BackgroundThis systematic review aimed to identify and describe the factors that influence female genital mutilation/cutting (FGM/C).MethodsSearches 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.ResultsOf 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.ConclusionsThere 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.
Background Female genital mutilation/cutting (FGM/C) is a nonmedical procedure entailing the modification of the external female genitalia. A description of the prevalence and distribution of FGM/C allows the tracking of progress toward ending FGM/C by 2030 (Sustainable Development Goal (SDG): target 5.3). This systematic review aimed to examine FGM/C prevalence and types, by World Health Organization (WHO) region and country. Methods and findings A systematic search using Medical Subject Headings (MeSH) and keywords from 2009 to March 24, 2022 was undertaken in MEDLINE, PubMED, PsycINFO, Web of Science, and Embase to identify studies presenting FGM/C prevalence. Abstract and full-text screening, quality assessment, and data extraction were undertaken by 2 reviewers. Only nationally representative studies were included in the meta-analysis. Pooled FGM/C prevalence was estimated by random-effects meta-analysis using generalized linear mixed models (GLMMs). FGM/C prevalence with 95% confidence intervals (CIs), prediction intervals (PIs), and FGM/C type were presented separately by women aged 15 to 49 years and girls aged 0 to 14 years. A total of 163 studies met the inclusion criteria and 30 were included in the meta-analysis, of which 23 were from the WHO African Region (AFR), 6 from the Eastern Mediterranean Region (EMR), and 1 from the South East Asian Region (SEAR). These studies included data from 406,068 women across 30 countries and 296,267 girls across 25 countries; the pooled prevalence estimate of FGM/C among women aged 15 to 49 years was 36.9% (95% CI: 19.6% to 58.3%; PI: 0.4% to 99.0%), and 8.27% (95% CI: 3.7% to 17.3%; PI: 0.1% to 89.3%) among girls aged 0 to 14 years. Among included countries, this gave a total estimated prevalence of 84,650,032 women (95% CI: 45,009,041 to 133,834,224) and 13,734,845 girls with FGM/C (95% CI: 6,211,405 to 28,731,901). Somalia had the highest FGM/C prevalence among women (99.2%), and Mali had the highest among girls (72.7%). The most common type of FGM/C among women was “flesh removed” (Type I or II) in 19 countries. Among girls, “not sewn closed” (Type I, II, or IV) and “flesh removed” (Type I or II) were the most common types in 8 countries, respectively. Among repeated nationally representative studies, FGM/C decreased for both women and girls in 26 countries. The main limitation of the study methodology is that estimates were based on available published data, which may not reflect the actual global prevalence of FGM/C. Conclusions In this study, we observed large variation in FGM/C prevalence between countries, and the prevalence appears to be declining in many countries, which is encouraging as it minimizes physical and physiological harm for a future generation of women. This prevalence estimate is lower than the actual global prevalence of FGM/C due to data gaps, noncomparable denominators, and unavailable surveys. Yet, considerable policy and community-level interventions are required in many countries to meet the SDG target 5.3. Trial registration Registration: CRD42020186937.
Background: Female Genital Mutilation/Cutting (FGM/C) is a non-medical procedure entailing the modification of the external female genitalia. The Sustainable Development Goals aim to end FGM/C by 2030. This systematic review aimed to examine FGM/C prevalence and types, by World Health Organization (WHO) region and country. Methods and Findings: A systematic search using MeSH headings and keywords from inception to March 2, 2020 was undertaken in MEDLINE, PsycINFO, Web of Science, and Embase to identify studies presenting FGM/C prevalence. Abstract and full-text screening, quality assessment, and data extraction were undertaken by two reviewers. Only nationally representative studies were included in the meta-analysis. Pooled FGM/C prevalence was estimated by meta-analysis using random effects models. FGM/C prevalence and types were presented separately by women aged 15-49 and girls aged 0-14. 3,205 articles were identified. 135 met the inclusion criteria and 28 were included in the meta-analysis. Across 27 countries, the pooled prevalence estimate of FGM/C in women aged 15-49 was 40% (95% CI: 26-55%; I2 =100%), and 15% (95% CI: 10-21%; I2 =100%) in girls aged 0-14 across 34 countries. The country with the highest FGM/C prevalence in women was Guinea (97%) and the lowest, Uganda (0.3%). The highest prevalence in girls was in Mali (77%), and the lowest in Ghana (0%). The most common category of FGM/C was flesh removed at 69% (women) and 70% (girls). Limitations include that studies had heterogeneous terminology and relied on recall. Conclusions: There is large variation in FGM/C prevalence, and the lower prevalence in the current generation of girls is encouraging. However, considerable policy and community-level interventions are required to meet the SDG. Future research should consider collecting data on the 15-19 age group in order to accurately assess generational differences in FGM prevalence. The study protocol is available: https://osf.io/ema9j/.
We calculated the difference between the observed number of hip fractures in 2019 and the expected number of hip fractures given stable fracture rates. IFPPs in 2019 attributable to changes in prevalences of BMI > 25 were estimated according to sex and 5-year age groups from 50 to 85+. Results Hip fracture rates decreased by 28% from 1999 to 2019 with 2,549 fewer hip fractures observed than expected in 2019. The prevalences of BMI > 25 had increased in all age groups in both men and women over the time period. Unadjusted estimates showed that the increased prevalences of BMI > 25 accounted for~30% of the decline. Increased BMI explained~50% of the total number of IFFPs in men and~25% of the total IFPPs in women. ConclusionThe incident hip fracture rates in Norway declined between 1999 and 2019. These preliminary results suggest that increased BMI in the population, reflecting a shift in the population BMI distribution, has significantly contributed to the declining hip fracture incidence, particularly in men.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.