Female Genital Mutilation (FGM), also known as female circumcision or female genital cutting, is defined as the partial or total removal of external female genitalia and injury to the female organs for cultural or other nontherapeutic reasons. FGM is performed in various forms in 28 African countries, and the social drivers behind the practice are multifaceted.
While Ghana has made strides toward the eradication of FGM, certain regions, particularly in the Upper East, Upper West, and Bono, remain hotspots for the practice. Data collection on FGM in Ghana is focused on accessible areas, leaving remote regions underrepresented. Many datasets lack disaggregation by factors like age and socioeconomic status, making targeted interventions difficult. Additionally, outdated data from the 2017-2018 Multiple Indicator Cluster Survey create gaps, hindering efforts to address FGM effectively.
Female Genital Mutilation In Ghana: Eradicated Or Lurking ? 23/02/2022
Prevalence and Statistics
Although the overall prevalence of FGM in Ghana is 4%, studies have shown that the prevalence varies by region and is widespread in northern Ghana. In the Upper East region, clinical research revealed an overall prevalence of 38%, with Bawku municipality recording the highest at 82% . In 1996, Amnesty International Ghana, together with the Association of Church Development Projects, estimated that 76 percent of all women in the Upper East, Upper West and Northern regions had been excised.
A number of studies over the past several years have been conducted producing differing estimates of the percentage of women who have undergone this procedure. In 1998, the Gender Studies and Human Rights Documentation Center estimated that it had been performed on 15 percent of the Ghanaian female population. The United Nations Population Fund (UNFPA) recently funded a study conducted by Rural Help Integrated, an NGO providing reproductive health care services in the Upper East Region. The study found that FGM/FGC had been performed on 36 percent of the Upper East Regions female population and estimated that between 9 and 12 percent of Ghanaian women nationwide had undergone the procedure.
Between 2011 and 2017-18, the overall prevalence for women aged 15-49 decreased slightly from 3.8% to 2.4%. However, breaking down the most recent data by age group shows that the prevalence for women aged 45-49 is 4.9%, while for the youngest age group this has fallen to 0.6%.
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Regional Prevalence
- Upper East Region: Highest prevalence, with specific areas like Bawku Municipality recording very high rates.
- Northern Region, Upper West Region, Northern Volta Region: Regular practice in remote parts.
- Southern Ghana: Practiced among migrants from northeastern and northwestern Ghana, as well as neighboring countries.
The World Health Organization (WHO) has provided seed money for research projects to develop statistics.
Map of Ghana showing regions
Types of FGM Practiced in Ghana
The form of female genital mutilation (FGM) or female genital cutting (FGC) most commonly practiced in Ghana is Type II (commonly referred to as excision). Other forms, such as Type I (commonly referred to as clitoridectomy) and Type III (commonly referred to as infibulation) are also practiced. The extent of the practice in Ghana as a whole is limited. These forms are generally practiced among a few groups in northern Ghana. There are also some migrants from neighboring countries who now practice it in southern Ghana.
- Type I: Type I is the excision (removal) of the clitoral hood with or without removal of all or part of the clitoris.
- Type II: The most common form in Ghana, involving excision.
- Type III: Type III is the excision (removal) of part or all of the external genitalia (clitoris, labia minora and labia majora) and stitching or narrowing of the vaginal opening, leaving a very small opening, about the size of a matchstick, to allow for the flow of urine and menstrual blood.
Attitudes and Beliefs
The practice among some groups in Ghana appears to have few spiritual roots. It is not perpetuated by religion, but rather by traditional tribal beliefs. Some believe it leads to cleanliness and fidelity of the woman. Others believe it will increase fertility and prevent the death of first-born babies. It is also seen as a way to suppress a womans sexual desires and make her less promiscuous.
Other common beliefs are that children born to uncircumcised women are stubborn and troublesome and more likely to be blinded or otherwise damaged if the mothers clitoris touches them during birth. In some areas the presence of a clitoris in women suggests she is a man and must be buried in mens clothing and the funeral performed as a mans when she dies. Uncircumcised women are regarded by some as unclean, less attractive and less desirable for marriage. Social or peer pressure is also cited as a primary reason that some undergo this procedure.
