a thus: “marry those women who please you; two, three or four”. But the only restriction imposed by Islam is that: “If you are apprehensive of not being fair, take only one” On the contrary, the Christians frown at polygamy as a marriage tradition because it is against the biblical injunction recorded in the Holy Bible, in Genesis 224 (RSV) where it is stated thus: “Therefore a man leaves his father and his mother and cleaves to his wife and they become one flesh” Although in most societies where there is much attachment to male children, very few Christians have become unplanned polygamists to ensure they have a male child; thereby flawing their Christian obligation. Frederick, (1996)consider the absence of a male child in a family as a danger and threat to the marriage because it has often led to the dissolution of most marriages or encouraged men to sleep around with other women who could give them a male child. Monogamy to some extent ensures peace and harmony in the family but children (especially the males) are regarded as the major ingredients that adds aroma to a home; its absence generates rift, which devastates a home (Oluwole, 2001). Obianyo (2000) contends that the aim of marriage should be harmony and happiness but most women in polygamous homes even though they are blessed with both male and female children, are never loved, free, healthy or happy. She also stated that instead of their husbands giving harmony to their wives they threaten them with divorce or sleeps out with other women.

Confirming the oppressive nature of polygamists, Leshabari (2001) confirmed in his study that a woman in polygamous home usually turn out to be passive as she is regarded as a property in her home and has no right to challenge her husband during a dialogue or discussion. In extreme cases according to Obianyo (2000) the sole husband succeeds in subduing the wives so much that they remain silent tolerating each other for fear of his adverse reactions, which may end up with her being thrown out of the family home. Continuing, she lamented that some women in polygamous homes who cannot support themselves often yield to pressures and accept to live with the sub-human conditions in their homes. Also in extreme circumstances too, Oleran (1993) mentioned that cases abound where a man (polygamist) has the prerogative to choose the wife he loves most. This new development in marital relationship between the man and the woman (he picks as his bone of his bone and flesh of his flesh) usually becomes the onset of quarrels, fighting and threat to lives among the wives. This is because the other women envy the one that is loved most since it is very likely that they have already lost their sleeping turns and their ultimate relationship with their husband may no longer be guaranteed. Onwejogwu (2000) opined that the state of affair between the wives and their children is that of constant jealousy which may end up with breaking of one of the marriages. The wives who are debased and subjugated often engage in physical fights with one another over the man, over money, food and sex. Such fights could result to death. However, no matter how the society or communities accept polygamy as a normal traditional marriage practice, Nze(1999) still maintained that the health problems associated with it are enormous. There could be the vicious cycle of sexually transmitted disease from one of the infected partners to others, which may take a longer time before it could be controlled. Ezumah (2003) also noted that exposure to multiple sexual partners predisposes men and women to sexually transmitted disease (STDS) and reproductive tract infection (RTI) especially where any of the partners engage in extra-marital sexual affairs with infected persons. Adekunle and Ladipe (1992) remarked that reproductive tract infectious are serious health issues that need to be addressed as it is greatly affecting women in both rural and urban areas of Nigeria. Reproductive tract infections can cause pelvic inflammatory diseases, infertility, adverse pregnancy outcomes and life threatening complications like cervical cancer. Also,

Chukwuezi (2000) confirmed from his studies that polygamy promotes contamination and dissemination of sexually transmitted diseases such as Candidiasis, Escherichia Coli, Staphylococcus aureus,and Vaginal warts. Due to women’s powerlessness and dependence on their husbands they are not able to refuse sexual advances from their husbands or protect themselves from infections or prevent unwanted pregnancies. Apart from sexually transmitted disease, Kisija (2001:25) observed that most women in polygamous homes pass through psychological, mental and emotional trauma arising from childlessness, powerlessness, maltreatment and rejection by husbands and other co-wives. Still elaborating on the problems experienced by women in polygamous homes, Kisija stated that: A woman also suffers when her husband dies if she opts to be inherited by one of the man’s relative she becomes a co-wife to the wife or wives of her in-law husband …life becomes worse than before because her responsibility toward herself or her children will not be inherited. If she opts not to be inherited, she is chased out from the husband’s home.

(c) Surrogate-Teenage Motherhood In almost all society, motherhood is the traditional way of defining a woman’s status. A woman is recognized as a woman only if she is a mother. That is to say that what determines a woman’s recognition as a mother depends on her ability to procreate (offspring’s) and perform her motherly roles in the family. Such motherly roles include the rearing of the children, providing family health care and producing/distributing food among others. Surrogate motherhood according to college dictionary (1985),simply mean a substitute for, or appointed to act for another. Teenage surrogate motherhood means a young girl taking over the responsibility of a mother. The concept surrogate-teenage motherhood connotes one delegated to act as a mother or to represent the actual mother either because she in unavoidably not available or for some other reasons like death. Surrogate teenage motherhood is yet another form of cultural practice, which is not usually common or noticed, but it exists in different forms in some communities in developing countries. For example, following the demise of the mother of the house and especially where the marriage is blessed with children the eldest daughter or grown-up house help automatically assumes the position of the caretaker of the entire members of the household with the assistance of the younger siblings and their father. The teenage girl assumes the responsibility of a

41 mother as a caregiver; food producer/distributor and health giver among others even though there may be the probability that she has not reached puberty. According to Leshabari (2001) this new position and assignment in the family begins a point around which some problems of the adolescent girl centers.. She is not married but she is always busy doing majority of the routine jobs in the house with or without strict parental guidance of the father. There is yet another type of surrogate motherhood practices where a young girl is retained in her family to produce children (males) for the father through surrogate fathers or an arranged sex partner as it is commonly practiced in Igboland (Mgbo, 2000). Eze (2000) remarked that this abnormal cultural approach to raising children has harmful effects on the health, social and economic status of the girl. She is the sole breadwinner and for ends to meet, she may be forced into commercial sex hawking. With all the possible health hazards, Zewdie (1993) noted that when girls with little or no sexual experience are exposed to unprotected sexual intercourse, they may become victim to sexually transmitted diseases which are spreading rapidly among young women mainly through prostitution and liaisons with any man in the name of relationship caused by poverty. immediate and long-term consequences of surrogate teenage motherhood abound. Firstly the girl-child is denied the opportunity to go to school. Illiteracy or limited education is almost always associated with early marriage and early pregnancy, which leads to limited ways of earning money and little potential for improvement in the quality of life and that of the family. Similarly, UNDP report 1995 emphasized that education is a fundamental human right which increases a women’s ability to participate in the society, improve her standard of living and quality of life. There are other consequences arising from teenage surrogate motherhood, which can profoundly affect the young surrogate girl. They include domestic violence/rape, which she may be exposed to. Domestic violence and rape are two abnormal incidences, which may affect the health of the teenage-girl. World Bank, (1998) records that domestic violence/rape are responsible for one out of 45 healthy days of life lost to women; and it accounts for 5-8% of the burden among women. Also, UN (2000) report revealed that women might also be exposed to illegal sexual relationship, which results to unwanted pregnancy and mental depression which is a serious mental problem common with women aged 14-44 years old; and this has significant impact on women’s well-being and productivity (Paltiel, 1999). This is why

42 the pregnancy rate among unmarried adolescent is at an alarming rate in many countries of the world where some of these teenage girls give birth to babies that are abandoned in the bush where they decay or devoured by wild animals. Such cases may be attributed to lack of strict parental guidance because to a large extent the wellbeing of children depends on their mother particularly those in developing countries where the woman and not the men are direcly concerned with child rearing. (Machera 2004). Continuing, he said that a mother’s death in childbirth invariably meant almost certain death for the newly born child and severe consequences for the older children. Therefore, improving women’s health has significant benefits not only for women but also for their children and the national economy.

(c) Female-Female Marriage Female-female husband or female-female marriage is a type of marriage contracted between two women. That is to say that a woman initiates and gets another woman for herself as wife. According to Eze (2000) under this context or arrangement, a woman legitimately marries a fellow woman as wife to raise offspring for the family in order to continue the lineage perhaps because she is unable to do so, although there are other factors motivating this form of marriage. Onah (1992) posits that in Africa the main reason (and often the only reason) for contracting marriages remains procreation. To buttress this assertion, Markinwa (1995) observed that in some culture the last installment of the bride price (an index of a unions legality and recognition) is paid or transferred only after the birth of the first child; preferably a male-child. So, it then follows that a woman who is not able to bear children is seen as a failure and the husband is likely to react by divorcing her and marry another wife; hence, the persistence of polygamy and marital instability which is associated with infertility (Anyisi, 1979; Onah, 1992). Supporting the above view, Uzuegbunam (2003) said that a barren woman especially in Igboland suffers from various inequities and so in order to gain her husbands favour, initiates woman-woman marriage. This is only relevant were the man is still very young but if otherwise another man may be arranged to father the children or the woman may be given the freedom of sleeping around with any man. In essence, woman-woman marriage in Igboland is portrayed as a flexible option available to such woman to pursue their personal companionship, social and

43 economic interests (Eze, 2000). In Igboland and may be in some parts of Africa, barrenness is regarded as a taboo and a curse for wrong doings. A barren woman (even if the husband is dead) would opt for woman-woman marriage so that she will also participate like other women in discussions about her children, her loved life and her companionship (Amadiume, 1997). More so, in a culture where role differentiation is strongly advocated, a woman is constantly reminded of her function as a child producer and so for the childless woman, she could through woman-woman marriage have children she could refer to as hers because one unintended consequence of childlessness is that of a woman loosing her socio- economic rights and contributions to her family. She is not only rejected but also undervalued because she could not fulfill her biological and social roles of producing children, Onah (1992); and thus the health consequences are also unimaginable (Mgboh, 2000). Female-female marriage according to Eze (2000) is becoming a cultural reality within African cultural milieu. It is now an acute problem, which has eaten deep into the fabrics of the society in Africa and especially in the Igbo-speaking areas of Nigeria. Although, it is a common marriage practiced in West Africa, Southern Africa, East Africa and the Sudan include O’Brien, (1977) but it is still a virgin area of research as academic literature concerning this social ill is still limited (Uzuegbunam, 2003). This may be the reason why earlier scholars like Obi, (2000) and Titi (2001) contend that woman-woman marriage in Africa is more of a social and not sexual custom driven by economic and social motives. Supporting the above view, Markinwa (1995) traced this type of marriage historically to the fact of the human person’s lineage, survival and continuity, which necessitated having many children so as to meet some family obligations. Such as farming which requires labour, which can also be provided by the children. Moreover, a situation may arise where a girl-child is used as collateral for loan with which to train the male offspring or celebrate funeral rites or for title taking (Mgbo, 2000). Continuing she noted that with these inherent socio-cultural traits especially among the Igbo race, all forms of abnormal marriages such as women-women marriage are being contracted, often times the woman in question is left without a definite and known husband. She lamented that this type of marriage practice is dehumanizing and humiliating. Taking into cognizance the fact that three systems of marriages are recognized, (marriage by statute, marriage under Islamic law and marriage under

44 customary law, and their offspring’s have legitimate rights unlike children from female-female marriage (1996). Moreover, children from such marriage are left without a social father to look up to, for care and direction. Although, there are available few literatures indicating the existence and acceptance of obnoxious cultural marriage practices (like women-women marriage, levirate marriage, surrogate marriage, marriage for the dead, for the insane and idiot) just to ensure offsprings in the family. But the fact still remains that with our unique Africa/Igbo culture certain marriage norms do not go down well and are therefore not acceptable to the present society we live in; and so are termed obnoxious (Amadiume, 1997; Eya (2003). The word obnoxious according to House College Dictionary connotes something objectionable. Mgboh (2000) posits that a practice is obnoxious if such practice do not only violate the fundamental human rights of those affected, but is against the rule of natural justice, equity and good conscience. For example, a widow, through the system of ghost marriage marries a wife for the deceased husband in order to raise offsprings for him or a young girl being retained in her family to produce children for the father through surrogate father(s) because he has only female children and no male child; are some of the obnoxious cultural practices. Likewise even though this practice is culturally acceptable it is quite disagreeable when we look at it from the religious angle. It is unimaginable how one can convince a child that a woman she knows is married to another woman when the child already know that in the Bible, Adam and Eve had Cain and Able, while Abraham and Sarah had Isaac. The outcomes of these obnoxious cultural practices are inexhaustible. First and foremost the practice is inimical to the dignity of the woman/girl whether it is for procreation, socio-economic or political reasons (Shinaba, 2005). Awasanye, (1997) stated that the practice promotes promiscuity on the part of the woman who may also contact sexually transmitted disease and HIV/AIDS in the process of her promiscuity In. Mgboh”s (2000) opinion, there is the likelihood that the offsprings of such union will have different and horrible characters, as one cannot determine their paternity. At this juncture one may wish to confirm the justification for female- female marriage. Uzoegbunam (2003) in her words posits that this marriage practice is endangered by the high level importance attached to children which ensures the springboard for the continuity of the husband’s lineage; inheritance and succession because in any Igbo family lineage without a male child is seen to

45 be heading for extinction. This is why the high premium for male children is reflected on the different Igbo names given to male children in Igbo land. Such names include Akunna, Nnanna, Nwawuihe, Nwauba, Alaoma, Obiajulu, Okenna and Amaechina among others. These names according to Murdock (2000) are very significant in the sense that security of the family is assured and the person/people to run the affair(s) of the family kinsmen is also assured. No wonder covertly or overtly with the birth of a male-child is celebrated as an asset whereas the birth of a female-child is seen as an impending economic drain (Kisija, 2000). However, what is of interest to the researcher is the issue of the obnoxious cultural female-female marriage. Though this type of marriage takes the same legitimate process as the usual man-woman marriage but to many civilized persons and society, such arrangement is an anathema. In the same vein Eze (2000) remarked that no matter how culturally acceptable is female-female marriage it is unchristian, has no legal backing and the church is silent on the issue which signifies that the marriage is a common practice in Igboland but it is quite disagreeable by many in the society. This type of marriage is inimical to the clause in the Decalogue, which states, “you shall not commit adultery” (Exodus: 20:4). Undoubtedly, the rejection of this type of marriage practice(s) by most people demands for a redress with a view to ameliorating the sordid practices against the women folk.

(d) Female Genital Mutilation (Circumcision) (i) Female genital mutilation (FGM) or female circumcision as it is sometimes erroneously refereed to as one of the harmful traditional practices associated with many cultural groups in Africa (Ras-work, 2001). The concept FGM has been defined by WHO (1998) as one of the several practices embraced, practiced and institutionalized in many societies of the world; deeply rooted in their traditions and carried out for several reasons. This must have been why most people describe it as an age-old practice which is perpetuated in many communities around the world simply because it is customary. Some say it forms an important part of the roles of passage ceremony for some communities, marking the coming age of the female child. Obviously the origin of FGM has not yet been established but available records show that the practice predates Christianity and Islam in practicing communities of today.

The procedure of FGM comprised the partly or total removal of the external female genitalia which may have severe health consequences on girls/women. Scholars like Akumadu (2001) viewed the concept female genital mutilation as a procedure where the external female genitalia is removed partly or wholly or injury to the genital organs for cultural or any other non-therapeutic reasons. FGM could be regarded as the equivalent of the male circumcision referred to in the Holy Bible Gen. 1710-14 where the male prepuce or foreskin is carefully removed without any damage done to the male organ. But in female circumcision part of an organ (the Clitoris) is chopped off. FGM has no biblical backing but just a practice emanating from nowhere within the society. Obianyo (2000) described FGM as one of the most degrading brutality meted on women, which was originally embodied in patriarchal power structures rooted in a desire to control women’s lives. Darkenoo (1998) described FGM as a barbaric mutilation of young women. Nevertheless, Toubia (1994) is of the opinion that FGM is a wrong terminology that signifies evil, which reminds everyone about the harm done precisely on young girls/women. Studies have shown that in some culture like in southeast Ibo communities PGM is inevitable because their girls are not eligible to marry until they are circumcised .The United Nations (UN) 2000 report show that in Africa and especially in many parts of developing countries,Nigeria inclusive, the age at which FGM is carried out varies from area to area. It is performed on infants as young as a few days old on children from 7 to 10 years old, as well as on adolescent. For example, the study earlier conducted in some communities in southern states of Nigeria by Akinola (2001) revealed that the Owu’s in Abeokuta circumcise their girls within 7 or 8 days; the Binis do theirs before the third month of the birth of the child; the Ijaws perform theirs before marriage while the Akwa Iboms circumcise their girls when she is having her first baby. He noted that for the Ijaws, FGM is mandatory for every girl-child; even where she escapes it alive she will go through the procedure when she dies. The Efiks of Cross River State circumcise their girls during her confinement in the fattening room. The variation in the age at which PGM is performed show that it was prescribed for females by the society which differs from the male circumcision which was a covenant prescription for males ordained by God and specifically done on the eight day of birth of the male child. In other words, there is justification for male circumcision and none even biblically recommended for females.

Societal Justification for Female Circumcision Virginity in young girls and fertility in married women are revered attributes which most women try to ensure and preserve for their girls hence they are subjected to FGM. But in a provoking thought by Bagunjoko (2001)who posed that since FGM is performed on infants as well as adults, it can no longer be seen as marking the rites of passage into adulthood, or as ensuring virginity. However, the Inter-African Committee Report (1998) showed that there were various reasons given by different people for performing FGM. Some reasons adduced for this practice range from funny to the absurd. The general belief according to them is that: - FGM helps to check female promiscuity - FGM is early initiation rite into womanhood - It is believed that FGM enhances fertility - Some people believe that when the head of the baby touches the clitoris during child delivery the baby would die; is simply a myth which has no scientific proof. According to Nahid (1998) and Thomas (1998) FGM is believed to enhance the aesthetics of the female organ. It makes a girl look beautiful by keeping her slims. FGM has also been regarded as a device for increasing the sexual pleasure of the husband at the expense of the excruciating pain the woman goes through. Gachiri (2000) confirm that most girls from south-south communities in Nigeria are subjected to the dangerous rituals of FGM simply to attenuate their sexuality, to make them socially clean, acceptable and eligible for marriage. For further clarification, Ogunmodede (1995) had earlier noted that FGM is the ritual which confers the full social acceptability and integration upon the females in some communities. He stressed that without FGM women become estranged from their own kith and Kin. Moreover, without FGM, many lose their right to contribute to or participate in the community life of their homeland. Similarly, Bogunjoko (2001) expressed concern for FGM as an obstacle to girls reaching their full intellectual and employment potentials. As a matter of fact FGM being an initiation rite into womanhood in most African society, keep such girls in bondage, as they will no longer be sent to school because they are supposed to remain at home until they are married. In such a situation, nobody would contest the fact that there will be an increase in the already existing number

48 of illiterate girl’s/women floating around. Increased number of illiterate girls means huge liability to a developing nation like Nigeria both at the present and in the future if nothing is done before they attain adulthood Aiso, In the words of Carr (1997), it is an established fact that the completion of even primary education broadens ones out look on life and increases ones ability to understand more complex information and question attitudes, beliefs and practices such as FGM. Thus this statement can be substantiated with the researches done in Sierra Leone, Nigeria and other developing countries, which proved that illiteracy is a cankerworm that could retard development. As contained in the UN (1995) report on the research done in Sierra Leone, it was observed generally that the illiterate population was the strongest supporter of FGM as an important means of cultural preservation. It was also revealed by, Koso-Thomas (1998) study that the practice of FGM in early African societies was used as a strong control over women’s sexuality and sexual desires. Notably, with the improvement in women’s education in Africa, women have been exposed to new thinking of female independence and security and so, should shun FGM for good.

The Prevalence of Female Circumcision (1) WHO (1998) report showed that in almost every society in Africa, FGM practiced in countries like Burkina-Faso, Chad, Djibout, Sudan and Egypt affects about 85-114 million girls. Also, an estimated 2 million girls are mutilated every year. For example in Sub-Saharan Africa, Female genital mutilation is practiced in various forms in 28 countries in Africa including Nigeria where it is already affecting over 85% women and girls (WHO, 1998). FGM seem to be a global issue because according to Kiragu (1995) and Gachiri (2000) it is a practice that cuts across social, economic and cultural distinctions, practiced by both Christians, Moslems, educated, illiterate, the rich and the poor and so not peculiar to Nigeria. The National Baseline Survey, (1998) puts the prevalence of FGM in Nigeria at 50%. The report further showed that one in every four Nigerian women between the ages of 15-49 years old was circumcised. Still on the prevalence of FGM the National Population Council (2000) reported that the practice of FGM is widespread among some ethnic groups. And so the prevalence and incidence rate is culturally specified in some communities that have cultural affinity. For example, their record show that the prevalence rate of FGM among the Yorubas of Osun

State was 98.7%, Oyo State 98.8%; the Owo’s and Ikates in Ondo State, 91.6%; Edo State 74%, Cross River State 95.4% and Delta was 93.1%. In an early study on the prevalence of FGM in Ibo speaking areas Obianyo, (2000) noted that the prevalence in Imo State was 95.4%; Anambra and Abia State was 82.4% respectively and Enugu State was 17.5%. The prevalence and incidence rate of FGM in the Northern States was generally low although the incidence of infibulation (Type 3), which is the most severe form of FGM, is practiced in some parts of Northern Nigeria. Infibulation is of two types (Angurua and Gishiri) are found to be prevalent in Sokoto and Kano States and to some extent in Jigawa, Kaduna and Taraba States (IAC, 1998; WHO, 1999 and Cleveland, 2000). Infibulation, according to them simply involves the removal of the clitoris, the labia minora and majora, which are stitched with native sticks to produce virtual occlusion of the introitus. According to WHO, (2000) there are many variations of FGM performed throughout Africa, Asia, the middle East, Australia and Latin America; three of which are practiced in Nigeria. NANNM Survey (1995) and WHO (1998) classified the various types of surgical operations on the female genital organ into four major rituals:

Type I: Is called the Sunna. It is the traditional circumcision of the female clitoris, which medically can be likened to male circumcision because the procedure simply involves the mere removal of the tip (prepuce) of the clitoris. Type II: Is called Excision or clitoridectomy, which involves the clitoris and often also the labia minora or labia majora. Type III: Is called Infibulation or Pharaonic circumcision. This is the most severe operation on the clitoris, which involves excision of the clitoris plus the removal of the laibia majora and the scaling of the two sides through stitching, but a small opening is left as the vagina orifice and another above the vagina, which will allow the passage of urine. Type IV: Is the Introcision, which is an uncommon type of FGM in this part of the world (Nigeria) hence it is regarded as unclassified. It is carried out in some tribal and ethnic loci like Austrial among the Pitta-Patta aborigines. This type of FGM is usually done when a girl reaches puberty. The whole tribe, both sexes assemble to observe the ritualistic procedure, which

involves enlarging the vaginal orifice down to the perineum. This is usually performed by an elderly male excissor. Like all other harmful traditional practices, FGM in particular is usually performed by elderly women who are non-medical persons but simply because they have acquired skills by years of apprenticeship. The procedure is usually done in the secret and under unhygienic conditions To support this claim, Akinola (1998) study show that sharp instruments like bamboo knife, piece of glass/razor blades are used to severe the hymen from the labia thus exposing the clitoris, which is then cut. Medicinal herbs are applied to arrest haemorrhage followed by the insertion into the vagina a slightly moistened object made of clay. The entire method involved in the circumcision is not only unhygienic but also crude, dehumanizing and no anesthesia is administered on the client; neither the pain, profuse bleeding, infection nor the violation of human rights are taken into consideration. Human rights according to Jacobson (2000:47) are privileges based upon the principles of equality and non-discrimination. These rights are articulated in several documents such as the United Nations Charter; the Universal Declaration of Human Rights 1948; the Internal convention on civil and Political Rights on the elimination of all forms of Discrimination Against Women 1981; the African Charter on Human and Peoples Rights 1993; the convention on the Right of the child 1993 and the Beijing Conference 1995. This practice doubles the risk of a woman’s death in childbirth and increases the risk of a child being born dead by up to four times (WHO, 1996). The major concern for the practice of FGM is the inhuman procedure, unsterilized instrument coupled with the unhealthy environment it is carried out. Such unhygienic environment has serious health implication for the patient; such as physical, mental and human rights dimensions. These dimensions identified by Murphy and Ringham (2001) violates women’s right to liberty decision-making and security. Continuing, they affirmed that FGM is regarded as gender discrimination and a practice, which violates the basic principles – the right to good health, life freedom from cruel and/or degrading treatment Apparently, that may have been the reason why scholars like Thomas, (1998) remarked that in poor health conditions women can not participate effectively in the development of their family, community and nation. Thus he suggested the need to invest in women’s health programmes,

51 which will enable them, have better opportunity for their empowerment to fully address the challenges before them. Consequences of Female Genital Mutilation The adverse effect of female circumcision or female genital mutilation (FGM) as it affects the health of women and girls are enormous as the worldwide condemnation by individuals, government, non-governmental and international organisations (Nahid, 1998). Although Kiragu (1995) opined that it is difficult to get accurate information on the complications of female genital mutilation simply because most women have been subsumed in the culture of silence and would dare not share their health predicament with anybody; not even their spouses.Continuing, he noted that women only let go their emotions when physical and gynaecological complications manifest but may be too late for any meaningful medical intervention. Commenting on the consequences of female genital mutilation, Mandara (1995) opined that most of the complications arise as a result of secondary infection following the use of unsterile tools coupled with the environmental conditions under which the excision is performed. Bogunjoko (2001) acknowledged that there could be immediate, intermediate and late complications, which may not be experienced by every circumcised girl/woman. In order words, health consequences of FGM may differ from person to person and also in the severity. He observed that physically, female victims of FGM suffer a myriad of health related problems, which occur at different stages such as: - Immediate complication - Intermediate complication - Late complication stage - Consummation of marriage complication - Delivery of first child complication, and - Post natal complication stage.

However, WHO (1998) report confirmed the various health implications of FGM affecting women/girls. They are (1) The immediate complications, which include shock, pain, bleeding which may, in extreme cases lead to death.

(2) Intermediate complications include, anaemia, delay in wound healing; scar tissue formation; pelvic inflammation due to ascending infection; Urinary tract infection; painful intercourse (dyspareunia) etc. (3) Late complications include: - recurrent pelvic inflammation, - recurrent urinary tract infection - blockage of the fallopian tubes - infertility (4) Prolonged labour due to stricture of the clitoral wall and adjacent organs thereby hindering full gapping of the vagina during parturition which can result to: - Vesico-vaginal fistula or - Recto-Vagina fistula resulting in - Obstructed labour will precipitate excessive bleeding, which could lead to shock. - There may be perineal laceration - There may be uterine inertia - There may be death of foetus and mother due to prolonged labour. (5) Post –natal consequences include: - Paralysis of the urethral muscles giving rise to urine incontinence. This is because of the pressure exerted on the urinary bladder by the head of the baby or there may be. - Paralysis of the rectal muscles giving rise to feacal incontinence due to pressure from the head of the baby on the maternal rectum. It is worth mentioning that all these obstetric complications are the most frequent and spectacular, resulting from vicious scars in the clitoral zone after excision; these scars open up during childbirth. Apart from these consequences already mentioned, Ras-work (1998) posits that FGM could devastate a woman psychologically. In her words she stated that: A woman could live with the painful memory of this inhuman act carried out on her for the rest of her life, which may trigger off behavioural disturbances

These behavoural disturbances according to her include: - psychological problems (anxiety, melancholy, depression etc.)

- psychiatric disturbances (hallucination, depression etc) - functional psychiatric manifestations which may take various forms and course serious behavioural reactions. Continuing, she exclaimed that the consequences of FGM are better imagined than experienced by any woman. The victims could suffer exaggerated feelings of rejection incompleteness, chronic irritability, frigidity, marital conflict and even outright withdrawal syndrome for fear and shyness to share bitter experience with anybody. Another issue of concern about FGM which was conceived by Bogunjoko (2001) although not yet widely studied, is the possible transmission of the Human Immune Deficiency Virus (HIV) and other viral infections such as Hepatitis B which are easily spread through reusing or repeated use of unsterilized instruments, which have been in contact with the blood of numerous girls. From the above discussions it is glaring that FGM has both physical and psychological adverse effects on the health and well being of girls/women. In conclusion, the issue of harmful cultural practices such as FGM has become a great concern in recent times because from the look of things, its persistence underscores the powerlessness of women. One could ask, for how long will the society (at the level of modernization and improvement in women education) just fold their hands, watch and accept the persistence of all barbaric harmful cultural practice meted out on women. Certainly, most people (men particularly) see these harmful cultural practices meted on women as an inseparable part of the culture or a way to preserving cultural integrity but obviously it is very possible to give up harmful practices without giving up meaningful aspects of the people’s culture, remarked Hersh (1998). Although attempts by various groups working towards the eradication of all forms of harmful cultural practices has become unnecessarily slow and difficult, remarked, Obinayo (2000). WHO (1998) identified various women groups, health professionals, human rights activists and international agencies who have taken firm stands against harmful cultural practices which are hinged on the desire to subjugate and dehumanize women by male-dominated society. In spite of all these efforts, the issue about harmful cultural practices must be addressed and so requires all hands on deck to shun it for good.

