Within the same exact community, the health experiences that individuals go through can be completely different from one another based on other factors such as culture, education, religion, socioeconomic status, and others. These social, economic, and cultural factors serve as social determinants of health, and they can be found within every community. Although female genital mutilization (FGM) as an issue in the country of Nigeria has had decreasing rates, the prevalence of female genital mutilization is much higher among certain groups of people, and there are factors to better suggest some reasons why.
A person’s or family’s education level is one major social determinant of health. A lot of the families that traditionally practice female genital mutilization are in general less educated, and are from the rural areas of Nigeria. According to a study I read about, over two thirds of female genital mutilization within the study was found among women with the least amount of formal education (Snow et. al., 2002), and this is consistent with many other studies that have been conducted on this topic. A lot of what the less educated families practice and believe is based off of ideas that have been passed by through the family for many years, so it has become a lifestyle; this is their own knowledge. Formal education isn’t the only type of education that can serve as a social determinant of health. Many times, people lack health education and are unaware of the negative effects that undergoing female genital mutilization can have on a woman. They overlook the severity of the matter. One study I looked into included women in a specific Nigerian community who all refused to continue the practice of female genital mutilization within their families. Although majority of the participating mothers have at least secondary education, 50% of them were ignorant about the dangers that female genital mutilization brings (Igwegbe & Egbuonu, 2000). Another study I read fostered a health education intervention program to a sample of the participants of the study, and it was observed that after being trained on the dangers of female genital mutilization, there was a statistically significant increase in the proportion of respondents who had no intention of making their future child undergo the operation (Asekun-Olarinmoye & Amusan, 2008). This sheds light on the importance of receiving a health education and not just a formal one. The study I just mentioned also brought up the fact that many of the women who acquired knowledge on the dangers of female genital mutilization received it from their friends and fellow women in the community, which suggests the importance of peer groups as well. The presence of positive peer groups in an individual’s life could also be considered a social determinant of health.
Snow et. al. brings up religion as a major social determinant of health within their study. Over 85% of the participants that had the operation reported themselves as an affiliate of a Christian faith, such as Catholicism, Pentecostal, or Protestant (Snow et. al., 2002). As mentioned in earlier posts I’ve written, many families have the women go through with the FGM procedure as an attempt to prevent promiscuity and sex before marriage. Because the Christian faith many times encourages waiting until marriage for sexual intercourse, it makes sense that individuals who practice certain religions would have higher rates of female genital mutilization compared to others.
- Marmot, Michael. “Social determinants of health inequalities.” The Lancet 365 (2005): 1099-1104.
- Snow, R.C., Slanger, T.E., Okonofua, F.E., Oronsaye, F. & Wacker, J. “Female genital cutting in southern urban and peri-urban Nigeria: self-reported validity, social determinants and secular decline.” Tropical Medicine & International Health 7.1 (2002): 91-100.
- Igwegbe, A.O. & Egbuonu, Ifeoma. “The prevalence and practice of female genital mutilation in Nnewi, Nigeria: The impact of female education.” Journal of Obstetrics and Gynaecology 20.5 (2000): 520-522.
- Asekun-Olarinmoye, E.O. & Amusan, O.A. “The impact of health education on attitudes towards female genital mutilation (FGM) in a rural Nigerian community.” The European Journal of Contraception and Reproductive Health Care 13.3 (2008): 289-297.