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The Process of FGM in Ghana
In Ghana, the procedures are performed by excisors known as "wanzams" (both men and women), the elderly in society (i.e. the traditionalists), mothers or traditional birth attendants (TBAs) who use unsterilized instruments such as knives and razor blades. No anesthesia is used and no antiseptic precautions are taken when the same instrument is used on multiple girls.
The procedure may be carried out during adolescence, at marriage, during a first pregnancy or on babies as young as seven days old. The 1998 Gender Studies and Human Rights Documentation Centers study reported that 51 percent of all women who have been subjected to this practice had it performed before the age of one. They reported that 10 to 14 year olds make up the second most targeted age group with more than 85 percent of all procedures performed on girls under the age of 15. The usual age for undergoing this procedure follows regional patterns. In the Upper East, it is most often performed during puberty as a rite of passage to womanhood.
Legal Status and Protection
In 1989, the head of the Government of Ghana, President Rawlings, issued a formal declaration against FGM/FGC and other harmful traditional practices. Article 39 of Ghanas constitution provides in part that traditional practices that are injurious to a persons health and well-being are abolished. In 1994, Parliament amended the Criminal Code of 1960 to include the offense of FGM/FGC.
There have been seven arrests under the Act since 1994 and at least two practitioners have been successfully prosecuted and convicted. In March 1995, police arrested and charged the practitioner of FGM/FGC on an eight year old girl and the parents of the girl under the law. In June 1998, a practitioner was sentenced to three years in prison for having performed this procedure on three girls.
The law in Ghana protects an unwilling woman or girl against the practice, but there is little real protection to turn to in many rural areas. All levels of government have come out strongly against this practice. Advocacy groups work to eradicate it. There is a history of enforcement against those who practice or threaten to practice FGM/FGC. There are indigenous NGOs and watchdog committees throughout the country who are prepared to intervene and have stopped practitioners by going to the police when necessary. However, their reach does not extend to many remote communities.
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Outreach Activities and Interventions
The government of Ghana speaks out against this practice. Officials at all levels of the government speak out publicly against it. The current and former President, and the former First Lady, Ministers, the National Council on Women and Development (CWD), the Commission on Human Rights and Administrative Justice (CHRAJ) and several Members of Parliament and District Assembly men are strong voices on record opposing the practice. The media always places the practice in the context of regressive traditions, unbefitting of an ambitious nation. Articles covering officials statements against the practice and efforts to inform the populace about the practice are common.
The commitment of government officials and the media has created an environment supportive of the efforts of NGOs. The most successful of the programs to date have been the collaborative efforts of the Ghana Association for Womens Welfare (GAWW) and the Muslim Family and Counseling Services (MFCS). GAWW, founded in 1984, is a charter member of the IAC (Inter-African Committee on Harmful Traditional Practices Affecting the Health of Women and Children). It believes that other means, in addition to legislation against FGM/FGC, are needed to totally eradicate the practice. It believes education at the grassroots is needed to change tradition, superstitions and beliefs.
GAWW brings resources including brochures, graphic educational films and models of the female genitalia to illustrate the procedures. MFCS makes these efforts more effective because Islam and its leaders (who are males) are highly respected in the communities where FGM/FGC is practiced. The Director of MFCS, is himself a learned Quranic scholar, an Imam and a village chief. GAWW and MFCS have been successful and have received invitations to speak in communities about the practice. Many practitioners and community leaders have renounced the practice.
GAWW and MFCS have worked with local leaders (community, ethnic and political) to organize and conduct their workshops. This groundwork has made the entire community receptive and has assured attendance at GAWW/MFCS workshops that are held throughout the country. Participants are given information on the harmful effects of this practice, the laws prohibiting the practice and the absence of Quranic imperatives for it. A very graphic film shows the procedure and consequences. The film has been very popular in getting the message across.
