ABSTRACT
Harmful cultural practices have been identified as significant causes of disability and deaths particularly among women of reproductive age in developing countries. Hence, the researcher conducted this study on the assessment of harmful cultural practices (HCPs) affecting the health of women in Ebonyi State using community women organizations as target population. To guide this study,five research questions were posed and three null hypotheses were formulated and tested at 0.05 level of significance. Descriptive survey design was adopted in this study. The population for this study comprised 11,424 members of the three hundred and twenty seven registered communities based women organizations in the thirteen Local Government Areas that make up the three senatorial zones of Ebonyi State. The sample consisted of sixty-five purposively selected community based association which has 1,962 registered members drawn from six out of the thirteen LGA’S selected for the study. The study employed multi-staged sampling technique. The selection of the sample was based on 40 per cent of the entire population from the purposively selected local government Areas in Ebonyi State. For the qualitative data a systematic sample size of twelve women from each group of Community Based Organization were used for Focus Group Discussion (FGD). A one hundred and sixty two questionnaire items on the Assessment of Harmful Cultural Practices (AHCPs) arranged in five sections was developed, validated and used for quantitative data collection. A Focus Group Discussion guide (FGDG) based on the five research questions were constructed by the researcher for data collection. Data collected were analysed using percentages, weighted means and standard deviation. The Focus Group Discussions were qualitatively analyzed. Among the major findings were that majority of the respondents were educationally disadvantaged. (2) it was confirmed from the study that harmful cultural practices such as early marriage, female genital mutilation, widowhood practices and nutritional taboos existed and were practiced in their different locations. The opinions of respondents to the questionnaire were similar to those of the discussants during the ( F G D) sessions. It was recommended among other things that women should be educationally empowered. This would enable them to challenge those discriminatory attitudes and cultural practices which has held them captive, such as not participating in decision-making process in issues concerning their welfare which has hindered them from being integrated into the whole spectrum of community development programmes. Education empowerment of women will pave way to their social economic and political empowerment.
TABLE OF CONTENTS
Title page – – – – – – – – – – i
Certification Page – – – – – – – – – ii
Approval Page – – – – – – – – – iii
Dedication – – – – – – – – – – iv
Acknowledgement – – – – – – – – – v
Table of Contents – – – – – – – – – vi
List of Tables – – – – – – – – – viii
Chapter one: INTRODUCTION – – – – – – – 1
Background to the study – – – – – – – – 1
Statement of the study – – – – – – – – 5
Purpose of the study – – – – – – – – 7
Significance of the study – – – – – – – – 8
Research Questions — – – – – – – – – 9
Hypotheses – – – – – – – – – – 10
Scope of the study – – – – – – – – – 10
Chapter two: REVIEW OF LITERATURE – – – – 11 A.Conceptual/theoretical background –
1.The concept of culture and women’s health- – – – – – – – 11
2Harmful cultural practices and women’s health- – – – – – 18
3.Manifestations of Harmful Cultural Practices – – – – – 26
4.Types of Harmful Cultural Practices that may Affect Women’s Health – 33
5.Why Harmful Cultural Practices Resist Change in Cotemporary Times – 62
6.Intervention Strategies to Eliminate Harmful Cultural Practices. – – – 67
7.Psychologically related theories- – – – – – – – 79
- Review of Emperically Related Studies- – – – – – 81
- Summary of Related Literature – – – – – 89
CHAPTER THREE: RESEARCH METHOD – – – – – – 91
Research Design – – – – – – – – – 91
Area of study – – – – – – – – – – 91
Population of the study – – – – – – – – 92
Sample and Sampling Techniques – – – – – – 92
Instrument for Data Collection – – – – – – – 93
Validity of the Instrument – – – – – – – – 94
Reliability of the Instrument – – – – – – – 95
Procedure for Data Collection – – – – – – – 95
Method of Data Analysis – – – – – – – – 96
Chapter Four: RESULTS – – – – – – – – 97
Findings from the Focus Group Discussion – – – – – 105
Summary and Findings – – – – – – – 110
Chapter Five: DISCUSSIONS, RECOMMENDATIONS, CONCLUSION and SUMMARY – – – – – -111
Discussion of findings – – – – – – – -111
Implication of the Study for Adult Education/Community Development -120
Conclusion – – – – – – – – – -121
Recommendations – – – – – – – – -122
Suggestions for Further Research – – – – – -123
References – – – – – – – – – -124
Appendix A – – – – – – – – -142 143
Frequency table of Respondent’s Bio-Data
Appendix B – – – – – – – – – 144-147
Distribution of the Randomly Sampled Local Governments and Community
Based Organizations using 40% Sample Interval.
