Health complications of female genital mutilation in Sierra Leone

Figures & data

Table 1 The World Health Organization classification of female genital mutilation

Complete typology with subdivisions: Type I – partial or total removal of the clitoris and/or the prepuce (clitoridectomy). ○ When it is important to distinguish between the major variations of type I mutilation, the following subdivisions are proposed: type Ia, removal of the clitoral hood or prepuce only; type Ib, removal of the clitoris with the prepuce. Type II – partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision). ○ When it is important to distinguish between the major variations that have been documented, the following subdivisions are proposed: type IIa, removal of the labia minora only; type IIb, partial or total removal of the clitoris and the labia minora; type IIc, partial or total removal of the clitoris, the labia minora, and the labia majora. ○ Note also that, in French, the term “excision” is often used as a general term covering all types of female genital mutilation. Type III – narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation). ○ Type IIIa, removal and apposition of the labia minora; Type IIIb, removal and apposition of the labia majora. Type IV – all other harmful procedures to the female genitalia for nonmedical purposes, eg, pricking, piercing, incising, scraping, and cauterization.

Reproduced with permission from World Health Organization. Eliminating female genital mutilation: an interagency statement (UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNHCHR, UNICEF, UNIFEM, WHO); 2008.¹

Figure 1 Sierra Leone with its main districts, cities, and neighboring countries.

Table 2 Names of aspects of Bondo society in the main Sierra Leonean languages

Ethnic group	Name of Bondo society	Name of head of society/bush	Name of new initiate	Name of noninitiate
Fulah	Baytee	Barajelli	Betijor	Jiwor
Limba	Bondo	Baregba	Gbonka	Gboroka
Loko	Bondona	Ligba	Bondona/Bondofayra	Gborrga
Mende	Sande	Sokonday/Sowei/Majo	Sandewi	Pkowei
Susu	Guhngiri	Joangojeri	Taysingeh	Amoogaangeh
Temne	Bondo	Digba	Aboanka	Gburka

Table 3 Sociodemographic characteristics of the study population

Sociodemographic variables	Numbers	Percentage (%)
Age (years)
11–15	18	11.7
16–20	45	29.2
21–25	39	25.3
26–30	17	11.0
31–35	20	13.1
36–40	10	6.5
41–45	5	3.2
Total	154	100
Religion
Christianity	72	46.8
Islam	81	52.6
None	1	0.6
Total	154	100
Educational status
Attended school	102	66.2
Only primary education	39
Only secondary education	55
Only tertiary education	8
Did not attend school	52	33.8
Total	154	100
Occupation
Employed	130	84.4
Unemployed	24	15.6
Total	154	100
Ethnic group
Temne	47	30.5
Limba	40	26
Mende	32	20.8
Fulah	7	4.5
Loko	11	7.2
Susu	4	2.7
Kono	5	3.2
Korankoh	5	3.2
Madingo	3	1.9
Total	154	100

Table 4 Age at female genital mutilation for the present study population and Demographic and Health Surveys (DHS) in Sierra Leone (SL) and neighboring countries

Age (years)	Infant	0–1	2–4	5–9	10–14	15+	Do not know	Total
This population – only those with sociodemographic data	0	1 (0.7)	11 (7.1)	28 (18.2)	64 (41.6)	39 (25.3)	11 (7.1)	154 (100)
The whole present study population	0	0	18 (7.0)	43 (16.7)	112 (43.4)	69 (26.7)	16 (6.2)	258 (100)
SL DHS 2008 (%)	22.2	0.1	0.9	13.0	35.6	19.1	9.1
Senegal DHS 2005 (%)	59.6	3.7	9.5	14.9	5.1	0.9	6.3
Guinea DHS 2005 (%)	33.7	0.1	1.9	31.5	26.5	3.1	3.2
Mali DHS 2006 (%)	57.0	4.6	6.5	17.0	8.2	1.1	5.6
Cote d’Ivoire DHS 2001 (%)	55 (0–4)			14 (5–8)	11.4 (9–10), 5.5 (11–12)	8.1
Nigeria DHS 2008 (%)	82.4 (under 1 year)		1.6 (1–4)	12.5 (5+)

Note: Percentages in parentheses.

Figure 2 Complication responses by age at female genital mutilation.

Table 5 Different types of complications reported by age at female genital mutilation (FGM) by two categories: ≤10 years and >10 years of age (respondents who did not know their age are excluded)

Complication	Age at FGM (years) (%)		P-value
	≤10 (n = 59)	>10 (n = 84)
Shock	4 (6.9)	38 (43.7)	<0.01
Bleeding	25 (43)	42 (48.3)	0.37
Fever	24 (41.4)	21 (24.1)	<0.05
Urine retention	8 (13.8)	19 (21.8)	0.17
Fainting	14 (24.1)	23 (26.4)	0.62
Swelling	18 (31)	52 (59.8)	<0.01
Tears	12 (20.7)	23 (26.4)	0.33
Wound	32 (55.2)	41 (47.1)	0.52
Wound infection	7 (12.1)	16 (18.4)	0.25

Table 6 Type of caregiver distributed by category of age at female genital mutilation (FGM) – frequency (percentages in parentheses)

	Sowei*	Nurse/sister	Traditional birth attendants	Traditional healer*
Age at FGM < 10 years (n = 34)	18 (52.9)	5 (14.7)	1 (2.9)	10 (29.4)
Age at FGM ≥ 10 years (n = 146)	56 (38)	8 (5.4)	4 (2.7)	78 (53.1)

Note:

* Although the χ² test gave a P-value of 0.05, this result should be treated with caution, as low numbers used in the statistical calculation make the results unreliable.

WHO Press, World Health Organisation, Geneva, Switzerland Available from: http://www.who.int/reproductivehealth/publications/fgm/9789241596442/en/index.htmlAccessed June 13, 2012

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