Female genital mutilation (FGM) refers to all procedures involving partial or total removal of female genitalia for non-medical reasons. It is a human rights violation, a public health issue and has substantially detrimental economic consequences.

It is carried out mostly on girls between infancy and the age of 15 and is a traditional cultural practice in many countries in Africa, the Middle East and Asia. It is also practised in the US and the UK by immigrant groups. More than 200 million girls and women living today have experienced FGM. A quarter of global estimates of the practice of FGM occur in Nigeria.

FGM has been outlawed by international legal instruments. It has been criminalised in 24 African countries including Nigeria. In 2012 the United Nations declared 6 February as International Day of Zero Tolerance for Female Genital Mutilation.

In 2020 the UNFPA-Unicef Joint Programme, in its annual report Elimination of Female Genital Mutilation: Accelerating Change, recorded 154 arrests, 100 court cases and 47 convictions and sanctions internationally in connection with the practice. Despite its illegality, FGM continues, but appears to be declining in prevalence.

In a 2020 statement, UN Secretary-General António Guterres called the practice “a blatant manifestation of gender inequality that is deeply entrenched in social, economic and political structures” and “a human rights violation and an extreme form of violence against girls”.

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The rationalisation of FGM

In some societies in Africa, FGM is practised as an initiation rite of passage of girls to womanhood, while in other societies on the continent, it is practised with the avowed intention of protecting women’s chastity and discouraging them from being promiscuous. Reducing the propensity for sexual arousal, FGM is believed to inhibit promiscuous and/or extramarital sexual behaviour. This belief provides the rationalisation or the religious and/or cultural reasons for the practice.

One particular reason behind the decision of families to circumcise their daughters in Nigeria is the family’s concern about the girl-child’s inability to marry if she is not circumcised. The reason is that many cultures in Nigeria and elsewhere believe that when the girl-child is circumcised, it is a sign that she is “pure”. Girls who are not circumcised are perceived as “unsuitable” for marriage on the reasoning that they “may not have control over their sexual desires after maturity and may be susceptible to promiscuity or being unfaithful in marriage”.

Ashifa Agede, the programme officer for sexual and reproductive health at Youth Hub Africa in Nigeria, says that: “Women and girls and mutilated for men’s sexual pleasure. It is done to prepare the girls for marriage, to preserve them so that they don’t become promiscuous. Everything is targeted towards the pleasure of the men that will be in their lives in the future.”

Agede’s youth-focused organisation primarily works with young men by facilitating dialogue and educating men on why the practice is harmful.

“We thought it’s strategic to engage young men, to take the lead in saying this thing has harmful effects, it is not helpful and it shouldn’t be done,” she said.

Lola Ibrahim, the president of the Wo-Men Against Violence and Exploitation Foundation, who herself is a survivor of FGM, said that when she asked her mother why she had to go through the traumatic experience, the answer was that her paternal grandmother had insisted that: “All the girls must be called because it is a tradition.”

Ibrahim explained further the view of her mother: “It is compulsory for girls to be cut and she told me that girls who are not cut are called ‘Akobo’ – it’s a Yoruba word for females who are uncircumcised. It is a derogatory word.”

The economic cost of FGM in Nigeria 

In 2020, the World Health Organization (WHO) launched an interactive data tool that calculates the current and future financial costs of healthcare for women living with conditions caused by FGM. A discussion paper by The Brenthurst Foundation used the cost calculator to calculate the economic cost of FGM in Nigeria at an estimated $49-million.

The cost calculator tool arrived at this figure by using data on the prevalence of FGM in the adult female population (aged 15-49) taken from the most recently available Demographic and Health Survey and Multiple Indicator Cluster Survey, which included a special module on FGM.

The calculator tool estimates the number of healthcare resources required to treat and manage complications of FGM and multiplies these quantities by unit costs. The WHO’s tool illustrates how FGM results in urogynaecological, obstetric, psychological and sexual complications, all of which may result in healthcare costs like outpatient consultations, hospitalisation, medication and other fiscal incurrences.

Agede explained the economic cost of FGM. “Not only does FGM affect reproductive health, it also affects mental health, which goes down to affect their productivity in life… [and] it goes into socioeconomic consequences because [survivors] are sometimes not able to work. It costs the time that [a woman] has been engaging in something productive because she will also be in the hospital or she’ll be too sick or in pain.

“It also has the economic cost to men. If [for example] a man’s wife is dealing with consequences [of FGM] around their reproductive health, he’s going to pay the bills.”

In sum, FGM has material costs and social costs with economic implications. The former refers to health complications caused by FGM resulting in medical expenses throughout the life of an affected woman. On scale, this is a public health burden on the state. The latter refers to the costs to education and labour. FGM adversely affects school performance, leading to higher rates of absence and dropouts among girls.

Early marriage, which often accompanies FGM, may prevent girls’ already limited access to education. Thus, FGM directly affects women’s ability to contribute to a country’s economic development. Affected women who join the labour force may underperform at work because of the possible long-term health effects of FGM. Complications resulting from FGM may lead to the death of a woman/girl. It also increases the mortality of newborns whose mothers have been subjected to FGM.

Recommendations 

• The federal and state governments of Nigeria could ensure that adequate funding is made available for anti-FGM programmes to disseminate clear and accurate information.
• There should be effective monitoring and collection of data concerning the enforcement of the law against FGM, which, in turn, would further facilitate future strategies and programmes.
• Retrogressive practices, such as FGM, and the silencing of women in respect thereof, hinder economic development across a broad front.

The Brenthurst Foundation released a discussion paper this week on the economic cost of FGM in Nigeria. This article provides a summary of the discussion paper’s findings.

You can read the full discussion paper here. DM

Alexandra Willis is the Machel-Mandela research fellow at The Brenthurst Foundation.

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