Appendix C – – – – – – – – – 148-158
Letter of Introduction from the Researcher and Questionnaire on the
Assessment of Harmful Cultural Practices that May Affect the Health of
Women in the Local Government Areas in Ebonyi State, used for the study.
Appendix D – – – – – – – – – 159-161
Letter of Introduction from the Researcher and Focus Group Discussion
Schedule.
Appendix E – – – – – – – – – -162
A Letter for Validator (s) of Research Instrument.
Appendix F – – – – – – – – – – 163
Modifications on Questionnaire and Observation made on FGD Instrument.
Appendix G – – – – – – – – – – 164 – 168
Reliability of Instrument.
Appendix H – – – – – – – – – – 169
Mean and Standard Deviation of the reason for the existence of HCPs
practices in the communities according to the respondents
Appendix I – – – – – – – – – 170-172
ANOVA Summary for mean ratings of respondents on HCPs based on location
Appendix J – – – – – – – – – 173-175
T-test analysis of the mean ratings of single and married parent on why the
HCP exist in communities
Appendix K – – – – – – – – – 176
Names of Primary Schools and Volunteered Teachers
CHAPTER ONE
Traditional cultural practice reflects values and beliefs held by members of a community or social groupings for periods often spanning generations. Saba{1997) noted that social groupings in the world have specific cultural practices and beliefs; some are beneficial to all members while others are harmful to a specific group such as women and girls’ Hence, Kiragu sees culture as part of human environment and a product of history which forms strong images in the minds of the people concerned Ofonagoro(1996) viewed culture as the totality of the life of a people which could be assessed and comprehended in terms of how they create and re-create their lives both in the material and non-material sense of their social existence. Suffice it here to observe that culture represents the development of specific people in the society which is often equated with civilization.
From the above interpretation of culture, it is glaring that the concept has many definitions as there are writers on the subject. Hernlund (2000) posits that culture is a totality of the way of life evolved by a people in their attempt to meet the challenges in their environment. In effect this is to say that culture embraces and includes challenges to social, political, economic, aesthetic and religious norms and mode of an organization, thus distinguishing a people from their neighbours. Also, from a different perspective Kisijia (2001) remarked that culture can be viewed as being complex and has a compelling nature which regulates all aspects of human life which include; for example, food, religion, dressing and language of the people, housing, marriage and family relations. Supporting, the above view, Seralgaldin (2002) noted that culture is a complex phenomena with distinctive spiritual, material, intellectual and emotional features that characterize a group or society. Hence, he maintained that the role of culture especially in traditional settings show that it is supreme and uncompromising, such as in discussing or sharing of lands (which excludes women) and women obtaining permission from their husbands before accepting or adopting any contraceptive method. Unfortunately, these old patriarchal systems are still maintained in some communities, to subjugate women and render them vulnerable to obnoxious cultural practices which violate the “rights” of girls/women. For example female circumcision, which is rooted in a whole set of beliefs, values, social and cultural behaviour pattern of some societies, is often culturally determined and incidentally transmitted by women themselves simply because of cultural adherence and not that it serves any useful purpose to individual families or the society.