All topics are addressed in an open forum where questions and comments are encouraged. In an effort to provide continuing vigilance and follow up, the community leaders are encouraged to form watchdog groups from their own community. Local Imams are asked to speak out against the practice. Voluntary watchdog committees, 18 in Ghana, have been organized. These groups keep their ears open and approach those involved in impending FGM/FGC ceremonies.
In addition to GAWWs collaborative effort with MFCS, GAWW members are active on a number of other fronts. They work with health officials to research the relationship of this practice to HIV infection and other sexually transmitted diseases. They consult with the Ministry of Education on incorporating education about this practice into the public school health curriculum. They conduct workshops to inform school health teachers about the detrimental health effects of the practice.
GAWW also conducts workshops for midwives and TBAs and collaborates with the Red Cross Mothers Club to incorporate education about FGM/FGC into their reproductive health education program. GAWW has organized workshops for former excisors to help them branch out into other work. Many have given up their work but now need help from NGOs on alternative means to earn a living.
WHO, in cooperation with GAWW and MFCS, toured 210 villages in the Volta Region in early 1997 and identified 18 practitioners to provide information and instruction about this practice. GAWW is very active in northern projects. In 1997, it held a series of workshops on the harmful health effects of the practice in the Volta and Upper East and Upper West regions. Workshops were also held in Jasikan, Kadjebi and Worawora in the Volta Region with 420 participants. Committees were formed after each workshop to ensure follow up. In the Upper East and Upper West regions, workshops were held for police, health workers, students and educators.
Agency for International Development (USAID) provides financial support to the Navrongo Health Research Centers efforts to bring reproductive health education and instruction about FGM/FGC to rural women and girls. Through the Center for Development and Population Activities (CEDPA), USAID supports MFCS Youth Reproduction Health Project in Greater Accra and the Eastern Region. The project incorporates information and instruction about FGM/FGC into their programs. In 2000, the U. S. Embassys Democracy and Human Rights Fund awarded a grant to the Rural Women Association for workshops on this practice in rural communities in the Upper East Region.
The Peace Corp in the north has incorporated information about this practice into their classroom lessons on reproductive health and in training courses for school health teachers.
Citizen Data and Inclusive Approaches
Inclusive data practices, particularly through citizen data, can revolutionize how data on FGM are collected. Citizen data enable marginalized voices to be heard, particularly in regions where FGM is covertly practiced. Real-time, disaggregated data are critical to creating targeted interventions and policies.
By incorporating citizen data approaches, such as community reporting and mobile surveys, stakeholders can gather more granular data, revealing underreported regions and enabling more responsive policy interventions.
Factors Influencing FGM
Several studies have examined factors that influence the practice of FGM. Some have highlighted important relationships between demographic factors such as age, education and religion. Studies in sub-Saharan African countries suggest a relationship between economic factors and female circumcision . Cultural and religious factors have been found to influence the practice of FGM.
Table 1 shows the characteristics of the 830 participants from the two sites included in the study. The number of respondents from each of the district is about the same - 417 in the Bawku Municipality and 413 in Pusiga. Approximately 57% of the women had received no education. Sixty seven percent of the women were aged 15 to 34 years. In addition, 61% of them were of the Busanga tribe and 70% were married. In all, 61% of women reported having undergone FGM and of those circumcised, 66% indicated their mothers influenced it. And the most important reasons for the practice included to continue a tradition (44%), control sexual desire (29%), and for social acceptance (20%).
Table 1: Characteristics of Study Participants
| Characteristic | Value |
|---|---|
| Total Participants | 830 |
| Participants from Bawku Municipality | 417 |
| Participants from Pusiga | 413 |
| No Education | 57% |
| Aged 15-34 years | 67% |
| Busanga Tribe | 61% |
| Married | 70% |
| Undergone FGM | 61% |
| Mother Influenced FGM Decision | 66% |
Call to Action
To achieve sustainable progress in eliminating FGM, stakeholders - including governments, policymakers, civil society, and communities - must take collective action. Eradicating FGM in Ghana requires a coordinated, multi-sectoral effort involving governments, civil society, religious institutions, and development partners. Inclusive data practices, stronger law enforcement, and community advocacy are key to ending FGM and ensuring the safety and dignity of all women and girls.
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