Estimating Utility value for Female Genital Mutilation

Abstract Background: Female genital mutilation/cutting (FGM/C) is a clear violation of women's rights and can have adverse and irreversible health effects as well. Worldwide, more than 200 million women and girls have undergone FGM/C. Utility value of FGM/C has not been estimated yet, so we designed this study to extract the health utility value of FGM/C for the first time in the world.Methods: In a cross-sectional study in Iran, 125 girls and women who underwent FGM/C procedure were examined by the trained midwives in order to determine its type. In addition, a questionnaire was completed for identifying the socio-demographic factors and extracting the health utility of these individuals. Health utility was measured using Time Trade-off method and also to determine the effects of the socio-demographic factors on the health utility a two-limit censored regression model was applied.Results: The mean and median of the health utility of women with FGM/C were 0.971 (SE: 0.003) and 0.968 (IQR: 1-0.95), respectively. Number of non-traders was 58 (46.4%) who reported perfect health utility. However, the mean of health utility among traders was 0.946 (SE: 0.002). Only type 1 (Clitoridectomy) and type 2 (Excision) FGM/C were seen in this study. Women with Type 1 FGM/C had significantly lower health utility value (Mean: 0.968, Median: 0.957) than their type 2 counterparts (Mean: 0.987, Median: 1.00). Moreover, women in the age group of 31-45 years (Mean: 0.962, Median: 0.956), single (Mean: 0.950, Median: 0.954), divorced (Mean: 0.951, Median: 0.950), employed (Mean: 0.959, Median: 0.956), and with supplementary insurance (Mean: 0.962, Median: 0.950) had significantly lower health utility than their counterparts.Conclusion: FGM/C affects physical and psychological well-being of these individuals, resulting in a lack of personal and marital satisfaction, which ultimately leads to a 3% reduction in their health related quality of life. Therefore, preventing from this practice is very important and should be considered by health system policy makers more than before.

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Estimating Utility value for Female Genital Mutilation

10.21203/rs.2.20583/v2 ◽

2020 ◽

Author(s):

Cyrus Alinia ◽

Bakhtiar Piroozi ◽

Fariba Jahanbin ◽

Hossein Safari ◽

Amjad Mohamadi-Bolbanabad ◽

...

Keyword(s):

Female Genital Mutilation ◽

Health Utility ◽

Utility Value ◽

Genital Mutilation ◽

Lower Health ◽

The Mean ◽

Socio Demographic Factors ◽

Female Genital

Abstract Background: Female genital mutilation/cutting (FGM/C) is a clear violation of women's rights and can have adverse and irreversible health effects as well. Worldwide, more than 200 million women and girls have undergone FGM/C. Utility value of FGM/C has not been estimated yet, so we designed this study to extract the health utility value of FGM/C for the first time in the world. Methods: In a cross-sectional study in Iran, 125 girls and women who underwent FGM/C procedure were examined by the trained midwives in order to determine its type. In addition, a questionnaire was completed for identifying the socio -demographic factors and extracting the health utility of these individuals . Health utility was measured using Time Trade-off method and also to determine the effects of the socio -demographic factors on the health utility a two-limit censored regression model was applied. Findings : The mean and median of the health utility of women with FGM/C were 0.971 (SE: 0.003) and 0.968 (IQR: 1-0.95), respectively . Number of non-traders was 58 (46.4%) who reported perfect health utility. However, the mean of health utility among traders was 0.946 (SE: 0.002). Only type 1 (Clitoridectomy) and type 2 (Excision) FGM/C were seen in this study. Women with Type 1 FGM/C had significantly lower health utility value (Mean: 0.968, Median: 0.957) than their type 2 counterparts (Mean: 0.987, Median: 1.00). Moreover, women in the age group of 31-45 years (Mean: 0.962, Median: 0.956), single (Mean: 0.950, Median: 0.954), divorced (Mean: 0.951, Median: 0.950), employed (Mean: 0.959, Median: 0.956), and with supplementary insurance (Mean: 0.962, Median: 0.950) had significantly lower health utility than their counterparts . Conclusion: FGM/C affects physical and psychological well-being of these individuals, resulting in a lack of personal and marital satisfaction, which ultimately leads to a 3% reduction in their health related quality of life. Therefore, preventing from this practice is very important and should be considered by health system policy makers more than before .