However the most revealing thing in the society is that culture is not static. Every culture has a dual tendency:
A tendency towards stability and a tendency to change. Culture changes perpetually because the individuals in the society or the cultural architects constantly modify their cultural plans, improve and adapt their behaviour to the caprices and exigencies of their physical, social, and ideological milieu (Gbotukama, 2002:17).
Hence, the definition of the essential elements of culture varies from time to time reflecting correct power structure and influences.
The variety of culture bound practices harmful to women, otherwise, known as harmful traditional practices reasonably fall under the rubric of 89violence against women which has direct effect on their health (Heise, 1998). Health, according to United Nations Organization (UNO) (1995) is a fundamental human right and not merely a social good. It is an asset for individuals in the family, community and nation irrespective of age, sex, origin or race. It is sad to note that women are the foremost victims of old and die-hard traditional attitudes which militate against their health and well-being (Berhane, 1998). Women are arbitrarily deprived of their liberty to express and exercise their fundamental rights. For example, inspite of the high risk of maternal morbidity health and financial impact of traditional or too closely spaced birth; women often cannot exercise control over their own fertility.This is the reason why the United Nations International Children Education Fund (UNICEF) (1998) concluded that women were often deprived of good health right from birth.For example, in some traditional set up, pregnant and lactating mothers are made to abstain from nutritious foods such as eggs, snail which are regarded as taboo but are also necessary for the growth and development of the child.
The issue of traditional practices adversely affecting the health of women have been the focus for discussions at several international and national conferences, workshops and seminars where intervention approaches to eliminating harmful practices meted on women were extensively deliberated on. Notable among the legal interventions to eliminate harmful cultural practices were the Viennia 1993 World Conference on Human Rights pioneered by women’s health and women’s Rights Advocates who declared that women’s Rights are Human right; the International Conference on Population and Development 1994 maintained that women have the right to control all aspects of their health and matters of sexual relations and reproduction; the Fourth World Conference on Women Beijing 1995 was another pointer where women activists worldwide vehemently reacted to the plight of women and in collaboration with the United Nations mandated Governments in various countries to make legislations and policies against harmful cultural practices affecting the health of women/girls. The article of the Convention on the Elimination of All forms of Discrimination Against women stressed on the need to promote women’s access to better health care and family planning services. Others include the AIDS Conference 2000 where it was resolved that women/girls should have access to the use of contraceptives and reproductive health counselling and the widows without Rights Conference 2001 which affirmed the right entitled every individual to be free from any form of inhuman treatment or discrimination. Nigeria is not left out in this struggle to eliminate harmful cultural practices.
It appears the impact of the resolutions at both international and national conferences to eliminate all harmful cultural practices have been particularly unevenly felt in most developing countries of Africa (Fredrick, 1996). For example, in Nigeria the National Population Council (2000) record showed that female genital circumcision is prevalent in Imo, Osun, Ondo, Delta and Cross River States. The practice of FGM is less prevalent in the North with 77 per cent in Kaduna. Likewise, the practice of FGM has not been given up by excissors in Ebonyi State. The National Base Line Survey (2004) revealed that Ebonyi State ranked 76 per cent score for FGM. Also, in July 2004 a widow from Iseke village in Enonyi State (televised) was brutally murdered in cold blood by the brother in-law for refusing to hand over the late husbands piece of land to him. The efforts made by different interest groups towards elimination of harmful cultural practices affecting the health of women does not seem to have made much impact. This may be due to lack of necessary information on the harmful cultural practices.Hence, the concern of the researcher on the need for an assessment of the problem. Such an assessment will provide information on the nature and dimensions of the problem. This will give direction or guide forwards the solution of the problem. Assessment, according to Okoro (2002) is an appraisal of situations and problems and using it in making appropriate decisions. It also involves the collection of data, judging the worth of the issue under study and the use such data to map out course of action towards enhancement or otherwise of the issue.
