Study into the Prevalence of FGM in Nigeria

analyse into the Prevalence of FGM in Nigeria 2. METHODOLOGY2.1 DataThe Nigerian demographic well upness Surveys (NDHS) of 2013 supporting evidence and additional sources of data from published reports of NDHS 2013 see been utilize in this scan.Datasets for 2013 Nigerian DHS were downloaded undermentioned approval from measuredhs.com. Authorisation was obtained via registering with measuredhs.com, requesting permission to rehearse datasets. Permission to use data was granted via email. (Appendix I).Demographic Health surveys have been ongoing for everyplace 30 eld in over 90 countries with over 300 surveys aimed at fostering global knowledge of health and nation trends in developing countries.DHS surveys be nationally representative sept surveys in women aged 15-49 (and sometimes men aged 15-49) which yield internationally comparable data on health indicators in developing countries. Datasets produced from this surveys are owned by measuredhs.com as part of the projects implemented by large International, with its funding from USAID. In most countries the DHS surveys are conducted every five years providing retrospective estimates of four years including year of study, with large ingests from phratrys through vista to face interviews using standardised questionnaires designed to gather information on female genital cutting, maternal and child health, nutrition, HIV/AIDS, family planning, gender, malaria as well as the socio sparing and demographic characteristics. DHS surveys involve large samplesIn Nigeria, the internal Population Commission (NPC) representing the Federal Government of Nigeria, conducts the survey with technical service from Macro International. The purpose of this data dispassionate is to direct policy making, planning, supervise and evaluation of programmes.Two phases are gnarly First phase involves register of urban and rural areas in clusters based on national population distributions. Eligible households are selecte d using systematic taste, allowing for a large sample to achieve statistically significant results (Hajian-Tilaki, 2011). The second phase involves data assembly using the three standard DHS questionnaires (household, women and men questionnaires).In the Nigerian Demographic Health Survey 2013, data was collected over five months, faultless questionnaires were then edited, processed in CSPro computer package and all that was cleaned. This ensures true statement of information and confidentiality to participants. Data collected is standardized by weighting adjusting for over and under sampling to produce representative results (NDHS, 2013).The NDHS 2013 facilitates a comprehensive externalise of the current global trends on knowledge and prevalence of FGM among women and their daughters, suits of circumcision, age at circumcision, and attitudes toward the convention to be constructed.Prior to NDHS Surveys of 2013 there were subsequent surveys in 1999, 2003, 2008 which collecte d data on FGM. This surveys reported prevalence of FGM in Nigeria amongst women age 15 to 49 as shown in mesa belowTable 2.1 covering prevalence of FGM in Nigeria from NDHS surveys.The prevalence of FGM in Nigeria from 2003 to 2008 recorded an increase and this was partially from the use of a new definition for what constitutes as FGM and also differences in the data available for selecting the sample. Interviewers used in the northeast of Nigeria include local anesthetic forms of cutting and scraping of the vaginal walls in their definition of what constitutes FGM. The data bases for selecting the samples for the Nigeria DHS of 2003 and 2008 were comparatively different, hence that made the distribution of the samples by region variant. (Yoder et al 2013). In the 2013 NDHS, the definition of FGM explicitly followed the WHO definition of FGM.In dissecting trends linked with FGM in Nigeria, it is incredible that comparing prevalence of FGM using Nigeria DHS over years will indue v alid reasons for the trends over the years due to differences mentioned earlier (NDHS, 2013).2.2 VariablesThe drivers of FGM from previous studies place as mix of cultural, religious and social factors within families and communities. The uncertains of intimacy in this study are those related to these drivers of FGM and are classified as social, cultural, frugal and geographical factors (WHO, 2014).For effective analyses some of the inconstants have been recoded. A full run of variables is attached in Appendix II.The knocked out(p)come or dependent variable considered in this analyses is FGM whether a woman had FGM or not.Other secondary outcomes of interest in this study is who performs FGM, perspectives and opinions on FGM were also examined (further categorized in table 2.1).The main independent variable in this study is maturate at time of survey which serves as an indicator of the birth cohort of the participant.The characterization variables of interest in this study- residence, region- in order to analyse subpopulation trends. Other variables included in this study religion, ethnicality, education and wealth. The variable wealth index, measures a household relative economic status. This is calculated by a process which recodes and pools in concert data on household assets such as fictional character of toilet, possession of durable goods, etc. to produce a continuous standardized scale.This variables although not exhaustive have been selected because of their association with culture, socio-economic status which have an impact on the FGM practice (WHO, 2014).The relationship examined in this study will use the pursual variablesTable 2.1 Definition and categorization of variables.*Types of FGM in table above (a) sign I and II flesh removed from genital area (b) type IV genital area nicked no flesh removed (c) type III genital area closed. WHO classification for FGM (WHO, 2014).**All major ethnic groups in Nigeria and FGM practicing groups of significance from NDHS 2013 survey.2.2 Data Analysis2.2. 1 Conceptual mannikin for analysing trends linked with FGM in Nigeria (WHO, 2014 NDHS Reports, 2013).The framework for analysis of trends linked with FGM will take in in to cognizance sociodemographic factors that can confound or mediate the practice of FGM in Nigeria. This factors are shown belowFigure 2.1 above showing abstract framework for analysis of FGM trends.2.4 Data AnalysisAll analyses in this study were computed using SPSS v.22. The Data was weighted and complex sampling procedures used to downplay errors from sampling techniques used in NDHS 2013, thus ensuring results are valid (IBM 2015). The sampling weight was used for all analysis. A major part of the analyses involved handling of data using syntax files, a programme of orders which automatically computes analysis and can be saved. Some programmes used for the analyses can be found in Appendix III.The following statistical analysis were carried out to ac hieve the aim and objectives of this study2.4.1 Descriptive AnalysisThe analysis examined the following areas public distribution of background characteristics of women age 15-49 frequency of background characteristicsGeneral Distribution of FGM related perspectives and opinions- frequencies of perspectives and opinions in the followingEver heard of FGMAge women had FGMPrevalence of FGM including typesWho performed FGMNumber of daughters with FGMBeliefs on FGM require by religionViews on if FGM practice should continue or stop.Trends of FGM prevalence including types of FGM serving of women with FGM and its relationship by background characteristics, percentage of types of FGM and its relationship by background characteristics.Trends of perspectives and opinions on FGM by background characteristics as listed above from b i, ii, iv, v, vi and vii.Trends of beliefs on FGM required by religion percentage of women with FGM by beliefs on FGM required by religionTrends on opinions of FG M practice should stop or continue percentage of women with FGM opinion on practice should stop or continueTrends of perspectives and opinions on FGM by age.Besides percentages and confidence intervals, chi-square test for trends are computed to get wind the statistical significance of these associations.2.4.2 Logistic turnaround analysisThe variables on women background characteristics and perspectives of FGM were fitted into reverting samples in order to determine the extent they predict the outcome i.e. having FGM (b) to ascertain if the practice is declining or increasing by birth cohorts.This form of analysis involves computing bivariate and variable analyses using the main outcome FGM as the dependent variable and the previous variables (i.e. background characteristics) as the independent variables.In the bivariate analysis all independent variables except region were fitted into the model to estimate the crude trends in having FGM. Region was exempted to minimise confoun ding.A multivariate analysis involved fitting the same variables into the model controlling for age, education, ethnicity, economic status (wealth), urban-rural residence, and religion. The aim is to ascertain the relative importance of each variable as a predictor of having FGM.The reference categories for each variable fitted into the regression model are age (15-19) education (no education), ethnic group (others), habitation (rural), religion (Islam), wealth index (richest).