Nutritional Taboos/Myths WHO, (2000) records that all societies have traditional beliefs regarding harmful and beneficial foods for women and girl-children. There are also beliefs regarding optimal amount of food to be taken during pregnancy for a successful reproductive outcome. Studies have shown that the food taken by a large number of pregnant women in developing countries are deficient in caloric content (protein and other nutrients), simply because of the sanction placed on some foods as taboos during pregnancy/lactating. To buttress this assertion, Villar (2000) and Tinker, (1998) posits that in various communities throughout Africa, there exist myths/taboos which dictate specific foods which may not be eaten by girls and women especially pregnant and/or lactating mothers because of the myths/taboos placed on some nutritional valuable foods that are needed for strength, energy, body building, protection and bone formation of both mother and child which are often excluded from the diet. Nitcher (1999) had earlier reported that restrictions of the commonly eaten food rich in nutrients have a deleterious effect on the health of pregnant women. And so maintained that the reasons for such taboos are many but most of the nutritional taboos are surrounded by myths and superstitious like the attack of evil spirits and attraction of bad omen. Supporting the above view, Obianyo (2000) confirmed that in Nigeria and particularly in Ibo speaking communities, there are certain foods that women abstain from not by choice but by imposition. For example women are not suppose to eat some parts of animals like gizzard (Eko-Okuku) liver (Umeju – anu), heart and male organ of an animal (ighu-anu); which are regarded as special parts of animals in Igbo land. These parts are exclusively reserved for the head of the family but particularly meant for the oldest man in the family, kindred, village or clan Traditionally,these animal parts must be shown and handed over intact to a male person who is supposed to take custody of them Also,the bony pelvic bones(ukwu-anu )reserved for women as the only animal part they are suppose to consume confirms the long-standing history of a male dominated society. She also noted that the unfortunate aspect of all the myths and superstitious surrounding food which are of nutritive values are the disappropriationate effects they have on women which can be attributed to certain food denial to females right from birth. And so, most food taboos exclude the consumptive nutritive elements essential for expectant mothers and foetus at any stage of pregnancy.

Interestingly too, Madu, (2001) and Okafor (2005) identified various Igbo myths and taboos peculiar to pregnant/lactating/mothers. For example, among the Nri people in Anaocha local government area, there are four pregnant-related Igbo myths which include: that an expectant mother should not eat donkey meat because it is believed that a tetanus baby with his or her flexed limbs, clenched fists and puckered face resembles a monkey; if she eats snail, it is believed that the baby will continually salivate; if she eats egg, the foetus will develop into fat, making delivery difficult if not impossible and if she eats grasscutter, she will go through prolong labour like a grass cutter. Still, on nutritional taboos Brems and Berg (2000) confirmed its existence in other contries outside Africa such as India where it is the practice of pregnant mothers abstaining from eggs simply because it is believed that when they eat eggs there would be red and blue patches on the baby’s skin. For religious reasons too, Nag (2000) noted that beef/pork is/are taboo among the Hindus. It is believed that when a pregnant woman eats pork, it can induce vomiting, abortion, skin disease and deformity in children. Also, some fruits according to Pool, (1997) are strictly avoided by pregnant mothers in India. For example, twin bananas if eaten by pregnant mothers are believed to be undesirable for fear of giving birth to twins, while some fruits also form a thick layer of fat around the foetus, thus leading to prolong labour. Gopatan and Rao (2002) maintained that nutritional denials are unnecessary impositions made on women by an inly blind society. This shortsightedness of some society to nutritional values needed by pregnant mothers/girl-children has contributed enormously to constant maternal and foetal mortality in developing countries. Although, there may be other causes of high mortality of mother and child such as those identified by Nichter and Nichter, (1999) which were not associated with restrictions of foods believed to be harmful to pregnant mothers. The high mortality rate of mothers according to their findings was associated with widespread poverty, inequitable distribution of household food and poor health care services, which resulted to undesirable reproductive outcome in most countries. Thus, they affirmed that the deficiency in dietary in-take and its negative effect on the nutritional status of women and particularly women of low income group both non-pregnant and pregnant can be attributed to their low purchasing power and the widespread prevalence of cultural beliefs regarding food

56 during pregnancy. Nutritional deprivation often results in anaemia or even malnutrition for females and poor development for infants. Looker, (2000) affirmed that adequate nutrition is essential for reproductive health, prevention of iron deficiency anaemia and stunting growth, which can contribute to pregnancy-related deaths. In the words of Carrol, Gunter and Johnson (2000: 277) Iron (Fe) deficiency remains the most common nutrient deficiency particularly in young mothers, children and older infants. They noted that severe anaemia constitute about 40% of maternal deaths each year in developing countries. Similarly World Bank Statistics, (1999) earlier reported that 450 million women in developing countries have stunted growth arising from childhood malnutrition; more than 50% of pregnant mothers are anaemic, 250 million women suffer from effects of iodine deficiency and many are blind due to vitamin a deficiency. No wonder Abrahim (2001) contracts the widespread belief regarding foods sanctioned taboos for pregnant women as being unrealistic. Though according to him the various studies on food beliefs and practices only revealed concern about desirability of eating in moderation during pregnancy for fear of having large babies; causing difficulty in childbirth or maternal death.

Widowhood Practices Among the persistent practices that consider a woman to be no more than property, is the obnoxious widowhood practice. It is amazing that when a married woman dies and perhaps the spouse (husband) is alive efforts are made by relations and close friends of the family to provide help and comfort to the bereaved. Such assistants include food, which is prepared by different female relations and well-wishers from time to time; aiming at rehabilitating him mentally, emotionally and psychologically. Then one may be inquisitive like the researcher to know why the story is different when a man(husband) dies? Onah (1992) posits that the socio-cultural co-factor, which creates conditions conducive to widow maltreatment, is the fact that marriage continues to be viewed and operated as a union between two families rather than between two individuals. A clear indication of this among the Ibos and Yorubas for example,is that custom still demands that the wife addresses her husband relatives as “husbands” despite a trend towards free partner choice. In the same vain, Olujobi (2002) opined that in some of our cultures, the equality of men and women is heavily compromised in the matter of celebrating death in the family. The widow who is a woman bereaved of her

57 spouse even in her grief and lamentation is traditionally presumed guilty of death of the husband until proven otherwise, even in situations where the deceased has been protractedly ill for a long time, and death, was being expected at anytime. Obianyo (2000) noted that the hatched heartrending grief associated with widowhood has become a well recognized phenomena which has refused to be dealt with in spite of efforts at national, local and International Conferences, Seminars and Workshops on the plight of widows and how best to redress the situation. From a similar perspective, Ahonsi (1997) remarked that it is unfortunate that widowhood marks the beginning of an extreme life crises and a woman”s dilemma, the discrimination the wickedness, hatred and violence even by close relations; particularly to those without children but they are close to each other(husband and wife). Those who had only female children and those who had very little children. In most African societies such as Nigeria, Ghana and Cameroon, the bereavement process is accompanied by several cultural practices, some of which are rituals harmful to the widow. Such rituals were identified by Madu (2001) in some communities in Aninri Local Government Area of Enugu State where it is the practice to take a widow to a shrine (by the brother-inlaw) at night naked where she is forced to have sexual relationship with him in front of the shrine. This shameful act is performed while the deceased is still lying-in state. According to the traditional belief, it is assumed that the widow is under bond not to have any intimate relationship with any other man or else she will die if she dare try it. Also, during the mourning period the widow is not suppose to bath for about eight days.In the same vein, Okoye (1995) provided a comprehensive review of the ethnographic evidence on the dazzling variety of widowhood practices across Nigeria updated by strategic informant interviews from his findings which is more descriptive than analytical and no conscious attempt is made to periodicize the description so as to convey a sense of change and discontinuity in widowhood practices. However, not withstanding the desperate nature of the few relevant materials that are available and the analytical limitations therein, the path of abuse and maltreatment experienced by widows is true and real (see Fig. 1). Moreover, he noted that the mourning rituals are not applicable to only widows in Africa because in India, many years ago, widows were even burnt alive at the cremation ceremony of their deceased husband. Likewise in Zambia and Ghana an

58 undesirable emotional violence is suffered by the widow as her husbands relations (i.e. her in-laws) swoop and confiscate the deceased property. Also, in Pakistan, the widow epitomizes bad luck. The widow according to Obianyo (2000) is subjected to a chain of torments, punishment and debasement aimed at proving to her that all is gone for her. Such inhuman conditions coupled with barrage of accusations levied against widows often times metamorphous into compulsorily asking her to drink water used for bathing the corpse of the deceased husband, sitting/sleeping on bare floor, eating food with her hands, her hair is shaved with blunt razor blades/broken bottles so that she feels the pain from the cuts, and to mark the loss of her beauty (nma nwanyi). She is not supposed to dress well but appear in rags. In essence, widowhood practices endanger the health and social well-being of the Nigerian women as they are in a vulnerable position. Nigerian widowhood rights according to Owasanoye (1999) constitute a gross abuse to womanhood and the human rights of women. The widow is not only tormented and subjugated but also denied financial resources (land) and nobody stands out boldly in the community to challenge such maltreatments on her behalf. Widowhood often leaves women destitute. Madu (2001) laments at the inhuman ceremonies and rituals performed at the death of a man which includes, keeping the widow under house arrest for three months, she is not allowed to leave her room for any other place except to ease herself, she walks on bare foot, she is restricted from even laughing to the hearing of people, she is not suppose to visit people during the day or take the main entrance/ext to/fro the compound except through a broken section of the fence at the backyard and people are assigned to monitor her mourning pattern which they report back to the elders. Although these harmful cultural practices vary from one community to another as most widows are no longer subjected to these extreme conditions as was in the past. The reason being that some enlightened widows and those with more economic endowment stand their grounds to resist oppressive widowhood policies (Oluwole, 2001). Continuing, she remarked that empowering women educationally and economically will expose them to taking up the challenges to advocate for cultural change in an oppressive environment which has reduced women to an insignificant level in the society. And so, she concluded by saying that education and enlightenment programes can bring profound changes and relief for widows under these oppressive conditions. In some communities of Amaigbo in

Nwangele Local government Area of Imo State, Odumegwu (2004) recalled that the widow is expected to cry three times daily, first at 5.30 a.m., 12 noon and before bed time. This emotional reaction depends on her age, the status of the deceased, how intimate the widow was with the deceased and the nature of the death. He also observed that there is usually extensive reduction in status and social opportunities for the widow, which leaves her in a lonely and devastating condition. Noticeably, too her woman habits and activities that had shaped her daily life all these years are ultimately shattered by the death of her spouse. Personal hygiene is denied the widow as she is prohibited from washing her body or combing her hair for several days until her husband is buried. After the discomforts of the first few weeks she is sentenced to wearing rags or one set of mourning dress (akwa nkpe), which in the case of very poor widows become faded and torn on their bodies. Similarly, Saba, (1997) observed that the Igbo’s believe that if the dead is not mourned according to tradition, the dead may not get “his share in the region of the dead and would disturb the family by bringing ill luck and mishap. Consequently, if any widow fails to carry out these rites, she is victimized, penalized or ostracized. This is why the widow in Igbo land is not expected to do the following during her period of confinement and mourning: - Become pregnant during the period of mourning - Defy the traditional mourning rites, - Attend markets and festivals, - Remarry while mourning, - Changing her mourning clothes without due process and/or before the expiration of the mourning period or - Abscond with her children. Kisija (2001) noted that as the widow is subjected to all the do’s and don’t of widowhood rites, scarcely any thought and consideration is given for her children who are automatically forced into denials such as good feeding, schooling, better clothing and other sundry demands. The absence of a father figure/role model may have adverse effect on children’s discipline and morally. The social environment is less enriched because of the absence of a role model. This could also affect the health and general well being of the widow especially where she could not enforce discipline on the children, she may also develop hypertension and other health conditions associated with raised blood pressure (Omiyi, 1990). With regard to

60 social and financial support of Igbo widows, the eldest son of the widow (if he is of age) takes his fathers place as the head of the family and becomes responsible for supporting and maintaining her mother and other children. On the fate of the childless widow he also noted that she might be supported from the husband’s estate as long as she remains in the husbands house. It is worth mentioning that the drop in economic well-being is stressful for widows and even worse if she is deprived of her husbands property. However, if the widow opts to be inherited by one of the late husband’s relation, she becomes a co-wife to the wife or wives of her in law (Ezumah, (2002). Continuing, she expressed concern over this new relationship, which could pose some health hazards for her, as she could be exposed to the risk of contacting a viscious cycle of an inherent sexually transmitted disease, or reproductive tract infections, which are associated with multiple sexual partners. Moreover, her life becomes worse for her if she opts not to be inherited. She may be chased out of the husband’s home with no property or her children and she dare not contest it; as there are no laws protecting or backing up widows. For example, Mark Ordu (1994) in his study gave a run-down of an emotive account of true life experiences of few widows who ended up in jail while fighting against the injustices meted out to them by their in-laws. And yet the Holy Bible reminds us in Deutronomy (27:19 KJV) “cursed be he that pervereth the judgement of the stranger, fatherless and widows”. And so, one may ask whether Christians are exempted from HTPs meted on widows? The answer is NO because according to Akpala (1998) it is sincerely believed that the perpetrators of HTP are our kits and kins especially the Umuada’s (Married & Unmarried) daughters of the immediate and extended family. Supporting the above view, Talbot (1968:6) earlier observed that from the moment the death of a great Efik chief was announced his widow/widows come under the care of Ndiro Iban society known among Ibibios by the name “Iban Isong” and among the igbos they are regarded as”Umuada,” that is women of the soil. Should an unfortunate widow offend against their custom in any way, such as by washing her feet or plaiting her hair, the women society will fine her. Widows were not allowed to leave their husbands compound but were forced to stay in their rooms sitting on small mat in a dark corner. No covering was allowed save the

61 narrow sirup usually worn around the waist beneath the robe called the “woman’s cloth”. However, Azikiwe (1992:30) dismissed the popular view about how influential the Umada’s are, in igboland such as in Afikpo community where they have no part to play in widowhood practices. Hence, she concluded by saying that the popularity and power of Umuada with regard to widowhood practice is not generalizable. It is worth mentioning here that the plight of widows have been the concern of various groups Christians and non-Christians notably among the groups is that cited by Falade (1963:236) an activist programme, “The Catholic Action family movement” for promoting the status of women and for emancipating them from out moded customs. At their national convention in Accra in February 1989 they adopted the following resolutions on widows: (1) That all maltreatment of widows be abolished – ordeal by poison, sleeping with the husband’s corpse, shaving the hair, smearing with ashes or other substances. That she be allowed to keep her own garments (usually taken by the husband’s family) and not be obliged to wear a coarse cloth and sleep on bare ground. (2) That widows’ freedom on the death of her husband should be ensured and that she should be protected from attempts to deprive her of her own or her husbands property. (3) That the funeral ceremony which takes place long after the burial be gradually done away with. (4) That on the occasion of a funeral thereby no collection or contribution except in the case of needy families. These gifts be used for the funeral expenses and anything left over be given to the widows and orphans. Also, in a research on the impact of Christianity on widowhood practices in traditional Igbo society conducted in 1998 by Okoli in Nsukka LGA Enugu State, her findings included, that apart from problems associated with widowhood, the public attitudes toward them are sometimes not favourable. This was confirmed by Ntozi (1997:125) who posits that widowhood all over the world is characterized by grief, rituals, forced remarriage, harassment, rejection, loneliness, poverty and relatively high mortality. And so at this juncture, Ahonsi (1999) convincingly stated that widowhood practices especially in Nigeria benefit men or serve their interest but subjugate and oppress women. The implication therefore is that it is through

62 the reduction and eventual eradication of the roots of gender inequality that one of its symptoms today, “widow maltreatment” can be wiped out. Similarly, Saba (1997) suggests the solutions to widowhood practices to include: proper identification of why these practices resist change, access to inheritance, public enlightenment campaign, community intervention to change social attitudes to widowhood rites, modernization of rites and government intervention among others. Therefore, supporting suggestions, made by Saba, the researcher reviewed some literatures on why HCPs resist change even in contemporary times as ours. Why Harmful Cultural Practices Resist Change Origins of most cultural practices are old as history. Craft (1998) maintained that origins of most traditions handed over from generation to generation cannot be traced but they exist and are real. For example in the past the killing of twins used to be a tradition in Nigeria but was put to an end by a great woman missionary by name Mary Slessor who worked in Calabar, preaching against the killing of twins. Also, the conferment of chieftaincy titles on women today was traditionally exclusively for men, simply because of the societal misconception about the relevance of women in decision-making since they should only be seen and not heard .Such insinuation and deriogatory statement about women is a mere fallacy born out of ignorance which has been identified as a major factor for the persistence of harmful cultural practices like nutritional deprivations by girls/pregnant and lactating women, FGM and the inability of women to exercise their human rights, in controlling and taking decisions responsively on matters concerning their sexuality and reproduction. That may be the reason why parents who subject their daughters to FGM, Female-Female marriage or early marriage do so with the best intentions not knowing a better alternative and the fear that whosoever dare discuss these harmful cultural practices affecting women or break with those traditions are often cruelly teased, humiliated or ostracized. And so, this is why these practices are repeated and enshrined in the social, religion, economic and political values of the people. No wonder it has not been very responsive of people disengaging from those harmful cultural practices as these individuals and societies are basically complacent and satisfied with the status quo. Osaranren (2001) confirmed that HCPs such as the persistent widowhood practices and female-female marriage are ways to preserve cultural integrity which is an inseparable part of the culture and belief of people who consider women to be

63 no more than property. To buttress the above assertion, Murdock (2000) in an earlier discussion, noted that in the overwhelmingly male-dominated societies of Africa like Nigeria which is highly patriarchal, where men dictate the standards of marriageability and respectability it is a belief that women’s fate is to suffer. For example the pain experienced from FGM is assumed as good preparation for the pain of childbirth. The practice of FGM cuts across cultures, and supported by Christians and non-Christians, rich and poor, literate and non-literate. World Bank index on censorship reported few years back between 1998 and 1999, revealed that some countries have outlawed FGM. For example as at June 1998, 29 villages in Senegal had outlawed FGM. It is worth mentioning that the US campaign against the practice started in 1980 when five cases of FGM among pregnant immigrant women in San Jose, California became public. Thus, a law against FGM was promptly passed in California to stop the abuse. Infact, it is not surprising that in the whole of U.S. today, FGM is an adequate ground for granting asylum. More importantly the U.S. government has taken the battle against FGM beyond its boarder, its representatives on financial institutions like the World Bank are required to refuse to give loans to governments that are not carrying out programmes to eradicate FGM. Articles concerning various moves to eliminate HCPs are too numerous to document and yet all these efforts have met resistance from perpetrators. Evolving literatures on HCPs are still very few but the researcher was able to ascertain from the available literatures, some reasons for the persistence in those practices harmful to the girl-child/women, even in contemporary times. Furthermore, the expositions by scholars like Toubia (1994) and Awobade (2000) on why HCPS resist change include: (i) faithful adherent of people to their belief, which is an inseparable part of their culture and religion. (ii) Women who have suffered from complications executed with some of the practices insist on subjecting other women/girl to what they went through. (iii) It is for virginity preservation, to promote cleanness, religion and greater pleasure for the husband among others. (iv) Practices like FGM is a source of livelihood for excissors and female-female marriage is for procreation. (v) The process of delayed social justice in the system also contributes to the persistence of HCPs. Ojior (2001:4), sees FGM as the best tool for curing promiscuity and excessive sexual desire. Unlike the western culture, female circumcision is the

64 actual rite of passage from girl-hood to becoming a married woman among Etsako people of Edo land as, “the promiscuity, laxity and lack of self comportment which seem to be associated with the non-circumcised females, compared with the highly African women of yesterday stands to warn us, as these are a clear evidence of moral ineptitude and indiscipline”. Kiragu (1995) observed that in a place like Sudan FGM is a social and peer pressure initiation rite and a ceremonial event used for entertainment. As an obligation and faithful adherent to the culture of the people, invited guests are usually thrilled as they watch FGM being performed openly on the girls who are willing to do it. Continuing, he confirmed that entertainment by guest singer/dancers adds glamour to the celebration and at the close of the ceremony gifts are distributed to the girls. According to Osaranren (2001) converts in Ogun State confessed that in addition to charging as much as N800 per excision, they also kept the girl’s chopped off clitoria for sale as love portion to some people who want charms for protection, marriage goodluck and success. With regard to other forms of HCPs like early marriage Akumadu (1998) and Obianyo (2000) identified poverty as one of the reasons why early marriage persists especially in the northern parts of Nigeria where it is traditionally rampant. They noted that poverty continue to drive illiterate and uninformed parents into giving away their daughters into early marriage. Early marriage leads to little or no schooling and early childbearing coupled with the long time adverse effect on the quality of life of women especially where she is not educated. Unfortunately too, most parents believe that the girl-child is another family and so investing in girls’ education means a benefit to the family she will be married to. Supporting the above view, Akubue (2002) from her studies confirmed that early marriage is very rampant in most Nigerian communities simply because the gestation of education is a long process and so parents are reluctant to invest in their daughters education unlike boys education whose dividends will be retained in the family. Other reasons for encouraging early marriage of the girl-child(ren) includes: (i) desire to avoid dishonour to the family as virginity can only be guaranteed between ages eight (8) to ten (10) years and (ii) desire by parents to reduce the burden of a large number of children to take care of this they marry off the girls to another family.

Also, the preference for male child(ren) or delay in child-bearing constitute yet another major reasons or justification for persistence in HCPs such as female- female marriage. According to Obi (2000) Murdock, (2000) and Robinson (2001) female-female marriage is widely practiced in Africa due to social/economic motives and not the sexual aspect. These authors claimed that the initiator of the female-female marriage may be childless or desire for a male offspring(s) and so provides all the economic/social security to the female wife as a seal to affirm their relationship. The female husband sponsors the choice of a male partner for the female wife. Culture they say is dynamic and this attest to the fact that many culture that has no direct benefit need to be eliminated. But atimes, the process to their elimination within the nook and cranny of the society is usually fraught with difficulties. These difficulties according to Ahonsi (2001) emanate from the fact that culture and attendant customs are not immutable and so are lost to some members of the society who control the larger share of resources and subsequently wield more power in the society and often succeed in ensuring the persistence of certain cultural practices which are no longer relevant. For example, according to him, the persistent harmful widowhood practices are associated with socio-cultural conditions that are conducive to the maltreatment of women in general; and widows in particular. Every culture has a dual tendency; a tendency towards stability and a tendency to change. Cultures change perpetually because the individuals in the society or the cultural architects constantly modify their cultural plans, improve and adapt their behaviour to the caprices and exigencies of their physical, social and ideological melieu. The long debated topic “HCPs” need to be resolved once and for all in the interest and the well being of women not only in Ebonyi State but women in Africa where giving up these practices is still met with resistance. However, Osaranen (2001) assumes that if encouragement concerning the elimination of all forms of HCPs comes from the victims themselves, communities, government and those who have received denials in some aspects of unpleasant traditions then, resistance to global elimination of HCPs will be impossible. She is optimistic that if the federal government enforces laws outlawing all forms of HCPs in Nigeria, coupled with efforts made by Inter-African Committee (IAC) in Nigeria and other International organizations who had joined in the fight against this societal plague the eradication of (HCPs); would have been a

66 success.Therefore Hersh(1998) opined that laws condemning HCPs must be implemented and enforced when respectful of traditions; advocacy can unite communities, reinforcing practices which benefit all member; while at the same time confronting those which damage integrity and diminish the humanity of girls and women. Hence, a dynamic shift is desirable to end all forms of brutality, structural frustration and marginality through relevant intervention strategies, which was the crux of this study. Intervention Strategies to Eliminate Harmful Cultural Practices Having identified the various harmful cultural practices that affect the health of women (based on available literatures reviewed) the fundamental fact is that the elimination of these practices is not an easy task. It requires an outburst and total rejection first, by the entire populace, both men and women and especially those who have directly experienced any of those harmful cultural practices (e.g. FGM, widowhoods, practices, early marriage etc). In order to challenge these HCPs women and all stakeholders in one way or the other must recognize the ideology that legitimizes such practices and thus put on a liberated mind to deal with those societal misconceptions about women that they are more of men’s property and inferior beings. Hersh (1999) observed that attitudes values and behaviour change usually take slow process. Literally, it is not easy to modify people’s worldview and unquestionable value of traditions. No wonder all efforts made in the past to eradicate HCPs did not yield expected dividends because for a desirable change the initiative must originate from the culture that established and implements them, there must be cooperative efforts and understanding of both community leaders, women groups, youths policy makers and the victims themselves Harmful cultural practices, such as early marriage, female-female marriage and widowhood practices among others have received global attention due to their severe negative consequences on the health and well-being of women. WHO, (2000) report revealed that cultural traditions are powerful and only careful efforts will eliminate harmful ones. For example, in the past women groups and human rights activities tackled three (3) harmful cultural practices that have received global scrutiny namely, female genital mutilation, son preference and early marriage. With regard to early marriage which is on the increase in most places in developing world; like in Northern Nigeria laws outlining minimum age/s for marriage have been enacted by some countries like Morroco; with reductions in

67 adolescent marriage and according to WHO, (2000) the prevalence of early marriage in sub-Saharan Africa and South Asia have remained low. Major Actions Taken so far to Eliminate Harmful Cultural Practices Based on global concern, the critical issues about HCPs and their health consequences on women have been taken up by various groups at both national and international levels and yet it has continued to reoccur daily at every discussion, signifying deep resentment with its rooted impact on individuals, communities and society. Notably, among the various moves to eradicate all forms of HCPs was the first seminar organized by WHO, in 1977 in Khartoun during which a decision to eradicate HCPs (like early childhood marriage, nutritional taboos, practices related to delivery and female circumcision) were taken. A follow up to this meeting was the forum of African legislators in Dakar in 1998 where they endorsed a plan to end FGM, by the year 2005. According to Marshal (2004) FGM is still practiced almost exclusively in Africa and the Middle East in spite of the active mediation, campaign and open condemnation by numerous international conventions. It is worth mentioning here that the inter African committee in collaboration with Economic Commission for Africa, OAU, WHO and UNICEF have made tremendous efforts since 1987 to eliminate all forms of HCPs directed on women. Also, United Nations Commission on Human Rights drafted pertinent petitions for the dehumanizing effect of HCPs on women and in 1993 their petitions began to yield some positive results. As a matter of fact, following the 1999 Regional Conference attended by participants from 28 African countries, it was confirmed that more and more mothers turned away from the practices particularly female genital mutilation (FGM). Similarly, Ghana, Sweden and United Kingdom outlawed various forms of genital cutting, while Sudan, Burkina-Faso and Djibouti forbid infilbulation, which had already been performed on more than 98% of women. In Egypt according to Khafegi (2001) the concern for FGM eradication started during and after the international conference on population and development (ICPD). The ICPD created public awareness and questioned the support for FGM. Presently, in Egypt, activities especially on awareness raising and advocacy to discourage the practice of FGM are included in most community development, gender development and health programmes. Also, many NGO’s are diligently addressing FGM issues within their varied activities. As a result of the activities of these NGO’s the minister of health and population issued a ministerial

68 decree banning doctors or any other person from performing FGM. Moreover, In Tanzania, the health authorities in Glasgow co-financed a big publicity campaign against FGM and domestic violence called “Zero Tolerance” Campaign. The result of the campaign showed that there was lack of support institutions for women who experience violence and they looked for ways to improve the lots of women through meaningful Information Communication Technology (ICT) programmes. One of the important advantages of ICT is the ability to link individuals and organizations to discuss ideas and share advocacy and strategies in a relatively quick and cost effective ways such as the Internet. In the context of human rights, the critical role of the Internet in disseminating information on rights violations has been widely acknowledged. Hamm (2001) viewed cyber discussions made possible by e-mail, listeners’ telnet and teleconferencing as having played critical roles in furthering understanding on HCPS. It is also of interest to note that since 1982, France have been partners in the eradication of harmful cultural practices. For example, she has prosecuted parents of more than 30 families in the last 15 fifteen years for genitally mutilating their daughters (Azuatatam, 2001). Nevertheless, some analysts still have their misgivings about passing a law on retrogressive traditional practices. According to them, there is need to have laws to back up actions that all concerned groups would want to take but enforcing it may be difficult due to traditional demands. Surprisingly, in Nigeria, in spite of the efforts made by local and international NGO’s like Inter African Committee on HTP and National Association of Nigeria Nurses and Midwives (NANNM) coupled with various communication programmes advocating for the eradication of female genital mutilation the expectations are still not encouraging. Even in one state, in Yoruba land the association introduced a symbolic dress to replace the traditional scaring used to mark the passage into womenhood (Adebajo, 1990). From available literatures on HCPs the prevalence of early marriage, widowhood practices and FGM is still very high in developing countries like Nigeria. For example, according to Akumadu (2001), the 1999 National Baseline Survey show that FGM prevalence in Nigeria is 50% with the highest in southwest Nigeria followed by south east and south-south. There is also no record of any government legislation for prosecuting offender. It was Jibril (2001) who recalled that in 1999 the Edo state of Assembly passed a bill criminalizing FGM. Thereafter, the bill was signed into law but some

69 highly placed individuals mounted pressure to repell the law because “it stands to insult the family of the traditionalists of Edo land. With this development one can deduce that the eradication process of HCPs affecting the health of women requires intensified long term campaign for changing the attitudes of men and women. In essence all hands must be on deck. Hersh (2000) opined that the collaboration of governments, NGO’s, religious leaders, traditional and community leaders etc. is indispensable. Therefore, at this juncture the researcher discussed some intervention strategies that could be adopted to influence the eradication of harmful cultures that may affect the health of women under the following headings: (1) Interventions to Increase Female Education (social Empowerment of Women) Equal access to education for women and girls is most desired in this millennium age in order to bring an end to all forms of discrimination against women, eradicate illiteracy and also reduce gender gap already existing in our educational system at especially the primary and secondary levels. Opportunity to education could be through formal, non-formal or informal mode of acquiring knowledge or skills to improve the quality of lives of women/girls in particular. According to UNESCO (2000) many countries especially those in developing countries face the problem of having large and growing number of illiterate citizens despite progress in reducing the overall rate of illiteracy the majority of these are likely to be women. Education is the fundamental human right of all (women inclusive which according to Paulo Freire (1970)) will help people develop critical awareness towards existing social conditions in the community/society affecting a segment of the population or the entire population. It is an established fact that when girls/women acquire knowledge through mere completion of primary education, it broadens ones outlook on life and exposes the individual to understand more complex information and freely question or challenge certain awful cultural norms, beliefs, attitudes and practices. Traditionally, women have circumscribed roles prescribed by the traditional society as being a full time housekeeper, child producer and child rear, food producer and provider. More seriously traditionally she is derogatorily regarded as a “women” and she mustn’t ask questions. But fortunately, because of the dynamic nature of the society the same “woman” has begin to be conscious of her status as a woman who should be part of the dramatic changes taking place in the society; hence the need for this

70 research. It is all about women divorcing themselves from those imposed cultural norms (which they are culprits in some) and bondages, which keep them a back and retracted from the challenges within the society in which they are part of. Commenting on the prospects of women in the society Okeke (2002) convincingly posits that education makes a women to be liberated from those societal misconception that women are contended with a subordinate position as wife and mother, passive in the face of abuse, tolerant of all forms of infidelity and harsh cultural practices meted on them just to retain a stable marriage and family. Continuing, she affirmed that education would offer women the opportunity for better performance and greater productivity. Although, productivity and performance depends on the level of knowledge and desirable skills acquired by the individual for holistic human development. Therefore, Nigerian women need to be empowered educationally in order to face the challenges of their times, participate in all aspects of development (politics, economic etc) and favourably address those structures that impede their full integration in National development. Osuala (1991) perceive development as a law of nature which is irrevocable and irreversible. For example, according to her, when a women is developed, she gets out of the shell of ignorance into a life full of activities; a life of self-fulfillment and self-reliance. Thus, she can participate in decision-making that will positively affect her life, her family and the society. Supporting the above view Obianyo (2000) noted that girls/women who attended school up to the secondary level or benefit from programmes adult education are more likely to adopt healthy behaviours that are not detrimental to health, such as not marrying too early or too late, having smaller family size, resisting all forms of harmful cultural practices e.g. FGM of their daughter(s), discouraging their daughter(s) from accepting marriage to an already married man or a female-husband, eating nutritious foods dispelling fears associated with food taboos/ myths. It is imperative that governments, communities and parents recognize the importance of education and the closing of the gender gap in this area. At international level, UNICEF has supported innovative programmes in several African countries (with special attention to girl’s education) including Nigeria, Burkina Faso, Egypt Morocco and Zambia. According to (UNICEF 1998) annual report. Their intervention/recommended strategies included: (i) encouraging girls enrolment in school.

