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Female genital mutilation (FGM/C), has no health benefits, it violates human rights and has adverse health (physical, psychological, sexual, maternal and child health), and social consequences 1, 2. Globally, over 200 million women have been cut and are living with FGM/C-related consequences 3, 4. In Africa, it is estimated that 27 million, 24 million and 20 million girls/women have undergone FGM/C in Egypt, Ethiopia and Nigeria respectively, making them the countries with the highest prevalence of FGM/C on the continent 5. In Nigeria, although the practice is considered widespread, national surveys suggest a gradual decline of FGM/C prevalence among women aged 15 – 49 years 30% in 2008 to 20% in 2018 . While these statistics suggest progress, the prevalence is, however, is still as high as 67% in some states8. Despite the existence of laws, policies and a plan of action that should drive the health system’s response to prevention and management of FGM/C, the practice persists. Nigeria’s National Strategic Health Development Plan Framework (20092015) highlighted the need to strengthen the health system to cater for an increasing population served by scarce skilled health professionals. The extent of preparedness of health facilities (primary, secondary and tertiary) to prevent and manage complications of FGM/C is poorly understood.

A diagnostic assessment of the health system's response to FGM/C management and prevention in Nigeria