A Spatial Analysis of the Prevalence of Female Genital Mutilation/Cutting among 0-14-Year-Old Girls in Kenya

Comparison of FGM prevalence among Nigerian women aged 15-49 years using two household surveys conducted before and after the COVID-19 pandemic

BACKGROUND

Due to its economic burden and change of focus, there is no gainsaying of the potential impacts of the COVID-19 pandemic on the progress of several female genital mutilation (FGM) interventions across the various countries. However, the magnitude of the potential changes in likelihood and prevalence should be more accurately explored and quantified using a statistically robust comparative study. In this study, we examined the differences in the likelihood and prevalence of FGM among 15-49 years old women before and after the pandemic in Nigeria.

METHODS

We used advanced Bayesian hierarchical models to analyse post-COVID-19 datasets provided by the Multiple Indicator Cluster Surveys (MICS 2021) and pre-COVID-19 data from the Demographic and Health Surveys (DHS 2018).

RESULTS

Results indicated that although there was an overall decline in FGM prevalence nationally, heterogeneities exist at state level and at individual-/community-level characteristics. There was a 6.9% increase in prevalence among women who would like FGM to continue within the community. FGM prevalence increased by 18.9% in Nasarawa, while in Kaduna there was nearly 40% decrease.

CONCLUSIONS

Results show that FGM is still a social norm issue in Nigeria and that it may have been exacerbated by the COVID-19 pandemic. The methods, data and outputs from this study would serve to provide accurate statistical evidence required by policymakers for complete eradication of FGM.

Prevalence and determinants of female genital amputation among adolescent girls and young women in Ethiopia: multilevel analysis

INTRODUCTION

Female genital amputation is a harmful traditional practice that has adverse risks on health outcomes. Consequently, it affects girls and women's physical, psychological, and mental health conditions. However, evidence on female genital amputation factors among adolescent girls and young women in Ethiopia was limited.

METHOD

Secondary data analysis was conducted from the 2016 Ethiopian Demographic and Health Survey. A weighted sample size included in this study was 2961 adolescent girls and young women. Data management and further analysis were performed using Stata 14 software. An adjusted odds ratio with a 95% confidence interval was used for measuring a significant relationship between factors with the outcome variable.

RESULT

This study found that the prevalence of female genital amputation among adolescent girls and young women in Ethiopia was 53.4%. Among individual- and community-level variables included in the multivariable multilevel analysis: maternal age, religious status, marital status, maternal educational level, occupational status, residence areas, community uneducated level, and community mass media were significant factors for female genital amputation.

CONCLUSION

The prevalence of female genital amputation among adolescent girls and young women in Ethiopia remains high. Those individual- and community-level factors influence female genital amputation among adolescent girls and young women in Ethiopia. It requires health interventions on female genital amputation to improve behavioral changes and create awareness about harmful practices.

Prevalence and drivers of female genital mutilation/cutting in three coastal governorates in Yemen

BACKGROUND

Female genital mutilation/cutting (FGM/C), a violation of human rights, remains common in the coastal areas of Yemen.

OBJECTIVE

This study aimed to identify the prevalence of FGM/C and its risk factors among the youngest daughters in families in the Yemeni coastal areas, as well as the knowledge and attitudes of the local population towards FGM/C.

METHODS

A cross-sectional survey was conducted among 646 women and 345 men from six districts in three Yemeni coastal governorates between July and September 2020 using a structured questionnaire. Categorical data were described by proportion. The chi-square test was used to identify factors associated with FGM/C. All factors with a p-value of ≤ 0.05 were included in the multivariate analysis. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated in the multivariate logistic regression analysis.

RESULTS

The prevalence of FGM/C in Yemeni coastal areas was 89.0% (95% CI 84.0%-92.5%) among women and 79.8% (95% CI 73.5%-84.8%) among the youngest daughters in the surveyed families. Nearly two-thirds of women and half of the men recorded a poor knowledge level about the harms of FGM/C. Furthermore, almost two-thirds of both women and men would like to continue the practice of FGM/C. Among women, significant predictors of FGM/C among youngest daughters included advanced maternal age of ≥ 40 years (AOR 7.16, 95% CI 2.73-18.76), mother's desire to continue FGM/C (AOR 8.07, 95% CI 3.64-17.89), and living in a rural area (AOR 3.95, 95% CI 1.51-10.30). Daughters of mothers who did not undergo FGM/C were more protected from FGM/C than those whose mothers had undergone FGM/C (AOR 0.04, 95% CI 0.02-0.09). Among men, the father's desire to continue FGM/C (AOR 15.10, 95% CI 6.06-37.58) was significantly associated with FGM/C among the youngest daughters.

CONCLUSION

This study confirmed that FGM/C is still prevalent among communities in Yemeni coastal areas. Thus, community-based interventions with a focus on the rural population are vital to improving the awareness of various harms of FGM/C.

Factors associated with female genital mutilation: a systematic review and synthesis of national, regional and community-based studies

BACKGROUND

This systematic review aimed to identify and describe the factors that influence female genital mutilation/cutting (FGM/C).

METHODS

Searches were conducted in Medline, PsycInfo, Web of Science, Embase and the grey literature from 2009 to March 2020 with no language restrictions, using related MESH terms and keywords. Studies were included if they were quantitative and examined factors associated with FGM/C. Two researchers independently screened studies for inclusion, extracted data and assessed study quality. The direction, strength and consistency of the association were evaluated for determinants, presented as a descriptive summary, and were disaggregated by age and region.

