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Knowledges, attitudes, and practices about Female Genital Mutilation/ Cutting among pregnant women assisting to Kwinalla Minor Health Centre (The Gambia)
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Resumo(s)
Resumo: A Mutilação Genital Feminina (MGF) é uma prática sociocultural que continua
a ocorrer, silenciosa e enraizada com graves consequências para a saúde e bem-estar das mulheres e raparigas. Na Gâmbia, as percentagens continuam a ser elevadas, apesar da ilegalização em 2015. As zonas rurais estão geralmente mais enraizadas na tradição.
Compreender o contexto das mulheres nas comunidades rurais é, portanto, crucial na
formulação de estratégias de prevenção, e sensibilização para a erradicação da MGF,
baseados na não estigmatização e no respeito pela sua cultura e identidade.
As mulheres grávidas são o futuro para a continuação ou abandono, no entanto, a sua
perspectiva tem sido escassamente explorada nos países africanos. Compreender os seus conhecimentos, atitudes e práticas, bem como as complicações percebidas e as suas opiniões sobre o efeito da MGF durante o parto, pode contribuir para a evidência mais recente sobre este campo.
Os Profissionais de Saúde desempenham um papel importante nas suas comunidades
como agentes de saúde, prevenção, e cuidados. As Clínicas de Cuidados Pré-Natais
(CPN) são espaços onde todos os meses uma equipa de saúde vai verificar a saúde das mulheres e das crianças.
Método: Questionário de Conhecimentos, Atitudes e Práticas aplicado no contexto dos
cuidados pré-natais a 77 mulheres grávidas nas áreas de Kiang West e Kiang Central em Lower River Region.
Resultados: Os resultados foram analisados de acordo com os grupos étnicos
maioritários (Mandinka/ Fula) e em função de se as mulheres foram mutiladas ou não.
Quanto aos conhecimentos, 50,0% das mulheres independentemente da etnia justificam
a prática com a base na tradição, e no que respeita à opinião sobre a prática ( 45,2% das fulas, 53,1% das Mandinkas) consideram a prática prejudicial. Em relação à questão
sobre se a MGF afeta o parto, cerca de 56% das Mandinkas e as Fulas acreditam que sim.
61,2% das mulheres com MGF também reconhecem que tem relação ( p>0.00328). Os
resultados sobre atitudes mostram percentagens elevadas de mulheres (75,3%) que
relatam não falar de complicações da MGF com ninguém. Mas a atitude é positiva em
relação à advocacia e sensibilização (70,0%). O medo entre as mandinkas (59,4%), é a
memória comum quando se recorda a MGF. A última secção revela elevadas
percentagens de discordância com a continuidade da prática entre Fulas (64,3%) e
Mandinkas (75%). Sendo a tradição a resposta comum entre aqueles que ainda querem a continuação da prática (33,3% Fulas; 21,0% Mandinkas).
Conclusões: Compreender o contexto sociocultural da região é crucial para interpretar
resultados, como o facto de as mulheres não falarem de complicações da MGF, mas,
quando questionadas na privacidade dos cuidados pré-natais, acreditam que a
sensibilização e a educação para a erradicação devem continuar. É por isso que os
Profissionais de Saúde desempenham um papel importante na erradicação da MGF. A
tradição é difícil de quebrar, mas o efeito que a MGF tem no parto pode ser um ponto de
partida para sensibilizar as futuras mães.