An assessment of HCP is very necessary to obtain information that will lead to its elimination. Okoro (1991) explained that, information from assessment is used for planning decision making and improvement. Improvements in elimination of HCP affecting the health of women constitute functions of assessment that could be used by various interest groups with a view to redeeming dwindling fortunes, images and revitalizing worthwhile practices through necessary inputs, special grants and education/sensitization activities. Akpan (1989) explained that in carrying out assessment, the necessary aspects of the issue under study or all the components that constitute the issue need to be assessed. It is imperative to study important aspects of HCP affecting the health of women in Ebonyi state in order to come up with necessary information that will aid its elimination.
In Nigeria, indigenous organizations such as Human Rights Activists Nigeria, Children’s Right Advocacy Group, Child Life Line and the Convention on the Elimination of All forms of Discrimination Against Women are working in different communities sensitizing and educating women on the dangers of some traditional practices such as widows rites and female genital mutilation (Akpala, 1998). It is of interest to note that countries like Ethiopia, Belgium, France, Sweden, United Kingdom and Ghana have outlawed female circumcision (Akinola, 2001).This may be due to the fact that such practice has no relevance to development.
Hence, the concern of the researcher for women in developing countries like those in traditional rural communities of Ebonyi State under study is very instructive. Harmful cultural practices are obviously widespread in Ebonyi where women are seen as backward and least literate, some must obtain permission to attend ante-natal clinics or even can not take imitative to go to the hospital during labour in the absence of their husbands (Akumadu, 2001).
Also, literature showed that the educational background of women is important in women related studies. This is because of the belief that educated women have greater respect and recognition than non-educated. It is therefore important in this study of this nature to critically examine the response of educated and non educated women so as to decipher if there are discrepancies in the HCPs meted out on them. Educated women in this study refer to any women who can read and write in the communities under study. Some women may be affected by HCP more than others because of the educational/ marital status. In some communities in Igbo land married women are treated with more respect more than their unmarried counterpart. Again, even among communities within a LGA or state may differ in their belief or culture especially as it concerns the rights of women. It is amazing but very sad to note that such inhuman and dehumanizing attitudes towards women have never been challenged by policy makers. Could it be that policy makers have thought about the serious implications of these HCPs because they have their origin in the history of the people long ago? And so, no legislation has been passed to eliminate harmful cultural practices even when Nigeria has been signatory to decisions taken at workshops and conferences at various levels.
The truth is that all hands (both the affected and unaffected) must be on deck to kill these man-made dragons especially at the grassroots levels, if a change is so desired. This is because in the words of Kisija (2001 ) for any meaningful change in attitudes or behaviour to be achieved, the people themselves should be involved in the change process. And that is to say that the women whose health status are threatened by harmful cultural practices meted on them should be involved in this struggle to enable them assert their fundamental rights which include freedom of choice and existence among others. Even among different communities in Ebonyi state, cultural practices differs. That is the intensity or extent of HCP affecting the health of women which may differ from community to community For instance there are certain cultural practices that can be meted to married women but not to single mothers or widows.
Statement of the Problem
In spite of the National and International affirmations on improving the lot of women in human society there still exist tenacious harmful cultural practices, which are yet to be done away with particularly as they adversely affect the health of the women/girl-child. Till date high premium is still placed on the males while females are regarded as a household property, which can be used and manipulated at will For example, the traditional bride price confers a property identify on a woman and also awards the husband with the implicit ownership of the wife (Obianyo, 2000).
