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Effect of Female Genital Mutilation Education on Knowledge of Female Genital Mutilation Health Consequences among Adolescent Girls in Nigeria

Abstract

Female genital mutilation (FGM) remains an important public health, human rights, and women's health concern in Nigeria. The practice involves the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons and may expose girls and women to immediate and long-term health consequences. These consequences may include severe pain, bleeding, infection, urinary difficulties, menstrual problems, psychological distress, sexual health complications, childbirth-related complications, and other adverse health outcomes. Adolescent girls may have limited knowledge of the health consequences of FGM because of cultural norms, family influence, social expectations, misinformation, limited access to accurate reproductive-health education, and reluctance to discuss sensitive issues. Female genital mutilation education provides an opportunity to improve adolescents' understanding of the health consequences of FGM and support informed health decisions. Against this background, this study investigates the effect of female genital mutilation education on knowledge of female genital mutilation health consequences among adolescent girls in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Social Cognitive Theory. The Health Belief Model explains how adolescent girls' perceptions of susceptibility to FGM-related health consequences, perceived severity, perceived benefits of avoiding harmful practices, perceived barriers, self-efficacy, and cues to action may influence their knowledge and health-related decisions. The Social Ecological Model emphasizes the influence of individual, family, peer, school, community, cultural, and broader societal factors on knowledge and attitudes toward FGM. Social Cognitive Theory emphasizes observational learning, social modelling, peer and family influence, self-efficacy, reinforcement, and environmental factors in shaping adolescents' understanding and responses to FGM. Collectively, these theoretical perspectives provide a suitable framework for explaining how FGM education may influence knowledge of FGM health consequences among adolescent girls in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adolescent girls aged 10–19 years enrolled in selected secondary schools across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, schools, classes, and eligible adolescent girls. FGM education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on the definition and forms of FGM, immediate health consequences, bleeding, pain, infection, urinary complications, menstrual difficulties, psychological consequences, sexual health consequences, reproductive and childbirth-related complications, long-term health effects, misconceptions about FGM, relevant cultural and social factors, prevention and protection information, and available health and support services. Knowledge of FGM health consequences will be assessed using indicators such as ability to identify immediate complications, recognition of infection risks, awareness of urinary and menstrual complications, knowledge of psychological effects, awareness of sexual health consequences, recognition of potential pregnancy and childbirth complications, understanding of long-term health effects, ability to distinguish myths from evidence-based information, and knowledge of appropriate healthcare and support services. Data will be collected using structured questionnaires, standardized FGM knowledge assessment tools, age-appropriate scenario-based questions, school health education records where available, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic and educational characteristics, exposure to FGM-related information, sources of information, and knowledge levels. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of FGM education on knowledge of FGM health consequences. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that FGM education has a significant positive effect on knowledge of FGM health consequences among adolescent girls in Nigeria. Adolescent girls exposed to structured, age-appropriate, evidence-based, culturally sensitive, and non-stigmatizing FGM education are expected to demonstrate greater knowledge of the immediate and long-term health consequences of FGM than girls without comparable exposure. Education may improve understanding of bleeding, infection, urinary and menstrual complications, psychological effects, sexual health problems, and potential reproductive and childbirth-related complications. It may also help adolescents distinguish evidence-based information from cultural misconceptions and misinformation. Improved knowledge may strengthen girls' ability to discuss concerns with trusted adults, recognize health problems associated with FGM, seek appropriate healthcare when necessary, and participate in informed conversations about prevention and protection. However, deeply established cultural norms, family influence, peer pressure, community expectations, stigma, fear of discussing FGM, misinformation, and limited access to adolescent-friendly health services may reduce the effectiveness of education alone. The study therefore expects accessible, age-appropriate, culturally sensitive, sustained, and participatory FGM education to contribute significantly to improved knowledge of FGM health consequences among adolescent girls in Nigeria. The study is expected to contribute to the literature on female genital mutilation, adolescent health, reproductive health, women's health, health education, health literacy, gender-based harmful practices, human rights, sexual and reproductive health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, state ministries of health and education, secondary schools, healthcare professionals, community health workers, women's and children's health organizations, development partners, human-rights organizations, and policymakers regarding strategies for strengthening FGM prevention and health education. The study will also provide evidence-based recommendations for integrating age-appropriate FGM education into school health programmes, strengthening adolescent reproductive-health education, improving access to adolescent-friendly healthcare and counselling, addressing harmful cultural misconceptions, engaging parents and communities in prevention efforts, strengthening referral and support systems, and developing sustainable interventions that promote informed decision-making and protection from FGM-related health consequences among adolescent girls across Nigeria.

Keywords: Female genital mutilation education, knowledge of health consequences, female genital mutilation, adolescent girls, adolescent health, reproductive health, women's health, harmful traditional practices, health education, gender-based violence, Nigeria, public health.