Female Genital Cutting in Sudan: Perceptions of the Practice and Implications for Social Workers

Background and Purpose:

Female Genital Cutting (FGC) is the cutting, pricking, or removal of all or part of a female’s genital area for non-medical purposes.  FGC can have lasting physical health implications, including chronic infection, vaginal cysts, infertility, and psychological implications.  While FGC is internationally recognized and almost globally condemned, still over 3-million girls are at risk annually.  It is considered a violation of human rights, a form of gender-based violence, and child abuse.  In Sudan, it is widely practiced whereby 9 in 10 females have been circumcised.  Reasons for the practice vary, however are most strongly connected to traditional roots upholding societal ideals of sexual morality and chastity, suppression of female libido, traditional norms, and cleanliness. This study examines the socio-demographic factors associated with female perceptions of whether FGC should continue in Sudan.  Findings will help inform programs and policies to minimize the global burden of FGC on women.    

Methods:

This is a secondary analysis using data from UNICEF’s Multiple Indicator Cluster Survey Round 5 (MICS) in Sudan, carried out by the Sudanese Central Bureau of Statistics in collaboration with the Sudanese Ministry of Health.  Data was collection from August to December 2014 by trained field workers conducting face-to-face interviews with household members.  Specifically, survey data focused on key health and social factors affecting women and children, informing progress towards sustainable development goals.  The current study examined data collected from 16,818 women and girls ages 15-49 regarding FGC.  Binary logistic regression was used for the analysis.  Perceptions of whether FGC should continue was the dependent variable while age, education level, wealth index, marital status, and whether a woman is circumcised were independent variables. 

Results:

Approximately 89% of women and girls surveyed underwent some form of FGC, while 55% indicated that the practice should discontinue.  Results from binary logistic regression found that age, wealth, education levels, marital status, and whether a woman is circumcised were significant predictors of perceptions that the practice.  Women in the poorest wealth index had lower odds (aOR = .27, CI = .32 - .42, p < .001) of reporting that FGC should discontinue compared to those who were among the richest. Women with higher education had higher odds (aOR = 5.37, CI = 4.56 – 6.33, p < .001) of stating FGC should discontinue compared to women with no education.  Finally, women who reported to have never been circumcised had greater odds (aOR = 14.55, CI =12.60 – 17.49, p < .001) of saying FGC should discontinue compared to those circumcised. 

Conclusions and Implications:

Social workers are uniquely positioned to work with Sudanese women to decrease this harmful health practice with implications for human rights.  As results indicated, women with no formal education and who are poor are more likely to perceive the practice should continue.  As such, outreach should focus on empowerment, improving economic and educational opportunities, including women as allies in such efforts.  Furthermore, outreach should focus on women who have been circumcised.  Importantly, prevention should be characterized by cultural competence and respect.