Female Sexual Dysfunction in a Third Level Health Facility, Southern Nigeria

Background: Observation during our gynaecology consultations does not tend to agree with reviews in literature suggesting high prevalence of sexual dysfunction. With this background, we decided to subject this general observation to scientific scrutiny to determine the proportion of our patients that actually have sexual dysfunction; and thepredisposing risk factors. Objective: To determine the prevalence and risk factors associated with sexual dysfunction in females attending the gynaecology clinic of the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt. Methods: This was a prospective cross-sectional questionnaire based study of 72 females of reproductive age group attending the outpatient gynaecological unit of UPTH. They were interviewed using the Female Sexual Dysfunction Index (FSFI). A total FSFI score of less than 26.5 was indicative of sexual dysfunction. The data were collated and entered into SPSS version23 statistical software which was also used for analysis. A p-value of < 0.05 was considered significant. Results: The prevalence of sexual dysfunction in females was 61.1% using the FSFI of less than 26.50. The most common type of sexual dysfunction among the respondents was desire disorders (66.7%) followed by disorders of orgasm (62.5%), lubrication (56.9%), arousal (43.1%) and pain (40.3%). Advanced age, higher education, parity and female genital cutting were found to be associated with sexual dysfunction. Conclusion: The findings in this study showed that a significant number of women in our centre are affected with sexual dysfunction.

Emotional Health Work of Women With Female Genital Cutting Prior to Reproductive Health Care Encounters

We used institutional ethnography to explore the social relations that shaped the reproductive health care experiences of women with female genital cutting. Interviews with eight women revealed that they engaged in discourse that opposed the practices of cutting female genitals as a human-rights violation. This discourse worked to protect those affected by the practices, but also stigmatized female genital cutting, making participants anticipate experiencing stigmatization during health care. Women’s engagement in this discourse shaped their emotional health work to prepare for such encounters. This work included navigating feelings of worry, shame, and courage to understand what to expect during their own appointment; learning from family/friends’ experiences; and seeking a clinic with the reputation of best care for women with female genital cutting. It is important to strive for more inclusive health care in which women do not have to engage in emotional health work to prepare for their clinical encounters.

Exploring Beliefs and Attitudes Toward Female Genital Mutilation/Cutting Among Healthcare Providers in New York City

Given the increase of African immigrants from countries with high female genital cutting (FGC) prevalence, this study explored U.S. healthcare providers’ beliefs and attitudes regarding FGC. A total of 31 professionals who have provided services to FGC-experienced women in New York City were interviewed; data were analyzed using grounded theory. Results indicated that, although a majority of respondents emphasized maintaining a nonjudgmental and open-minded attitude toward clients’ experiences, some only focused on the negative aspects of FGC. Also, multifaceted efforts by providers to understand the cultural meanings of FGC and resolve their own cultural dissonance were identified. The implications for practice were discussed.

Female genital mutilation remains high in Senegal: an analysis of DHS 2018

Background Female genital mutilation (FGM), also known as female genital cutting or female circumcision, threatens the health and well-being of millions of girls, women and their children across the globe. In Senegal, despite numerous health interventions, female genital mutilation is still a harmful practice. The objective of this study is to conduct a descriptive and analytical analysis of female genital mutilation practices in Senegal in 2018. Methods This study is a secondary analysis of the 2018 Senegal DHS. The analyses for this study were done on the Individual Records file. The DHS data covered 9414 women aged 15 to 49 years. A multivariate analysis was performed to consider confounding factors. The dependent variable was the existence of female genital mutilation in women. Data were analyzed with STATA 17 software. Results The prevalence of FGM was 17.18%. Women who had flesh removed from genital area represented 60.96% (1338), 29.39% (252) had genital area just nicked without removing any flesh, 6.88% (151) had genital area sown closed. Women who thought that FGM was justified by religion represented 11.52%. However, 80.59% of the women thought that it was a practice that should be stopped. The protective factors for the occurrence of FGM were women's empowerment factors (high level of education of the woman (primary ajOR=0.64 [0.50-0.83] and secondary ajOR=0.43 [0.32, 0.57]) and the fact that the head of the household is a woman ajOR (0.75 [0.59-0.97]); belonging to the central region of Senegal and the Christian religion (ajOr=0.05 [ 0.02-0.13]). The risk factors for female genital mutilation in Senegal were ethnicity and belonging to certain regions in the northeast and southeast of Senegal. Conclusions The prevalence of FGM in Senegal is still high. Ethnicity remains an important risk factor. Women's empowerment would allow the reduction of FGM. In the fight against FGM, politics should include women's autonomy strengthening like girls schooling. Key messages This study highlights the still significant extent of FGM. Women's empowerment factors would prevent these harmful traditional practices.

Barriers and facilitators to the access to specialized female genital cutting healthcare services: Experiences of Somali and Sudanese women in Norway

Background Girls and women subjected to female genital cutting (FGC) risk experiencing obstetrical, gynecological, sexual, and psychological health problems. Therefore, Norway has established low-threshold specialized healthcare services where girls and women with FGC-related health problems can directly seek medical attention. Nevertheless, we lack data about access to these services, especially for non-maternity-related purposes. In this article, we explore experiences of seeking medical attention for health problems that are potentially FGC-related, aiming to identify factors that hinder or facilitate access to FGC-specialized services. Methods We conducted a qualitative study in three Norwegian cities employing semi-structured repeat interviews with 26 girls and women subjected to FGC, participant observation, and three validation focus group discussions with 17 additional participants. We thematically analyzed the data and approached access as a dynamic process of interactions between individuals and the healthcare system that lasts from an initial perception of need until reception of healthcare appropriate to that need. Findings We identified several barriers to healthcare, including 1) uncertainty about FGC as a cause of experienced health problems, 2) unfamiliarity with FGC-specialized services, 3) lack of assessment by general practitioners of FGC as a potential cause of health problems, and 4) negative interactions with healthcare providers. In contrast, factors facilitating healthcare included: 1) receiving information on FGC-related health problems and FGC-specialized services from a non-profit immigrant organization, 2) referral to gynecologists with good knowledge of FGC, and 3) positive interactions with healthcare providers. Conclusion Assessing whether FGC is the cause for experienced health problems requires diagnostic competency and should not be left entirely to the patients. We recommend that Norwegian policymakers acknowledge the central role of GPs in the clinical management of patients with FGC-related health problems and provide them with comprehensive training on FGC.