(ii) planning instructions during hours on programmes when household chores and agricultural demands are not competing for their time and energy. (iii) providing enabling learning environment such as child-care so that younger siblings of girls can be looked after while the school age will go to school. (iv) Encouraging governments to eliminate policies which force girls out of school on the grounds of pregnancy. (v) Sensitizing parents and communities about the importance of girls education and their improved incomes earning capacity. (vi) Making curriculum more relevant and gender sensitive The importance of education to the girl-child/women is enormous. According to Mbagwu (2005) education of women means educability, qualitative livelihood and ability to link up with other power structures especially in decision making and so there could be no other better tool for those accomplishments other than education. Also, researchers like Oprah (2004) advocates for women education. For him, education is “freedom” which will go a long way to reduce many of the obstacles to women’s self-worth, self-communication and self-reliance. Education according to him has the following attributes, which can benefit women: (i) Education will equip women with better understanding for the need to empower the girl-child right from her cradle home to regard herself as an important member of the society. (ii) It will equip school aged girls and especially adolescents with knowledge required for involving in programme planning and implementation. (iii) It will equip them properly with information on consequences of cultural practices that had kept women marginalized, subservient and virtually ineffective; and to resist them. (iv) Education will enable women to evolve from powerlessness into women of virtue and integrity envisaged for better tomorrow among others. Still on the attribute of women education as an intervention strategy for eradicating HCP, Whithead (2001) emphasized on the inclusion of other strategies such as economic empowerment policies and programmes that can improve the health of the poorest groups (women) especially in developing countries. Such economic empowerment policies and programme will reduce economic poverty,

72 which has been identified as the major risk factor for poor health and premature deaths. These conditions can be averted through public awareness on the need to improve access to education for marginalized groups , better job training for skill acquisition, awareness creation on family health education which is an essential national programme and the first step to overcoming most diseases in the family, community and society. Chukwukere (1998) had earlier in her studies identified some hindrances to economic empowerment of women, which may also affect their health adversely. These include: (i) the customary land rights which do not allow women to own land (ii) the exclusion of women from credit, modernized agricultural techniques, training facilities and extension farm supplies. (iii) lack of access to new farming technologies like the use of tractors that lighten the burden of men but increases and complicates that of the women and (iv) Cultural belief systems that impose restrictions on the type of crop a woman should cultivate. Certainly, if women are allowed to also enjoy what men benefit from, they will be free from too much work, ill-health and other numerous problems associated with their socio-economic activities. (2) Intervention through Community Advocacy to change Peoples Orientation and Perception about Harmful Cultural Practices meted on women: Harmful cultural practices associated with women’s subordinate status (e.g. female genital mutilation, discriminatory access to food, female-female marriage and widowhood practices among others) emanate from and are perpetrated by men and women in our various communities. Charity, they say, begins from home and so there is need to sensitize individuals, parents and communities about the consequences of these harmful cultural practices emanating from our cultural melieu. Khafagi (2001) opined that community advocacy is the surest weapon to use in fighting harsh cultural practices perpetrated by ‘man’ to dehumanize fellow man. Thus, he suggests the counselling of parents about girls’ education and their income potentials as a first step approach to addressing unhealthy cultural norms and behaviours. A holistic approach to eliminating HCPs must involve traditional rulers, community leaders, youths, professionals in promoting behavioural change

73 interventions (BCI) in the community. BCI involve talking to people (man and women) in the community about adopting healthy behaviours, legislative support for women,to abolish practices harmful to women’s health educating women about increased nutritional needs, public information and health services to prevent unwanted pregnancy (through appropriate family planning methods) and sexually transmitted diseases (Nutbeam, 1998). In order to influence positive change in behaviour of individuals and communities towards the eradication of all cultural practices affecting the health of women, Nutbean further suggests the need for communities to take action in partnership with individuals/social groups, to mobilize community resources for better health promotion so as to overcome cultural barriers detrimental to health. Supporting community advocacy as an intervention strategy to bringing an end to HCPs, Obetta (2002) expressed the need to work at various level approaches for the realization of this goal. He suggests multi-level approaches viz-a-viz, the individual/community level, with education as the key element, group levels in the community where a culture of tolerance and mutual respect need to be consciously inculcated; but above all at a national level where durable and credible institution which balance the rights and responsibilities of groups need to be put in place. These groups in the communities need to show commitment to think ahead concerning HCPs and participate in devising positive alternatives for achieving better results. (3) Intervention to Change Societal Misconception about Women/HTPs through Media Advocacy Media advocacy can be defined as an intervention approach operating at both the policy level and the community level to promote or facilitate a change on the social, economic or political conditions of a people. Advocacy institute (1998) defined media advocacy as a bottom-up grassroot approach involving community organizing and capacity building for community networking and development. Also, Stead and Henderson (2002) credit media advocacy to an appropriate approach which uses technology (like radio) to talk about a particular policy solutions to inherent social problems either in the community or society. Such inherent problems could be on health, education, politics or any other issue as it affects the lives of the people. Though, another way of conceptualizing media advocacy is the community based intervention, which aims at encouraging, and empowering

74 communities on the practice model whose principle stresses on dialogue between professionals and members of the community. Community based level intervention according to Minder (1993) seeks to have impact on socio-cultural norms and protracted conditions within the community, therefore it is presumed that media advocacy among other measures is expected to expose all forms of violence against women including those arising from customs and traditions and the perpetrators of such violence. Perhaps many people do not know that violence in such degrees exist and so through the media (radio, television etc.) such awareness will be disseminated to many people, including women themselves who have been identified as perpetrators of most of the HCPs such as FGM, female- female marriage and widowhood practices. Their attitudes and perceptions of the HCPs also need to change so as to sustain changes accruing in the direction of other members of the society. Raswork (2001) noted that media advocacy is not new because a series of experiments using the media as a sensitization medium were initiated long before now in many parts of Africa and it is expected that a lot of impact would have been made to change people’s attitude behaviour and perception toward HCPs meted on women; but sadly, it is not so. The question that may arise following the above claim, is whether the media conveys intended messages and the modes of disseminating information and other factors, Mbagwu (2005) observed that, Although a wide range of media is used to provide useful information on education, health etc. but because a times the most popular media (radio) may not have impact on the beneficiaries perhaps, due to their low literacy level which may hinder their ability to code and decode these messages.

Therefore, women need to be empowered through education which will enable them reinforce their identities, respond to democratic aspirations and reduce inequality between the sexes which has always been the crux of the matter. A well informed citizen will be in a position to code and decode relevant information and use them as it affects him/her, protect his or her own right and sustain his/her independence. From another angle, Obetta (2002) maintained that other modes of disseminating information such as poster, family programes and jingles are easy to comprehend even by an illiterate and so perpetrators of cultural norms are consciously alert to those harmful practices which they execute daily. For example, jingles like “Mmakwa soro ibem gaba akwukwo” is self-explanatory that education

75 is very important, and this information is also available in different dialects. Also the slogan “cigarette smoking is dangerous to health” has not stopped the smoking of cigarette. The truth is that efforts already made at national and international levels to “kill” HCPs have been met with stubbornness from those who perpetrate them; as they continue to reinforce patterns, values, attitudes and practices which assign women to specific status and roles in the society. Unquestioning those deep-rooted cultural practices which are perpetrated by women themselves, are also responsible for the low status and low-esteem of women in the society (Okeke, 2002). However, Jacobson (2000) noted that worldwide studies on media advocacy show that radio, television and newspapers etc which are part of modern social process of sensitization are guilty of distorting the image of women and portraying them in stereotypical roles as “only housewives, dependants or objects of male pleasure and male violence. According to him, he emphasized on the need for women to be better informed through the media on pertinent issues like; determinants of health, diseases associated with pregnancy and childbearing, consequences of HTP on women and girl-children etc. Be it as it may, it is believed that when women completely take the stage in the media industry they will be in a position to fight for their rights, for fairness, justice, equity, integration, recognition and prospects in the society. (4) Intervention to Improve the Health of Women through Integrated Expanded Services Evidence around the world have shown that low socio-economic status of women have exposed them and served as a major factor to many health problems/diseases they suffer, which could be avoided. Investing on health of people (women inclusive) is fundamental to improving a country’s general welfare and economic growth. Unfortunately, today women suffer a disproportionate share of avoidable disability largely because of their law socio-economic status and reproductive role (World Bank, 2000). Surprisingly even in the 21st century, women in most parts of Africa, including Nigeria (e.g. Northern States) are still denied access to health facilities. They are not allowed to be attended to by male health givers/provider Khafag (2001) or allowed to take decisions concerning their fertility or sexuality (Uzuegbunam, 2003). Such decisions include, adopting the family planning of her choice to space her children, taking initiative to attend antenatal clinics or opting for hospital delivery even when she falls into labour in the absence

76 of her husband; and no other man, no matter how related to the husband can hold brief for him. This was why Tinker (1998) who observed the level of powerlessness women have been subjected to, suggests that women in developing countries in Africa and sub-Saharan Africa with lower financial base could benefit from integrated expanded programme directed at giving them a sense of belonging, improving their economic status, equipping them with basic knowledge concerning their rights, to recognize signs/symptoms of diseases and to seek prompt medical attention. Speaking further about the need for integrated expanded programmes of women as on intervention strategy to HTP, he re-emphasized that when women begin to have concern about their health and well-being, there will be great reduction in the incidence of maternal mortality. Integrated expanded programmes imply extending activities that is desired to improve the well-being of women. Such as women’s physiological and reproductive health promotion through the following approaches; (a) Enhanced maternity care for women (b) Increased choice of contraceptive methods (c) Designing delivery strategies to meet women’s needs (d) Promoting health services and healthy behaviours in the communities (e) Community strengthening the health care delivery infrastructures (f) Expanded screening for and treatment of sexually transmitted diseases including HIV/AIDS (g) Educating women and girls about services available to prevent unwanted pregnancies, STDs and HIV/AIDS. (h) Increasing the number of female health care providers (i) Integrating women into decision making in all aspects of development, planning and implementation. (j) Strengthening collaboration with the private sector including NGO’s on the elimination of all harmful cultural practices affecting women’s health. (k) Extending nutrition assistance to vulnerable groups (l) Education of mothers about nutritional requirements especially for the girl-child, pregnant and lactating mothers. Supporting the above view Okafor (2005) noted that it is dangerous to deny pregnant and lactating mothers some specific foods sanctioned as taboos/myths by some people due to their cultural belief. He maintained that the nutritional status

77 of a woman especially during pregnancy determines to a considerable degree the child’s educability and intellectual development. He also remarked that mothers’ pre-pregnancy nutrition affects the intra-uterine growth, and development of the foetus birth-weight and level of immunity. No wonder, nutrition education provided by United Nations has been part of their advocacy for the well-being of mother and child. (5) Policy Level Intervention to Eliminate HTP’s Discriminatory laws and policies on harmful traditional practices if duly formulated and signed will serve a better weapon against all offenders and perpetrators of HTPs. HTPs are on the increase because there are no existing laws/policies to back up those who could have taken action against those involved and resenting to all the efforts taken so far to bring terrible practices meted on women to a stop. Reacting to the consequences arising from harmful traditional practices such as FGM, early marriage and widowhood practice, Clark and Mcleron (1998) identified 2 broad level policy interventions which could serve as a better approach to liberating women from those barbaric and dehumanizing conditions they experience within their family, community or society that adversely affect their health. The 2 broad-policy level intervention include: (a) Public Policy (b) Organizational Policy Public policy according to them concerns new laws or regulations affecting large number of citizens in a community whereas, the organizational policy refer to sanctions placed on certain social norms and terrible conditions in a community which affects adversely the health of the people (e.g. widowhood bitter experiences, FGM and wife battering some women are going through). Right here in Nigeria a typical example of an organizational policy was the law no 4 of 1999 signed by Edo State house of Assembly to criminalize female genital mutilation but because some highly placed individuals from the state mounted pressure and passed a motion to repeal the law, it died instantly. However, it is on record that as at the year 2000, only four (4) states in Nigeria namely Oshun, Cross River, Bayelsa and Ogun have legislated FGM while there is still evidence of resistance in other states (Osarenren, 2001). According to him, there has been various attacks on perpetrators but taking a bolder step towards eradicating HCPs, he suggests that sensitization of people should be

intensified. The awareness creation could be on regular basis by talking to the policy makers and government officials at the state level and local government chairmen, to involve the Christian segment of the community, traditional and opinion leaders, women groups/ associations and market women at the community level. She also emphasized on the need to sensitize professionals, traditional birth attendants and all those who provide health care, about the consequences of HCPs and to improve their attitudes toward women. For excissors, alternative income generation or micro-financial assistance could be made available to them because FGM has been their source of livelihood over the years. On the same issue of eliminating HCPs, Hersh (1999) advocates for the following measures: (a) sensitizing law enforcement agents on issues concerning violence against women. (b) Providing counseling services to both girls and women about sexually transmitted diseases (STDs) and reproductive tract infections (RTI). (c) There is need to address other social needs that is/are constraints to women such as drudgery and over work transport difficulties, lack of water, poor sanitation and lack of access to resources/capitals among others. Ezumah (2002) also made the following suggestions toward eliminating HTPs, which includes: (i) Production of statistical information on the progress of women that women are not disadvantaged in anyway. (ii) Intensifying publicly education programmes to advocate new policies, change perceptions about unhealthy or harmful practices.

(iii) Increased male support for women to assume greater control over their health and well-being could go a long way to reshape traditional beliefs and customs harmful to women. Psychological Theories Related to or Justifying HTPS For a theoretical conceptualization, this study draws on some related theories which explain the anti-social behaviour exhibited by individuals on another in the name of tradition better called harmfull cultural practices. Barbaric acts/violence experienced by women in the name of cultural practices like early marriage, female-genital mutilation and widowhood rites are better imagined than experienced.One of the protagonist of social learning theory, according to Abraham protagonists of social learning theory, according to Abraham (1995) views violence as a learned phenomena in a social environment. This assumption agrees with the role modeling theory which assumes that violent behaviours especially children see their parents or other significant individuals doing something (whether good or bad). For example, parents who resolve issues by means of violence may be regarded as a normal behaviour by the child who in turn may become desensitized and cease to respond to environmental cues that inhibit his own tendencies towards violence (Abaney, 1997). And so, children model this role of violent interpersonal behaviour as they grow up till they become adults. This may have been the reason why harmful cultural practices are said to be deep rooted in the peoples culture, simply because children imbibe what they see their parents do. Cases like widowhood rites, nutritional taboos, and FGM are direct/indirect experiences which are boldly inscribed on the minds of the victims and perhaps the children. This persistence in these practices have been attributed to people desiring to play back on someone else. This is also the reason why people learn and internalize social and moral justification for abusive behaviour, because to them, there is nothing harmful with what they do or its consequences. For Adeleye (1999), the social or anti-social behaviour like harmful cultural practices meted out on women is essentially the by-product of child rearing practice; and it depends upon the value judgement of the cultural pattern in which the child is brought up. Furthermore, the social learning theory is determined primarily by learning which takes place in the social context. The social-learning approach (embedded in the individual actor) is directly guided by the role observation model in determining the individuals behaviour through learning. This is why diverse human behaviours could be attributed to the product of observing

80 and interacting with others (e.g. our parents, peers, or relations, etc). And so, people learn and internalize social and moral justification for abusive behaviour (like widowhood rites, inheritance, female-female marriage, FGM) because to them such practices are pleasant and rewarding. There are some related existing theories to explain these peoples (perpetrators) claim for the violence meted on women in the name of HCPs. These theories include: 1. The intra-individual theory: This theory simply explains violence on women in terms of the actor (Gelles and Strauss, 1979) and his behaviour which is governed by some components of human personality; the id, the ego and the superego. This theory agrees with the psychoanalytic theory propounded by Freud, 1979 which explained the function of individual defence mechanism, the “id” as being responsible for instinctual impulses for satisfaction (Adeleye, 1999). So this could be linked to pleasure derived by those who resist even the mention of eliminating HCPS without consideration for the realities of life or those affected. The individual defence (“id”)mechanism is completely out of touch with the world outside, remarked Adeleye. 2. Another related theory according to Goode (1971) is the resource theory which explains why an individual would hardly give up anti-social behaviour because of the gain or dividends he expects. For example, the harsh widowhood rites/inheritance practices are good examples of anti-social behaviours. Both men and women in our different communities are directly or indirectly involved. The men who want to inherit their late brothers wife do not inherit their responsibilities (her children, feeding, schooling, etc) but rather inherits the woman for his sexual pleasures and not even problems arising from their sexual relationship (e.g. pregnancy or sexually transmitted disease), Thanks to God that women with significant resources like money, education and integrity may be less willing in contemporary times to put up with such abuse in the name of culture. Could one then conclude that HCPs are engraved in power domination by men in the society long before now empowered by the interaction within our cultural milieu (i.e. our environment) and the social structures established through patriarchy. Apparently it may be true based on remark made by Iman (1989:155) that those social structures

already accepted by the society in principle as normal, are vehicles for female subordination which could be described as male supremacist. The empirical underpinnings of this theory according to Marayo (1997) hinges on the patriarchal relations which insist on the supremacy of men. No wonder, with regard to some HCPs such as. widowhood inheritance, FGM and son preference,which most people swear they dare not break off the terrible vicious cycle. However, Glenn and Feree (1992) observed that the problematic nature of giving up most cultures on women is associated with patriarchy, hierarchy of gender and devaluation However, from all fronts, an immediate dynamic shift is desirable,simply because the state of patriarchal and societal induced practices that are harmful traditions meted out on women are matters of grave concern which this study challenges.

Empirical Studies on Harmful Cultural Practice Evolving empirical studies on issues surrounding harmful cultural practices affecting the health of women such as early marriage of the girl-child; female genital mutilation(FGM); female-female marriage, widowhood and nutritional taboos are still under research and as such very scarce. To support this claim, Quedrago (2001) noted that harmful cultural practices exist but were undocumented or little studied and could not be included. However, there are a few empirical studies on harmful cultural practices. Available information on various aspects of harmful cultural practices including its prevalence were documented by authors like Awogbade and M’uazu(2000); Akumadu(2001) UNICEF 2003 and 2005 respectively and Oreh(2005) among others. According to the various studies, the manifestation of harmful cultural practices which cuts across different societies in the world were confirmed. One of such harmful culture that has been empirically proved to have severe health consequences on women is the early marriage of a girl-child (Akumadu 2000). The distribution pattern by age and deaths arising from early marriage was earlier reported by the United Nations (1995) which showed that 18% of girls married between the age of 10-15 years died due to pregnancy related cause. Other forms of death arising from early marriage appeared in the United Nations publications 1998. This include, a survey research carried out by Modo(1996) in Sokoto on the prevalence of early marriage. In the survey, the questionnaire was

82 the major research tool used. A total of 1,124 men and women purposively selected from 96 households were used. The data was analyzed using percentages. The findings from the study showed among others that majority (59%) of the respondents opined that their, girls marry early, 32% of the respondents were unable to accommodate their husbands sexually and as such 9% of the girls had vesico-vagina fistula (VVF) because they were forcefully incised by their husbands. Following these findings it was recommended by the rsearcher that programmes that keep girls in school should be promoted. This will prevent less child-marriages, promote the use of reproductive health services and better employment prospects for these young girl Still on the pattern of early marriage and its consequences, Jibril a columnist for vanguard newspaper on May 17th 2006 reported a case of a 15 year old girl who had VVF during delivery of the baby because of disproportion to the maternal pelvis. In another newspaper report by Ewulike on June 2000, was sad because an 18 year old girl from Sabon-fege in Zamfara State committed suicide by drinking poison in protest of her marriage to a 90 year old man. And so, the health implications of some cultural practices can not be overemphasized.Similarly, available information on specific age pattern and prevalence was generated from a survey conducted by Awogbade and M’uazu between 1998 and 2000 in 2 Local Government Areas (Dala and Sabon-Gari) within Kaduna and Kano States.The population for the study was made up of 427 women and girls between the age bracket of 18 and above who were randomly selected from households within these locations. The instruments used for the study were questionnaire, interviews and focus group discussions. The data generated from the study was analyzed using percentages and weighted means. The findings revealed that 37.2% of the respondents from Dala agreed that their girls married between the ages of 9 and 15 years while 3.8% from Sabon-Gari opined that the girls from their area married when they are over 26 years. Since most of these young girls were forced into marriage early, the study also revealed that only 8.8% them were still living with their spouses; while most of these child brides ran to major cities and towns to become commercial sex workers. In extreme situations according to their findings, a young girl who is about to be forced into marriage could contemplate or actually commit suicide.

In conclusion, the specific age pattern and prevalence of early marriage as practiced in the Northern part of Nigeria vary from one area to another, even within the same locality and its adverse health implications are obvious as was confirmed by the study. UNICEF 2003 report on studies conducted in five countries in Africa namely; Burkina Faso, Cameroon, Niger, Benin and Djibouti, show that the number of girls forced into early cohabitation each year vary across the countries. The number of such marriage stood at 2.9 million annually with 30% for Africa, 40% for Asia and 30% for Latin America. Surprisingly between the year 2003 and 2005, another survey data based on 1000 households purposively randomly sampled from five African countries earlier mentioned, showed a drop in Africa for girls who married before 18 years and an increase from 40-48% and 3-29% respectively for Asia and Latin America. The drop in early marriage in Africa could be attributed to the impact of reactions and growing rigor from various groups at local, national ad international levels towards influencing the eradication of HCPs affecting the health and education of the girl-child, remarked (Oberneyer, 2001). The issue around early marriage was further crystallized by the Loc hoi (2000) in a survey conducted on age pattern, early marriage and early motherhood in Nepal. A total of 2,800 urban youths and 5,075 rural youths aged 14-22 years with complete information on the variables used ( both married and unmarried male and female) were included in the study. Two different models were used for the study namely; proportional hazard models were used to estimate covariates of early marriage and early motherhood. Logistic regression model were used to estimate covariates of delayed consummation of marriage. The Nepal Adolescent and Youth Adult Survey (NAYA) questionnaire was the major instrument used for the study. The data from the Nepal Adolescent and Youth Adult Survey (NAYA) questionnaire revealed that early marriage and early motherhood are common among the Nepalese women especially in rural areas and less common among men. Delayed consummation of marriage is common among very young brides especially those in rural areas.Loc hoi (2000) lamented that Early marriage which invariably means early motherhood, accounts for nearly 25 percent of the currently high maternal mortality rate (MMR) of over 600 per 100,000 live births found in many African countries. The main covariates associated with early marriage and early motherhood according to the study, are respondents education, region of

84 residence and ethnicity. The covariates of delayed consummation of marriage are; age at first marriage, region of residence and ethnicity. These results were determined through weighted means. This available information about early marriage shows that it is a common practice within and outside the continent of Africa, with similar consequences on women and girls. And so, the study highlights the need to focus on less educated female youths in order to reduce the reproductive and child health risks associated with early marriage and early child bearing. With regard to another harmful cultural practice, known as female genital mutilation (FGM), Gachiri(2000) quoting the National Baseline data1998, derived from survey on the prevalence of FGM was confirmed to be alarming with a prevalence rate of 50% across Nigeria. The data revealed that the practice of FGM vary from one location to another in terms of the age religion, ethnicity and socio-economic background. The data also revealed that the most prevalent type of the four classifications of FGM practiced in Nigeria is Type 1 (clitoridectomy) found mainly in the South-East, South-South and South-West. Type 3 or infibulation is the most severe form practiced in some parts of Northern Nigeria namely Sokoto, Kano, Jigawa, Kaduna, Plateau, Bauchi and Taraba states. Further information about the practice of infibulation exist in parts of Imo state in South Eastern Nigeria and in Ondo State, South-Western Nigeria. The research instruments used in this study include focus group discussions and interview schedules. In this study, 3 groups of people were used namely, teenage girls, adult women (ages 15-45 years) and male head of households from 119 ethnic groups in the then 31 states of the federation. In all there were 4,922 purposively randomly sampled subjects from the various ethnic groups including the Yorubas, Hausas, Fulanis, Ibos, Itshekiris, Urhobos, Edos and some minority groups were also interviewed. The responses from these subjects were analyzed using percentages. The findings of this study include that FGM was widely practiced in Nigeria but not widespread among all ethnic groups studied, hence the observable difference in the incidence and prevalence rate within and between the six geo-political and cultural groups is that: variations in FGM practice is more of a cultural affinity as revealed among the Yoruba States with 98.7% in Osun, 98.8% in Oyo state and 91.6% among the Owos and Ikales in Ondo state. Also, cultural affinity with the Yorubas explains the high prevalence rate of 74% in Edo State. In the South-East, Imo State had the

85 highest prevalence rate of 95.4%, Anambra and Abia with high concentration of Ibos have 82.4% while Enugu State had 17.5%Yet in another survey conducted in 1999,the data collected between August and September on the incidence level (refusals not included) of FGM, are highest in South-West Nigeria with Ekiti State recording 89%, Ondo and Oyo recorded 83% and 73% respectively. In South-East Nigeria, Ebonyi State recorded the highest with 76%. Imo State had 66% closely followed by Enugu State with 59%. In South-South Nigeria, Bayelsa State recorded 74% incidence rate while Delta State had 59% (National Baseline Survey 1999). And so, in summary, FGM as a belief and a practice is accepted and enshrined in some people’s way of life but it was recommended in this study that such repugnant customs should be banned because of its severe health consequences affecting women/girls. There is yet another dehumanizing cultural practice targeted at women which is called the widowhood rights/inheritance. Studies conducted by Ahonsi and Awasanya(1997), Onyemuche (2000), Odumegwu (2004) and Oreh (2005), among others,confirmed that widowhood rites practices exist in the six geo-political zones in Nigeria. Onyemuche (2000) reported a study conducted on the prevalence of widowhood practices in the six geo-political zones of Nigeria. The population for the study was through the use of stratified random sampling technique to select 2,800 subjects. The major instruments used were questionnaire and focus group discussions. The responses from the various groups were analyzed using percentages, weighted means and standard deviation. The results showed that 91.8% of the respondents (Market Women) in the South-East agreed to the options which said that widows were maltreated in their areas, 54.5% from South-West, 36% from South-South, 71.7% from North-West, 60% from North-East and 42% from North Central. In effect the South-South Zone of Nigeria is where the practice of widowhood rights is lower. Likewise, from the six geo-political zones a total of 135 women purposively randomly selected were used for the focus group discussions. These women provided more insights to the various widowhood rites being practiced in their communities. On investigating how widows were treated when a man dies, 45 or 36% of the women responded in the affirmative that widows must shave their hair, 35 or 28% opined that widows slept on bare floor, 10 or 8% agreed that a widow should drink the water used for bathing her late husband’s corpse to prove her innocence that she was not responsible for his death.

