Quality Of Sexual Life In Women With Female Genital Mutilation/cutting And Associated Factors At Garissa Level Five Hospital.

Abstract

Background: Globally an estimated 3million young girls undergo female genital mutilation/cutting (FGM/C) each year in the world. FGM/C has no health benefits and is associated with complications including sexual problems. According to the Kenya Demographic Health Survey Statistics (KDHS) 2014, 21% of women were reported to have undergone FGM/C with a high prevalence of 97.5% in North Eastern Kenya where Garissa County is located. While efforts to encourage the abandonment of FGM/C in Kenya began in the 1930s and anti-FGM/C campaigns have employed various strategies including alternative rites of passage for adolescent girls, empowerment of the girl child, public education campaigns, and advocacy programs for women and girls, government reports indicate major challenges persist towards eradicating FGM/C. Objectives: To determine the quality of sexual life post FGM/C and its associated factors among women attending the reproductive health (RH) clinics at Garissa level V Hospital in 2018. Methodology This descriptive cross sectional study was used to determine the quality of sexual life in women who have undergone FGM/C. The study population comprised of 165 women with FGM/C. We used the Female Sexual Function Index score (FSFI) Questionnaire to obtain quality of sexual life history post FGM/C as well as the associated FGM/C complications. The women were examined to ascertain the type of FGM/C and the associated complications. Study site: Garissa level Five Hospital, Reproductive Health clinics. Results: During the study 165 respondents with different types of FGM/C were interviewed, The mean age of the participants was (28.4 SD 6.4) with a mean age at cutting (7.4 SD 1.7). The older women, those who had no or low level of education as well those who were not gainfully employed had poor FSFI scores. Majority (39%) had FGM/C type II – Excision, while only 13% had FGM/C type IV. Analysis reported overall sexual function to be significantly different across the different types of FGM/C. there was a significant association (p< 0.001) between the FGM/C types and the sexual function score, with women who have FGM/C type I having higher x FSFI scores compared to women with type III and IV ( 28.9 VS 13.3 ).The data showed a significant association (p< 0.001) between long term complications and sexual function with women who have long term complications e.g. scarring having low FSFI scores (15.8 SD 6.6). Conclusion: Our study revealed that sexual experiences and functioning of women is negatively affected by FGM/C. The women who had FGM/C types III and IV scored poorly on the FSFI compared to types I or II. The effect of a reduced sexual functioning is likely to negatively impact the general wellbeing of these women.