As it is typical of most patriarchal societies throughout the world, Nigeria inclusive; women are usually expected to be submissive, obedient and respectful to their husbands no matter how educated they may appear to be. Women were never heard but only seen even on issues concerning their sexuality and reproductive rights. Hence women face complex health issues particularly those arising from pregnancy. Information from World Fertility Survey, (1999) revealed that in countries like Nigeria, gender-based disparity in health care received are largely the result of the girl-child being undervalued by their family. Women’s vulnerability to maltreatment in diverse forms are deeply rooted in the culture and traditions of their communities. Kamara (1991) observed that culturally prescribed traditions such as female-female marriage and male health providers not attending to pregnant mothers may have serious health consequences on women. Unfortunately, many of these harmful practices still prevail in some societies. For example HCPs like widowhood rites is prevalent in six geopolitical zones in Nigeria, Ebonyi state inclusive (Akumadu, 2000). For example in the year 2003, a widow from Okwuato Ibeku in Aboh Mbaise LGA was alleged to have been stripped of everything she had including her children; by her in-laws (Daily Sun, October 2003). Also, sometime in the year 2004, in Isieke (Ebonyi state) a widow was brutally murdered by her brother in-law over the deceased husband’s piece of land. Likewise the practice of FGM has not been given up by excissors in Ebonyi state which ranked highest in the South-East geopolitical zone with a 76% score.
It is also a cruel irony that women themselves in the name of tradition perpetuate some of the harmful cultural practices like FGM, widowhood practices, female-female marriage. Perhaps these people put up a crafty defense mechanism, feel justified and even seek social legitimacy for their conduct while the victims may not openly report/discuss their experiences. This culture of silence of the abused or oppressed may have been the reason why literature on various dimensions of HCPs is yet evolving. Moreover, information on these practices may be concealed for myriad reasons such as fear-induced restrictions, ignorance, low literacy level/development, backwardness of the people and women’s subordinate positions imposed on them by the society.
Women also teach, practice and uphold traditional practices surrounding differential feeding and food taboos harmful to their girl-child as is the practice in Igboland, ( Okafor 2005). Certainly, practices sanctioned by culture that may have threatened the health and well being of women; seem to have recurrent health problems, (Chukwuezi, 2000). Such health problems could be those associated with their culture, sexual and reproductive tract infections. For example Ezumah, (2002) observed that women are stigmatized as disease carriers and not the men. According to her, among the Igbos, reproductive tract infection called “Nsi-Nwanyi” or women’s disease have not only debased women but has encouraged male permissiveness and absolved them of their responsibility for disease transmission. Such perception will certainly affect women’s health in various ways. Despite outrage by human rights group, international courts and feminist groups at both national and local levels; all efforts to eradicate harmful cultural practices in contemporary societies have often been met with hostility from the implementers, coupled with a number of reasons given for its persistence. Other reasons why harmful cultural practices still exist may be attributed to issues such as delayed pregnancy, sex-preference in the family; as the male child is valued more than the female. Policy makers have never challenged the serious implication of these practices either because these practices have their origin in the history of the people long ago, and also ostracization from ones group because of their tradition is not possible. It may also be possible that mothers adhere to traditional harmful practices because of their religious belief, ancestral attachments; their loyalty to their deity, their husbands, limited access to education, information and essential services;renderd them powerless to boldly assert their rights even when they are maltreated. This is the reason why IkejIani (2001) suggests the need for education of the rural population especially the secluded, invisible poor and powerless women on pertinent gender issues.
Hence, the researcher was interested in establishing whether HCPs exist in the communities under study; their impact on women’s health, reasons why these HCPs resisted change and intervention strategies needed to eliminate them.
The main purpose of the study was to assess the harmful cultural practices affecting the health of rural women in Ebonyi state. Specifically, the study sought to:
- find out those harmful cultural practices which are practiced in the study areas in Ebonyi State.
- determine why these HCPs exist in the study areas
- ascertain the consequences of these harmful cultural practices on women’s health
- establish reasons why harmful cultural practices resist change in contemporary times.
- determine intervention strategies for eliminating the identified harmful cultural practices affecting the health of women.
The subjugation of women to harmful cultural practices even in contemporary times calls for urgent attention so as to adopt measures to alleviate or eliminate predominant authoritarian traditions imposed on women, which affects their health.