Closely related to widowhood rites is the widow’s inheritance rights which is used to discriminate against widows. According to section 36 of the marriage Act under the English law cited by Okagbue (1997) either spouse has the right to inherit from the other whether or not the deceased dies testate. However, Ahonsi (1997) noted that the pattern of this cultural practice in question vary from one cultural group to another. For example, the widow’s inheritance rights is a matrilineal affair among some ethnic groups like (the Ohafias) in Abia State, Nigeria To buttress the above assertion Oreh (2005) carried out a study in a matrilineal community in Ozuabam in Abia State, on changing out-dated cultural practice against widows, using community education. The population for the study comprised both male and female subjects including widows, numbering 1,808. The stratified sampling technique was used to separate the associations into male and female while systematic random sampling technique was used to select two hundred members from each of the association. The research instruments were two sets of interview scale, one for the widows only and another set for the community development association members. The responses from the discussants were analysed using simple percentage, mean and standard deviation. The chi-square was used to test the null-hypothesis formulated for the study.The findings of the study include that, a widow is not entitled to inherit any of her husband’s property or benefits. However, the null- hypothesis which states that the inheritance rights of widows are not dependent on their residential status was accepted only for the item on death gratuity of the deceased. Therefore, based on the findings, the author recommends community education as an alternative to schooling capable of altering certain out-dated beliefs and practices such as the dis-inheritance of widows especially in a matrilineal community. Onwujogwu (2000) confirmed other ways widowhood practices could be modified and if possible brought to an end through the study he conducted on two states, Anambra and Imo States. In both states, he used 1,916 surrogate informants selected through stratified random sampling technique in three local government areas each. The questionnaire and focus group discussions were the research instruments used. To analyze the responses of the respondents, percentage and weighted means were used. The results of the study showed that in both states, 67% and 66% respectively agreed to reduce mourning period, reduce confinement period and wearing of white mourning clothes as against the traditional black dress previously

87 worn by widows. These cultural modifications are in line with the words of Potash (1998) that culture represents man’s rule which is subject to modification or extinction by man. Also, the study revealed that the 121 women purposively selected for the focus group discussions confirmed that there has been a concerted effort by various groups and continuous pressure exerted on individuals, families and their communities heads on how best to eliminate these H C Ps. 68% of the discussants from Anambra State confirmed that the practice of widowhood rites was at its peak, as against 15% from Imo State. The researcher however, suggested that obnoxious and dehumanizing rites that intrude into the privacy of the widow and violate her fundamental human rites should be abrogated. Moreover, relations, religious groups, husbands’ friends and government should support widows. On the issue of female- female marriage, Eze (2000) and Uzuegbunam (2003) lamented that it is a harmful cultural practice. Uzuegbunam (2002) conducted a survey research between January 2000- July 2001, on conflict management; implication of woman-woman marriage among the Igbos of Nigeria. The study was carried out in five main Igbo cultural areas of Nigeria; Abia, Anambra, Enugu, Imo and Ebonyi State. The population for the study was drawn through purposively random sampling technique where 20 women from each State (ages 20 and above) who were concerned with this type of marriage. In all 10 households from each State were used for the study, making a total of 50 households. The instrument for the data collection include oral interview and focus group discussions. The data was analysed using frequencies, percentages and weighted means. The findings of the study revealed among others that female-female/ woman-woman marriage are contracted by childless married women. 60% for old widows who were unable to get pregnant 30%; love and need to have children were motivating factors; thus socio cultural conflict of childlessness from the family and society is resolved for the initiator of woman-woman marriage .Based on these findings the author recommended that more researches should be carried out on woman-woman marriage so as to investigate more details in its effectiveness to the solution of woman cultural problems in particular and societal cultural problems in general as well as in other parts of Nigeria. Researchers have also found harmful traditions regarding some food taboos and as such some people consistently avoid eating them. Avoidance of such foods over a period of time becomes an inherent habit deeply rooted in the beliefs (and not abstinence) of individuals in a community.

Fisher,Wilson and Faqua(1975) opioned that the tradition of a people is the major contributory factor to food choices because it gives them emotional satisfaction. But these food choices or food taboos are not peculiar to a group of people; it varys from one country to another or even within the same community. For example, the eating of snail is a sacrilage to some people from Nsukka whereas to others it a nutritious proteinous delicacy which is even very expensive. Okafor (2005) carried out a formative and qualitative survey study on Nri Igbo food, myths and taboos. The population for the study comprised of a 60 man community health committee members from various arms of the community. The study adopted a participatory approach guided by the five way theoretical models: Power (pass a law); logic (give people certain facts); emotional appeals, incentives (providing reward for doing something); and facilitation (removing obstacles that are preventing people from making a change in the right direction). Also a “Triple A” cycle was used which stand for assessment, analysis and action.

The main instrument used was the informal discussion groups who generated responses which enabled the author to identify and assess the existing myths and taboos of Nri people. The study identified in all thirteen food myths and four food taboos which were analysed using the informal group’s discussions. The findings include that: a pregnant mother does not breast feed the baby, She should not eat snail, an expectant mother should not eat eggs, a child should not be trained with meat and a child who eats egg turns to be a robber among others. Though, according to the author, reducing the magnitude and impact of food myths and taboos is a difficult task, but the use of a long term health education programmme to influence a change in behaviour of Nri people was suggested. However, this change process should be handled with caution. It is worth mentioning that the food myths and taboos are not perculiar to countries in Africa. This is because Pool (1998) Boema (2000) reported case studies on snail and egg restrictions in Tamil Nadu and Mahabubnager rural areas of India. The data collected during the study was analysed using frequencies and percentages. Among the 500 mothers from Tamil Nadu district who were interviewed, 45% avoided eating snail during pregnancy while 72% of 1,106 women from Mahabubnager district who were interviewed expressed their dislike for eggs and snail because it is believed that they were harmful during pregnancy. Coincidentally, (49%) of the mothers from Tamil Nadu also shared the same view as the respondents above. On this note, the study recommended that food items which

89 were believed to be harmful for pregnant mathers were good for them especially for successful reproductive outcome. From the available empirical studies on harmful cultural practices, already discussed, it is glaring that they exist, and are practiced by men and women from families/communities. The prevalence of theseHCPscuts across societies in Africa, Asia and Latin America. However, documentation on these harmful cultural practices such as early child marriage, female genital mutilation (FGM), female-female marriage widowhood practices, and nutritional taboos is still very scanty in Nigeria and particularly in Ebonyi State. Thus, a burning desire in the researcher, prompted the assessment of harmful cultural practices affecting the health of women in Ebonyi State; so as to determine ways to influence a change in such practices through appropriate community-based intervention strategies.

Summary of Related Literature Reviewed Related literature reviewed, revealed that HCPs could be regarded as anti- social behaviours displayed by individuals on another without remorse. Anti-social behaviours according to some related theories are exhibited for some reasons ranging from ungodliness, individual biological make-up, sociological factor to the structure of the society which considers culturally defined goals and means of achieving them. A contrary view was advanced by some classical theorists like Cesare Baccarie and Jeremy Benthan who believe that human beings are born with free will to choose actions they want to display in order to derive satisfaction. Although an earlier claim was that the behaviour of an individual is prompted by evil forces/demons but there is no proof to such claims. However, be it as it may, traditional practices such as female genital mutilation, female-female marriage, early marriage, nutritional taboos and widowhood practices fall under the rubrics of harmful traditions which are detrimental to the health and well-being of women. Health has been referred to as a priceless treasure and a fundamental human right of all (women inclusive). Hence the need to invest on women’s health as there is still a hinge and unmet challenges to respecting women’s sexual rights. For example, women are still victim of old and die-hard traditional practices which exist in many forms such as FGM. Although, there is a great deal of variation in practices harmful to women and girl-children depending on the country, tribe or ethnic group and religion. But many of these HCPs enforced on women stem from the fact that women were abinitio (from birth) assigned inferior status. However many writers are of the opinion that HCPS are perpetrated/persist because of

90 ignorance and many victims would dare not share their awful experiences with anybody. Obnoxious and dehumanizing cultural practices, which violate the fundamental human rights of women, are still glaringly enforced in most communities in Africa and particularly in developing countries like Nigeria.The cultural influence on women is so bad that they have no control over their own fertility or sexuality like adopting prompt and appropriate family planning devices. Cultural restrictions on women associated with HCPs has become a global issue which has been addressed at local, national and international levels but every efforts to eliminate these practices have not yielded substantial results; as only very few countries have outlawed them. Reasons have been advanced for the persistence of harmful cultural practices, which are adversely affecting the health of the victims (women). For example, female genital mutilation, which is still being practiced in many communities, has no biological advantage, religious or scientific backings. Although perpetrators of FGM claimed that it guarantees virginity or reduce promiscuity but are they aware of consequences like hemorrhage, infection, infertility, severe scar and obstetric complications like vesico-vagina or recto- vagina fistula. Other consequences arising from HCPs like female-female marriage include sexually transmitted diseases, HIV/AIDs and reproductive tract infections. The consequences of HCPs are enormous as the practices and perpetrators, which also include women themselves (e.g. the Umuada’s in the case of widowhood practices/rites). This is the reason why efforts to eliminate HCPs have been receiving lukewarm attitude from those who have personal and selfish interests at heart. For example, the excissors of female genitalia may have alternative income-generating activities but the question is, will they give up the practice completely? Certainly, efforts to protect women must be strengthened at all levels; but any strategy to eliminate HCPs must first attack the root causes, treat its symptoms, remedy its consequences and empower the victims so that they will resist those attitudes/practices emanating from their families, relations/friends, communities and the society where there ought to be equity, fairness, justice and balance of power between men and women at all levels. No study to the best of the researcher’s knowledge has addressed these. Hence, the present study is intended to fill this gap.

CHAPTER THREE RESEARCH METHOD This chapter presents the design procedures that was adopted for this study. They are explained under the following headings: Research design, Area of study, Population for the study Sample and sampling technique, Validation of the instrument, Reliability of the instrument, Method of data collection and Methods of data analysis. Research Design The descriptive survey research design was adopted for the study. Survey research focuses on people, the vital facts of people, their beliefs, opinions, attitudes, motivations and behaviour. (Osuala, 2005). Therefore, the survey research design is considered appropriate for this research which sought to obtain data on harmful cultural practices affecting the health of women in Ebonyi state and the intervention strategies needed for eradicating them. This research design will help the researcher to obtain relevant information required during the study from a sample that is a representative of the whole population. In addition a qualitative method of field survey in the form of Focus Group Discussions (FGD) was also be employed. According to Knodel and Pramulratarana (1984) FGD is a research method which involves organizing and conducting series of group discussions with the objective of better understanding the attitudes, beliefs, practices and values on a specific subject. FGD enabled the researcher to obtain opinions from different segments of the population. With the assistance of a discussion moderator and a written (structured questions) guide of questions, relevant to the study, participants of FGD are encouraged to express their ideas in a spontaneous manner, which is not structured according to the researchers’ prejudices. Hence both quantitative and qualitative methods of field survey was used in this study by the researcher. Area of Study The area of the study is Ebonyi State which is made up of three senatorial zones, namely, Ebonyi North, Ebonyi Central and Ebonyi South. These three senatorial zones have 13 local government areas. Ebonyi state is a developing state and is known to still hold tenaciously to old traditions most of which are detrimental to the health of women in particular. Geographically, Ebonyi State lies approximately 5,932sq km. She is bounded on

92 the North by Benue state, in the South by Abia state, in the East by Cross River state and in the West by Enugu State. Population for the Study The population for this study comprised all the 11,424 members of the 327 registered community based women associations within the thirteen (13) Local Government Areas that make up the three Senatorial Zones namely; Ebonyi North, Ebonyi Central and Ebonyi South Table 1: Distribution of Community Based Women Organization in the thirteen Local Government Area of Ebonyi State. No Senatorial Zone Local Government No of Community Total Area Based Association Members 1 Ebonyi North Abakiliki 47 1,431 Ohaukwu 28 1,012 Ebonyi 19 559 Izzi 19 621 2 Ebonyi Central Ishelu 28 836 Ezza South 21 612 Ezza North 28 627 Ikwo 11 599 3 Ebonyi South Onicha 30 904 Ohaozara 41 1,306 Afikpo South 18 811 Afikpo North 20 1,143 Iro 17 563 13 LGA’s 327 11,424 Source: Ministry of Information and State Orientation, Ebonyi Sate (14/11/05)

Sample and Sampling Techniques The sample for the study was made up of 1, 962 registered members drawn from 65 Community Based Association (CBA). A multi-stage sampling technique which involved the identification of clusters or strata in the population, was adopted. A Multi-stage sampling according to Osuala (2005) is a sampling technique involving two or more stages of selection. The first stage involved a random sampling of two local government areas from each senatorial zones. This sampling technique gave each local government an equal opportunity of being selected. The six LGAs (ie two each from three senatorial zones) have a total of

162 registered Community Based Association with 4,905 members.(see Appendix B). The second stage involved, a sample proportion of 40% of the CBAs and the registered members from the random sampled local government areas were used to determine the sample size of the study, which was 65 CBAs and 1,962 registered members. The choice of 40% is based on the premise that if the population is about 5,000, a sampling interval of 40% will do (Osuala 2005). Table 2: Distribution of the radomlysampled local governments and Community Based Organizations using the 40% sample interval propounded by Osuala (2005).

Senato LGA’s Randoml No of 40% Total 40% of rial y Community Sample Wome total Zones Sampled Based of CBA’s n women LGA’s Associations Membe member rs 1 Ebonyi Abakiliki Ebonyi 47 19 1,431 572 North Ohaukwu Izzi 19 8 559 224 Ebonyi and Izzi 2 Ebonyi Ishelu Ishelu 28 11 836 334 . Central Ezza North Ikwo 21 8 612 245 Ezza South Ikwo 3 Ebonyi Onicha Iro 17 7 563 225 . South Ohaozara Onicha 30 12 904 362 Iro Afikpo South Afikpo North Total 6 LGA’s 162 65 4,905 1,962 See appendix B for continuition of table 2

Instrument for Data Collection A combination of two research instruments for data collection namely; the Questionnaire and Focus Group Discussions (FGDs) schedule were used in this study. The Harmful Cultural Practices Assessment Questionnaire (HCPAQ) and Focus Group Discussion schedule based on the six research questions; including three hypotheses were constructed by the researcher.

The Questionnaire A 157 item questionnaire was designed by the researcher for the purpose of collecting data for the study. The questionnaire was organized in two parts. Part A sought to collect personal data of the respondents. The 4 –point likert-type is assigned numerical values as follows: Strongly Agree (SA) 4-points value, Agree (A) 3 -points values, Disagree (D) 2-points value and Strongly Disagree (SD) 1- point value. Cluster A of the instrument sought to find out the various harmful cultural practices that are practiced in these communities which may affect the health of women. The total number of questionnaire items in this cluster is 6. Cluster B of the instrument sought to find out why HCPs exist in the study area.The total number of questionnaire items in this cluster 78 Cluster C of the instrument sought to find out the consequences of harmful cultural practices on women’s health. The total number of items in this cluster is 36. Cluster D of the instrument sought to find out why harmful cultural practices resist change. The total number of items in this cluster is 6. Finally, cluster E of the instrument sought to find out what strategies could be adopted in eliminating harmful cultural practices. The total number of items in this cluster is 6. (See Appendix C) Focus Group Discussion (FGD) Schedule A Focus Group Discussion (FGD) Schedule was used to collect qualitative data using women selected from each Community Based Organizations used for the study (See Appendix D.). The FGD schedule was based on the purpose and research questions guiding the study, which were followed tactfully by the discussion moderator. The FGD schedule was designed in two parts. Part A is an introductory letter written by the researcher to intimate the respondents on the purpose of the discussion and thereby solicit for their cooperation and to feel free to give information on issues that were raised during the discussion. Part B is the Focus Group Discussion schedule based on the research questions. This section contains four major (open ended) questions that were discussed; although other related questions were raised as the need arose.

Validity of the Instrument The instrument was subjected to face validation by five experts. Two from Measurement and Evaluation and three from Health and Physical Education all in

95 the University of Nigeria, Nsukka. These experts were requested to make suggestions on the relevance, adequacy, language level, content and comprehensiveness of the questionnaire items and the FGD schedule. In all, the research had a modified questionnaire of 157 items and 15 FGD schedule items. (See Appendix E and F) Reliability of the Instrument The internal consistency of the instrument was ascertained using Cronbach alpha to compute each of the clusters of the questionnaire (A,B,C,D and E). The use to Crombach alpha is appropriate due to the fact that items are not dichotomously scored. This fact agrees with Nworgu (1992) that Cronbach alpha is a statistical approach which is applicable to non-dichotomously scored items. The internal consistency reliability coefficient obtained for each of the clusters, A, B, C, D and E. were 0.865, 0.891, 0.789, 0.281 and 0.616 respectively (See Appendix G). The reliability coefficient result of the various sections of the instrument showed high positive related scores. These are indications that the research instrument is reliable. An overall reliability value of 0.6884 was obtained and was adjudged high enough. Therefore, the instrument was considered reliable and used for the study. Procedure for Data Collection The researcher made use of four assistants who assisted in distributing the questionnaire to the respondents. The research assistants were briefed and trained on the modalities for administering by the researcher with the help of four field assistants who administered the questionnaire on the respondents on their regular Afor, Nkwo, Eke and Orie Monthly meetings; with the help of four field assistants who are indigenes of the studied communities. These research assistants were briefed and trained before the field survey on the procedure for administering, collecting the questionnaire and moderating the Focus Group Discussion. A total of (1,962) copies of the questionnaire were printed for distribution. In the process of distribution the researcher discovered that in almost all the community based associations used for the study, the total number on attendance did not correspond with the records collected abinitio. The researcher was informed that some of their members were dead, some relocated to other urban centres and others decided not to continue because of their indebtedness to the

96 association. And so, in all 1,398 copies of the questionnaire representing 70.70% were distributed to members of the selected CBOs (in the six LGA’s) who were in attendance at meetings. On return of the questionnaire for analysis, it was observed that some sections of the instrument were not completed by some respondents while few items had multiple responses. In all 291 copies of the questionnaire representing 26.6 percent were not used. Therefore, a total of 1,098 copies of the questionnaire representing 79% were returned out of the total number administered. Method of Data Analysis The responses from the respondents were analysed using percentages, weighted means and standard deviation according to the research questions. Means the standard deviation were the statistic used to analyzed research question 1-5. To get the calculated mean response for each item. The 4 point rating scale were assigned numerical values of Strongly Agree (SD) 4 Points Agree (A) 3 points Disagree (D) 2 points Strongly Disagree (SD) 1point Therefore, criterion mean is 2.5. The decision rule is that where the calculated mean is less than the criterion mean the responses were not accepted but where the calculated mean is equal or more than the criterion mean, it was accepted. The data from the Focus Group Discussion were qualitatively analysed as follows to involve: (a) The transcription of the content of tape used during each group session. (b) Listening to each tape and documenting the various response/comments of respondents. (c) Organizing the responses under each question for all the FGD groups used. (d) Interpreting the findings and comparing one group session with another with regard to the problem being investigated.

Also, the hypotheses were tested using ANOVA and t-test statistics respectively at P < 0.05 level of significance.

CHAPTER FOUR RESULTS In this chapter, the results of the data analysis based on the six research questions and three hypotheses that guided the study are presented in tables. A record of the results of the focus group discussions are also presented.

Research Question 1 What Harmful Cultural Practices are practiced in your community?

Table 3 : Mean and Standard deviation of the harmful cultural practices in the communities of the respondents S/NO Items X Std. Deviation Decision

1 Early marriage 3.51 .632 ACCEPTED 2 Nutritional taboos 2.92 .772 ACCEPTED

3 Female-female marriage 2.38 .963 UNACCEPTED 4 Teenage-surrogate 2.31 .906 UNACCEPTED motherhood 5 Female circumcision 3.55 .681 ACCEPTED 6 Widowhood practices 3.58 .740 ACCEPTED

Table 3 shows that widowhood, female circumcision, early marriage, nutritional taboos are being practiced in many communities according to the respondents that participated in the study. Each of these items have the mean that is greater than 2.50, (i.e. 3.58, 3.55, 3.51 and 2.92 respectively). However, female- female marriage and teenage-surrogate motherhood are not commonly practiced in some of the communities from where the respondents were drawn. Each of these items have mean that is less than 2.5 (i.e. 2.38 and 2.31 respectively).

Research Question 2 Why do harmful cultural practices exist in these communities? Table 4: Mean and Standard Deviation of the reason for the existence of HCPs practices in the communities according to the respondents. S/N ITEMS Std.Deviation Remark X

7 Women are regarded as men's property 4.30 .872 ACCEPTED 8 Women are not considered equal to men 3.26 .777 ACCEPTED 9 Women are seen as powerless 2.81 .787 ACCEPTED 10 Women should be seen and not heard 2.57 .909 ACCEPTED 11 Women are thought not to have any right 2.47 .970 UNACCEPTED 12 Women are subordinate to men 3.00 .947 ACCEPTED 13 Prevent Promiscuity 2.82 1.031 ACCEPTED 14 Preserve the girl's Virginiity 2.71 .913 ACCEPTED 15 Promote cleanliness of the woman 2.52 .913 ACCEPTED 16 Promote Aesthetics 2.49 .898 UNACCEPTED 17 Ensure Marriage of the girl child 2.34 .891 UNACCEPTED 18 Improve Male Sexual Pleasure 2.32 .847 UNACCEPTED 19 Very old women 3.03 .944 ACCEPTED 20 old men 1.94 .860 UNACCEPTED 21 Traditional birth attendants 3.17 .765 ACCEPTED 22 Doctors 2.07 .818 UNACCEPTED 23 Midwives in maternity homes 3.02 .888 ACCEPTED 24 I have never seen it done 1.80 .142 UNACCEPTED 25 Prevents unwanted pregnancy 3.19 .905 ACCEPTED 26 Ensures a girl's virginity 2.78 .919 ACCEPTED 27 Ensures fertility in girls 2.34 .843 UNACCEPTED 28 Combats family poverty 2.88 .872 ACCEPTED 29 Ensures grandchildren for parents 2.64 .835 ACCEPTED 30 Will ensure the use of bride price for training the 2.48 .907 UNACCEPTED BOYS 31 Girls are not allowed to eat beef/pork 1.84 .711 UNACCEPTED 32 Girls are not allowed to eat eggs 1.81 .698 UNACCEPTED 33 Pregnant mothers are not supposed to eat snail 2.36 .881 UNACEEPTED 34 Pregnant mothers are not supposed to drink milk 2.02 .746 UNACCEPTED

35 Pregnant mothers are not supposed to eat eggs 2.04 .761 UNACCEPTED 36 Pregnant mothers are not supposed to eat grass 2.22 .952 UNACCEPTED cutters 37 Prevent women from being extravagant 2.07 .852 UNACCEPTED 38 Curb their Gluttonous behaviour 2.16 .800 UNACCEPTED 39 Prevent Them From Experiencing Prolonged 2.17 .951 UNACCEPTED Labour If They Eat Grasscutter 40 prevent the unborn child from stealing if the 2.10 .787 UNACCEPTED mother eats egg when pregnant 41 maintain the belief that babies will behave like cows 2.13 .817 UNACCEPTED if pregnant mothers drink cow milk 42 Maintain the belief that babies will salivate 2.53 .953 ACCEPTED excessively if pregnant mothers eat snail 43 Female-female marriage for the mentally retarded 1.88 .783 UNACCEPTED

44 Female-female marriage for an idiot 1.83 .698 UNACCEPTED 45 Female-female marriage for the childless couple 2.27 .976 UNACCEPTED 46 Female-female marriage for an old childless widow 2.33 .930 UNACCEPTED See Appendix H for Continuation

Research Question 3

What are the consequences of the HCPs on women’s health? The data collected for research question 3 are presented on table 5 below from item 85 through 120. Table 5: Mean and Standard Deviation of the consequences of the HCPs on women’s health according to the respondents. S/N ITEMS X Std. REMARK Deviation

85 Severe pain 3.39 .706 ACCEPTED 86 Profuse bleeding 3.10 .773 ACCEPTED 87 Adhesion to labia majora/vagina 2.17 1.096 UNACCEPTED 88 Infection 2.44 1.077 UNACCEPTED 89 Scar Tissue formation 1.97 1.089 UNACCEPTED 90 Vesico vagina or recto vagina fistula 1.80 1.067 UNACCEPTED during child birth 91 frequent closely spaced pregnancy 3.07 .933 ACCEPTED 92 late recovery of mother following 2.84 .959 ACCEPTED childbirth 93 prolonged labour 2.58 1.003 ACCEPTED 94 Exhaustion of mother, leading to death 2.66 .886 ACCEPTED 95 excessive bleeding 2.63 .961 ACCEPTED 96 Vesico vagina/recto vagina fistula 2.35 1.007 UNACCEPTED 97 Easy transmission of hiv/aids 2.57 1.173 ACCEPTED 98 Transmission of sexually transmitted 2.57 1.063 ACCEPTED diseases such as candidiasis 99 Transmission of cervical cancer 1.78 1.040 UNACCEPTED 100 Unplanned pregnancy 2.53 1.103 ACCEPTED 101 Frequent abortion 2.17 1.026 UNACCEPTED 102 Infertility due to infection 2.20 1.025 UNACCEPTED 103 Low blood Count/Haemoglobin 2.88 .972 ACCEPTED 104 Anaemia 2.95 .932 ACCEPTED 105 Poor lactation of mother 2.73 .881 ACCEPTED 106 Low Immunity 2.58 1.006 ACCEPTED 107 Delayed healing of episiotomy 1.97 1.031 UNACCEPTED 108 Blood transfusion complication 1.68 .916 UNACCEPTED 109 Vulnerable to sexually transmitted diseases 2.81 1.085 ACCEPTED 110 Vulnerable to hiv/aids infections 2.74 1.128 ACCEPTED 111 Infertility 2.22 1.154 UNACCEPTED 112 Cervical cancer 1.82 1.075 UNACCEPTED 113 Unplanned pregnancies 2.61 1.020 ACCEPTED 114 Illegal abortions may lead to death 2.50 1.053 ACCEPTED 115 Emotional trauma 3.34 .824 ACCEPTED 116 Depression 3.18 .871 ACCEPTED 117 Social withdrawal 2.81 1.066 ACCEPTED 118 Loneliness 3.10 .848 ACCEPTED 119 Pschological trauma 2.92 .916 ACCEPTED 120 Mental trauma 2.76 .974 ACCEPTED

100

Table 5 shows that out of 36 items identified as consequences of HCPs on women’s health, only 24 items (85, 86, 91, 92, 93, 94, 95, 97, 98, 100, 103, 104, 105, 106, 109, 110, 113, 114, 115, 116, 117, 118, 119 and 120) are acceptable to the respondents as consequences of HCPs on women’s health. Each of these items has a mean greater than 2.50. However 12 items out of 36 items identified as consequences of HCP, on women’s health (87, 85, 89, 90,96, 99, 101, 102, 107, 108, 111, 112) are not acceptable to the respondents. Each of these items has mean less than 2.50. Therefore, majority agreed that HCPs has adverse consequences on women.

Research Question 4 Why do these HCPs resist change in contemporary times? The data collected for this research question are presented on table 6 from item 121 through 126.

Table 6: Mean and Standard deviation of the reason why HCPs are resistant to change. S/NO ITEMS X Std. Remark Deviation

121 Preserve the Culture of the 3.05 1.181 ACCEPTED People 122 Put Women in their Place 2.19 1.195 UNACCEPTED 123 Subject Women To Practices 2.77 1.012 ACCEPTED Other Women Suffered Long Ago 124 enable traditional midwives 2.27 1.012 UNACCEPTED continue their livelihood 125 Do not Punish the Perpetrators 2.72 .953 ACCEPTED 126 Check Female Promiscuity 2.54 1.050 ACCEPTED

Table 6 shows that to preserve the culture of the people, subject women to practices other women suffered long ago, lack of punishment for perpetuators, and check female promiscuity are the reasons why HCPs are resistant to change according to the respondents that participated in the study. Each of these reasons

101 has a mean greater than 2.50. On the other hand, reasons such as to put women in their place, and enable traditional midwives continue their livelihood are not seen as the causes of resistant to change. Each of these items has a mean less than 2.50.

Research Question 5 What intervention strategies can be adopted in eliminating HCPs? The data for this research question is analysed on table 7 from item 127 through 132,.

Table 7: Mean and Standard deviation of the intervention strategies for eliminating HCPs S/NO ITEMS X Std. Remark Deviation

127 Openly, Individuals Should 3.41 .674 ACCEPTED Condemn the Negative Cultural Practices 128 Perpetraitors of Harmful Cultural 3.12 .927 ACCEPTED Practices Should be Punished by Legal Action 129 Traditional Rulers Should Enforce 3.24 .620 ACCEPTED Rules Against Harmful Traditional practices in Their Communities 130 The government should make these 3.27 .746 ACCEPTED harmful practices illegal 131 Church leaders should 3.13 .834 ACCEPTED excommunicate members who remain perpetrators of harmful cultural practices 132 I have no idea. 1.91 .864 UNACCEPTED

Table 7 shows that all the six items identified to be intervention strategies for eliminating HCPs are acceptable to the respondents. Each of these items has a mean greater than 2.50.

