Title: Cohort Analysis of the State of Female Genital Cutting in Nigeria: Prevalence, Daughter
Circumcision and Attitude towards its Discontinuation
Version: 3 Date: 30 Jan 2021
Reviewer:  Hassan Abduljabbar
Reviewer's report:
BMC Women's Health
Cohort Analysis of the State of Female Circumcision in Nigeria: Prevalence, Daughter
Keywords: Cohort analysis, Complications, Female circumcision, Harmful Traditional
Practices, Nigeria
Report
Abstract: was well written.
Background:
Female circumcision inflicts life-long injuries on women and girl child.
Constitutes a violation of women’s fundamental human rights
threats to bodily integrity.
Though decreasing, the practice is high and widespread in Nigeria
efforts towards its eradication.
The study's objective was to perform a cohort analysis of the state of female circumcision
between the years 2009 and 2018 in Nigeria.
• It is a good summary.
• Easy to understand
• Have good massage
• Important subject
• It is not Original (a similar study was done 2011)
Abiodun, Alfred A., Benjamin A. Oyejola, and Obalowu Job. "Female circumcision in Nigeria,
prevalence and attitudes." CPJ 2011133, (2011): 17202.
Methods
Study Area
Nigeria
women of childbearing age who had given birth to at least a daughter.
The practise of female circumcision is widespread in the country with the exclusion of a few
tribes.
Study Design and Data Collection
The study used the Nigeria Demographic and Health Survey (NDHS) data for 2008, 2013, and
2018.
NDHS is a nationally representative household sample survey designed to collect data on
fertility, mortality, reproductive health, family planning, child health, nutrition, HIV/AIDS,
malaria, female genital mutilation, and a host of other topics [8].
The surveys specifically collect data on various aspects of female circumcision such as
• Knowledge of female circumcision,
• The prevalence of female circumcision among mothers and daughters,
• Types of circumcision,
• Age at circumcision,
• Persons who performed circumcision,
• Attitudes towards female circumcision.
The survey employed a stratified two-stage sampling procedure in collecting data from the
households.
We confirm that all methods were carried out in accordance with relevant guidelines and
regulations (http://dhsprogram.com/data/available-datasets.cfm).
Variable Description
Three outcome variables were used. The variables were created based on the question of whether
or not the:
• Respondent is circumcised,
• Respondent circumcised her daughter, and
• cCrcumcision practice should be discontinued.
However, at the point of data analysis for each of the outcome variables, women with missing
information on that particular outcome variable were excluded.
Since the practice of circumcision is usually done within the first five years of life in Nigeria
[9], the analysis based on the first question was restricted to four variables (place of residence,
religion, ethnicity, and region) while that of the second and third questions were based on
background characteristics of the respondents (place of residence, religion, ethnicity, and region,
wealth index, education, partner’s/husband’s education, marital status, circumcision required by
religion, and circumcision status of the respondent).
The primary independent variable was “birth cohort”. The cohorts were created in five based
on the year and month of birth, the century month code (CMC) approach was used [31]. Three
rounds of Nigeria
Demographic Health and Survey dataset were merged to obtain the cohorts. Consequently, nine
5-year birth cohorts were created, these include: 1959-1963, 1964-1968, 1969-1973, 1974-1978,
1979-1983, 1984-1988, 1989-1993, 1994-1998, and 1999-2003.
Data Analysis
Data analyses were carried out at three different levels, ranging
from univariate to multivariate levels.
Frequency distribution of important variables was carried out at the univariate level. The chi-
square distribution test was performed at the bivariate level, and logistic regression at the
multivariate level; variables that were not statistically significant at the bivariate level were not
included in the final analysis.
The logistic regression
Results:
The study found that that female circumcision
has reduced over the years from 56.3% among the 1959-1963 birth cohort to 25.5% among
1994-1998 cohorts
But a rise in female’ circumcision between 1994-1998 cohorts and 1999-2003 fellows (28.4%).
The percentage of respondents who circumcised their daughters reduced from 40.1% among the
oldest birth cohort to 3.6% among the younger cohort.
• Birth-cohort,
• Religion,
• Education,
• Residence, region, and
• Ethnicity was associated with female circumcision.
Factors associated with the daughter’s circumcision were birth-cohort,
• Religion,
• Residence, region,
• Ethnicity,
• Wealth, marital status,
• Circumcision status of the respondent, and circumcision required by religion. Similar factors
were found for discontinuation intention.
Only 1 figure” Five-year birth cohorts of circumcised women and daughters’ circumcision and
discontinuation of the practice in Nigeria.”
Number of table 5 all very crowded
Discussion good analysis of similar study
Conclusions:
The practise of female circumcision is still high but decreasing among younger birth-cohorts
in Nigeria.
There is no significant change in the perception of the discontinuation of female circumcision.
More awareness about the adverse effects of female circumcision, particularly among women
with poor education in Nigeria, will significantly contribute to the timely eradication of this
cultural menace.
The manuscript is written in (English language with few spelling and grammar mistakes.)
Statistical method and analysis used are appropriate.
Methods clear retrospective study
Results The tables (3 Table)
Table – 3: Comparative analysis of IVF cost and patient’s BMI illustrates the result
The length of the manuscript is appropriate.
Plagiarism .. There are a few sentences in the manuscript taken from the web.
No conflicts of interests
Ethically approved
References; 37 references, few references need to be checked old before 2009 (not verified or
not checked)
Discussion similar study was disused, and analysis and statement were appropriate
There are many Limitations:
Retrospective
Missing data
Conclusion clarify the aim of the study