Female Genital Mutilation Among Women of Reproductive Age in Nibo Community, Awka South Local Government Area, Anambra State, Nigeria: A Mixed-Method Assessment of Knowledge, Perception and Practice

Background: Female genital mutilation (FGM) remains a persistent public health and human rights challenge across sub-Saharan Africa. Nigeria carries the world's third-largest absolute number of survivors, and the South East consistently records the highest national prevalence. Despite substantial advocacy and legislative progress, community-specific evidence on the drivers of FGM knowledge, perception, and practice remains limited, constraining the effectiveness of targeted interventions. Aims: This study assessed the knowledge, perceptions, and practice of FGM among women of reproductive age in Nibo Community, Awka South LGA, Anambra State, and examined the socio-demographic correlates of these outcomes. Method: A convergent mixed-method design was employed. Quantitative data were collected via structured questionnaires administered to 300 women aged 18–49 (response rate 81.1%). Knowledge, perception, and practice were each measured across multiple domains and categorised into graduated levels. Chi-square analysis tested associations between socio-demographic variables and outcomes. P<0.05 was considered statistically significant. Qualitative data were drawn from seven in-depth interviews with community key informants and analysed using Braun and Clarke's thematic analysis framework. Results: FGM awareness was near-universal (94.3%), yet Good Knowledge was demonstrated by only 48.3% of respondents. Legal awareness of the Violence Against Persons (Prohibition) Act 2015 was especially low (59.5%). Perceptions were predominantly negative (70.3% opposed FGM), with a mean score of 1.60 (SD = 0.84) for intention to circumcise daughters. A personal FGM prevalence of 61.7% was recorded, yet only 20.0% had arranged circumcision for their daughters, representing a 41.7 percentage-point intergenerational discontinuity. Educational attainment was the strongest predictor of both knowledge (χ²(4) = 65.32, p < 0.001) and practice (χ²(2) = 154.57, p < 0.001). Thematic analysis identified four sustaining factors: intergenerational cultural transmission; the marriageability-stigma nexus; religious leadership ambiguity (37.8% zone of unclear stance); and limited comprehensive health and legal knowledge. Conclusions: Nibo Community is in measurable transition: perceptions have shifted markedly against FGM and an intergenerational break in practice is evident. Education is the most powerful protective factor. Strategic engagement of faith leaders, legal literacy campaigns, and integration of FGM education into routine healthcare contacts represent the most actionable intervention priorities.