102

Hypothesis 1

Ho1: There is no statistically significant difference in the mean ratings of respondents on harmful cultural practices based on location. Table 8: ANOVA Summary for mean ratings of respondents on HCPs based on location ANOVA S/N Items Sum of df Mean F Sig Squares Square . 7 Women are regarded as Between Groups 57.082 5 11.416 16.110 .000 men's property Within Groups 737.021 1040 .709 Total 794.103 1045 8 Women are not Between Groups 23.273 5 4.655 7.964 .000 considered equal to men Within Groups 613.693 1050 .584 Total 636.966 1055 9 women are seen as Between Groups 30.343 5 6.069 10.230 .000 powerless Within Groups 612.806 1033 .593 Total 643.149 1038 10 Women should be seen Between Groups 52.461 5 10.492 13.461 .000 and not heard Within Groups 797.395 1023 .779 Total 849.856 1028 11 Women are thought not to Between Groups 90.381 5 18.076 21.075 .000 have any right Within Groups 883.436 1030 .858 Total 973.818 1035 12 Women are subordinate Between Groups 49.981 5 9.996 11.741 .000 to men Within Groups 865.018 1016 .851 Total 914.999 1021 13 Prevent Promiscuity Between Groups 211.986 5 42.397 48.971 .000 Within Groups 906.449 1047 .866 Total 1118.435 1052 14 Preserve the girl's virgiity Between Groups 41.561 5 8.312 10.434 .000 Within Groups 819.786 1029 .797 Total 861.347 1034 15 Promote Cleanliness of Between Groups 87.124 5 17.425 23.184 .000 the Woman Within Groups 752.355 1001 .752 Total 839.480 1006 16 Promote aesthetics Between Groups 78.193 5 15.639 21.392 .000 Within Groups 725.207 992 .731 Total 803.400 997 17 Ensure marriage of the Between Groups 31.003 5 6.201 8.084 .000 girl child Within Groups 762.428 994 .767 Total 793.431 999 18 Improve male sexual Between Groups 47.226 5 9.445 14.029 .000 pleasure Within Groups 657.088 976 .673 Total 704.314 981 19 Very old women Between Groups 31.977 5 6.395 7.395 .000 Within Groups 876.890 1014 .865 Total 908.867 1019 20 Old men Between Groups 50.351 5 10.070 14.579 .000 Within Groups 661.034 957 .691 Total 711.385 962 21 Traditional birth Between Groups 35.552 5 7.110 12.840 .000 attendants Within Groups 567.054 1024 .554 Total 602.606 1029 22 Doctors Between Groups 70.957 5 14.191 23.686 .000 Within Groups 580.576 969 .599 Total 651.532 974 23 Midwives in maternity Between Groups 55.033 5 11.007 14.958 .000 homes Within Groups 717.428 975 .736 Total 772.461 980 See Appendix I for Continuation

103

Table 8 shows that there is significant difference in the mean ratings of the respondents on HCPs based on location on the items except item number 29. In each of the items where there is significant difference, the z-tail significant level set by the computer is less than the 0.05 alpha level of which the hypothesis is tested. On the other hand, the z-tail significant level set by the computer is greater than 0.05 alpha level, at which the hypothesis is tested, for item 29. Hypothesis 2

Ho2: There is no statistically significant difference between the mean rating of single and married parents on why HCPs exist in communities. To test this hypothesis a t-test analysis of the difference between the mean scores of respondents was computed as shown below. Table 9: t-test analysis of the mean ratings of single and married parent on why the HCP exist in communities MARIT N Me Std. t dsf Sig Remark AL an Deviati . STATU on S HYP 7 women are regarded as men's MARRIE 699 1.72 .902 property D 3.723 607.617 .000 SINGLE 281 1.51 .761 8 women are not considered equal to MARRIE 704 1.79 .830 men D 3.456 654.235 .001 SINGLE 286 1.61 .665 9 Women are seen as powerless MARRIE 692 2.23 .805 D 2.855 556.354 .004 SINGLE 282 2.08 .751 10 Women should be seen and not MARRIE 695 2.46 .940 heard D 2.025 527.141 .043 SINGLE 269 2.33 .864 11 Women are thought not to have any MARRIE 697 2.58 1.032 right D 1.083 619.266 .279 NS SINGLE 274 2.51 .826 12 Women are subordinate to men MARRIE 700 1.95 .988 D - 523.256 .215 NS SINGLE 257 2.04 .854 1.241 13 Prevent promiscuity MARRIE 707 2.24 1.063 D 2.130 562.730 .034 SINGLE 280 2.09 .961 14 Preserve the girl's virginity MARRIE 687 2.40 .912 D 4.946 537.655 .000 SINGLE 282 2.09 .885 15 Promote cleanliness of the woman MARRIE 675 2.50 .964 D .981 571.733 .327 NS SINGLE 268 2.44 .821

16 Promote aesthetics MARRIE 669 2.51 .920 .627 533.991 .531 NS D SINGLE 266 2.47 .834 17 Ensure marriage of the girl child MARRIE 673 2.72 .886 D 2.591 935 .010 SINGLE 264 2.55 .875

104

18 Improve male sexual pleasure MARRIE 658 2.68 .840 D .383 918 .702 NS SINGLE 262 2.65 .856 19 Very old women MARRIE 684 1.91 .914 D - 473.437 .092 NS SINGLE 273 2.02 .974 1.687 20 Old men MARRIE 640 3.03 .909 D - 588.899 .044 SINGLE 260 3.14 .735 2.022 21 Traditional birth attendants MARRIE 686 1.90 .765 D 3.475 512.351 .001 SINGLE 281 1.71 .778 22 Doctors MARRIE 653 2.90 .846 D - 912 .028 SINGLE 261 3.03 .803 2.206 23 Midwives in maternity homes MARRIE 656 2.01 .867 D .420 453.667 .675 NS SINGLE 264 1.98 .937 24 I have never seen it done MARRIE 594 3.27 1.091 D 4.213 422.691 .000 SINGLE 255 2.89 1.269 25 Prevents unwanted pregnancy MARRIE 708 1.83 .973 D 1.062 661.107 .289 NS SINGLE 283 1.77 .758 26 Ensures a girl's virginity MARRIE 685 2.28 .950 D 3.156 589.915 .002 SINGLE 282 2.09 .837 27 Ensures fertility in girls MARRID 664 2.75 .841 SINGLE 267 2.45 .867 4.950 929 .000 See Appendix J for Continuation Table 9 shows that there is significant different between the mean ratings of single and married parent on the following items – 7, 8, 9, 10, 13, 14, 17, 20, 20, 21, 22, 24, 26, 27, 28, 30, 31, 32, 33, 34, 35, 36, 40, 41, 42, 46, 50, 52, 53, 55, 56, 57, 59, 71, 72, 73, 77 and 80. This is because the z-tail significant level set by the computer for each of those items is lower than the tabulated t-value at 0.05 significant level set for testing the hypothesis. In other word, there is no difference in the opinions of single and married parents on the existence of HCPs. However, there is no significant different between the mean ratings of single and married parent on the following items – 11, 12, 15, 16, 18, 19, 23, 25, 29, 37, 38, 39, 43, 44, 45, 47, 48, 49, 51, 34, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 70, 74, 75, 76, 78, 79, 81, 82, 83 and 84. This is because, the z-tail significant level set by the computer is greater than 0.05 significant level set for the testing of hypothesis for each of these items. Therefore, the decision is that the null hypothesis should be accepted. Hypothesis 3 There is no significant difference between the mean ratings of educated and non-educated respondents on why HCPs resist change in contemporary times. Table 10: t-test analysis of mean ratings of educated and non-educated respondents on why HCPs resist change in contemporary times.

105

Table 10: t-test analysis of mean ratings of educated and non-educated respondents on why HCPs resist change in contemporary times

Variables EDUCATIONAL N Mean Std. T Remark S/N QUALIFICATION Deviation DF SIG. HYP 121 Preserve the EDUCATED 593 1.89 1.165 - culture of the NON EDUCATED 368 2.03 1.259 1.731 732.359 .084 NS people 122 Put women in EDUCATED 563 2.80 1.240 1.269 their place NON EDUCATED 361 2.70 1.125 820.264 .205 NS 123 Subject women EDUCATED 556 2.41 1.097 8.240 to practices NON EDUCATED 360 1.92 .688 913.119 .000 S other women suffered long ago 124 Enable EDUCATED 556 2.73 1.049 .455 traditional NON EDUCATED 362 2.70 .944 827.158 .649 NS midwives continue their livelihood 125 Do not punish EDUCATED 567 2.15 .956 - theperpetrators NON EDUCATED 361 2.42 .882 4.441 926 .000 S 126 Check female EDUCATED 578 2.51 1.130 1.664 promiscuity NON EDUCATED 363 2.39 .950 863.528 .096 NS

Key: NS = not significant, S = Significant Table 10 shows that there is no significant difference between the mean ratings of educated and non-educated respondents on the following items- 121, 122, 124, and 126. This is because the calculated t-value which is required for significance at .084, 205, 649 and .096 is less than the tabulated t-value which is 1.96. On the other hand, there is significant difference between the mean rating of educated and non-educated respondents on item – 123 and 125. This is because the z-tail significant level set by computer is less than 0.05 level of significant set for testing the hypothesis for each of the items. Therefore, the null hypothesis is accepted. Findings from the Focus Group Discussion Focus group discussions were organized in six community-based organizations within the six local government areas used for the study. They are Ochonma women

106 organization,Ebonyi; Umutoaba alaiju women group, Izzi; Wepa-mgbolopu women’s group Ishelu; Ofuobi edekwu egwu women association Ikwo; Nwanneamaka women organisation Iro and Eziokwubundu women organization Onicha. From each of the local government women organizations used, twelve women which included members of the executives and patrons where purposively sampled and used for the focus group discussions. In each of the meetings the researcher began the session with a familiar story titled Mary slessor, the determined woman, who inspite of the stumbling blocks fought hard and succeeded in putting an end to a die-hard tradition of killing twins. This story was used as an awareness package for the discussants in order to capture their attention, steer up their interest on the pertinent issues surrounding most traditions (such as those under study), their adverse effects on the affected and how people have reacted to put an end to such horrible practices. In the process of the discussion, few women expressed how their relations were victim to losing their twins. One of them said that the aunt’s experience of loosing her twin babies left an indelible mark on the lives of all of them because the aunt never got pregnant again till her death few years back. The mental, emotional, psychological and other traumas imposed on the affected by most of our die-hard traditions cannot be exhausted. They are better imagined than experienced exclaimed one of them. Although it has not been empirically proved that a HCP such as the killing of twins then, can also result to secondary infertility as was experienced by a relation of one of the discussants. The first question on the discussion schedule sought to find out the respondents knowledge about traditional practices practiced in their various locations. Discussants were of the opinion that early marriage, nutritional taboos, female circumcision and widowhood practices were the visible negative cultural practices practiced in their communities. Majority of them testified to the existence of these HCPs but were not observed strictly in their community because of the influence of Christianity, education and cultural diffusion. However, few woman argued and still maintained that they do not support the elimination of female circumcision because it prevents promiscuity, preserves a girl’s virginity, thereby accords her respect in her matrimonial home. At this juncture, hot arguments ensured between those for or against FGM. A male observer (an indigene) who graduated from the University of Nigeria Nsukka as a

107 veterinary doctor challenged one of the discussants that if FGM prevents promiscuity, how come she is carrying a two year old child her sixteen year old daughter bore for her without being legally married? This singular question prolonged the argument and raised more dust. Some group of women who are above child-bearing age also gave reasons to why widowhood practices should not be stopped. One of their reasons include that they were victims to such practices and so others must pass through similar widowhood experiences. But majority who have human face and conscience reacted vehemently by disagreeing openly to widowhood practices which signifies man’s inhumanity to man. Reacting to their views, one woman from Ikwo (to be precise) aggressively cautioned that the researcher should discontinue further discussions on FGM and widowhood practices since they have been able to survive all the pains and stress which is a good experience for them. It was observed that majority who were against HCPs were those whose lives have been touched and shaped by urbanization and Christian doctrines. With regard to nutritional taboos such as a pregnant mother not allowed to eat eggs, snail or grass cutter. Majority of the discussants opined that it was a mere fallacy. One of them asked the question, who has ever seen a grasscutter in labour since it is assumed that the eating of grasscutter by a pregnant woman will result to prolonged labour. One of the discussants quickly corrected the wrong impression of associating prolonged labour with the consumption of eggs, snails or grasscutter. She cleared the air with an interactive but educative session on factors that contribute to prolonged labour which has been empirically proved. Some of them are over feeding, particularly starchy food, which will lead to both baby and mother gaining more weight. The weight gain will lead to disproportion on the size of baby and the birth canal. Although, there may be disproportion in the size of the maternal pelvis right from birth, which can cause prolonged labour. Also, malposition or malpresentation of the baby in utero may give rise to prolonged labour if the baby do not assume a good position before the pregnancy gets to term. On the issue of female-female marriage, four women from different locations expressed their individual observations and impressions about the practice. They gave a run-down of the origin of female-female marriage which they described as an alternative to a coincidence but it is no longer practiced because of the birth to the practice of child adoption which is now in vogue. Continuing, one

108 of them reiterated that in the past women were the initator of female-female marriage but now they initiate the adoption of children while the husband may agree or disagree. The women in question were either not married or married but had delayed pregnancy or were barren but would like to have their own children. The women will arrange to marry a younger girl/women who will bear children for her. For a man who is impotent, the wife can also arrange and marry a woman who will be responsible for child bearing with an arranged husband. One of the discussants shouted that such arrangements have serious health implications.She exclaimed that in the past , women suffered from ‘nsi-nwa’ but now the situation has graduated to the visitor called HIV/AIDS better called “Obirinajaocha” or “Echi- eteka” in igbo. Another discussant said that although those concerned usually go for their closest relation (girl/woman, within, child-bearing age) who will live with her as a co-wife but the practice should be discouraged. With regard to early marriage, majority said they married early because their parents had no interest in educating the females. Some said that because of poverty, food production became their parents priority. Others said the reason for early marriage was to prevent their girls from sleeping around with men since they recognized that an idle mind is the devils workshop. One discussant said that many of them who claim to be married were not legally married because some were impregnated and so were imposed on the men. Continuing, she said that legal marriage proceedings confer respect on a woman and as such women who are legally married would never support HCPs like early or female-female marriages. She indicated their willingness to participate in any move that would usher in developmental changes in all spheres of lives of women in their community-Ikwo where the education of their females is not encouraging. Reason, according to her is because some of the girls lack financial support from their fathers and usually would drop-out from school. Worse still, the alternative for such girls is to engage in hair salon business which is a compatible environment for prostitution by feeble minded girls. Reacting to the question, on who implements those HCPs being addressed, the discussants acknowledged that women themselves are the problem because they are the originator, establisher and implementer of all the traditional practices identified to have adverse effects on women and their health. A heated up argument ensured between those who are for or against the continuity of practices

109 like FGM widowhood rites and early marriage. Amazingly, augments during the FGDS were usually resolved by discussants themselves. This was observed by the researcher and her assistants in all the LGAS used. Each group resolved to sincerely talk to fellow women on the need to embrace relevant innovations in their communities especially those that infringe on the welfare of women. Their other resolutions include getting representatives of women who will lead delegations to their various traditional rulers, community leaders, NGO’S, LGA Chairman and Chairpersons and intimate them, on the desired change now on pertinent issues concerning women, for better recognition and involvement in development of their communities and Ebonyi State in general. A discussant informed us about the suggestion to ban offenders in one of their monthly meetings some years back when the incident of a widow who was ejected from the late husbands apartment for refusing to re-marry her brother in- law was brought before the women, but majority of the women did not approve of the sanction. Hence, the women unanimously screened that cultural practices such as these that resist change in contemporary times should as a matter of urgency be eliminated from their communities. Moreso,one of the discussants remarked that their fore fathers regarded HCPs as good practices simply because of their myopic reasoning and selfish desires like playing around with hungry widows, their belief that women are mere property that should be disposed at will and as such they should not be heard but seen. Moreover, women in the past were regarded as “Oriaku” but now they are indispensable in development activities and so should be respected and cared for. Another discussant cheaped in that she feels ashamed when she remembers that their state (Ebonyi) is enlisted as one of those where HCPs are prevalent with very high incidence of F. G. M. and widowhood practices. Others who spoke said among other things that if culprits are brought to book it will serve as a deterrent to all. One of the discussants who is a lecturer in Ebonyi state university opined that the government right from the Federal, State and LGA should be genuinely interested in promulgating decrees and enforcing legislation on offenders. Jokingly, a young discussant retorted that the government would have reacted if those cultural practices were targeted on men or where it directly affects them

110

In conclusion, the good news is that the executive members of the various community based organizations solicit the help of the researcher on information concerning the upliftment of their girls/women in all spheres of life. Form the responses collated by the researcher, majority of the focus Group Discussants said that they were prepared now to involve all-community leaders, youths, other women groups in what they called “operation stop HCPs on women” This is because according to them,HCPs has no development agenda that will benefit the common man.

Summary and Findings With regard to Table 1, majority of the respondents agreed to four out of six items on negative cultural practices practiced in their communities, thus confirming the practice of harmful cultural practice like early marriage, FGM, nutritional taboo and widowhood practices in their various communities. Results on research question 2 (Table 2) on why HCPs exist in their various communities were generally unaccepted by respondents. Concerning the consequences of HCPs on women’s health, respondents agreed to two thirds of the questionnaire items and during FGD. The options include among others that following the performance of FGM, and prolonged labour there could be excessive bleeding and vesico vagina/recto-vagina fistulae. On why HCPs resist change even in contemporary times majority of the respondents agreed that these traditions were handed over to them. And so there is need to preserve them for posterity. Few agreed to other responses such as, they want others to experience these HCPs too and that perpetuators/offenders have never been punished. On strategies that can be adopted in eliminating HCPs respondents used for the quantitative and qualitative studies agreed that the practices should be openly condemned, legal action should be taken against perpetuators, the government should declare these HCPs illegal and church leaders should excommunicate their members who are perpetuators among others. There is a significant difference in the mean rating of respondents on the various HCPs practiced in their locations. There is no significant difference in the opinions of single and married parents on why there is existence of HCPs in their various communities. There is no significant difference in the opinions of educated and non-educated respondents on why HCPs resists change in contemporary times as ours.

111

CHAPTER FIVE DISCUSSIONS, RECOMMENDATIONS, CONCLUSION AND SUMMARY This chapter presents discussion of results presented in the proceeding chapter, implications of this work, recommendations and suggestion for further research.

Discussion of Findings Result of the study showed that majority of the respondents used for this study are married and between the ages of 36-40.It is presumed that married women within this age bracket are those mostly affected by some or all of the HCPs studies. And so, they could be regarded as those who are in a better position to discuss extensively issues surrounding HCPs based on their personal experiences which often drain them of their peace, joy and good health. Ahonsi (1997) contends that he who wears the shoe know where it pinches. Their experiences as women and mothers would make these younger women who are already over stressed with numerous family and community responsibilities to earnestly wish their situations and conditions as women to receive spontaneous lifting up for healthier and better livelihood. It is a statement of fact that when the conditions of women are improved, they wouid at least enjoy some element of freedom to take decisions on development issues as it affects them and boldly face such challenges especially those that will bring about a positive wind of change in their family, community and nation. . Empathizing with women, Tijiani (1998) lamented that women pass through various health problems arising from physiological roles of domestic chores in the home, child-bearing and child rearing among others. Some of these health problems could be identified early and handled medically by older women than younger ones who are ignorant of what marriage is all about or reproductive health issues. In marriage the concern is the age at which the girls are bethrothed to a man. Though marriage is a fundamental right and a social union but when it is contracted before the full age of the party concerned, devoid of economic, social, educational and political potentials to assume full responsibilities of maintaining a family, it is the violation of human rights. These women may have been married early and as such their schooling and other aspects of their lives have been negatively affected. Early marriage invariably means early childbearing, early grand parenthood and perhaps improved finances.

112

No wonder they give out their girls early in marriage so that the bride price could be used for the upkeep of other male siblings. This is in line with Ladman (2000) who also noted that parents who are instrumental to early marriage of their girl-child do so simply to alleviate their economic hardship but in most cases this has contributed early dissolution of most marriages. Also, going through the academic profile of the respondents it is so glaring that majority are educationally disadvantaged. In fact, those who are educationally disadvantaged are liabilities to their family, community and nation. They only add bulk to the population but not qualified to participate in meaningful development. However, it is believed that when women are empowered educationally, they will be able to organize themselves better and challenge societal ills such as HCPs and obstacles that has robbed them of their joy, free existence, women self-worth, self-communication and self reliance. Certainly, it is worth mentioning at this juncture that marriage is not and can never be an alternative to education. Also, findings from the Focus Group Discussion revealed that, their low education status contributed to why majority of the respondents can not assert their fundamental human rights. This may be why they are still romancing with HCPs in the name of protecting and preserving and preserving their cultural identity in spite of the adverse effects those practices have on their well-being. Although, this may not be applicable to educated women who already have acquired the basic skills and knowledge with emancipatory potentials to assert their rights and find solutions to them unlike the non-educated who may be gripped by fear, timidity and intimidation. The women’s low literacy level is reflected on their occupation and quality of life. Although education is a fundamental right of all but it has not reached the unreached because to millions of people it remained an empty promise (USAID,2005). If the female had the same educational opportunity as the boys, they would have before now challenged those traditional practices that has served no useful purposes to their communities or its members. This is in lines with the view of Monkman (2005) who affirmed that education is particularly a significant tool for women empowerment and an inevitable ingredient for challenging any oppressive social structures and relations. No nation can develop without a segment of its populace, women inclusive. The National Policy on Education even reminds us that education in Nigeria will continue to serve as an instrument of

113 excellence for effective national development (FRN, 2004). Majority of respondents opined that they could not discuss openly issues affecting them, even their own sexuality. This may be the reason why most health problems particularly those affecting women which are preventable usually fail medical intervention because of unusual delays with letting the cat out of the bag. Such delays may not be associated with educated women who abinitio are aware of their rights to have and enjoy good health and seek for prompt medical attention. Davis (2000) supporting the above view, remarked that with good education women will earn a higher income to take care of themselves and their family. Education promotes change in behavior, attitude and values; gives one a greater sense on how to reduce risks in life, live a better and healthy life. The findings of this study showed that one third of the respondents are farmers since they are in rural communities. Certainly, they may be subsistent farmers and may not have the knowledge or skills or financial resources to enhance their agricultural productivity. They may not also have the opportunity to access finance houses for loans because of lack of collateral to do so. When these women have access to quality education, they may do better in agriculture, with enhanced productivity. This in line with the view of Schultz (2001:20) who noted that education of women enable them to enjoy social and economic benefits which gives them a leverage to effectively participating in community development activities because of improved finances and less vulnerable to some of the HCPs. The study also revealed that the respondents agreed to all the negative cultural practices except two, which are not practiced in their communities. Those practiced include, female genital circumcision, early marriage, nutritional taboos and widowhood practices. These results were confirmed during the Focus Group Discussion sessions. Though they opined that majority who are affected by some of the negative cultural are not known. This agrees with the view of Ladman (2000) who noted that those affected are invisible in our communities but could be known through extensive confirmatory data in the near future. It is not surprising that accurate data on victims to HCPs are invisible because of the conservative nature of most women, which can be attributed to shyness, particularly when it is associated with their sexuality. This explains why some do not have courage to discuss their health problems, which invariably becomes impossible to cure because of the delay. For example, Chukwuezi (2000) noted that cases of sexually

114 transmitted diseases if not promptly addressed usually have adverse effect on both men and women/girls. From further discussions with discussants, it was glaring that many of them have experienced one or more of the harmful cultural practices. For example many of them and their children were circumcised while majority got marred early . Circumcision has served a means of livelihood for excissors who would not like to give up the practice since they have been long on the profession. Concerning widowhood practices, the Umuada’s are usually the perpetuators with the men in camera. In the case of widowhood practices, the widow is voiceless as she submits herself to all form of trauma because the husband is late. The Umuada’s develop and hands in a list of commandments to their fellow women (widow) who is bereaved and mourning her late husband. From another angle, the husband’s relations aggressively may demand from her, their late brothers property such as houses, cars, and a times the children. If she has no child or no male child, she might be thrown out of the family’s house. The treatment given to women particularly widows is very unfair and need to be addressed with a human face. This view agrees with Obianyo (2000) who noted that the widow is subjected to a chain of torments, punishment and debasement aimed at proving to her that all is gone. Also, it is a shame that Nigeria widowhood rights constitute a gross abuse to womanhood and to human rights of women. Certainly, if women are empowered educationally and economically they will take up the challenge to advocating for cultural changes in an oppressive environment, which has reduced women to an insignificant level in the society. With regard to nutritional taboos, only women with myopic reasoning and particularly those educationally disadvantaged residing in a typical rural area where the old diehard superstitions beliefs exist will be the originators of such stories. The women in question will bias the minds of other women not to eat snail, grass cutter and eggs especially when pregnant. This may be the situation which some respondents found themselves because they abstained from nutritious food like snail, eggs, etc. It is assumed that a child whose mother consumed egg will steal, if she eats snail, the baby will salivate continually and for eating grass cutter she will experience prolonged labour. Amazingly, the above nutritional taboo has no empirical backings to show how pregnant mothers or their foetus are disadvantaged. If one may ask, who has observed a grass cutter in labour? Also,

115

Focus Group Discussion findings revealed that those nutritious foods like eggs, snail and grass cutter are nourishing to pregnant mother/child for growth, development and immunity for body protection against disease germs. That was why respondents unanimously disagreed to options like pregnant mothers abstaining from nutrition food. Although, most women are not educated but they are aware that prohibiting pregnant women from such nutritious foods is detrimental to the health of the mother and child. This is the reason why Okafor (2005) regarded such stories as fallacy. Gopation and Rao (2002) also maintained that nutritional denials are unnecessary impositions made on women by an inly blind society and so should be disregarded. On why harmful cultural practices exist in their communities, it was also found that respondents opinions were unanimous in most of the items. Those items include, that women are regarded as men’s property, FGM is done to preserve the girl’s virginity, girls are given away in marriage early to combat family’s poverty. The finding of the study is similar to previous views expressed by Ahonsi (1997) about the attitude of male dominated society on women whom they have failed to recognize for their various contributions in the society. This could be simply understood following the biblical junction that women should be submissive to their husbands (1peter 3:1), hence the wrong impression of regarding them as men’s property, using them as a collateral or for a plate of porriage yam, mutilate their clitoris so that they will not enjoy their marriage which may expose them to numerous health problems. Subjugation of women/girls-child is being practiced in almost every community. This may be evidenced by what is happening in the society today, with regard to slave trade which seem not been abolished because of the incidence of child trafficking. If parents give away their girl-child in marriage without her consent or a girl-child being deposited as collateral for loans which were never repaid, or a girl-child forcefully sent out of her home to else where as a house- help, is regarded as slavery because the motives behind these actions are to be combat family poverty. With the numerous examples that abound concerning the girl-child, she is the escape goat usually preferred to the boys. These options agree with Obianyo (2000) who observed that the females and not the males are usually regarded as another family’s property. It was also revealed in this study that respondents agreed to two thirds of the responses on the consequences of HCPs. Some of these options favourable to

116 respondents include, that HCPs causes severe pain, infection, scar tissue formation, vesico Recto Vagina fistulae, easy transmission of HIV/AIDS, cervical cancer, Anaemia and psychological trauma among others. These consequences of HCPS agrees with the view of Petals (1998) that the Psychological trauma resulting from widowhood practices is the most extreme life crisis for a woman. This is in line with Itcher and Nitcher (1999)who saw HCPs (early marriage) as the cause of undesirable reproductive outcome. Also, Raswork (2000) laments that HCPs devastates a woman. The opinions of these authors are true because most of those affected by these harsh cultural practices are known to us in our communities and, we are aware of the health problems they are passing through. Discussants also revealed that many of them are presently passing through such ordeal which is affecting their health seriously. This may be the reason why Murphy and Ringman 2001) considered HCPs as gender discrimination in practice, which violate basic human principles such as the right to good health, life and freedom. It was the unanimous opinion of respondents that preserving the culture of the people, putting women in their place, subjecting women to cultural practices other women suffered, perpetuators are not punished and checking female promiscuity are reasons why HCPs resists change. Some discussants reiterated that most of what they are practicing now which has devastating effects on them were handed over to them by their grand parents but it is possible that they too can hand over the modified aspect of these traditions/culture to the present and future generations to come. For example FGM has been disproved as unhealthy preparation for the pains at birth, as was claimed by some respondents. This may be the reason why some countries like Senegal; California outlawed the practice (World Bank, 1999). During the Focus Group Discussions some young Christian mothers disclosed that they did not circumcise their daughters but it is not so with older women who continue to be socialized into believing that lives and values are costly attached to die-hard traditions such as FGM, widowhood practices and others. Other reasons given by some discussants also include that it is a source of livelihood to exicissors and middle men (in the case of marriage). Some elderly women expressed fear of the gods reacting if they stopped those traditions handed over to them long ago. She maintained that a culture is said to be harmful when it has no direct benefit to the people and so those aspects that are harmful need to be eliminated

117 while still preserving the good ones. Generally their responses were not surprising because many of them may have been badly affected directly or indirectly by few or all of the HCPs. Like democracy, many of them were initiated into the cultural practices that seem not to serve any useful purpose to themselves and perhaps to others and would want it uprooted from their communities. They believed that they can find other sources of livelihood apart from being an excissor or exchanging their toddlers for money or food in the name of early marriage. And so, it is a general belief that in the present era of promoting holistic human potentials for sustainable community development there is an urgent need to modify some of the traditions, which are not useful to man. By so doing individuals will begin to adapt to behaviours that will bring about total human transformation for meaningful developments. It was also found that respondents and the Focus Group Discussants unanimously agreed to the options on interventions strategies for eliminating HCPs. These options include-the open condemnation of negative cultural practices, legal punishment of perpetuators. Their expressions revealed that respondents and Focus Group Discussants are now aware of the undesirable outcomes of these cultural practices and are unanimously saying that enough is enough to the inhuman practices meted on women in the name of cultural adherence for posterity. Hence, the women are in support of measures that will be adopted to bring an end to these dragons (HCPs) in their various communities. More importantly if laws and policies have been promulgated prohibiting deadly activities associated with HCPs, certainly nobody would want to become a culprit. they believed that open condemnation of a culprit to any of the harmfull cultural practices will serve as a deterant to others. This is in line with the Defence Theory chritigued by criminologists which states that, it is not formal punishment that deter offenders rather informal measures like exposures through sanctions, gossips, satire songs, emphasis on shaming practices restricts people from abnormal behaviour. Most of the Focus Group Discussants expressed their bitterness against their parents who (although some are late now) refused to educate them and this lost of educational opportunity has hindered most of them from realizing their potentials. These individual’s opinion agrees with Akubue (2002) who noted that the best approach to dealing with HCPs against women is through the participation of all actors of civil society coupled with formation of

