A STUDY ON THE EFFECTS OF FEMALE GENITAL MUTILATION ON WOMEN'S REPRODUCTIVE HEALTH IN CAMEROON

CHAPTER ONE INTRODUCTION 1.1 Background of the Study Female Genital Mutilation (FGM), also referred to as female circumcision or female genital cutting, is an age-old cultural ritual that involves the partial or total removal of external female genitalia, or other forms of injury to the female genital organs, performed for non-medical reasons (World Health Organization [WHO], 2023). This deeply rooted tradition has existed for thousands of years and is predominantly practiced in Africa, parts of the Middle East, and some areas in Asia. Often, it is carried out as a rite of passage into womanhood, a way to control female sexuality, or as a prerequisite for marriage. Globally, FGM is regarded as a serious human rights violation and a form of gender-based violence. It is frequently inflicted on young girls without their consent, resulting in both immediate and long-term health complications. FGM is classified into four main types: Type I (clitoridectomy), Type II (excision), Type III (infibulation), and Type IV (all other harmful procedures done to the female genitalia for non-medical purposes, such as pricking or cauterization). The prevalence of FGM varies from country to country, but it remains widespread in regions like sub-Saharan Africa and parts of the Middle East, where cultural, religious, and social norms continue to uphold the practice. In countries like Somalia, Guinea, and Djibouti, over 90% of women and girls between the ages of 15 and 49 have undergone FGM (United Nations Children’s Fund [UNICEF], 2022). Despite global campaigns and local initiatives aimed at its eradication, the practice continues to affect over 4 million girls annually (UNICEF, 2022). The health impacts of FGM are extensive and multifaceted. Immediate effects include intense pain, heavy bleeding, shock, and in some severe cases, death. The procedures are often carried out in unsanitary conditions by untrained individuals, heightening the risk of infections such as tetanus and sepsis (WHO, 2023). Long-term consequences may include chronic health problems like urinary tract issues, menstrual complications, frequent infections, and problems during childbirth. Women who have undergone FGM are more likely to face complications during labor, including prolonged delivery, postpartum hemorrhage, and severe tearing, which can lead to obstetric fistula and endanger both mother and child (Banks et al., 2021). The psychological toll is equally significant. Women subjected to FGM are at a higher risk of experiencing anxiety, depression, post-traumatic stress disorder (PTSD), and emotional trauma, particularly if the procedure was performed during childhood without their informed consent (Berg & Denison, 2012). Additionally, FGM can reduce sexual pleasure and cause pain during intercourse due to scarring and narrowing of the vaginal opening, which often affects intimacy and overall quality of life (Abdel-Azim, 2020). Efforts to eliminate FGM have spanned decades, spearheaded by international and local organizations that focus on advocacy, education, and legal reform. Agencies like WHO, UNICEF, and the UNFPA have been at the forefront of these campaigns, promoting community-based awareness and legal protections for women and girls (UNICEF, 2022). In recent years, many countries have enacted laws banning FGM, but enforcement is often inconsistent, and deep-rooted cultural beliefs continue to perpetuate the practice. Beyond the health implications, FGM also has far-reaching social and economic consequences. Women affected by FGM may suffer from stigma, discrimination, and reduced access to education and employment opportunities, thereby reinforcing cycles of poverty and gender inequality (Shell-Duncan et al., 2018). In many areas where FGM is prevalent, limited access to healthcare only exacerbates the problem, as affected women may not receive adequate treatment due to a lack of healthcare facilities or trained professionals. Despite growing global awareness and efforts, FGM continues to place millions of girls at risk each year. This reality underlines the need for more targeted research into its effects, particularly on women’s reproductive health. As such, this study aims to explore the impact of female genital mutilation on reproductive health among women in Cameroon. 1.2 Statement of the Problem Female Genital Mutilation (FGM), which involves the partial or complete removal of the external female genitalia or the infliction of harm to female genital organs for non-medical purposes, remains a pressing issue in many parts of the world. Despite concerted efforts at both global and local levels to abolish the practice, it is estimated that more than 200 million girls and women alive today have undergone some form of FGM—particularly in regions such as Africa, the Middle East, and Asia (WHO, 2023). The continuation of this practice is largely fueled by cultural norms, social pressure, and entrenched gender inequality, all of which contribute to its harmful impact on women’s reproductive health. The associated health risks are both immediate and long-lasting, ranging from acute pain, severe bleeding, and infection to complications during childbirth, increased infant mortality rates, and profound psychological trauma (WHO, 2023). Studies show that women who have experienced FGM are significantly more likely to encounter childbirth-related complications such as obstetric fistula, fetal distress, and even maternal death (Berg et al., 2019). Additional consequences include the development of cysts, chronic pelvic infections, and sexual dysfunction—factors that severely undermine a woman's physical and emotional well-being (Banks et al., 2021). Despite the known dangers of FGM, there is still a lack of comprehensive understanding regarding its full impact on reproductive health—especially in communities where reliable data is scarce, and cultural taboos hinder open discussion. This gap in knowledge calls for further investigation into how FGM affects women’s reproductive health, particularly within the context of Cameroon. 1.3 Objective of the Study The general aim of this study is to examine the impact of female genital mutilation on women’s reproductive health in Cameroon. The specific objectives are to: i. Assess the prevalence of FGM among women in Cameroon. ii. Explore the perceived cultural and social reasons for the continued practice of FGM in Cameroon. iii. Identify the reproductive health complications associated with FGM in Cameroon. iv. Investigate how FGM affects fertility rates and reproductive functions among affected women in Cameroon. v. Recommend strategies to improve reproductive healthcare services for women who have undergone FGM. 1.4 Research Questions The following research questions will guide the study: i. What is the prevalence of FGM among women in Cameroon? ii. What are the perceived reasons for the practice of FGM in Cameroon? iii. What reproductive health complications are associated with FGM in Cameroon? iv. How does FGM impact fertility and reproductive functions in affected women? v. What strategies can be adopted to improve reproductive healthcare for women who have undergone FGM? 1.5 Significance of the Study The findings of this research are expected to contribute meaningfully to public health initiatives aimed at reducing the prevalence and harmful effects of FGM. By shedding light on the most common health complications and identifying the demographics of those most affected, the study can help inform targeted interventions. These may include tailored healthcare services, mental health support, and educational campaigns that address both the medical and social consequences of FGM. Academically, this study will enrich existing literature on FGM and its effects on reproductive health. It will also serve as a valuable resource for scholars, health professionals, and policymakers, while offering a foundation for future research on the topic. 1.6 Scope of the Study This study focuses on exploring the impact of female genital mutilation on women’s reproductive health within the Cameroonian context. Specifically, it will assess the prevalence of FGM among women, investigate the cultural and social reasons behind its continuation, identify the related health complications, examine its effects on fertility and reproductive functions, and propose measures to improve healthcare for affected women. Geographically, the study is limited to women residing in Douala, Cameroon. 1.7 Limitations of the Study As with any academic undertaking, this study faced a few limitations: Time Constraints: The researcher had to balance the demands of this study with other academic responsibilities, such as attending lectures and participating in school-related activities. Financial Challenges: The study required significant financial resources for activities such as printing, data collection, and accessing relevant materials and literature. Access to Materials: Obtaining sufficient literature on the subject posed a challenge due to the sensitive and under-researched nature of the topic, making it difficult to find adequate references and empirical studies. 1.8 Definition of Terms Female Genital Mutilation (FGM): A traditional practice involving the partial or complete removal of the external female genitalia or other injuries to the genital organs for non-medical purposes. It is commonly carried out on young girls and is associated with severe health complications. Reproductive Health: A comprehensive state of physical, mental, and social well-being in all aspects related to the reproductive system. This includes the right to a safe and fulfilling sex life, the ability to reproduce, and the freedom to decide when and how often to do so. Short-term Complications of FGM: These are immediate health risks following the procedure, including intense pain, excessive bleeding, infections, and in some cases, shock—all of which can lead to life-threatening situations if untreated. Long-term Complications of FGM: These include chronic pain, recurring infections, painful menstruation, sexual dysfunction, infertility, and childbirth complications that can persist long after the procedure. Psychological Effects: The emotional and mental trauma experienced by FGM survivors, which may include conditions like anxiety, depression, PTSD, and a diminished sense of self-worth. Sexual Well-being: Refers to a state of physical, emotional, mental, and social health in relation to sexuality. FGM can impair sexual well-being by causing pain during intercourse, reducing libido, and diminishing sexual satisfaction.