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Estimating Utility value for Female Genital Mutilation

10.21203/rs.2.20583/v1 ◽

2020 ◽

Author(s):

Cyrus Alinia ◽

Bakhtiar Piroozi ◽

Fariba Jahanbin ◽

Hossein Safari ◽

Amjad Mohamadi-Bolbanabad ◽

...

Keyword(s):

Female Genital Mutilation ◽

Health Utility ◽

Utility Value ◽

Genital Mutilation ◽

Lower Health ◽

The Mean ◽

Socio Demographic Factors ◽

Female Genital

Abstract Background: Female genital mutilation/cutting (FGM/C) is a clear violation of women's rights and can have adverse and irreversible health effects as well. Worldwide, more than 200 million women and girls have undergone FGM/C. Utility value of FGM/C has not been estimated yet, so we designed this study to extract the health utility value of FGM/C for the first time in the world. Methods: In a cross-sectional study in Iran, 125 girls and women who underwent FGM/C procedure were examined by the trained midwives in order to determine its type. In addition, a questionnaire was completed for identifying the socio -demographic factors and extracting the health utility of these individuals . Health utility was measured using Time Trade-off method and also to determine the effects of the socio -demographic factors on the health utility a two-limit censored regression model was applied. Findings : The mean and median of the health utility of women with FGM/C were 0.971 (SE: 0.003) and 0.968 (IQR: 1-0.95), respectively . Number of non-traders was 58 (46.4%) who reported perfect health utility. However, the mean of health utility among traders was 0.946 (SE: 0.002). Only type 1 (Clitoridectomy) and type 2 (Excision) FGM/C were seen in this study. Women with Type 1 FGM/C had significantly lower health utility value (Mean: 0.968, Median: 0.957) than their type 2 counterparts (Mean: 0.987, Median: 1.00). Moreover, women in the age group of 31-45 years (Mean: 0.962, Median: 0.956), single (Mean: 0.950, Median: 0.954), divorced (Mean: 0.951, Median: 0.950), employed (Mean: 0.959, Median: 0.956), and with supplementary insurance (Mean: 0.962, Median: 0.950) had significantly lower health utility than their counterparts . Conclusion: FGM/C affects physical and psychological well-being of these individuals, resulting in a lack of personal and marital satisfaction, which ultimately leads to a 3% reduction in their health related quality of life. Therefore, preventing from this practice is very important and should be considered by health system policy makers more than before .

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Female Genital Mutilation/Cutting in Sudan and Subsequent Pelvic Floor Dysfunction.

10.21203/rs.3.rs-505947/v1 ◽

2021 ◽

Author(s):

Özer Birge ◽

Aliye Nigar Serin ◽

Mehmet Sait Bakır

Keyword(s):