118 women activists network, which will facilitate solidarity among victims. Moreover, the government involvement was also seen by the discussants as an inevitable strategy in the implementation of the platform for action and protection of the rights of its citizen, women/girls inclusive. It was also gathered from the study that there is a significant difference in the opinions of respondent based on their location. It is not surprising because as individuals from different locations or even from the same location, we must not loose sight of the law of individual differences. Based on their perception, interest, conception, values, attitudes and behavior towards HCPs there may be obvious difference/s in their opinions. These differences have profound effect on people’s personal opinion, perception about HCPs which stem from their experience as victim or that of a close friend or relation. This is in line with Oladele (1998) who stated that no two individual even from the same parent behave alike. Continuing, he noted that twins,-not even identical twins (monozygotic twins) who may be expected to have identical hereditary may differ in their perception, reasoning, interest, attitude and behavior. One may deduce that the discriminatory practices against women is therefore a pointer to poor perception. The differences in their opinion based on their location could be attributed also to the fact that culture has been realized as part of human environment, the rights of the human beings value system, their traditions and beliefs but it could vary from one location and society to another. At this juncture, it is logical to state that no two society/location can have identical experience and history, their way of life, cultural values/beliefs can never be the same. Also culture according to Ggbotunkuma (2002:9) has dual tendency, hence it is not static. In essence this characteristic of culture may also be exhibited and reflected in practice in the different locations. And so, in the attempts of people in the different locations to meet the day-to-day challenges in their environment (location) they may modify their cultural plans, improve and adapt their behaviour to the demands within their individual melieu, because these values are amendable to change. Also, respondents and the Focus Group Discussants identified four out of the six HCPs which are practiced in their communities. These cultural practices may be practiced in different ways in these locations and therefore their impact or their severity on the victims may vary. However, whether HCPs are practiced in various ways or not, the truth still remains that they are harmful and so the except

119 outcome is usually serious on the affected. For example, in three communities used for the study a group of women testified to the fact that some of their members, who could not bear the pain associated with widowhood, abandoned their homes for sex work in urban centers. It was also revealed from the study that there is no significant differences in the opinion of single and married parents on the existence of HCPs. In their responses they unanimously agreed that HCPs exist. This may be as a result of their involvement in the practices either as perpetrators or that their children or their relations have been victims to one or more of these HCPs. And so, their experiences confirm the existence of HCPs in their communities. Most of the Focus Group Discussants revealed the cold war going on among some women groups in their communities concerning stiff-necked perpetuators of HCPs. The respondents opined that they wished that the cold war will escalate so that every issue concerning their dislike for cultural practices, adversely affecting their lives and well being will come to an end. Finally, with regard to the last hypothesis, the study showed that there is no significant difference in the opinions of educated and non-educated respondents on why HCPs resist change. It was observed that their responses were not dependent on their level of education. Certainly, women in both groups and/or their children may have had trammatic experience following any of those identified harmful cultural practices. Some of them may also be exissors and would not like to give up their source of livelihood. Also, women represent the Umuada’s who perpetuate widowhood practices in different communities and because of the material or financial benefits they would not like to abstain from such practices. In fact, few of the Discussants said that they have not recovered from the harsh treatment they received when they lost their husbands and so wished no woman would pass through the ordeal they went through. Concerning early marriage, some of the Focus Group Discussant said that they got married early for reasons best known to them but were not constrained by their husband/marriage not to benefit from education which was sponsored by their husbands right from the primary through their secondary school education. Few of the discussant exclaimed that during their own time, it was a taboo to mention or express the desire to go to school. Still embittered by this denial, one of them confided in the researcher that when she expressed her desire for schooling, the father told her that she needed yam tubers for the next planting season and that was how the man who provided the yam tubers became her master and later her husband. In other word she became a collateral for yam tubers.

120

This is in line with Al-Barwani’s (2001) view that atimes the girl-child is used as a collateral or exchange for food to save families from poverty and hunger. Such dehumanizing treatment of the girl-child may have spurred up reactions from individuals, groups, governmental and non-governmental organizations, at National and international levels towards making serious efforts to eliminate all forms of discrimination and harmful cultural practices against women/girl-child. Generally, one may ask why are these practices resisting change even in contemporary times as ours? It may be because these inhuman practices have been so deeply ingrained for so long in virtually every culture including that of the studied communities in Ebonyi State and the effort to dismantle the societal structures that tolerate them or patently refuse even to see them die, will require well articulated intervention strategies, patience and actions on many fronts; because an old Spanish adage which says that the longest journey begins with a single steps, applies here. Implication of the Study for Adult Education and Community Development Based on the findings of this work, the disabilities arising from HCPs coupled with ignorance and low literacy level will invariably have serious impact on a segment of the population who are essential ingredient to the family, community and national. For example in the family, community and nation women have contributed immensely without being acknowledged but they can do better if they have access to education and if their health is taken care of by providing necessary information that will be beneficial to them. Such information can be provided through adult and Non-Formal education programme activities. Which can be used to mobilize and sensitize women on their right to improve access to education. The information from this study on why HCPs exist, resist change and the consequencies can be dessiminated through adult education programmes to sensitize women on their right to better health care services and labour absorbing economic growth opportunities required for national development. Since adult education is a special field of study, it accommodates all categories of learner; it has a wide range of learning activities and flexible attributes which allows for part-time educational commitments. The literacy level in the rural communities studied as was revealed from the findings is not encouraging. (See Appendix A) therefore, local and state government authority and state agencies for mass literacy adult and non-formal education should ensure that adult education programmes are taken to the door steps of the rural dwellers. This is intended to reduce and possibly eradicate illiteracy through the conscious efforts of adult educators serving in rural communities in Ebonyi State. Adult

121 education agencies could liase with other change agents, government and non- governmental agencies in designing and providing materials for educational programmes that can be used to motivate clientels. Adult education being a multi-dimensional field of study can from time to time be used as a bridge to access the un-reached and marginalized functional illiterates in our rural communities who earnestly desire to acquire knowledge for personal improvement and societal development. Such ones can be reached through organized adult education programmes, workshops, seminars and symposium for awareness creation on pertinent issues affecting the well-being of individual or their community. Knowledge acquired through this forums will help to reduce illiteracy, poverty and all form of cultural practices that have led to subjugation of women. The non-educated adults through this forum will be opportuned to learn to read, write and ask questions for clarity and better understanding of issues affecting their conditions in the community and the way to solve them. And so, the findings of this study has implication to the family. The information on the consequencies of HCPs can be utilized through .Adult and Non-Formal education programme activities which can be described as the best motar for moulding the pillars of the society of which women are inclusive. It has been realiesd that Adult education serve as a panacea to ignorance, low literacy and by so doing enlighten family members. The findings of this study also has implications to Non-governmental organization and faith-based organizations who are interested in eradicating or even curbing harmful cultural practices. Information on what these HCPs are, why they exist and resist change will surely guide them on how to proffer solution s that can bring about attitudinal change. The intervation strategies adopted in this work have implication for the ministry of education in particular and Federal Government of Nigeria in general. Based on this finding, these stakeholders will now use them as a road map towards what to do to mitigate HCPs not only in Ebonyi State but in even other endemic places in Nigeria. It will undoubtedly, help in planning administration and implementation of health-for-all programme.

Conclusion One of the major indices of development in any society is good health for its citizenry. To achieve this, every government make frantic efforts towards such goal attainment. Such efforts become share waste. If the root cause of the health problem is still inherent in the people. As such any positive effort towards solution to such problem should first of all appraise in totality the situation on the ground in order to be equipped with adequate information that can lead to its solution.

122

This study, in the same vein, found out information that if purposefully utilized can lead to a lasting solution to HCPs in Ebonyi State. The study has contributed to knowledge and information on HCPs in the following ways: 1) The study was able to ascertain the harmful cultural practices (HCPs) in Ebonyi State. 2) The study found out why HCPs exist in the study areas. These reasons for HCPs existence need to be addressed before and any meaningful solution can be proffered. 3) The study ascertained the consequences of these HCPs on women’s health. 4) Furthermore, the study found out why HCPs resist change in Ebonyi State. 5) The study also identified intervention strategies for eliminating HCPs affecting the health of the women in communities studied.

Recommendations Parents should pay attention to the education of their children irrespective of the sex. It is believed that the dividends accruing from education of our children will help us to face the present and the future challenges. There is need to empower women educationally through comprehensive and intensive formal, informal and non-formal education awareness raising programme. This is because education of women will pave way to more access to their social, economic and political empowerment. Enthusiasm for literacy education should be generated by the Agency for Adult and non-formal education in Ebonyi State so that viable literacy centres are established in all rural communities. This will enable women to integrate into the whole spectrum of development programme. There is need to employ qualified adult educators in our rural community literacy centres so as to meet the demand of both the non-educated and functionally illiterate adults to improve themselves educationally; which gurantees a leverage to better livelihood. The Ministry of Women Affairs Ebonyi State should intensify their efforts on the re-orientation of women about their rights, their prospects as women and to refrain from cultural beliefs/practices which are harmful to the health of women or the girl-child so that they can live a free, full and productive lives. The poverty cycle tends to promote these HCPS and so through Non-formal education useable skills

123 for attracting improved finances can be acquired; then voice will be given to the voiceless poor. Also, women should be sensitized on the health implications of some cultural beliefs/practices which constitute a serious violation and infringement on the privacy of women and their right to human dignity. There is need for government, non-governmental organizations, church and other stakeholders to demonstrate their commitment to the elimination of HCPs by enforcing laws prohibiting such practices. Women should be encouraged to vie for leadership positions so that they can be part of the decision making process especially on the protection of rights of women and the extinction of marginalization and discriminatory behaviors against women Finally, the researcher also recommends that laws and policies prohibiting HCPs should include the public exposition of offenders so that such publicity will serve as a deterrent to both visible and invisible perpetuators.

Suggestions for further Research (1) A comparative study on the impact of the Interventions to Harmful Cultural Practices on women in communities in Ebonyi State. (2) Assessing the pre-independence impact of HCPs on women in Igbo Land

124

References

Abraham, S. and Steinmetze, K. (1992). Ethnicity, General and Marital Violence: South Asian Wonen’s Organisations in the US, in gender and society (9): 4

Abrahim, B. I. (2001). Women’s lives and health: Cairo Women’s health book collection. Involving women in Development of Reproductive Health care. New York population Council Quarterly (4): 117-123.

Acsadi, G. (1993). “Socio-economic, cultural and legal factors affecting Girl’s and Women’s Health” World Bank Women’s health and Nutrition work programme working paper series World Bank. Washington D.C. National Academic Press 69-92

Adebajo, C. (1990). A Community Mobilization: Steps towards eradicating female circumcision and other harmful traditional practices in Nigeria. Paper presented at the 118th Annual Meeting of the American Public Health Ass. New York.

Adekunle, A. O. and Ladipe (1992). Reproductive Tract Infections in Nigeria: Challenges, for a fragile Health Infrastructure” pp. 297-3. In Reproductive Tract Infections: Global impact and priorities for women Reproductive Health Adrienne. Germain King K. Holmes, Peter Piot Judith N. Wassssheit (eds) New York and London Planning Press.

Adewunji R. (1997). Traditional Medicine and Women in the Impact Imo State Family Support Newsletter, pp. 31-32.

Adewunmi O. A. (1986). Maternal Mortality in Ibadan city. West Africa Medical Journals p. 121-126.

Advocacy Institute (1998). Blowing away the smoke A series of Advanced media Advocacy. Advances for tobacco control advocates. revised series September 1998, Washington D. C.

Aguene, I. N. (1999). The Impact of Gender Discrimination on the participation of women in rural development. Readings in Sociological Studies. P.

Ahonsi, B. and Awasanya, E. (1997). Society Culture and the status of widows in contemporary Nigeria: A Gender Analysis.

Akinola, A. (2001). World Against FGM: Female Circumcision is alive and well but a Global action may kill off this Traditional Practice Newswatch 2001 p. 16.

125

Akpala, S. A. (1998). Women’s rights are Human Rights. Enugu: SNAAP Press Ltd. Akpan, V.C.J (1998), Administration and Supervision in Vocational Education. Uyo: Dorand Publishers Ltd.

Akubue, F. N. (2002). “Women in Society” Status, and contribution to National Development. Journal Liberal studies vol. 9 nos. 1 & 2.

Akumadu, T. (2001). Repudiating Repugant Customs. The call to Ban FGM in Nigeria. Women center for peace and development WOPED pg. 4.

Al-Barwani, N. (2001). How Marriage Customs Affect women’s progress in Zanzibar: In culture and Tradition African women our Burdens and Struggles pp. 39

Amadiume I. (1997:35). Male daughters and Female husbands: Gender and sex in African society. London: Zed Press.

Anyisi, E. O. (1979:7). An Introduction to the study of African Culture (Ports mouth: Heinemann and London James Currey).

Awogbade and Mu’azu (2000). “The girl and Boy child in Kaduna States Nigeria” in The Nigerian Girl-child Today IAC-Nigeria.

Azikiwe, U. (1992). Women Education and Empowerment. Fulladi Publ. Nsukka.

Azikiwe, U. (1994). Widowhood practices in Nigeria. A case study of Afikpo community. International Journal of Women Studies Vol. 1 (1).

Azuatalam, C. (2001). Girls Cultural Burden: world against FGM, Newswatch May 14 p. 18.

Beijing and platform of Action fourth World Conference on women, Beijing China 4-15 September 1995, New York United Nation.

Benezeval, M. Judge, K. and Whitehead, M. (1995). Tackling inequality in health: an agenda for action. London: Kings fund.

Berhane, R. (1998). Female Genital Mutilations: In Voices from Africa. Issues (4): 11-121 Geneva 10 Switzerland.

Bledsoe, C. and Cohen, B. (1999). Social dynamics of adolescent fertility in sub- Saharan Africa Washington, D. C.: National Academy Press.

126

Blondel, B. and Marshal, B. (1998). Poor Ante-natal care in 20 French districts. Risk factor and pregnancy outcomes Journal of epidemol.

Boema, A. (2000). Micro Nutrient Deficiencies. The first link in chain of Nutritional and Health Events in Economic crisis HKI, Jarkata.

Bogunjoko, N. (2001). ‘Eating down during pregnancy Nutrition, obstertrics and culture considerations the third world Discussion paper presented for the UN advisory group on nutrition Washington, D. C.

Burikhardt, E. G. (2002). Changing Behaviours to Optimize Women’s Health: a Multidimensional Seminar. J. Am Diet Association. 98: 818-820.

Carr, D. (1997). Female Genital Cutting: Findings from the Demographic and Health surveys program. Calverton MD: macro international.

Cars, K. and Prather C. (1995). Improving the Quality of Life of Girls. New York UNICEF and AWD.

Carrol, R. Guntger, O. and Johnson, U. (2000:277) Childhood and its consequences for cognitive and behavioural developments: Investing in future, Atlanta, G. A., 8-9 April.

Chukwuezi, A. B. (2000). Specific and Peculiar Health problems of women in Nigeria and Available remedies in New Impact, Imo State Newsletter, 13- 14.

Chukwukere, G. (1998). The Importance of Gender Issues in Nation Building: The Impact, Imo State FSP Newsletter , 53-55.

Clark, N. M. and MCLERON< K. R. (1998). Reviewing the evidence of or health promotion in Davids K. K. (ed): Quality evidence and Effectiveness in health. London, 21-46. West View Press.

Cleveland, M. (2000). “Archetypal fears a female circumcision” In violence watch 2,: 8.

Cook, R. J. (2003). Reproductive Health and Human Rights: Integrating Medicine Ethics and Law Oxford: Clarenda press.

Craft, N. (1998). “Women’s Health is a global issue B. M. J. West African Edition. Journal of Health Services 20, 29-300.

127

Davies, P. H. (2000). Marriage makes you more responsible. Trop News magazine July 10, 12.

Darkenoo E. (1998). FGM: A threat to womanhood Newswatch 123.

Dixton-Mveller, R. (1998). Abortion Policy and Women’s Health in Developing Countries. International Journal of health Services. 20, 297-314.

Doyals, L. (1998). What makes women sick: Gender and the political Economy of Health. Hound mills Macmillan.

Duetz, M. (2003). Health measures: Differentiating associations with gender and socio-economic status. European Journal of public health 13, (4) 313-379.

Ebrahim, F. (2000). “Women’s Lives and Health. The Cairo Women’s Health book collective in By and for women: Involving women in the development of reproductive health care materials Quality/Calidad Quality 4. New York: Population council.

ECA, UNICEF “Atlas of the African Child” A cross-sectional Review. African center for women. Occasional paper.

Ekejiuba F. (1991). “Women in the context of Nigerian rural development in Ijere, M. O (ed) . Women in Nigerian Economy, Enugu: ACENA Publishers.

Ekejiuba F. (1996). “Violence Against Women” Saturday Champion, March, 9.

Eggleston, E. and Tsue, A. O. (2001). “UN-intended pregnancy and low birth weight in Ecuador American Journal Publication. Health 9, (5) 808-810.

Eya, R. (2000). Women Empowerment as Tool for Poverty Alleviation: In Readings in Sociological Studies Rainbow Pub. Ltd. 11, 66-82.

Eze, C. (2000). Woman-Husband phenomenon-A sociological perspective. A paper presented at a Workshop organized by Belle Afrique, July 13, 2000.

Ezeliora, B. (1999). The Evil Women Do to Womanhood: The Torch 17, 48

Ezulike, I. (2000) Traditional and Cultural Practices harmful to the girl-child.The Guardian,6th June.

Ezumah N. (2002). Women and Empowerment strategies to overcome harmful traditional practices affecting the health of women in Nigeria, Readings in Sociological Studies, 2, 53-65.

128

Fagbolu I. (2001). Women and National Development: Productivity and Challenges of Women Academic in the 21st Century. NAWCS, UNN 11th – 14th November.1(1) 18-21.

Fashel, S. and Bush, F. (1997). Long term Medical consequences of rape and Molestation. South Medical Journal 84:328 – 331

Fisher.K.H, Wilson,E.D.and Fugua,M.E.(1975) Principles of Nutrition(1st ed) New York, John Willey and sons Inc.

Freedman L. P. (2001) Human Rights in Maternal Mortality Programme: from Analysis to Strategy, International Journal of Gynecology & Obstetrics 75, 52-60.

Fredrick, J. (1996). Giving up Harmful Practices not culture; Preference for son run deep World Bank discussion 255. Washington, D. C. World Bank.

Gachiri, E. W. (2000). Female Circumcision Pauline Publication Africa, 30

Gbotokuma, Z. (2002). Cultural identify and under-development in Sub-Saharan Africa. Voices from Africa. Issues 4 culture and development.

Gelles, R. T; and Strauss, M. A. (1979). Determinants of Violence in the Family. Towards a Theoretical Integration in Burr, W. et al (eds.). A Handbook of Social Sciences Research, London Sage.

Gender Action (1997). Violence Against Women: on Issue of human Rights. 4, Summar.

Gilbert and Walker L. (2002) Reading the Path of Least resistance: HIV/AIDS and Social Inequalities – A South African case study, Social Science & Medicine 54 (7), 1093-1110.

Goode, W. (1971). Force and Violence in the Family; in Journal of Marriage and the Family. Vol. 33.

Gopatan, C. and Rao, K. S. (2002). “Nutrition and Pregnancy Tropical Doctor, 2, 188-92.

Hamm, S. (2001). Explores how NGO have used the news ICT to prevent violence against women development. 44 (3) September.

Hanssey, D. and Onyeulor, B. (1997). Working Against Violence Against Women. Recommendations from rape crisis (cape town) in South Bazill: (ed) Put Women on the Agenda: even press. Johnesburg 182.

129

Harrison, K. (1996). “Growth during pregnancy in Nigerian Teenage prime gravidae” British Journal of Obstetrics and Gynoecology 5 (Supplement): 32-39.

Hayward, R. (2000). Breaking the Eathern ware jar; lessons from South Asia to end violence Against women and girls.

Havonon, N. (1993). “Sexual Networking in Provincial Thailand” Studies in family planning 24 (1): 1-17.

Heise, L. (1998). “Violence Against Women: The hidden health burden” World Bank discussion paper World Bank population, Health and Nutrition department, Washington D. C.

Hernlund, J. (2001) Women marriage in Africa: A critical study for Gender and Rights. Newzeal and Journal of Sociology 17 (4) 32-40.

Hersh, L. (1994). “Violence Against Women: The Missing Agenda” Marge Koblinsky eds; The health of women: A global perspective West view press 171-195.

Hersh, L. (1994). “Violence Against Women: The Missing Agenda” (World Bank Discussion paper. #2557 Washington D. C.: World Bank.

Holland M. F. (1994). “Gender differences in child health: Evidence from demographic and health surveys” World Bank, Population, health and nutrition dept. Washington, D. C.

Hosken, F. (1997). The Epidemiology of Female Genital Mutilation. Tropical Doctor, 19-31.

Human Security network (2003). Focus: Human understanding Human Rights: Manual on Human Rights Education. Graz, Austria European. Training and Research Centre for Human Rights and Democracy (ETC) and the Federal Ministry of Foreign Affairs of Austria.

IAC (1999). Inter-African Committee on Traditional Practices Affecting the health of Women and children Addis Ababa.

IRRAG (1995:113) Voices: Findings of a Research into Reproductive Rights of Women In Nigeria Benin city, Nigeria. 1-163. Grace Osakwe, Bene Madunagu, Hajara Usman.

130

Ikejiani-Clark, M. (2001) Women and Governance in Nigeria: Productivity and Challenges of women academics in the 21st century: NAWCS, U.N.N. 11th- 14th November. 1, 13-17.

Iman, A. (1998:34). Ideology the Mass and Women: A study from Radio Kaduna Nigeria. In C. Coiles and Mack, P. ed. Hausa women in twentieth century (Madison: The University of Wisconsin press.

Jacobson (2000). Special Focus: Human Rights Gender and Reproductive Health. 47.

Jeffery, R. (1999). Labour pains and labour, power’ women and childbearing in India, Zed Books London and New Jersey and Manohar, New Delth.

Jewkes, R. and Cornell, A. (1998). Steeping stones, south African adaptation from the original by Alice wellborn Pretoria: Medical Research Council.

Jewkes, R. (2001). Reflections on gender violence in the south African Public Health Agenda Department. 44, 3 September.

Jibril, M . (2006)

Kader, R. (2001). Marriage law and practice in the sahel. Studies in family planning. 22, (6)12-15.

Kanu, J. M. (1995). Continuity and change in the Traditional Marriage System of Arochukwu Mscthesis Sociology/Anthropology UNN.

Kamara, A. (1991) “Causes and Prevention of Adult Mortality in Developing Countries Experiences in Prevention of Maternal Mortality in West Africa.

Khafagi, F. (2001). Breaking Cultural and Social Taboos. The fight against FGM in Egypt. Department. 44, (3) September.

Kim, J. Y. (2000). Dying for growth: Global inequality and the health of the poor. Maine: courage press.

Kindigau, C. F. (1999). Theory of Marriage. London Longman Publisher

Kiragu, K. (1995). Female Genital Mutilation a Represent health concern in population report supplement series 41,( xxiii), 3 October, 1995.

131

Kisija, E. R. (2001). The Impact of Tradition on rural women in Tanzania. African- Women: Our Burdens and Struggles. Institute for Africa Alternatives 26-28.

Klasen and Wink (2002). Health consequences of Gender: Women’s human rights net (WIYR net). www.whnet.org.

Kogan, M. D. Alexander, G. R. and Jack M. (1998). The changing pattern of prenatal care utilization in the United States 1981-1995, using different prenatal care indices. JAMA 279 (20): 1623-8.

Koso-Thomas, O. (1998). The Circumcision of Women. A strategy for its eradication and New Jersey. Zed Books, Lond

Kun, V. (1997). The power of the small group. From crisis to disclosure. Ag, (39), 34-30.

Ladman, S. (2000). “Divorce, custody of the children” Sunday stakesman, March 27.

Lane, S. D. Cibulg, D. A. and Milano, L. P. (2001). “Racial and Ethnic Disparities in Infant Mortality. Risk in Social Context: Pub. Health Management Practice 7 (3): 30-46.

Leiskin L. S. (1992). Maternal Morbidity in developing countries: a review and comment. International journal of Gynecology and obstertrics 37,77-87.

Leshabari, S. (2001). The concept of “Motherhood” as an instrument of women’s oppression: In African and Women: Our Burdens and Struggles, 34-38

Lestharge, R. (1998). Reproduction and Social Organisaiton in Sub-Saharan Africa (Berkeley: University of California Press.

Lestharge, R. (1998). Age Marriage, Polygamy and Post partum Abstinence: A macro-level Analysis of Sub-Saharan Societies” Paper Presented on the status of women and fertility. Belligio Italy.

Lewis, C. J. Matthews, T. O. Heuse R. L. (1996). “Prenatal care in the United States 1980-94 National center for Health statistics. 21 (54).

Looker, A. C. (2000). Prevalence of iron deficiency anaemia in the United States SAMA 227, 973-976.

Lopez, A. (1993). Causes of Death in Industrial and Developing Countries: Estimates for 1985-90 in Deam T. Jamison, Control priorities in Developing countries New York. Oxford University Press.

Luxon, M. (1993). Dreams and Dilemas: Femnists musing on “The man question: In Ihadid (ed) Toronto: Canadian Scholar press.

132

Machera, M. (2004). The behaviour of Early marriage. Nigerian Voice. 5.

Machienbach, J. and Kunst A. (1997). The EU Working group on socio-economic inequalities in Morbidity and Mortality in Western Europe Lancet 349 (9066), 1655-9.

Madu, C. (2001). Women’s Health Status: Implications for socio-economic development Towards Gender Equality in Nigeria in the 21st Century.

Mark-Ordu, E. (1994). Widow Behind Bars: True Stores of Widowhood Travails in Africa. Lagos Princes Communications Ltd.

Markinwa, P. (1995). Women Control over resources and demand for children P. Makinwa and A Jensen eds. Women’s position and Demographic Change in Sub-Saharan Africa Cleige: IUSSP.

Marshall, K. (2004). Mind, heart and social: In the fight against poverty: Washington D. C.: World Bank.

Mandara M. U. (1995). “Prevalence of male genital mutilation in Zaria: A critical appraisal” Benin City Nigeria, 29-38.

Mbagwu, F. O. (2005). Education: An asset for Gender Equality and Participation of Women in Development of Nigeria. Journal of Adult Educaiton and Development Vol. 3 (1), 66 – 79.

Mccormick, M. C. (2001). Prenatal care: necessary but not sufficient. Health service 36, 399-403.

Mgboh, A. (2000). “Obnoxious Marriage practices in Igboland Particularly the case of female husbands”. A key-note address presented at a conference organized by Belle Afrique Association Enugu, July 13th 2000.

Minder, C. E. (1993). Socio-economic factors and Mortality in Switzerland 502 praventioned 38 (5), 313-28.

M’uazu, E. (2000). The aetiology of Vesico-vagina fistulae: Women and the Family in Nigeria. Newswatch. 27-30.

Mukhupadhyay, M. (1984). Silver Shackles: Women and Development in India, Oxford, Oxfan 11-12.

Murdock, G. P. (2000). Descriptions of family Patterns in African Societies,

Murphy, T. & Ringham M. (2001) Women and Tropical Diseases: Introduction “ Social Science Medicine 37(4), 58.

Myles, M. (2000). Quality of Medical care and Choice of Mdeical treatment in Kenya: An empirical analysis” Technical working paper, 4.

133

Nag, S. (2000). Violence Against Women: Initiation in the 1990’s Development, 44 (3) September.

Nahid, T. and Thomas K. (1998). “Female Genital Mutilation”: A call for Action women Ink, New York.

Nasara, A. (2001). New Marriage Customs affect women’s Progress in Zambia, African Women: Our Burdens and Struggle. 17

National Association of Nigerian Nurses and Mid-wives Project 1995. 22,(3)

National Centre for health statistics (1998)

National Baselin Survey 1998

National Population Council (2000). Nigeria Demographic and Health Survey, 1999 Draft. Abuja: IRD/macro International Inc. columbia, USA.

Ngowi, O. N. (2001). Water women’s Health and Development African Women: Our Burdens and Struggles.

Nitcher P. and Nitcher, E. (1999). Linking Community Based Nutrition Programmes with service delivery. Asian Development Review.

Norton, B. and Moorman, E. (1997). Prenatal pregnancy” In Marriages and Families. 734, L214- 243.

Nutbeam, I. (1998:30). Evaluating Health promotion progress, Problems and solutions. Health promotion International, 13, 27-44.

Ntozi, JPM (1997). Widowhood Re-Marriage and Migration during the HIV/AIDS Epidemic in Uganda” JPM et al (Eds) Health Transition Review: Vulnerability to HIV infection and Effects of AIDs in Africa and Asia/India.