Abstract Female Genital Mutilation /Cutting (FGM/C) is an ongoing, silent, and rooted sociocultural practice with severe consequences for health and well-being of women and girls. Percentages continue to be high despite the illegalization in the Gambia in 2015. FGM/C is even more prevalent in Rural Areas. Understanding the context and perceptions of women in rural communities, is a must to be able to create successful prevention strategies and appropriate sensibilization, based on non-stigmatization and respect for their culture and identity. Pregnant women are the future towards the continuation or abandonment, nevertheless their perspective had been barely explored in African Countries. Understanding their knowledges, attitudes, and practices, as well as the perceived complications and their opinions towards the effect of FGM/C during childbirth, can contribute to the most recent bibliography on this field. Health Care Professionals (HCP) play an important role in their communities as agents of health, prevention, and care. Antenatal Care Clinics (ANC) are spaces where every month a health team goes to check on women and children´s health. Methods: Knowledges, Attitudes and Practices questionnaire applied to 77 Pregnant women assisted by Antenatal Care in Kiang West and Central Areas of Lower River Region. Results: The results were analysed according to the main ethnic groups (Mandinka / Fula) and whether the women were mutilated or not. Within the knowledge section, half of them justify the practice based on tradition, and consider the practice to be harmful. 56% of the women independent of the ethnic group and 61% women, who were mutilated, believe that FGM/C has an effect on childbirth (p>0.00358). Attitudinal results show high percentages of women (75,3%) who report not to talk about FGM/C complications with u anyone. But have a positive attitude towards advocacy and sensitization (70%). Psychological questions show that fear among Mandinkas (59,4%) is the common memory when remembering FGM/C. The last section reveals high percentages of disagreement with the continuity of the practice among Fulas (64,3%) and Mandinkas (75%). Being tradition the common answer among those who still want the continuation of the practice (33,3% Fulas; 21% Mandinkas). Conclusion: To understand the sociocultural context of the region, and levels of education it is crucial to interpretate results like the fact that women do not talk about FGM/C complications, but, when ask in the privacy of the Antenatal Care, they believe advocacy and sensitization towards the eradication should continue. That is why Health Care Professionals play a major role in the abandonment of the practice. Tradition is hard to break but the effect that FGM/C has on childbirth can be a starting point to raise awareness among future mothers.
Abstract Female Genital Mutilation /Cutting (FGM/C) is an ongoing, silent, and rooted sociocultural practice with severe consequences for health and well-being of women and girls. Percentages continue to be high despite the illegalization in the Gambia in 2015. FGM/C is even more prevalent in Rural Areas. Understanding the context and perceptions of women in rural communities, is a must to be able to create successful prevention strategies and appropriate sensibilization, based on non-stigmatization and respect for their culture and identity. Pregnant women are the future towards the continuation or abandonment, nevertheless their perspective had been barely explored in African Countries. Understanding their knowledges, attitudes, and practices, as well as the perceived complications and their opinions towards the effect of FGM/C during childbirth, can contribute to the most recent bibliography on this field. Health Care Professionals (HCP) play an important role in their communities as agents of health, prevention, and care. Antenatal Care Clinics (ANC) are spaces where every month a health team goes to check on women and children´s health. Methods: Knowledges, Attitudes and Practices questionnaire applied to 77 Pregnant women assisted by Antenatal Care in Kiang West and Central Areas of Lower River Region. Results: The results were analysed according to the main ethnic groups (Mandinka / Fula) and whether the women were mutilated or not. Within the knowledge section, half of them justify the practice based on tradition, and consider the practice to be harmful. 56% of the women independent of the ethnic group and 61% women, who were mutilated, believe that FGM/C has an effect on childbirth (p>0.00358). Attitudinal results show high percentages of women (75,3%) who report not to talk about FGM/C complications with u anyone. But have a positive attitude towards advocacy and sensitization (70%). Psychological questions show that fear among Mandinkas (59,4%) is the common memory when remembering FGM/C. The last section reveals high percentages of disagreement with the continuity of the practice among Fulas (64,3%) and Mandinkas (75%). Being tradition the common answer among those who still want the continuation of the practice (33,3% Fulas; 21% Mandinkas). Conclusion: To understand the sociocultural context of the region, and levels of education it is crucial to interpretate results like the fact that women do not talk about FGM/C complications, but, when ask in the privacy of the Antenatal Care, they believe advocacy and sensitization towards the eradication should continue. That is why Health Care Professionals play a major role in the abandonment of the practice. Tradition is hard to break but the effect that FGM/C has on childbirth can be a starting point to raise awareness among future mothers.
Descrição
Palavras-chave
Doenças tropicais Mutilação genital feminina Cuidados pré-natais Profissionais de saúde Mulheres grávidas