Background
All social groups in the world have specific practices and beliefs which often have strong cultural underpinnings. These can be either positive or negative. Almost all societies have positive cultural practices that are beneficial to all members. But, there are also practices which are harmful to specific groups, for example, for women and children. These harmful cultural practices are often dubbed as Harmful Traditional Practices (HTPs) [
1].
It is a mere fact that HTPs are global problems affecting millions of women and girls of all culture, religion, socio-economic strata, educational levels and other diversities [
1]. HTPs pose grave consequences especially on women and girls who are subject to them. Mostly, these segments of the population face physical damage, psychological problems, health complications including sexually transmitted infection, social stigmatization, denial of educational and other opportunities, inability to control their reproductive right and the like [
2]. In precise terms, HTPs are used as a weapon to keep women and girls in subordinate positions by denying their health, social, economic and human rights [
3].
Even though various international, regional and national legal instruments have been used to eliminate HTPs, every year millions of women and girls across the world are still the victims of different harmful traditional practices [
4]. HTPs are plenty in number, but international and national agencies have given priority only to certain types of HTPs by considering their geographical coverage. Among the recognized HTPs, dowry, female infanticide, early marriage, female genital mutilation (FGM) and inheritance marriage are the major ones [
3]. However, the authors of this article believe that geographical coverage should not be the only criterion to label HTPs as major or minor social problems. Rather, HTPs that are practiced by minority groups should also get equal attention by the international and national agencies working on issues related to HTPs.
Similarly, there are several harmful traditional practices in Ethiopia; nonetheless, the nation has given emphasis only to a limited number of HTPs by considering the geographical area covered by the HTPs. In this regard, Ethiopia has identified 12 major HTPs that need intervention. These are FGM, early marriage, uvula cutting, milk teeth extraction, marriage by abduction, food prohibition, work restriction, massaging of the abdomen of pregnant women, excessive feasts, incision, and inheritance marriage [
5].
The Amhara National Regional state, the second largest state of Ethiopia, on its part identified FGM, early marriage, milk teeth extraction, and uvula cutting as the major HTPs that need special focus in the region [
6]. However,
Shilshalo is not yet recognized as a major HTP though it has been practiced in the region for many years. The reason why the region failed to treat it together with the other four HTPs is not because it has less adverse impact on the overall wellbeing of women; rather it is practiced only by minority groups of people, namely
Argoba community. Given this fact, it is hardly possible to get information about the overall features of
Shilshalo. Therefore, this study attempted to generate a deep empirical investigation about the practices, consequences and causes of
Shilshalo.
Methodology
Description of the study area
Argoba is one of the ethnic groups found in Amhara National Regional State of Ethiopia. The
Argoba Nationality special
Woreda [an autonomous administrative region or district], was founded in June 2006. It is found in
South Wollo Zone of Amhara National Regional State. It is bordered with
Kalu Woreda of
South Wollo zone in the north and northwest,
Dewa Chefa Woreda of
Oromia Zone in the south, and
Telalak Woreda of Afar Regional State in the east. The center of the
Woreda is
Medina, a small town 85 Kms and 375Kms far from
Dessie and Addis Ababa, respectively [
7].
With an area of 30,918.70 Km
2, the
Argoba Nationality special
Woreda consists of seven rural
kebeles [the lowest administrative region under
Woreda]. It is a home for about 40,000 people (22,715 Male; 17,594 Female). The community is entirely Islam. Only some of the government employers, who came from other areas, are non-Islam. With respect to the economic activity, 99.5% of the total population is engaged in agricultural activities. Only the rest 0.5% participate in trade and other service economy [
7].
Research approach
Qualitative approach was employed in this study. Among the different kinds of qualitative research designs, case study design was used since the nature of the study calls for an empirical investigation of a particular phenomenon within its real life context. Hence, exploratory case study design was used to investigate the features of Shilshalo by taking the setting and context of Argoba community into account.
Data gathering instruments and data collection procedures
The information about
Shilshalo was elicited from the participants of this study through in-depth interview, key informant interview, and focus group discussion. To this effect, in-depth interviews were held with 8 girls and 6 boys and semi-structured interviews were conducted with 8 key informants comprised of religious leaders, elders, and health professionals. The in-depth and semi-structure interview guidelines were developed and used only for this study purpose (See Additional file
1).
Since Shilshalo is practiced by boys and girls in the stage of puberty before marriage, the boys and girls were purposively selected based on two inclusion criteria: having the experience of Shilshalo and being in the age range of 15 and 18. Before interviews were held with boys and girls, written consent from their parents and oral assent from them were obtained. Each interview lasted for an hour on average. The in-depth interviews were held in Amharic. The interview focused on issues such as why and how the teenagers practiced Shilshalo and the harms it brought to them.
Key informant interviews were held with two groups of purposively selected participants including two male religious leaders, two elderly women, two elderly men and two female health professionals. The first group consisted of religious leaders, and elderly women and men who could provide explanations about the socio-cultural rationales of performing the Shilshalo. The second group involved Kebele health professionals who could clarify the potential harm of practicing Shilshalo on the wellbeing of girls. A face-to-face interview was undertaken in Amharic with each of the key informants.
To validate the interview data and to get collective information, three separate focus group discussions were conducted with girls, boys and community members. Also, three discussion guidelines were prepared for each group of discussants to properly moderate the focus group discussion (See Additional file
2). Each focus group discussion consisted of eight individuals; and in total 24 people (12 women/girls and 12 men/boys) participated in the discussions. All focus group discussions were moderated by the researchers, and tape recording was used to capture the reflection of both interviewees and focus group discussants.