Nwanunobi, C. O. (1997). African Social Institution. Nsukka: University of Nigeria Press.

Nworgu, B. G. (1992). Educational Measurement and Evaluation: Theory and Practice Nsukka: Hallman Publishers on culture and tradition campaign against AIDS: International Conference Centre Abuja 10th – 12th December.

Nyamele, A. and Nwabu, G. (1991). Quality of Medical Care and Choice of Medical Treatment in kenya: An Empirical Analysis, Tech. Working Paper . 4. World Bannk, Washington, D.C.

Nze, B. (1999). Addressing the Plight of Women. The Guardian, March 10, 14.

134

Obetta, K. C. (2002). “Aggression and Violence Against Women” Paper presented to the Department of Adult Education , U. N.N. March.17.

Obeneyer, A. (2001). War Against FGM Newswatch . 14.

Obi, C. A. (2000). “Marriage among the Igbo of Nigeria, “http//users”101 .it/osorio/igbo-marriage.htm

Obianyo, N. (2000). Harmful Traditional Practices that affect the well-being of women: In the Impact FSP Newsletter. 61.

Obilade, A. (1998). “What Legal System Governs the Validity of Marriage”. Newswatch July 1998 p.4.

O’Brien, W. (1977). “Female husbands in Southern Bantu Societies” in a Schlegal ed. Sexual Stratification: A cross-cultural new, 109-120 New York Columbia University Press.

O’connell, H. (1994). Women and the Family. London: Zed Books Ltd.

Odumegwu, C. (2004). Widowhood rites and wife inheritance in Anambra and Imo State in Plight and widowhood rites in Nigeria IAC Nigeria . 52.

Ofonagoro, W. (1996). The Nigerian Culture and Tradition past, present and future: A paper presented at the National Workshop on culture and Tradition campaign against AIDS: International Conference Centre, Abuja 10th-12th December.

Ogbalu, F. C. (1995). Igbo Institution and Customs Onitsha. University press. . 35.

Ogunmadede, M. N. (1995). Female Circumcision. British Medical Journal 307.

Ojior, P(2001) War against FGM: Global action to kill off this traditional practice. Newswatch, 16.

Okafor, R. U. (2005). The Health educator’s Action Points on the Nri Igbo food Myths and Taboos: In Nigerian school Health Journal, 17, 1 &2

Okeke, M. C. (2002). Women Education and Empowerment in Igboland in the 21st century: Issues and challenges in Eya, C. O., Sustainable Education System and the Nigeria Civil Rules: A book of reading. 1, `(1) Enugu: Fred-Ogan Publishers.

135

Okogbue, I (1997) The Legal Rights of Widows in Nigeria. Being a paper presented during a workshop on the rights of widows in Nigeria.

Okoro, O. M (1991) Programme evaluation in education . Unowulu-Obosi Pacific Publishers.

Okoye, P. U. (1995). Widowhood: A National or cultural Tragedy. Enugu: Nucik Pub.

Oladele, J. O. (1998) Fundamentals of Psychological Foundations of Education. A hand book for education students and teachers 4th eds. John-lad pub. Ltd

Olujobi, G. (2002). Addressing the Plight of Widows. The Guardian February, 8, 14.

Oluwole, G. (2001). Coping with Teenagers: Everyday woman Punch, April 18, 27.

O’Malley, J. (2002). The Battle Against AIDS in the International Development Magazine – “Development”, Issue 17, 4-7.

Omiyi S. (1990). A critical appraisal of the widows under the Nigerian law in women and children under Nigerian law. Lagos: Federal Ministry of Justice, 73.

Onah, B. N. (1992). The socio-cultural perception and implications of childlessness in Anambra State. In M. N. Kisekka ed. Women’s Health Issues in Nigeria. Zaria Tamoz publications.

Onwejogwu, C. (2000). Widowhood Rites and wife Inheritance in Anambra & Imo State in right and Widowhood Rites in Nigeria, IAC, Nigeria, `

Oprah, W. (2004). Accelerating efforts to achieve UBE: A critical component of global AIDS response.

Oreh.C.I. (2005) Changing out-dated cultural practice against widows in a matrilineal set up using community education CARESON Journal of Research and Development 4(1).

Osarenren, L. (2001). War Against FGM: Global action to Kill off this traditional practice. Newwatch. 16.

Osuala, E. C. (2005). Introduction to Research Methodology: The Millennium edition Cheston Books.

136

Osuala, J.D.C. (1991). Enhancing women’s Economic Potentials through Appropriate Technology”. In M. O. Ijere (ed). Women in the Nigeria Economy Enugu: ACENA Publishers.

Owasanoye, B. (1999). Prospects for the Socio-legal Empowerment of widows in Nigeria . 22 widowhood practices.

Paltiel, F. (1999). Health: A global Perspective”. In Marge Koblinsky, Judith Timyan and Jill Gay, eds. The Health of Women, 197-216.

Palade, S. (1963:236) “Women of Dakar and the Surrounding Urban Area” in Denisp (ed) women of Tropical Africa USA: Univ. of California Press.

Potash, D. (1998). The effects of widowhood Health in ACC Series, 1. 13

Panos Institute (1999). AIDS and Children: A family disease. London: Panos Institute.

Parkin, D. M. (1999). “Estimates of the worldwide Incidence of Eighteen major concerns in 1985. International Journal of Cancer 54:594-606.

Pool, M. (1997). Beliefs and Practices about food during pregnancy and Implication for maternal nutrition Economic and political weekly p. 2427- 2438 SWDT Church gate.

Pratt, B. (2005) The Field Directors Handbook: An Oxfam Manual for Development workers. Oxford: The Oxford University Press.

Quedraogo J. (2001). Traditional and Cultural Practice Harmful to the girl-child occasional paper no.1 African centre for women.

Ras-work, N. (1998). “Female Genital Mutilations: In voices from Africa. Issues. 4 –121 Geneva 10 Switzerland.

Ras-work, B. (2001). “Culture and Development”. Published by UNS NGO Laison, 89. CH-121 Geneva Switzerland

Saba, K. O. (1997). The Psychological effects of widowhood an Women and Children findings from a plot study in Lagos.

Sani, M. (1996). Family Support Programme Culture and Tradition, Campaign Against AIDS and Domestic Violence December 10.

Sandstron, K. (1999). “Abortion: A Reproductive health issue: World Bank Women’s Health and Nutrition work Programme working paper series. Washington, D. C.

Schultz, T. P. (1989). Returns to Women’s Education. PHRWD Background paper 98/001. Washington D. C. World Bank, population and Human Resource Department Washington, DC.

137

Seragaldin I. (2002). Rural well-being: from vision to action proceeding series 15 Washington D.C. World Bank.

Shinaba,, S. (2005). Forum X-rays harassment of women-at work places: Champion newspaper, October 6, 2005, 35.

Shirima and Kisija (2001). Women and Land Ownership: African women: Our Burdens and Struggles: 29.

Shyrock, M. D. (1993). Happiness for Husband and Wife. New York: John Wiley and Sons Press.

Singh, S. and Wulf, D. (1999). “Early Marriage Among Women in Developing Countries. Internet Pam Plann Perspec,t 137-144.

Standing, H. (1999). Frameworks for understanding gender inequalities and health sector Reforms working paper on Gender and health equity.

Stead, M. and Henderson, L. (2002). A. Investigation into the potential of media Advocacy as health promotion strategy. Report for the health development agency Univ. of strath cyble Brussel.

Stone, D. D. (2001). Nutrition as key factor for National Development. The Guardian September 27, 39.

Strong , M. A. and Bonilla, A (1996). “The Health of Adults in the Developing World: The view from Bangladesh” Health Transition Review 2 (2), 215-224.

Tahzib, F. (1995). “Factors in the Actiology of vesico vaginal fistulac” In A. Imam et al. (ed) Women and the family in Nigeria, Codestrin Book series. Senegal. 75-803.

Talbot, D. A. (1968). Women’s Mysteries of an African Tribe. London: Frank Cass and Co. Ltd.

Teachman, B. (1983) in Chick, B. and Norton, I. (1991). Effective care in Pregnancy and Childbirth. New York. Oxford University Press.

The Economist (1996: 45). “Helping Women get to the top: Traditional and cultural practice Harmful to the girl-child. A review.

The Holy Bible (RSV)

The Random House College Dictionary 1987.

Tijani, K. D. (1998). “Perspectives of women’s Reproductive Health and Rights” the Post Express, 28.

Tinker A. (1998). “Women Health and Development” Paper presented at the Bellagio Conference on Women’s Health and Nutrition May 1998, World Bank population; health and Nutrition Department.

138

Toubia, N. (1994). Female Genital Mutilation: A call for global Action. New York: Women, Ink.

Titi, S. (2001). Early Marriages among women in developing countries: Internet Fam Plann Perspect (21), 148-157.

Uba, A. (2005). Group Condemns Virginity test for Girls. Daily Champion, Thursday Oct. 6, 35UNO, (1995). The World Women, Trends and Statistics. New York :U.N. . UNDP (1995:92). Human Department Reports. New York: Oxford University Press.

UNFPA (1998). Investing in Woman. The focus of the 90’s New York.

UNFPA (2000). Lives of the World Together worlds Apart: Men and Women in a time of change: The State of the World Population 2000, New York: UNFPA.

UNS Women 2000 Conference/www.un.org/womenwatch/confer/beijing5).

UN Committee on the elimination off Discrimination against women (2000).

UNDP (1997). Human Development Report. Oxford University Press, New York.

UNICEF (1990) Strategies for improved nutrition of children and women in Developing countries New York. UNICEF.

UNICEF (1998) The Education of girls: Strategy to increase access persistence and achievement. Washington .D.C.USAID’

UN (1990) Patterns of First Marriage: Timing and Prevalence, New York.

United Nations (1991). Patterns of first Marriage Timing and Prevalence. New York.

UNO (1993). Women in Decision-Making: Case-study of Hungary. New York:

UNO,(1995) The World Women, Trends and Statistics. New YORK:U.N.

Uzoegbunam, A. O. (2003) Conflict Management: Implication of women –women marriage among the Igbos of Nigeria. Readings in Sociological Studies , 96-109.

Uzor, R. U. (2005) Who is afraid of large families ? Guardian Newspaper Jan.4,:65.

Villar, J. (2000) and Tinker, A. (2002) Making Motherhood Safe. World Bank Population Health and Nutrition Department. Washington, D. C.

Whitehead, B. (2001). Socio-Economic Position, Gender and health. How do they Interact? Journal Health Psychology. 2(3), 315-34.

139

WHO (1996). Coverage of pre-natal care: a listing of available information. Fourth edition.

WHO (1997). Global Database on child Growth and Malnutrition http://www.who.int/nutgrowthdb. Geneva: WHO.

WHO (1998). Youth and Reproductive health: Facts for Action no. 6 Geneva.

WHO (1999). Management of Severe Malnutrition: A Manual for physicians and other senior health workers. Geneva: Who.

World Bank. (1994). Violence Against Women. The Hidden health Burben. Discussion paper no. 255. Washington D. C.

World Bank. (1997). African Development Indicators. Washington D. C. International Bank for Reconstruction and Development.

World Bank (1998). Implementing the Ethiopian National Policy for women: Institutional and regulatory issues. The women’s affairs office, Federal Democratic Republic of Ethiopia and the World Bank. Washington D. C.

World Bank (1999). Education: The World Bank Education Sector Strategy. Washington. D. C. World Bank p. 29.

World Bank (2000). World Bank Report on Higher Education in Developing Countries. Washington D. C.

WHO (1997). Applied Health Research Priorities in Complex Emergencies. Geneva: WHO

WHO, UNICEF (1992). “Low birth weight. A Tabulation of available Information” WHO/MCH/922 Geneva: WHO Maternal Health and Sage Motherhood programme.

WHO (2000). The World Health Report 2000 Health System: Improvising Performance (Geneva: WHO, 2000), accessed online at www.whoint/wh-2001

Younis, N. H. (1998). “A Community Studies of Gynecological and Related Morbidities in Rural Egypt”. Studies in Family Planning 24 (3).

Zewdie, D. (1993). “Men women and AIDS,” Paper presented at the xiii International Conference on AIDS in Africa, Marrakeh Morocco Dec. 12-60. AID Control and Prevention project, Arlington, V.A.

140

Figure 1: Sequence and functions of harmful widowhood practices in Nigeria STAGE/ SEQUENCE OF MANIFEST FUNCTIONS LATENT FUNCTIONS PRACTICE A PRE-BURIAL 1 Demonstration of excess (or Validation/announcement Engenders the notion suppressed) grief of fact of death; means of of women’s emotional relieving grief malleability 2 Partial/full stripping and/or Respect for the dead; Reduces self-esteem; shaving of hair; general sacrifice for man’s family makes impossible inattention to physical to prevent a heterosexual appearance reoccurrence relations; gender violence 3 Spatial confinement, social Adaptation to social Denial of right to free restrictions and/or exposure vacuum/loss created by movement; to some measure of physical demise of husband; strengthens ideology discomfort plus poor feeding. linking/delinking from of female domesticity; spirit world of the male control of female deceased husband. sexuality. 4. Adoption of mourning dress, Communicate mourning Exposure to infection non-use of ornaments and status and hence evoke and lower quality of imposed lack of attention to appropriate behavioural life. personal hygiene. responses from others; respect for the dead. B. TRIAL BY ORDEAL 5. If accused of having a hand in Social adaptation to Avenue to the total husband’s death (as is often death-related guilt disinheritance of the case) widow. C. POST BURIAL 6. Disinheritance from property, Reaffirms the supremacy Exploitation and at times with children. of the lineage impoverishment of widow. 7. Formal commencement of Religious obligation Continuing restriction mourning period of participation in productive activities 8. Final purification rites Marks re-entry into Further proceeded by heavy feasting normal activities; impoverishment of for husbands relatives/friends destigmatization from widow through the death related pollution. very heavy cost of prescribed feasts. 9. Husband succession (levirate Social security for Satisfaction of man’s or widow inheritance) woman and children; family’s sexual and reaffirmation of the reproductive interest permanence of marriage denial of the right to between two families choose marriage partner; dehumanization of woman.

141

Based on the findings of the study, the following intervention strategies were developed by the researcher in collaboration with the member of the women executives using “THE Triple A” process model adapted from UNICEF (1990) for solving problems. The researcher used three research assistants and twenty-one school teachers from the different locations, who volunteered to participate in the communication Behavioural change programme for actualizing the. “The Triple A” process. The formative intervention results are summarized below. It covered September 2006-November 2007.

Community Behavioural change Results Remarks and Intervention. Implications.

Community Advocacy Approach: Various groups were mobilized headed by two The approach was initially not an  To support upliftment of women representatives from each location. Drama groups easy task because two out of the through enhanced opportunities for were organized for sensitizing other members in six communities were not going to education of women/girls the communities about the dangers of some of compromise their cultural heritage.  Eradicating cultural practices not their culture. This is to promote the protection of But after a long deliberation and useful to individuals or community women in their communities. The drama show revisits by the research team they for their development. guaranteed interest from the study communities. agreed to participate in some of the  Awareness creation on educational Adult literacy programmes were organized in 5 interventions such as encouraging opportunities available through different centers in the communities used for the their girls to go to school and not formal, non-formal and informal study. In all only four centres are viable till date marry early. The turn out is mode for knowledge and survival with clientele strength of 427 women at the end of encouraging and we hope it will skills acquisition to eradicate poverty September 2007. By November 2007 their continue. The implication here is and give voice to the voiceless. number started fluctuating. Reason being that the that through adult and non-formal  Effective community mobilization to women were engaged in crop harvesting. educational activities clienteles do facilitate change in people’s However, the women benefited from teachings on not only acquire basic knowledge orientation and perception about reproductive health information, household food of reading, writing and calculation HCPS. security and resource management. Activities on but also engage in survival skills for  Mobilize community resources for how to make wealth through hairdressing, dress poverty eradication. socio-economic and better health making, soap and cream were part of their promotion of the people. learning discussions. During demonstrations they showed how excited they were.

 Media Advocacy The Protocol involved was cumbersome so it was Certainly, the Each-woman-talk-to not used. But the attitude of each woman talk-to- –another (EWTTA) mode of another about HCPS was adopted. Result so far sensitization was encouraging. The showed some encouragement. churches were used in disseminating information on the need to eradicate every discriminatory attitudes and cultural practices affecting women.

 Infrastructural Support Primary school buildings were used as learning centres between 4-6 PM every Tuesdays and Thursdays.

 Human resources Support Resource persons in the various fields were drawn By the end of September 2007, six from the different locations. It comprised of both women had started their own men women. Eg volunteered Teachers, fashion projects and had their outfit shops and designer, and hair dressers etc. See Appendix where they also employed young G. The formation of cooperative (thrift or isasu) girls and women to work for them. associations by the women was a product of what they were taught on how to make wealth to improve their family finances for survival.

Figure 2: FORMATIVE EVALUATION REPORT

FORMATIVE EVALUATION REPORT This intervention strategy is just at the formative stage, and so has not yielded much dividend. Innovations concerned with behavioural change usually take a gradual process which matures over time. So, it applies to issues concerned with inhuman practices like FGM, early marriage and widowhood rites etc. Certainly, success is in sight judging from respondents and discussants responses to questionnaire items and FGDs.

142

Appendix B

Distribution of the randomly sampled local Governments and Community based Associations from three(3) Senetorial Zones.

1 Senatorial Zones Ebonyi North Ebonyi Central Ebonyi South Total 3 2 L G A’s Abakiliki Ishelu, Ezza North, Onicha, Ohaozara 13 LGA Ohaukwu Ezza South, Ikwo. Afikpo South, Ebonyi, Izzi. Afikpo North, Iro. 3 Purposively Ebonyi, Izzi. Ishelu, Ikwo. Onicha, Iro. 6 LGAs Sampled LGA’s

4 Number of 47 28 17 162 CBAs

Community Based 19 21 30 Association (CBAs) 5 40% Sample of 19 11 7 65 CBAs CBA’s 8 8 12 6 Total Women 1431 836 563 4,905 Members 559 612 904 7 40% of Total 572 334 225 1,962 Women Members 224 245 362

143

Appendix C QUESTIONNAIRE

Department of Adult Education University of Nigeria, Nsukka. February 3, 2006

Dear Respondent,

I am a Postgraduate Student in the department of Adult Education and Extra Mural Studies of the University of Nigeria, Nsukka.

I am carrying out a research on Interventions to Harmful Cultural Practices Affecting the Health of Women: A Study of Women in Community Based Associations in Ebonyi State.

I will be very grateful if you respond to the following questions as they concern you. Any information given herein will be treated with the strictest confidence and used for research purposes only.

Thanks for your co-operation.

Yours faithfully, Mbagwu F.O. (Mrs)

144

APPENDIX C

QUESTIONNAIRE

SECTION A

Biodata of Respondents

Please tick(-/) where applicable

(1) Your L.G.A

Ebonyi ( )

Ishelu ( )

Iro ( )

Izzi ( )

Ikwo ( )

Onitcha ( )

(2) Your Age

16-20 ( )

21-25 ( )

26-30 ( )

31-35 ( )

36-40 ( )

41-above ( )

145

(3) Your Marital Status

Single parent ( )

Married ( )

Widowed ( )

(4) Your Qualification

No schooling ( )

Below FSLC ( )

FSLC ( )

WASC/GCE ( )

NCE ( )

University Degree ( )

(5) Your Occupation

Housewife ( )

Farming ( )

Trader ( )

Civil Servants ( )

146

Section B

Cluster A

Indicate, using a 4 point scale of Strongly Agree (SA), Agree (A), Disagree (D) and Strongly Disagree (SD), those harmful cultural practices that are practiced in your community.

Tick (-/) against each answer according to how you agree or disagree to the following statement.

KEY: SA = Strongly Agree

A = Agree

D = Disagree

SD = Strongly Disagree

6. The following are practiced toward women in your SA A D SD community.

(a) Early marriage (b) Nutritional taboos. C. Female-female marriage (c) Female circumcision. (d) Widowhood practices. (e) Female circumcision (f) Widowhood practices

147

Cluster B.

Indicate using a 4 point scale of strongly Agree (SA) Agree (A) Disagree (D) and

Strongly Disagree (SD) on why those harmful cultural practices meted out on women exist?

7. The following are practiced toward women in your SA A D SD community.

7. Harmful cultural practices meted on women exist in your community because: (a) Women are regarded as men’s property. (b) Women are not considered equal to men. (c) Women are seen as powerless. (d) Women should be seen and not heard. (e) Women are thought not to have any rights. (f) Women are subordinate to men.

8. Female circumcision is practiced in your community so as to: (a) Prevent promiscuity. (b) Preserve the girl’s virginity. (c) Promote cleanliness of the woman. (d) Promote aesthetics. (e) Ensure marriage of the girl-child. (f) Improve male sexual pleasure.

9. Female circumcision of the girl-child in your community is performed by: (a) Very old women. (b) Old men. (c) Traditional birth attendants. (d) Doctors. (e) Midwives in maternity homes. (f) I have never seen it done.

148

10. Early marriage is practiced in your community because it: (a) Prevents unwanted pregnancy. (b) Ensure a girl’s virginity. (c) Ensures fertility in girls. (d) Combats family poverty. (e) Ensures early grand children for parents. (f) Will ensure the use of bride price for training the boys.

11. The following nutritional taboos are practiced in your community: (a) Girls are not allowed to eat beef/pork. (b) Girls are not allowed to eat eggs. (c) Pregnant mothers are not supposed to eat snail. (d) Pregnant mothers are not supposed to drink milk. (e) Pregnant mothers are not supposed to eat eggs. (f) Pregnant mothers are not supposed to eat grass cutters.

12. The nutritional taboos practiced in your community are to: (a) Prevent women from being extravagant. (b) Curb their gluttonous behaviour. (c) Prevent them from experiencing prolonged labour if they eat grass cutters. (d) Prevent the unborn child from stealing if the mother eats egg when pregnant. (e) Maintain the belief that babies will behave like cows if pregnant mothers drink cow milk. (f) Maintain the belief that babies will salivate excessively if pregnant mother eat snail.

149

13. The type of female-female marriage traditions practiced in your community include: (a) Female-female marriage for the mentally retarded. (b) Female-female marriage for an idiot. (c) Female-female marriage for the childless couple. (d) Female-female marriage for an old, childless widow. (e) Female-female marriage for male children. (f) Female-female marriage for male children.

14. Female-female marriage is practiced in your community because of the following reasons: (a) It is practiced because of childlessness. (b) It is for companionship. (c) It is to give joy to childless couples. (d) It is to secure a man’s property when he dies. (e) It is to raise children for the deceased husband. (f) It is to try for a male child who will continue the family lineage.

15. The following teenage-surrogate motherhood practices are practiced in your community. (a) Girls are encouraged to stay at home and bear children for their old parents. (b) Teenage girls care for children born out of unconsummated marriage. (c) Teenage girls take care of their brothers and sisters at the demise of their mother/father. (d) Teenage girls arranged to take car of other children in another home. (e) Teenage girls take care of their handicapped/challenged relations. (f) I am not aware of such practices.

16. The teenage-surrogate motherhood is practiced in your community in order to: (a) Provide companionship to the bereaved father/husband. (b) Fill an existing vacuum of the late mother. (c) Give a male child to the family. (d) Raise children for the family lineage. (e) Give care and hope to the fatherless and motherless children.

150

(f) I am not aware of such practices.

17. The following widowhood practices carried out in your community include: (a) Subjecting widows to sleeping on the bare floor. (b) Widows not eating with good plates. (c) Widows wailing day and night. (d) Widows being dispossessed of their husband’s property. (e) Windows should look untidy. (f) Windows should not visit people during the day.

18. The widowhood practices are considered in your community because: (a) We inherited them from our forefathers. (b) It is to preserve our people’s tradition. (c) It ensures permanent separation of the wife from the deceased. (d) It is an opportunity for kinsmen to punish an obstinate wife of their late brother. (e) It is to ensure that the widow actually mourned her husband. (f) It is an opportunity for sisters-in-law to retaliate to any past grievances in the family.

19. The perpetrator(s) of harmful cultural practices in your community is/are: (a) Sisters-in-law. (b) Kinsmen. (c) Members of Women Association. (d) Brothers-in-law. (e) Youth/Age grade. (f) Traditional rulers.

Cluster C

151

Indicate using a 4 point scale of Strongly Agree (SA) Agree (A), Strongly Disagree

(SD) and Disagree (D), the consequences of harmful cultural practices on women’s health.

20. The consequences of female circumcision on women’s health include one or more of the following: (a)Severe pain. (b) Profuse bleeding. (c) Adhesion to labia majora/vagina. (d) Infection. (e) Scar tissue formation. (f) Vesico Vagina or Recto Vagina fistula during childbirth.

21. The consequence(s) of early marriage/child bearing on women’s health is/are (a) Frequent, closely spaced pregnancies. (b) Late recovery of mother following childbirth. (c) Prolonged labour. (d) Exhaustion of mother, leading to death. (e) Excessive bleeding. (f) Vesico Vagina/Recto Vagina fistula.

22. The consequence of female-female marriage on women’s health includes one or more to the following. (a) Easy transmission of HIV/AIDS. (b) Transmission of sexually transmitted diseases, such as candidacies. (c) Transmission of cervical cancer. (d) Unplanned pregnancies. (e) Frequent abortion. (f) Infertility due to infection.

152

23. The consequences of nutritional taboos on women’s health includes any of the following: (a) Low blood count/hemoglobin. (b) Anaemia. (c) Poor lactation of mother. (d) Low immunity. (e) Delayed healing of episiotomies wound (f) Blood transfusion complication.

24. The Consequences Of Teenage………………….. Motherhood Practice on women’s health includes any of the following: (a) Vulnerable To Sexually Transmitted. (b) Diseases. (c) Vulnerability To HIV/AIDS. (d) Cevical cancer. (e) Unplanned pregnancies. (f) Illegal abortions may lead to death.

25. The consequences of widowhood practices on women’s health includes any of the following: (a) Emotional trauma. (b) Depression. (c) Social withdrawal. (d) Loneliness. (e) Psychological trauma. (f) Mental trauma.

153

Cluster D

Indicate using a 4 point scale of Strongly Agree (SA) Agree (A) Disagree (D), and Strongly Disagree (SD) why harmful cultural practices resist change.

26. Harmful cultural practices in your community resist change because they: (a) Preserve the culture of the people. (b) Put women in their place. (c) Subject women to practices other women suffered years ago. (d) Enable traditional midwives continue their livelihood. (e) Do not punish the perpetrators. (f) Check female promiscuity.

Cluster E

Indicate using a 4 point scale of Strongly Agree (SA), Agree (A), Disagree (D), Strongly Disagree )SD), those strategies that could be adopted in eliminating harmful cultural practices.

27. Harmful cultural practices could be stopped through the following measure(s): (a) Openly, individuals should condemn the negative cultural practices. (b) Empowering women through education, income generation etc. (c) Perpetrators of harmful cultural practices should be punished by legal action. (d) Traditional rulers should enforce rules against harmful traditional practices in their communities. (e) The government should make these harmful practices illegal. Church leaders should excommunicate members who remain perpetrators of harmful cultural practices.

154

APPENDIX G Reliability: CLUSTER A Case Processing Summary N % Cases Valid 1098 100.0 Excluded 0 .0 Total 1098 100.0 a. List wise deletion based on all variables in the procedure.

Reliability Statistics Cronbach’s Alpha Cronbach’s Alpha N of

Based on items

Standardized items

.865 .865 6

Items Statistics

Mean Std. Deviation N Early marriage 3.64 .573 1098 Nutritional taboos 3.65 .619 1098 Female-female marriage 3.44 .676 1098 Teenage surrogate 3.45 .660 1098 motherhood Female circumcision 3.48 .652 1098 Widowhood practices 3.49 .675 1098

Inter-Item Correlation Matrix

Early marriage Nutritional taboos Female-female Teenage surrogate marriage motherhood Early marriage 1.000 .601 .444 .559 Nutritional taboos .601 1.000 .449 .558 Female-female .444 .449 1.000 .624 marriage Teenage surrogate .559 .558 .624 1.000 motherhood Female .454 .427 .529 .672 circumcision Widowhood .390 .491 .487 .552 practices

155

The covariance matrix is calculated and used in the analysis. Inter-Item Correlation Matrix Female Circumcision Widowhood practices Early marriage .454 .390 Nutritional taboos .427 .491 Female-female marriage .529 .487 Teenage surrogate motherhood .672 .552 Female circumcision 1.000 .519 Widowhood practices .519 1.000 The covariance matrix is calculated and used in the analysis.

