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CHAPTER FIVE
SUMMARY AND CONCLUSION
This chapter highlights the summary of findings discussed in chapter four, the conclusion, implications, suggestions for further studies and recommendations.
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5. 97% of the programme trainees used ante/postnatal clinic sessions, health talks and one-on-one approach as major means of disseminating information on the dangers of FGC as well as available management opportunities for FGC victims. Five (5) out of the seven (7) approaches (one-on-one, step down, health talks, immunization clinics and market/open spaces) were found to have dual ratings of high and moderate effectiveness;
while two (2) of the approaches (house to house/door to door and ante/postnatal clinic sessions) had singular ratings of high effect.
6. Fifty two (52) focus group discussants within the age ranges of 15 to 19 yrs (15%), 20 to 29 years (56%) and 30 to 40 years (28%) were pooled from five (5) focus PHCs/MHCCs in the two (2) LGAs of intervention of these 19% were currently in school at higher education level, 81% had their last levels of education as JSS, SSS, Grade II/NCE. Others had formal trainings and higher education; while their parents‟ educational status ranged from no education (19%) to Grade II/NCE (81%).
7. For status factors of marriage and work, majority of the discussants (92%) are married while 8% are unmarried; and a negligible number (4%) are not working while those who are working (96%) are engaged in professions such as trading, fashion designing, hairdressing, patent chemist, catering, as well as apprentices on similar professions.
8. In respect of religious affiliation, 58% were Christians and 42% were Muslims, majority were cut as infants (61%), as toddlers (12%) and as adolescents (27%), with FGC Type I (Olopon) being dominant among the discussants (22, 42%), while the other 13 (25%) and 4 (8%) had FGC Types II and III (i.e. Alabede and Apa ati enu) respectively. Thirteen (13, 25%) did not know the FGC type that was carried out on them.
9. In relation to number of female children and their cut status, 44 (85%) discussants have female children, of which 20 (45%) were cut at infancy, 18 (90%) and 2 (10%) as toddlers; while the remaining 24 (55%) did not have FGC carried out on their female children.
10. Female genital cutting (also referred to as A be di da obirin‟; Ila fun obirin‟; Di da abe omo „birin‟; A da „be obirin‟; and Ki ko ila fun omo „birin), was identified by the fifty two (52) discussants as the most prominent traditional practice that affects females‟
psychological and physical well being as well as cause maternal mortality in practicing communities in LGAs of intervention in Oyo State; and they had contrary views on FGC
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(i) Reducing promiscuity in females; and (ii) Preventing death of a new born baby during the delivery process.
11. Psychological experience (also referred to as wahala okan; okan ri ru; ipo ri ru okan) of fear, pain, depression, recall of unpleasant memories and shame (embarrassment for cut status) were the frequently mentioned experiences associated with FGC by discussants.
Victims of Types II or III (17, 33%) were found to be fearful of sexual intercourse because of anticipated and experienced pain during penile penetration as well as de-infibulations and episiotomy during the delivery process.
12. Discussions with interviewees revealed that though causes of prolonged labour are not disaggregated, blockage of the vagina which is a major cause of prolonged labour due to the healing of more extensive FGC cut types (FGC Types II and III), is a contributory factor in maternal mortality, especially among FGC victims.
13. As part of the outcomes of discussions with mothers who have experienced FGC, it was concluded that there is a close relationship between fear and pain, and recall of unpleasant memories of the FGC process and depression.
14. The age of respondents from intervention and no intervention LGAs ranged from 10 to 14 years (700; 44%), 15 to 19 years (367, 23%) and 20 to 24 years (533, 33%); with 934 (58%) currently in school and 666 (42%) having their last levels of education as secondary, primary, and no education.
15. For status factors of parents‟ education, FGC, marriage and work, 83% of respondents parents had either primary, secondary or higher education; 50% of parents are not cut, 41% are cut while 9% do not know their FGC status. Majority of the respondents are single (89%), 9% are married and a negligible number are either separated or divorced.
Work status is inferred from respondents educational level: working, 42% and not working 58%; and the majority of the respondents 844 (53%) reside in Urban areas;
while the remaining 756 (47%) resided in Rural areas.
16. Profile of respondents from intervention LGAs on knowledge revealed a significant difference on only nine (9) items with adolescents performing better than the young adults, with an independent t-test analyses corroborating the result; while profile of intervention LGAs respondents in relation to attitude showed significant differences for
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80% (12) of the items, but no significant difference between adolescents and young adults was observed using the independent t-test analysis.
17. Also, the result of Hofstede‟s Cultural Dimension Theory (HCDT) analysis for intervention LGA respondents showed that attitudes towards the practice of FGC are negative, with communities having low UAI; high PDI; high feminity score; high IDV and STO score.
18. The obtained equation resulting from a set of nine predictors (intervention activities/programmes, psychological experience, age range, present educational level/status, parents‟ educational status, fgc status, marital status, work status and location of residence) allowed reliable prediction of the criterion (knowledge on dangers of FGC); and present educational level and work status significantly contributed to the prediction model on knowledge.
19. The obtained equation resulting from a set of nine predictors (intervention activities/programmes, psychological experience, age range, present educational level/status, parents‟ educational status, fgc status, marital status, work status and location of residence) allowed reliable prediction of the criterion (attitude towards FGC);
and intervention activities/programme, psychological experience, age range, present educational level, work status and location of residence significantly contributed to the prediction model for attitude.
20. Analysis of results indicate that update training for programme trainees/HCPs had a positive-significant relationship with opportunities and expert counselling accessed by FGC victims.
21. The result of the independent t-test analyses for early, middle and late (young adults) adolescents from intervention LGAs in relation to knowledge showed that there was a significant difference in their knowledge of dangers of FGC with middle adolescents performing better than the early and late (young adults); while for attitude towards the practice, early adolescents had a higher mean score than middle and late (young adults) adolescents.
22. Results of significant differences in knowledge of dangers of FGC and attitude toward the practice of FGC for intervention LGAs revealed that in-school respondents performed
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better on the FGCKT, while out-of-school respondents had higher negative attitudes towards FGC.
23. The independent t-test results on knowledge of dangers of FGC and attitudes towards FGC between all the female respondents, female in-school respondents and female out-of-school respondents in intervention LGAs and LGAs with no intervention revealed that, respondents in intervention LGAs had higher mean scores than their counterparts in LGAs with no intervention.