Female Genital Mutilation ◽

Pelvic Floor Dysfunction ◽

Reference Category ◽

Genital Mutilation ◽

Group 2 ◽

Type 3 ◽

Female Genital ◽

Group 1

Abstract Background: We aimed to evaluate the socio-demographic characteristics of women with female genital mutilation/cutting (FGM/C) and the results of FGM/C due to pelvic floor dysfunction.Results: The prevalence of FGM/C was 87,2% in Sudan and Type 3 (50.4%) was the most prevalent. Type 3 (50.4%) was the most prevalent, followed by Type 2 (35%) and Type 1 (8.5%). In the multinominal logistic regression analysis performed for the effect of FGM/C alone on pelvic organ prolapse, it was observed that FGM/C in group 2 was not statistically different when the reference category was taken as group 1. In the evaluation for symptomatic POP (group 3), compared to type 3 FGM/C, there was a significantly less risk of developing POP in patients without FGM/C at a rate of 82.9% (OR(odds ratio): 0,171 (p:0,002), (Confidence Interval (CI) %95; 0,058-0,511), in patients with type 1 FGM/C at a rate of 75% (OR:0,250 (p:0,005), CI %95; 0,094-0,666) and in patients with type 2 FGM / C at a rate of 78.4% (OR:0,216 (p:0,0001), CI%95; 0,115-0,406). In the multinominal logistic regression analysis performed by including other variables affecting POP when group 1 was taken as the reference category, we found that the possibility of developing mild POP (group 2) decreased in FGM/C type 1 and 2 compared to FGM/C type 3 but it was not statistically significant. However, the evaluation for symptomatic POP showed up a significantly lower risk of developing POP in patients with type 2 FGM/C at a rate of 58.4%, compared to type 3 FGM/C (OR:0,416 (p:0,016), CI%95; 0,205-0,847). In addition, older age and being unemployed were found to be significant risk factors for increasing symptomatic POP (p:0,004, p:0,045; respectively).Conclusions: Female genital mutilation/cutting (FGM/C) defined by the World Health Organization and consists of all procedures that involving partial or total removal of the external female genitalia or another injury to the female genital organs whether for cultural or other non-medical reasons. Especially type 2 and 3 FGM/C continues to be an important health problem in terms of complications that may develop in advanced ages as well as many short-term complications as a result of mechanical or physiological deterioration of the female genital anatomy.

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Female genital mutilation/cutting in sudan and subsequent pelvic floor dysfunction

BMC Women s Health ◽

10.1186/s12905-021-01576-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Özer Birge ◽

Aliye Nigar Serin ◽

Mehmet Sait Bakır

Keyword(s):

Female Genital Mutilation ◽

Pelvic Floor Dysfunction ◽

Reference Category ◽

Genital Mutilation ◽

Group 2 ◽

Type 3 ◽

Female Genital ◽

Group 1

Abstract Background We aimed to evaluate the socio-demographic characteristics of women with female genital mutilation/cutting (FGM/C) and the results of FGM/C due to pelvic floor dysfunction. Results The prevalence of FGM/C was 87.2% in Sudan and Type 3 (50.4%) was the most prevalent, followed by Type 2 (35%) and Type 1 (8.5%). In the multinominal logistic regression analysis performed to show the effect of FGM/C on pelvic organ prolapse (POP), it was observed that FGM/C frequency in POP group 2 was statistically similar when POP group 1 was taken as reference category. In the evaluation for symptomatic POP (POP group 3), risk of developing POP in patients without FGM/C was significantly lower than patients with type 3 FGM/C with a rate of 82.9% (OR(odds ratio): 0.171 (p: 0.002), (Confidence Interval (CI) %95; 0.058–0.511). Risk of developing POP rate in patients with type 1 FGM/C was 75% (OR:0.250 (p: 0.005), CI %95; 0.094–0.666) and in patients with type 2 FGM/C was 78.4% (OR:0.216 (p: 0.0001), CI%95; 0.115–0.406). In the multinominal logistic regression analysis including other variables affecting POP, when group 1 was taken as the reference category, it was found that the possibility of developing mild POP (group 2) decreased in FGM/C type 1 and 2 compared to FGM/C type 3 but it was not statistically significant. However, the evaluation for the symptomatic POP group showed up a significantly lower risk of developing POP in patients with type 2 FGM/C compared to patients with type 3 FGM/C, with a rate of 58.4%. (OR:0.419 (p: 0.016), CI%95; 0.206–0.851) (Table 3). In addition, older age was found to be significant risk factor for increasing symptomatic POP (p: 0.003). Conclusions Type 2 and 3 FGM/C continues to be an important health problem in terms of complications that may develop in advanced ages as well as many short-term complications as a result of mechanical or physiological deterioration of the female genital anatomy.