156

CLUSTER B Reliability *****method 2 (covariance matrix) will be used for this analysis*****

157

RELIABILITY ANALYSIS - SCALE (ALPHA) Item-total Statistics Scale Mean Scale Variance Corrected Item Squared Multiple Alpha if If Item Deleted if Item Deleted Total Correlation Correlation Item Delete

ITEM43 213.4000 366.0414 .2651 . .8676 ITEM44 213.3333 367.3333 .2472 . .8679 ITEM45 212.9667 364.8609 .3545 . .8667 ITEM46 212.9333 360.0644 .5051 . .8649 ITEM47 213.0333 367.6195 .2469 . .8679 ITEM48 213.2667 366.1333 .3037 . .8672 ITEM49 212.8333 368.6954 .1718 . .8688 ITEM50 213.0333 368.7230 .2069 . .8683 ITEM51 213.0333 368.9989 .2626 . .8678 ITEM52 212.9333 368.0644 .3239 . .8674 ITEM53 212.7333 371.8575 .2590 . .8683 ITEM54 212.6333 373.8264 .0364 . .8698 ITEM55 212.6333 364.5851 .3743 . .8665 ITEM56 213.0333 368.3782 .2613 . .8678 ITEM57 213.0333 373.8264 .0275 . .8701 ITEM58 213.1333 374.3954 .0085 . .8701 ITEM59 213.5333 376.3264 -.0664 . .8712 ITEM60 213.6667 377.4023 -.0946 . .8721 ITEM61 213.2333 366.5989 .2841 . .8675 ITEM62 212.9000 364.6448 .4071 . .8664 ITEM63 212.9000 364.4379 .4157 . .8663 ITEM64 213.7333 364.8920 .5378 . .8660 ITEM65 213.3000 366.5276 -.2117 . .8738 ITEM66 213.0667 377.8575 -.0923 . .8742 ITEM67 212.5667 366.8057 .2018 . .8686 ITEM68 212.3000 372.4241 .0943 . .8693 ITEM69 212.4000 371.5586 .0880 . .8698 ITEM70 213.6667 373.0575 .0459 . .8701 ITEM71 213.1000 364.3690 .3384 . .8668 ITEM72 213.3333 363.8161 .3482 . .8666 ITEM73 213.0000 369.1034 .2121 . .8682 ITEM74 213.2667 368.8230 .2231 . .8681

158

ITEM75 213.2333 372.6678 .0811 . .8694 ITEM76 213.1667 369.1782 .2045 . .8683 ITEM77 213.0333 368.8609 .2193 . .8682 ITEM78 212.8667 368.6713 .1696 . .8689 ITEM79 213.5333 365.2920 .2199 . .8684 ITEM80 213.0000 366.9310 .1659 . .8691 ITEM81 213.2667 376.1331 -.0580 . .8713 ITEM82 213.3333 371.4713 .0946 . .8815 ITEM83 212.9667 376.7230 -.0748 . .8710 ITEM84 213.3000 375.4586 -.0352 . .8676

RELIABILITY ANALYSIS- SCALE (ALPHA)

Reliability Coefficients 78 items Alpha = .8692 Standardized item alpha = .8911

159

CLUSTER C Reliability *****method 2 (covariance matrix) will be used for this analysis*****

160

RELIABILITY ANALYSIS - SCALE (ALPHA) Mean Std. Dev Cases

1. ITEM85 2.8667 .8193 30.0 2. ITEM86 2.7000 .7944 30.0 3. ITEM87 2.4667 .6288 30.0 4. ITEM88 2.2667 .5833 30.0 5. ITEM89 2.3667 .7649 30.0 6. ITEM90 2.4333 .8976 30.0 7. ITEM91 2.8333 .8339 30.0 8. ITEM92 3.1333 .6288 30.0 9. ITEM93 2.9000 .5477 30.0 10. ITEM94 2.9333 .5833 30.0 11. ITEM95 2.8333 .5307 30.0 12. ITEM96 2.9333 .6397 30.0 13. ITEM97 2.9333 .6397 30.0 14. ITEM98 3.0667 .6397 30.0 15. ITEM99 2.7333 .7397 30.0 16. ITEM100 2.7667 .6261 30.0 17. ITEM101 2.7667 .8976 30.0 18. ITEM102 2.7333 .8683 30.0 19. ITEM103 3.1333 .7303 30.0 20. ITEM104 3.2000 .8052 30.0 21. ITEM105 3.0000 .6948 30.0 22. ITEM106 2.8667 .6288 30.0 23. ITEM107 2.5333 .8193 30.0 24. ITEM108 2.6667 .8841 30.0 25. ITEM109 2.8000 .8469 30.0 26. ITEM110 3.1000 .7120 30.0 27. ITEM111 3.0667 .7397 30.0 28. ITEM112 2.9333 .8683 30.0 29. ITEM113 2.9000 .6618 30.0 30. ITEM114 3.2000 .7144 30.0 31. ITEM115 3.3000 .5960 30.0 32. ITEM116 3.2333 .7739 30.0 33. ITEM117 3.2667 .5833 30.0 34. ITEM118 3.0000 .6433 30.0 35. ITEM119 3.1000 .6618 30.0

161

36. ITEM120 3.0000 .6433 30.0

RELIABILITY ANALYSIS- SCALE (ALPHA)

Reliability Coefficients 36 items Alpha = .7763 Standardized item alpha = .7894

162

CLUSTER D Reliability *****method 2 (covariance matrix) will be used for this analysis*****

163

164

CLUSTER E Reliability *****method 2 (covariance matrix) will be used for this analysis*****

165

166

Appendix H Table 4: Mean and Standard Deviation of the reason for the existence of HCPs practices in the communities according to the respondents. S/N ITEMS X Std. Remark Deviation

47 Female-female marriage for male 2.46 .975 UNACCEPTED children 48 Female-female marriage for 1.97 .780 UNACCEPTED companionship to an old widow 49 it is practiced because of 2.52 1.110 ACCEPTED childlessness 50 it is for companionship 2.05 .867 UNACCEPTED 51 it is to give joy to childless couples 2.18 .897 UNACCEPTED 52 it is to secure a man's Property when 2.30 .977 UNACCEPTED he dies 53 It is to raise children for the deceased 2.44 .986 UNACCEPTED when he dies 54 It is to try for a male child who will 2.50 1.013 ACCEPTED continue the family lineage 55 Girls are encouraged to stay at home 2.54 1.132 ACCEPTED and bear chilren for their old parents 56 Teenage girls care for children born 2.01 .795 ACCEPTED out of unconsummated marriage 57 Teenage girls take care of their 2.47 .899 UNACCEPTED brothers and sisters at the demise of their mother/father 58 Teenage girls arranged to take care of 2.04 .790 UNACCEPTED other children in another home 59 Teenage girls taking care of their 2.10 .809 UNACCEPTED handicapped/challenged relations 60 I am not aware of such practices 2.14 1.214 UNACCEPTED 61 Provide Companionship to the 2.18 .903 UNACCEPTED bereaved/husband 62 Fill the existing vacuum OF the late 2.22 .884 UNACCEPTED mother 63 Give a male child to the family 2.58 1.000 ACCEPTED 64 Raise Children for the family lineage 2.56 1.011 ACCEPTED 65 Give care AND hope to the fatherless 2.35 .906 UNACCEPTED and motherless children 66 I am not aware of such practices 2.03 1.248 UNACCEPTED 67 subjecting widows to sleeping on the 3.06 .961 ACCEPTED bare floor 68 Widow not eating with good plates 2.77 1.035 ACCEPTED 69 Widows wailing day and night 2.97 1.040 ACCEPTED 70 Widows being Disposed of their 3.07 .983 ACCEPTED husbands' property 71 Widows Should Look Untidy 2.44 .804 UNACCEPTED 72 Widows Should Not visit people during 2.26 .864 UNACCEPTED the day

167

73 We Inherited from our Forefathers 2.97 1.147 ACCEPTED 74 It is to preserve the people's tradition 2.58 1.221 ACCEPTED 75 It ensures that permanent separation 2.06 1.223 UNACCEPTED OF the wife FROM the deceased is ASSURED 76 It is an opportunity for kinsmen to 1.97 1.062 UNACCEPTED punish an obstinate wife of their late brother 77 It is to ensure t1hat the widow actually 2.72 1.071 ACCEPTED mourned her husband 78 It is an opportunity For 38sisters-In- 2.32 1.107 UNACCEPTED Law To Re214taliate To Any Past Griev54ances In The Family 79 Sisters-In-Law 2.90 1.263 ACCEPTED 80 Kinsmen 2.37 1.252 UNACCEPTED 81 Members of women Association 1.37 .750 UNACCEPTED 82 Brothers-in-law 2.51 1.119 ACCEPTED 83 Youth/AGE grade 1.62 .916 UNACCEPTED 84 Traditional Rulers 2.25 1.168 UNACCEPTED

Appendix I Table 8: ANOVA Summary for mean ratings of respondents on HCPs based on location ANOVA Sum of df Mean F Sig. S/N Items Squares Square 28 Combats Family Poverty Between 20.291 5 4.058 5.456 .000 Groups Within 739.309 994 .744 Groups Total 759.600 999 29 Ensures grandchildren Between 5.371 5 1.074 1.543 .174 for parents Groups Within 706.545 1015 .696 Groups Total 711.916 1020 30 Will ensure the use of Between 102.432 5 20.486 28.387 .000 bride price for training Groups the boys Within 701.479 972 .722 Groups Total 803.911 977 31 Girls are not allowed to Between 43.155 5 8.631 18.542 .000 eat beef/pork Groups Within 469.668 1009 .465 Groups Total 512.824 1014 32 Girls are not allowed to Between 32.275 5 6.455 14.131 .000 eat eggs Groups Within 453.589 993 .457 Groups

168

Total 485.864 998 33 Pregnant mothersare Between 47.002 5 9.400 12.825 .000 not supposed to eat Groups snail Within 739.603 1009 .733 Groups Total 786.605 1014 34 Pregnant mothersare Between 29.084 5 5.817 10.974 .000 not supposed to drink Groups milk Within 526.339 993 .530 Groups Total 555.423 998 35 Pregnant mothersare Between 20.275 5 4.055 7.218 .000 not supposed to eat Groups eggs Within 561.211 999 .562 Groups Total 581.487 1004 36 Pregnant mothersare Between 80.955 5 16.191 19.539 .000 not supposed to eat Groups grass cutters Within 806.267 973 .829 Groups Total 887.222 978 37 Prevent women from Between 57.348 5 11.470 17.068 .000 being extravagant Groups Within 668.616 995 .672 Groups Total 725.964 1000 38 Curb their gluttonous Between 8.672 5 1.734 2.735 .018 behaviour Groups Within 622.035 981 .634 Groups Total 630.707 986 39 Prevent them from Between 101.839 5 20.368 25.319 .000 experiencing prolonged Groups labour if they eat Within 788.351 980 .804 grasscutter Groups Total 890.191 985 40 Prevent the unborn Between 19.013 5 3.803 6.307 .000 child from stealing if the Groups mother eats egg when Within 595.724 988 .603 pregnant Groups Total 614.737 993 41 Maintain the belief that Between 35.855 5 7.171 11.295 .000 babies will Behave like Groups cows if pregnant Within 627.898 989 .635 mothers drink cow milk Groups Total 663.753 994 42 Maintain the belief that Between 61.914 5 12.383 14.537 .000 babies will salivate Groups excessively if pregnant Within 852.654 1001 .852 mothers eat snail Groups Total 914.568 1006

169

43 Female-female marriage Between 36.636 5 7.327 12.655 .000 for the mentally Groups retarded Within 576.702 996 .579 Groups Total 613.338 1001 44 Female-female marriage Between 18.604 5 3.721 7.899 .000 for an idiot Groups Within 460.202 977 .471 Groups Total 478.806 982 45 Female-female marriage Between 106.202 5 21.240 24.970 .000 for the childless couple Groups Within 843.830 992 .851 Groups Total 950.032 997 46 Female-female marriage Between 61.760 5 12.352 15.308 .000 for an old childless Groups widow Within 791.573 981 .807 Groups Total 853.333 986 47 Female-female marriage Between 136.270 5 27.254 33.390 .000 for male children Groups Within 795.015 974 .816 Groups Total 931.285 979 48 Female-female marriage Between 50.224 5 10.045 17.895 .000 for Companionship to Groups an old widow Within 557.935 994 .561 Groups Total 608.159 999 49 It is practiced because Between 128.909 5 25.782 23.243 .000 of childlessness Groups Within 1100.335 992 1.109 Groups Total 1229.243 997 50 It is for companionship Between 31.603 5 6.321 8.748 .000 Groups Within 705.148 976 .722 Groups Total 736.751 981 51 It is to give joy to Between 71.161 5 14.232 19.361 .000 childless couples Groups Within 711.574 968 .735 Groups Total 782.735 973 52 It is to secure a man's Between 127.492 5 25.498 30.831 .000 property when he dies Groups Within 800.567 968 .827 Groups Total 928.059 973

170

53 It is to raise children for Between 100.884 5 20.177 23.077 .000 the deceased when he Groups dies Within 858.592 982 .874 Groups Total 959.477 987 54 It is to try for a male Between 137.915 5 27.583 30.981 .000 child who will continue Groups the family lineage Within 869.829 977 .890 Groups Total 1007.744 982 55 Girls are encouraged to Between 236.539 5 47.308 45.249 .000 stay at home and bear Groups children for their old Within 1021.459 977 1.046 parents Groups Total 1257.998 982 56 Teenage girls care for Between 44.809 5 8.962 15.207 .000 children born out of Groups unconsummated Within 574.018 974 .589 marriage Groups Total 618.828 979 57 Teenage girls take care Between 65.903 5 13.181 17.705 .000 of their brothers and Groups sisters at the demise of Within 723.615 972 .744 their mother/father Groups Total 789.517 977 58 Teenage girls arranged Between 61.583 5 12.317 21.836 .000 to take care of other Groups children in another Within 547.697 971 .564 home Groups Total 609.279 976 59 Teenage girls taking Between 70.462 5 14.092 24.080 .000 care of their Groups handicapped/challenged Within 562.403 961 .585 relations Groups Total 632.865 966 60 I am not aware of such Between 127.654 5 25.531 19.065 .000 practices Groups Within 1189.147 888 1.339 Groups Total 1316.801 893 61 Provide companionship Between 74.258 5 14.852 20.020 .000 to the Groups bereaved/husband Within 703.272 948 .742 Groups Total 777.530 953 62 Fill the existing vacuum Between 41.444 5 8.289 11.158 .000 of the late mother Groups Within 710.150 956 .743 Groups Total 751.594 961

171

63 Give a male child to the Between 195.975 5 39.195 48.906 .000 family Groups Within 769.387 960 .801 Groups Total 965.362 965 64 Raise children for the Between 201.067 5 40.213 49.292 .000 family lineage Groups Within 777.471 953 .816 Groups Total 978.538 958 65 Give care and hope to Between 89.807 5 17.961 24.707 .000 the fatherless and Groups motherless children Within 668.828 920 .727 Groups Total 758.635 925 66 I am not aware of such Between 171.725 5 34.345 25.150 .000 practices Groups Within 1171.714 858 1.366 Groups Total 1343.440 863 67 Subjecting widows to Between 84.277 5 16.855 19.914 .000 sleeping on the bare Groups floor Within 867.572 1025 .846 Groups Total 951.849 1030 68 Widow not eating with Between 175.123 5 35.025 38.826 .000 good plates Groups Within 910.211 1009 .902 Groups Total 1085.334 1014 69 Widows wailing day and Between 134.392 5 26.878 28.290 .000 night Groups Within 937.762 987 .950 Groups Total 1072.153 992 70 Widows being disposed Between 169.752 5 33.950 42.269 .000 of their husbands' Groups property Within 808.816 1007 .803 Groups Total 978.569 1012

71 Widows should look Between 48.147 5 9.629 16.000 .000 untidy Groups Within 601.217 999 .602 Groups Total 649.363 1004 72 Widows should not visit Between 22.243 5 4.449 6.109 .000 people during the day Groups Within 733.978 1008 .728 Groups Total 756.221 1013

172

73 We inherited from our Between 17.639 5 3.528 2.703 .020 forefathers Groups Within 1349.496 1034 1.305 Groups Total 1367.135 1039 74 It is to preserve the Between 28.421 5 5.684 3.865 .002 people's tradition Groups Within 1486.973 1011 1.471 Groups Total 1515.394 1016 75 It ensures that Between 96.479 5 19.296 13.709 .000 permanent separation of Groups the wife from the Within 1424.440 1012 1.408 deceased is assured Groups Total 1520.919 1017 76 It is an opportunity for Between 72.822 5 14.564 13.755 .000 kinsmen to Punish an Groups obstinate wife of their Within 1033.436 976 1.059 late brother Groups Total 1106.258 981 77 It is to ensure that the Between 31.805 5 6.361 5.672 .000 widow actually Mourned Groups her husband Within 1147.334 1023 1.122 Groups Total 1179.139 1028 78 It is an opportunity for Between 62.002 5 12.400 10.605 .000 sisters-in-law to Groups Retaliate to any past Within 1162.314 994 1.169 grievances in the Family Groups Total 1224.316 999 79 Sisters-in-law Between 129.552 5 25.910 17.598 .000 Groups Within 1462.034 993 1.472 Groups Total 1591.586 998 80 Kinsmen Between 176.375 5 35.275 25.251 .000 Groups Within 1373.202 983 1.397 Groups Total 1549.577 988 81 Members of women Between 30.116 5 6.023 11.264 .000 association Groups Within 530.450 992 .535 Groups Total 560.566 997 82 Brothers-in-law Between 32.555 5 6.511 5.307 .000 Groups Within 1229.302 1002 1.227 Groups Total 1261.857 1007

173

83 Youth/age grade Between 47.542 5 9.508 11.960 .000 Groups Within 794.203 999 .795 Groups Total 841.745 1004 84 Traditional rulers Between 30.992 5 6.198 4.623 .000 Groups Within 1352.945 1009 1.341 Groups Total 1383.937 1014 85 Between 6.544 5 1.309 2.646 .022 Sever plan Groups Within 506.930 1025 .495 Groups Total 513.474 1030 86 Profuse bleeding Between 20.142 5 4.028 6.945 .000 Groups Within 582.349 1004 .580 Groups Total 602.491 1009 87 Adhesion to labia Between 88.495 5 17.699 15.845 .000 majora/vagina Groups Within 1084.617 971 1.117 Groups Total 1173.112 976 88 Infection Between 37.783 5 7.557 6.710 .000 Groups Within 1082.182 961 1.126 Groups Total 1119.965 966 89 Scar tissue formation Between 179.066 5 35.813 35.657 .000 Groups Within 961.177 957 1.004 Groups Total 1140.243 962 90 Vesico vagina or recto Between 241.418 5 48.284 53.850 .000 vagina fistula during Groups child birth. Within 874.217 97 .897 Groups Total 1115.635 980

174

Appendix J Table 9: t-test analysis of the mean ratings of single and married parent on why the HCP exist in communities

MARIT N Mea Std. t dsf Sig Re AL n Deviat . ma STATU ion rk S HYP 28 Combats family poverty MARRI 66 2.5 .929 ED 8 5 7.81 669.331 .00 SINGL 26 2.1 .681 3 0 E 9 2

29 Ensures grandchildren for parents MARRI 67 2.4 .885 1.64 616.272 .10 NS ED 8 0 3 1 SINGL 28 2.3 .741 E 0 0 30 Will ensure the use of MARRI 66 2.6 .926 bride price for training the ED 6 5 5.80 484.764 .00 boys SINGL 25 2.2 .849 9 0 E 0 7 31 Girls are not allowed to eat MARRI 67 3.2 .671 beef/pork ED 6 3 3.99 950 .00 SINGL 27 3.0 .811 9 0 E 6 3 32 Girls are not allowed to eat MARRI 66 3.2 .657 eggs ED 8 8 4.80 418.934 .00 SINGL 26 3.0 .795 1 0 E 7 1 33 Pregnant mothers are not MARRI 67 2.68 .888 supposed to eat snail ED 3 3.31 950 .00 SINGL 27 2.47 .901 4 1 E 9 34 pregnant mothers are not MARRI 66 3.04 .713 supposed to drink milk ED 8 4.26 429.234 .00 SINGL 26 2.80 .834 0 0 E 7 35 pregnant mothers are not MARRI 66 3.04 .753 supposed to eat eggs ED 8 5.31 487.919 .00 SINGL 27 2.75 .788 5 0 E 4 36 pregnant mothers are not MARRI 64 2.89 .971 supposed to eat grass ED 9 5.14 914 .00 cutters SINGL 26 2.53 .919 7 0 E 7 37 prevent women from being MARRI 66 2.95 .895 extravagant ED 6 .723 569.694 .47 NS SINGL 27 2.90 .789 0 E 3

175

38 Curb their gluttonous MARRI 65 2.87 .824 behaviour ED 9 1.79 923 .07 NS SINGL 26 2.77 .781 0 4 E 6 39 Prevent them from MARRI 66 2.86 .990 experiencing prolonged ED 2 1.32 922 .18 NS labour if they eat grass SINGL 26 2.76 .908 5 5 cutter E 2 40 Prevent the unborn child MARRI 66 2.97 .784 from stealing if the mother ED 6 5.11 476.144 .00 eats egg when pregnant SINGL 26 2.67 .810 3 0 E 7 41 Maintain the belief that MARRI 66 2.93 .842 babies will behave like ED 7 4.19 520.375 .00 cows if pregnant mothers SINGL 26 2.69 .789 1 0 drink cow milk E 7 42 Maintain the belief that MARRI 66 2.55 .988 babies will salivate ED 9 5.36 586.679 .00 excessively if pregnant SINGL 27 2.20 .861 3 0 mothers eat snail E 7

43 Female-female marriage MARRI 66 3.09 .815 - 940 .15 NS for the mentally retarded ED 7 1.41 9 SINGL 27 3.17 .766 0 E 5 44 Female-female marriage MARRI 65 3.19 .727 for an idiot ED 8 - 921 .67 NS SINGL 26 3.21 .684 .425 1 E 5 45 Female-female marriage MARRI 66 2.66 1.028 for the childless couple ED 6 - 587.395 .12 NS SINGL 27 2.76 .874 1.52 8 E 2 4 46 Female-female marriage MARRI 66 2.72 .929 for an old childless widow ED 1 3.47 925 .00 SINGL 26 2.49 .900 2 1 E 6 47 Female-female marriage MARRI 65 2.56 .988 for male children ED 7 1.72 503.909 .08 NS SINGL 26 2.44 .943 9 4 E 3 48 Female-female marriage MARRI 66 3.05 .749 for companionship to an ED 6 1.02 462.022 .30 NS old widow SINGL 27 2.99 .831 8 4 E 3 49 It is practiced because of MARRI 66 2.55 1.160 childlessness ED 1 2.86 573.260 .30 NS SINGL 27 2.33 1.035 1 4 E 6 50 It is for companionship MARRI 65 3.00 .878 ED 4 2.32 919 .02

176

SINGL 26 2.85 .870 2 0 E 7 51 It is to give joy to childless MARRI 65 2.82 .920 couples ED 1 - 512.708 .02 NS SINGL 26 2.84 .861 .302 0 E 2 52 It is to secure a man's MARRI 65 2.79 .984 property when he dies ED 3 3.17 480.304 .00 SINGL 26 2.56 .975 0 2 E 0 53 It is to raise children for MARRI 65 2.63 .991 the deceased when he dies ED 5 2.76 925 .00 SINGL 27 2.43 .996 9 6 E 2 54 It is to try for a male child MARRI 65 2.53 1.054 who will continue the ED 3 .785 545.097 .43 NS family lineage SINGL 26 2.47 .960 3 E 9 55 Girls are encouraged to MARRI 65 2.53 1.124 stay at home and bear ED 2 2.74 473.604 .00 children for their old SINGL 27 2.30 1.201 6 6 parents E 0

56 Teenage girls care for MARRI 64 3.06 .802 2.99 531.589 .00 children born out of ED 9 1 3 unconsummated marriage SINGL 27 2.89 .760 E 1 57 Teenage girls take care of MARRI 64 2.57 .930 their Brothers and sisters ED 9 2.05 537.731 .04 at the demise of their SINGL 26 2.44 .857 8 0 mother/father E 8 MARRI 65 3.00 .769 58 Teenage girls arranged to ED 2 1.03 454.357 .30 NS take care of other children SINGL 26 2.94 .832 4 2 in another home E 4 59 Teenage girls taking care MARRI 64 2.95 .796 of their ED 6 1.41 457.776 .15 NS handicapped/challenged SINGL 26 2.86 .836 7 7 relations E 0 60 I am not aware of such MARRI 59 2.90 1.264 practices ED 3 1.05 491.010 .29 NS SINGL 24 2.80 1.131 7 1 E 0 61 Provide companionship to MARRI 62 2.85 .898 the bereaved/husband ED 7 1.59 469.874 .11 NS SINGL 26 2.74 .963 3 2 E 6 62 Fill the existing vacuum of MARRI 64 2.77 .925 the late mother ED 2 .342 899 .73 NS

177

SINGL 25 2.75 .843 2 E 9 63 Give a male child to the MARRI 63 2.46 1.051 family ED 8 1.42 563.230 .15 NS SINGL 26 2.36 .924 8 4 E 7 64 Raise children for the MARRI 63 2.42 1.056 family lineage ED 7 - 531.313 .17 NS SINGL 26 2.52 .955 1.36 3 E 1 4 65 Give care and hope to the MARRI 62 2.62 .929 fatherless and motherless ED 8 - 863 365 NS children SINGL 23 2.69 .895 .906 E 7 66 I am not aware of such MARRI 56 2.86 1.277 practices ED 7 - 461.848 .06 NS SINGL 23 3.04 1.211 1.84 6 E 6 3 67 Subjecting widows to MARRI 68 1.99 .974 sleeping on the bare floor ED 6 1.92 524.155 .05 NS SINGL 28 1.86 .972 5 5 E 2 68 Widow not eating with MARRI 67 2.24 1.059 good plates ED 9 -497 951 .61 NS SINGL 27 2.28 1.022 9 E 4

69 Widows wailing day and MARRI 65 2.08 1.056 2.06 928 .03 night ED 8 6 9 SINGL 27 1.93 1.053 E 2 70 Widows being disposed of MARRI 68 1.96 .965 their husbands' property ED 2 .368 482.802 .71 NS SINGL 28 1.93 1.061 3 E 2 71 Widows should look untidy MARRI 67 2.62 .793 ED 7 4.38 498.914 .00 SINGL 28 2.37 .832 1 0 E 0 72 Widows should not visit MARRI 67 2.81 .819 people during the day ED 9 3.80 430.912 .00 SINGL 27 2.55 .984 3 0 E 3 73 we inherited from our MARRI 69 2.14 1.216 forefathers ED 0 3.72 636.238 .00 SINGL 28 1.85 1.019 1 0 E 8 74 It is to preserve the MARRI 67 2.42 1.226 people's tradition ED 8 .994 543.330 .32 NS SINGL 27 2.34 1.151 1 E 7

178

75 It ensures that permanent MARRI 67 2.97 1.209 separation of the wife from ED 6 1.16 954 .24 NS the deceased is assured SINGL 28 2.87 1.214 8 3 E 0 76 It is an opportunity for MARRI 65 3.02 1.071 kinsmen to punish an ED 8 - 524.248 .99 NS obstinate wife of their late SINGL 26 3.02 .975 .001 9 brother E 2 77 It is to ensure that the MARRI 68 2.27 1.063 widow actually mourned ED 8 2.46 548.964 .01 her husband SINGL 27 2.09 .986 6 4 E 8 78 It is an opportunity for MARRI 66 2.70 1.110 sisters-in-law to retaliate to ED 9 1.93 936 .05 NS any past grievances in the SINGL 26 2.54 1.121 3 4 family E 9 79 Sisters-in-law MARRI 66 2.14 1.297 ED 3 .640 540.872 .52 NS SINGL 27 2.09 1.209 2 E 3 80 Kinsmen MARRI 66 2.54 1.251 ED 1 - 925 .02 SINGL 26 2.74 1.266 2.25 4 E 6 8

179

81 Members of Women MARRI 66 3.65 .707 Association ED 0 1.44 442.235 .14 NS SINGL 27 3.56 .837 9 8 E 4 82 Brothers-in-law MARRI 67 2.46 1.110 ED 4 - 944 .14 NS SINGL 27 2.58 1.117 1.45 5 E 2 8 83 Youth/age Grade MARRI 66 3.40 .882 ED 7 1.95 461.546 .05 NS SINGL 27 3.27 .998 5 1 E 6 84 Traditional Rulers MARRI 68 2.72 1.137 ED 3 - 468.488 .24 NS SINGL 26 2.81 1.198 1.15 9 E 9 5

157

23 The consequences of nutritional taboos on women’s health includes any of the following: (a) Low blood count/hemoglobin. (b) Anaemia (c) Poor lactation of mother (d) Low immunity (e) Delayed healing of episiotomies wound Blood transfusion complication 24 The Consequences Of Teenage……………….. Motherhood Practice on women’s health includes any of the following; (a) Vulnerable To Sexually Transmitted (b) Disease (c) Vulnerability To HIV/AIDS (d) Cervical cancer. (e) Unplanned pregnancies. (f) Illegal abortions may lead to death. 25 The consequences of widowhood practices on women’s health includes any of the following: (a) Emotional trauma (b) Depression. (c) Social withdrawal (d) Loneliness (e) Psychological trauma (f) Mental trauma

180

Cluster D

Indicate using a 4 point scale of strongly Agree (SA) Agree (A), Disagree (D), and strongly disagree (SD) why harmful cultural practices resist change.

26 Harmful cultural practices in your community resist change because they: (a) Preserve the culture of the people (b) Put women in their place (c) Subject women to practices other women suffered yeas ago. (d) Enable traditional midwives continue their livelihood. (e) Do not punish the perpetrators (f) Check female promiscuity

Cluster E

Indicate using a 4 point scale of Strongly Agree (SA), Agree (A), Disagree (D),

Strongly Disagree (SD), those strategies that could be adopted in eliminating harmful cultural practices.

27 Harmful cultural practices could be stopped through the following measure(s): (a) Openly, individuals should condemn the negative cultural practices (b) Empowering women through education, income generation etc (c) Perpetrators of harmful cultural practices should be punished by legal action (d) Traditional rulers should enforce rules against harmful traditional practices in their communities. (e) The government should make these harmful practices illegal (f) Church leaders should excommunicate members who remain perpetrators of harmful cultural practices.