Women's knowledge and attitudes toward female genital mutilation and associated factors in Diguna Fango, a rural district in Southern Ethiopia: A community-based cross-sectional study using mixed method

Wubishet Gezimu ^1* Tamirat Beyene ^2* Asresash Demissie ³ Enatfenta Sewmehone ³

• ¹ Department of Nursing, College of Health Sciences, Mettu University, Mettu, Ethiopia
• ² School of Midwifery, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
• ³ School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Oromia Region, Ethiopia

Background: Female genital mutilation (FGM) is a widely practiced custom in Ethiopia. The women's knowledge and attitudes toward it and influencing factors have not been explored in Ethiopia, particularly in the rural districts. Hence, this study assessed women's knowledge and attitudes toward female genital mutilation and associated factors in Diguna Fango, a rural district in southern Ethiopia.This study adopted a community-based cross-sectional study design using a sequential mixed-method explanatory approach. It was conducted from May 20, 2023, to June 30, 2023, among 821 participants selected using a multistage sampling technique. The quantitative data were collected using a structured interviewer-administered questionnaire. A key informant interview was conducted to collect the qualitative data. A binary logistic regression analysis was conducted to identify factors associated with the outcome variables. A p-value < 0.05 at a 95% CI was used to declare statistical significance.Results: Of the 821 participants included in the study, 53.2% had good knowledge and 46% had an unfavorable attitudes towards female genital mutilation, respectively. Monthly income (AOR = 1.61; 95% CI: 1.39-2.95) and partners' educational status (AOR = 2.17; 95% CI: 1.37-4.89) were significantly associated with knowledge, whereas being a government employee (AOR = 2.12; 95% CI = 1.45-3.11) and private employee (AOR = 3.99; 95% CI = 1.63-6.77), having student partners (AOR = 2.64; 95% CI = 1.40-4.95), circumcision history (AOR = 2.58; 95% CI = 1.41-4.71), and knowledge (AOR = 1.48; 95% CI = 1.11-1.98) were shown to be associated with attitude towards female genital mutilation. Moreover, sociocultural drivers, awareness of adverse health effects, religious attributes, and sexuality concerns were explored as attributes of knowledge and attitudes toward female genital mutilation/cutting.Compared to previous similar local and global findings, lower levels of knowledge and higher levels of support for female genital mutilation were observed in the area. Sociocultural, religious, and sexual concerns influence knowledge and attitudes toward female genital mutilation.Therefore, the concerned bodies need to mobilize the community and work closely with the health development armies and religious institutions to boost women's knowledge and change favorable attitudes towards FGM/C.