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Novel Clitoral Reconstruction and Coverage With Sensate Labial Flaps: Potential Remedy for Female Genital Mutilation

Aesthetic Surgery Journal ◽

10.1093/asj/sjab218 ◽

2021 ◽

Author(s):

Adel M Wilson ◽

Amr A Zaki

Keyword(s):

Sexual Function ◽

Female Genital Mutilation ◽

Genital Mutilation ◽

Labia Minora ◽

Clitoral Reconstruction ◽

The Mean ◽

Clitoral Pain ◽

Arterial Anatomy ◽

Potential Remedy ◽

Female Genital

Abstract Background Clitoral reconstruction after female genital mutilation (FGM) could help alleviate complications caused by FGM, such as clitoral pain, reduced sensation, diminished sexual function, as well as improving aesthetics of the genitalia and restoring anatomy. Objectives Create sensate labial flaps to cover the neo-clitoris and assess its outcome. Methods Between December 2018 and July 2020, forty patients with FGM underwent clitoral reconstruction and coverage with sensate labial flaps donated by the remnant of the labia minora and were followed prospectively. Flaps were mapped on the less mutilated labia minora, based on recent description of arterial anatomy and innervation. Before the surgery, the patients’ clitoral sensation was assessed on a 6 point scale and they were also given the Female Sexual Functional Index (FSFI) to complete. Eight and twenty four weeks postoperatively, the same assessment was repeated and the data compared. Results The mean preoperative FSFI was 11.64 (range 2.8-25.6) and post-operatively was 29.14 (range 12.8-35.4), demonstrating a significant increase. Similarly, the Clitoral sensation increased from 2.35 (range 1-4) before the surgery to 4.9 (range 2-6) after the surgery, demonstrating a significant increase. In total, 95% of patients benefited from the surgery. Conclusions Clitoral reconstruction after FGM using sensate labial flaps resulted in significant improvement of sexual function, clitoral sensation, genital aesthetics and self-esteem.

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Estimating utility value for female genital mutilation

BMC Public Health ◽

10.1186/s12889-020-08947-4 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Cyrus Alinia ◽

Bakhtiar Piroozi ◽

Fariba Jahanbin ◽

Hossein Safari ◽

Amjad Mohamadi-Bolbanabad ◽

...

Keyword(s):

Female Genital Mutilation ◽

Utility Value ◽

Genital Mutilation ◽

Female Genital

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Religion, Culture and Medicine Analysis of Female Genital Mutilation amongst 84 Antenatal Clinic Attendees at the Rivers State University Teaching Hospital

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i1530615 ◽

2020 ◽

pp. 89-90

Author(s):

S. Eli ◽

D. G. B. Kalio ◽

N. C. T. Briggs ◽

K. E. Okagua

Keyword(s):

Teaching Hospital ◽

Female Genital Mutilation ◽

Antenatal Clinic ◽

University Teaching ◽

State University ◽

Genital Mutilation ◽

The World ◽

The Mean ◽

Rivers State ◽

Female Genital

Introduction: Female Genital Mutilation (FGM) or Female Circumcision (FC) have been influenced by religion, culture and medicine. The practice of FGM have been associated with myriads of negative health consequences, resulting in its abolishment by the World Health Organization (WHO). This is unlike male circumcision which is well accepted by most religions of the world, culture and medically. Aim: To ascertain the influence of religion, culture and medicine as regards FGM amongst antenatal clinic (ANC) attendees at the Rivers State University Teaching Hospital (RSUTH). Methods: It was a cross sectional study of ANC attendees at The RSUTH. The Information was retrieved using a self structured questionnaire which was coded and analyzed using SPSS version 25. Results: A total number 84 ANC attendees were recruited for the study. The mean age was 30.7 years and the modal parity was 1. The mean gestational age was 15.8 weeks. Twenty (23.8%) respondents had FC, all of whom were Christians. Eighteen (21.4%) of the respondents were of the opinion that FGM was a good practice; while 66 (78.6%) respondents believed that FGM was a wrong practice. The 2 most common reasons for FGM were to prevent promiscuity 7 (8.3%) and cultural reasons 7 (8.3%). The commonest known complication by respondents following FGM was bleeding from the genital tract 24 (28.6%). Conclusion: The prevalence of FGM from the study was 23.8% amongst ANC attendees at the RSUTH. Religion, culture and medicine may play vital roles in the eradication of FGM in our sub-region as recommended by WHO.

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