On this note, this study will be useful not only to mothers who are members of community based organizations in the study areas but also to all mothers in Nigeria, NGOs, faith based organization and other interest groups on types of HCPs in Ebonyi state, why they exist and how they can be curbed.
From the findings of the work, more light will be shed on the terrible effect of harmful cultural practices on women’s physical, psychological, social, emotional, and mental well-being. The changing times demands that a more aggressive approach be adopted on these inhuman traditions as the surest way to eradicating them. Information on their consequences will sensitize all concerned and help to quicken them to take immediate action towards its extinction.
There is no doubt that the findings of this work will make significant contributions to knowledge as not much study has been done in the area of assesment/ community based intervention strategies for eradicating harmful cultural practices affecting women’s health in Nigeria. The findings of this study will stimulate the interest of future researchers in this direction or other related issues on women.
Also, to adult educators and community development workers, the findings of this study will equip them with information, which will, be used as a motivational tool for illiterate mothers to embrace literacy education. Education is the best ‘key’ to unlock illiteracy for better tomorrow, better family life, better nutrition/balanced diet for the child, pregnant and lactating mothers, better child care and better knowledge about reproductive health information. When mothers are well informed, they will be more relaxed, willing to accept innovations and take decisive actions as it affects them. Women in Nigeria particularly those in Igboland where die-hard cultural practices has been so persistent will be free to enjoy their liberty and drop their false humility/blind submissiveness to their husbands.
The findings of this work if published and implemented will certainly boost media sensitization of the general public condemnation of all kinds of HCPS against women.
The findings of this study will be most relevant to traditional rulers who are in charge of communities where such harmful practices prevail. The finding of this study will convict the traditional rulers to see the need/seriousness to improving traditional values status of females and to forgo all harmful cultural practices that may be detrimental to women’s health
Additionally, the findings of this work will be of immense importance to religious bodies like churches that are known for soul winning, use the word of God to preach righteousness, justice, love, peace, equality and equity. The findings will also reveal to the churches that women are still subjected to harmful cultural practices in the name of tradition of the people.
The findings of this study will be relevant to non-governmental organizations that are into serious efforts of empowering women to start addressing their various areas of denial in the society and to fight all forms of discrimination against womanhood and urgently possess their fundamental rights for the challenges ahead. This by extension will help in the achievement of the Millennium Development Goal (MDG) as it relates to gender and women empowerment.
Furthermore, to policy and law makers, the findings of this work will provide specific information on the present situation of women and the need to reassess the status of women in contemporary times so that women/health status will be given a prominent place in their research process. Policy makers will also see the need to involve women in the design, defining strategies, implementing process on how to improve the health of women and also eradicating harmful cultural practices in our communities This in line with the fact that” Health For All” remains an elusive goal especially in developing countries like Nigeria. Therefore, the findings of this study will provide useful information that will be relevant to actualizing the anticipated millennium development goal, which includes health promoting, gender equality and empowerment of women.
Research Questions
- What harmful cultural practices are practiced in Ebonyi state?
- Why do these HCPs exist in Ebonyi state?
- What are the consequences of these harmful cultural practices on women’s health?
- Why do these harmful cultural practices resist change in contemporary times?
- What strategies can be adopted in eliminating these harmful cultural practices?
The following null hypotheses were tested at (0.05) level of significance.
HO1: There is no significant difference in the mean ratings of respondents on harmful cultural practices practiced based on location
HO2: There is no significant difference between the mean ratings of single and married parents respondents on why harmful cultural practices exist in their communities.
HO3: There will be no significant difference between the mean rating of educated and non-educated respondents on why harmful cultural practices resist change in contemporary times.
The study was limited to investigating harmful cultural practices affecting the health of women in the communities under studied in Ebonyi State. Furthermore, the study recommended intervention strategies to eliminate such practices that adversely affect the health of women. In this study, an educated women refer to those who went beyond primary school. While non-educated ones are those who stopped at primary six and below.
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