Factors associated with parental intent not to circumcise daughters in Enugu State of Nigeria: an application of the theory of planned behavior

Abstract

This study explored intention of parents not to circumcise daughters in Enugu State, Nigeria using theory of planned behavior (TPB) as a framework. A survey of 1345 parents was carried out using structured questionnaire with FGM question items based on TPB constructs of attitude, subjective norm (SN), perceived behavioral control (PBC), and intention. Intention was dichotomized into two categories and logistic regression analysis was performed to examine the association between the constructs of TPB while controlling for some socio-demographic factors. 70% of respondents did not intend circumcising daughters. Constructs of TPB associated significantly, at p < 0.0001, with intention not to perform FGM on daughters with PBC having the strongest association. Having a post-secondary education (OR = 3.94; CI = 2.73-5.67) and absence of history of FGM in family (OR = 3.39; CI = 2.62-4.39) are the socio-demographic variables most significantly associated with the intention not to circumcise daughters. Homer-Lemeshow goodness-of-fit statistics indicated logistic regressions model 1 was significant (p < 0.05) making TPB a good theoretical basis for study of FGM. Intervention activity should focus on improving attitude of parents and especially those with less than post-secondary education and those with cases of FGM in their household.

Keywords: Female genital mutilation, parental intent, circumcision, childbearing age, Enugu State, Nigeria, Theory of planned behavior