RESULTS

Of 2230 studies identified, 54 published articles were included. The majority of studies were from the African Region (n=29) followed by the Eastern Mediterranean Region (n=18). A lower level of maternal education, family history of FGM/C, or belonging to the Muslim religion (in certain contexts) increased the likelihood of FGM/C. The majority of studies that examined higher paternal education (for girls only) and living in an urban region showed a reduced likelihood of FGM/C, while conflicting evidence remained for wealth. Several studies reported that FGM/C literacy, and low community FGM/C prevalence were associated with a reduced likelihood of FGM/C.

CONCLUSIONS

There were several characteristics that appear to be associated with FGM/C, and these will better enable the targeting of policies and interventions. Importantly, parental education may be instrumental in enabling communities and countries to meet the Sustainable Development Goals.

Female Genital Mutilation as a Social Norm: Examining the Beliefs and Attitudes of Women in This Diaspora

In this article, we explore the beliefs, values and attitudes about female genital mutilation in the diaspora of sub-Saharan women and how the migration process has influenced these beliefs. Our qualitative analysis of the life stories and lifelines of 10 women in the sub-Saharan diaspora in light of the Social Convention Theory indicated that making public statements about the topic is complex and that the taboo permeating the practice remains intact even outside of Africa. Furthermore, we discovered that, in our context, this practice was not a requirement and did not improve the chances of marriage, with female behaviours considered 'appropriate' instead gaining value. Any interventions based on this theory must consider the broad networks that help shape marriages in this diaspora. This work opened new lines of research regarding the situation of the diaspora of sub-Saharan women and the relationship of the practice of female genital mutilation with marriage.

Evaluating changes in the prevalence of female genital mutilation/cutting among 0-14 years old girls in Nigeria using data from multiple surveys: A novel Bayesian hierarchical spatio-temporal model

Female genital mutilation/cutting (FGM/C) is considered a public health and human rights concern, mainly concentrated in Africa, and has been targeted for elimination under the sustainable development goals. Interventions aimed at ending the practice often rely on data from household surveys which employ complex designs leading to outcomes that are not totally independent, thus requiring advanced statistical techniques. Combining data from multiple surveys within robust statistical framework holds promise to provide more precise estimates due to increased sample size, and accurately identify ‘hotspots’ and allow for assessment of changes over time. In this study, rich datasets from six (6) successive waves of the Nigeria Demographic and Health Surveys and Multiple Indicator Cluster Surveys undertaken between 2003 and 2016/17, were combined and analyzed in order to better assess changes in the likelihood and prevalence of FGM/C among 0-14-year old girls in Nigeria. We used Bayesian hierarchical regression models which explicitly accounted for the inherent spatial and temporal autocorrelations within the data while simultaneously adjusting for variations due to different survey methods and the effects of linear and non-linear covariates. Parameters were estimated using Markov chain Mote Carlo techniques and model fit assessments were based on Deviance Information Criterion. Results show that prevalence of FGM/C among 0–14 years old girls in Nigeria varied over time and across geographical locations and peaked in 2008 with a shift from South to North. A girl was more likely to be cut if her mother was cut, supported FGM/C continuation, or had no higher education. The effects of mother’s age, wealth and type of residence (urban-rural) were no longer significant in 2016. These results reflect the gains of interventions over the years, but also echo the belief that FGM/C is a social norm thus requiring tailored all-inclusive interventions for the total abandonment of FGM/C in Nigeria.

Factors associated with female genital mutilation among women of reproductive age and girls aged 0-14 in Chad: a mixed-effects multilevel analysis of the 2014-2015 Chad demographic and health survey data

BACKGROUND

Chad is one of the African countries with high prevalence of female genital mutilation (FGM). The aim of this study was to examine the factors associated with FGM among women aged 15-49 and girls aged 0-14 in Chad.

METHODS

Data for the study were obtained from the 2014-2015 Chad Demographic and Health Survey. FGM among women aged 15-49 and girls aged 0-14 were the outcome variables. The prevalence of FGM among women and girls were presented using percentages while a mixed-effects multilevel multivariable logistic regression analysis was carried out to assess the factors associated with FGM. The results were presented using adjusted odds ratio with associated 95% confidence intervals.

RESULTS

The results indicate that more than half (50.2%) of the women and 12.9% of girls in Chad had been circumcised. Among women aged 15-49, level of education, employment status, ethnicity, religion, wealth quintile and community literacy level were significant predictors of FGM. Age, partner's level of education, marital status, employment status, ethnicity, religion and mother's FGM status were associated with FGM among girls aged 0-14.

CONCLUSION

This study has identified several individual and contextual factors as predictors of FGM among women and girls in Chad. The findings imply the need to adopt strategies aimed at addressing these factors in order to help eliminate the practice of FGM. Government and non-governmental organisations in Chad need to implement policies that enhance media advocacy and community dialogue to help deal with FGM in the country.

Migrant Women-experiences from the Mediterranean Region

Introduction:

The phenomenon of migration is characterized and influenced by a number of different variables; and the different stages of journey are related to different levels and types of psychological distress. Women, in particular, are exposed to further specific risks during migration.

Aim:

To determine the factors that affect the psychological health of migrant women during the different stages of the migration journey.

Methods:

We provide a narrative review of the literature around the experiences of women during migration process, with a geographical focus on women migrating to the Mediterranean area.

Results:

Little data is currently available on the burden of mental health disorders for female migrants. Most studies about the mental health status of migrants were not gender-disaggregated or focused specifically on migrant women’s experiences of violence. Sexual and Gender-Based Violence (SGBV) was found to be a common risk factor faced by all the women who leave their native country to migrate to other countries.

Conclusion:

Despite the importance of the issue and the gender-specific variables related to the experience of migrant women, few studies have looked specifically at psychological variables and mental health status in the female migrant population. It is crucial that future studies are conducted around female migration, violence towards women, and women’s mental health, in order to provide an evidence-base for promoting adequate policies and prevention/treatment programs for women.