Data analysis
The data were analyzed using qualitative thematic analysis technique, involving the following stages. First, the audio recorded data gained from interview and focus group discussions were transcribed. Then, the transcribed data were translated from Amharic to English. The English version of the raw data was read repeatedly to maintain familiarity (See Additional file
3). Next to this, the data were sorted and arranged into different types depending on the sources of the information. After that, detailed analysis was done with a coding process. This involved the process of organizing the material into chunks before bringing meaning to those chunks. And, it involved taking text data in categories and labeling those categories with themes. Finally, the data were interpreted and analyzed qualitatively.
Trustworthiness of the study
Trustworthiness is seen as the strength of a research. It is used to determine whether the findings are accurate from the stand point of the researchers, the participants, or the readers of the account [
8]. To ensure the trustworthiness of this qualitative study, we triangulated different data sources of information by examining evidence from the source and used it to build a coherent justification for themes. In addition to this, we used easy and simple language and description to convey the findings.
Discussion
Many of the medical, psychological and epidemiological researches clearly assert that sexual experience is assumed to be inappropriate for adolescents and preserved for adults [
9]. As opposed to this idea, the
Argoba community promotes the early sexual experience of young boys and girls by adopting
shilshalo which is an uncommon type of harmful traditional practice in the rest of the world.
Shilshalo is performed by practicing all sorts of sexual activities with the exception of inserting the male genital organ (penis) into the female sexual organ (vagina). This feature of
Shilshalo makes it different from masturbation since
Shilshalo is a kind of sexual stimulation done between partners while masturbation is to give oneself a sexual pleasure by rubbing one’s own sexual organ.
Most harmful traditional practices including FGM and early marriage have been practiced against girls with forceful action meaning that the will of girls is not respected [
5]. Unlike these harmful traditional practices,
Shilshalo is not practiced by forcing girls to perform it rather the option is given for them although it has negative effect on their lives. However, this does not mean that there was no family pressure on the practice. As the present study showed, the mothers were the one who encouraged their daughter to engage in
Shilshalo.
Some studies conducted in Ethiopia stated that the practice of abduction is often accompanied with physical injury since the abductor uses force [
9,
10]. Similarly, girls practicing
Shilshalo face physical injury especially when they do it with many boys. Most boys who perform
Shilshalo with their friends’ partner would use excessive physical force and make the girls to be weakened.
In some African countries, women aged 15–24 are being infected with HIV/AIDS at rates five times greater than men with the same age category. This higher rate can be described by the fact that girls are more susceptible to contracting HIV because they are married to older men due to the presence of early marriage practice [
11,
12]. This indicates that early marriage has negative health impact on young girls as it makes them vulnerable to HIV infection. Also, predisposes girls to HIV infection. The studies conducted in sub-Saharan countries revealed that the same equipment was used on 15–20 girls to mutilate their genital organs in a traditional way. And, this circumstance would, in turn, expose girls to be infected with HIV [
13‐
15]. Similarly, the present study postulated that
Shilshalo might play a role in the transmission of HIV/AIDS. It is practiced in a way that the boy ejaculates on the gate of the girl’s vagina and the sperm cell then possibly flows into the inner part of the vagina and as a result of this, it gives chance for STIs including HIV/AIDS to be transmitted from one to the other especially from males to females. Apart from the STIs and related consequences,
Shilshalo had also brought virgin pregnancy upon young girls. This virgin pregnancy was the very unique feature of
Shilshalo and it is hard to find an HTP that has such kind of consequence all over the world. Besides, once girls experienced virgin pregnancy, they were excluded by the community and they would never marry someone else since virginity is the major prerequisite for marriage in the
Argoba culture.
Almost all HTPs are done for some cultural-based reasons. For instance, the strongest reason for early marriage in Ethiopia is the desire to maintain the family’s prestige and popularity. It is also practiced by some parents just to create an alliance between two families for social, political and economic reasons [
6]. When we see the reason associated with the practice of FGM in Ethiopia, it is practiced for making woman to able to do proper sexual intercourse and protecting her from prostitution [
6]. Regarding rationales that underpin
Shishalo to become long lasting traditional practice, there were different reasons justified by the community. To mention the major ones, it was believed to be a way of maintaining girls’ virginity. The mothers were also used it to cross check whether their daughter would get a husband or not in the future. When their daughters had boyfriend to practice
Shilshalo, they would assume as if their daughters would surely get husbands. However, unlike the other HTPs, the victimized groups (girls and boys) were favoring the practice of
Shilshalo because they considered it as an opportunity to entertain their sexual needs before marriage.
As a matter of fact, religion has strong association with HTPs especially with polygamy. The Islamic religious teachings encourage men to marry up to 4 women. In this case, religion has a direct connection with HTPs. However, the other canon of Islamic religion is that any sexual practice before marriage is forbidden [
16]. Since
Shilshalo is practiced before marriage, it did not get religious support rather it has been opposed by Islamic religious leaders. Given this wisdom, we can understand that religion is not always in favor of all forms of HTPs rather it depends on the nature of the HTPs.
Conclusion
Based on the findings of this study, it was concluded that Shilshalo is basically practiced in the Argoba community to preserve young girls’ virginity until marriage. The community believes that restricting young girls from any sexual relationship is not a long lasting option to protect them from losing of their virginity before marriage, rather the community allows them to involve in a kind of sexual practice but without actual genital intercourse. While practicing Shilshalo, there is high possibility that the male’s sperm enters into the vagina. As a result, there are many girls who experience virgin pregnancy and they are also exposed to sexually transmitted diseases including HIV/AIDS. Once they experience virgin pregnancy, they are excluded by the society and their fate to get a husband would be in danger. Although Shilshalo has a devastating effect on the health and overall wellbeing of young girls, it has been still considered by most of the Arogoba people including the actors as a beneficial cultural practice. Hence, it was suggested that concerned bodies should take measures to eliminate this harmful traditional practice.