Geographic Variation and Factors Associated with Female Genital Mutilation among Reproductive Age Women in Ethiopia: A National Population Based Survey

Setegn, Tesfaye; Lakew, Yihunie; Deribe, Kebede

doi:10.1371/journal.pone.0145329

Cited by 62 publications

(90 citation statements)

References 19 publications

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“…Although the relationship was not linear in the bivariate analysis, the results of regression analysis adjusted for confounders showed a significant increase in the odds of reporting FGM among respondents in the lower educational categories. Evidence of the beneficial effect of educational qualification on FGM were also reported in other studies in sub-Saharan Africa (Setegn et al 2016;Achia 2014;Kaplan et al 2013). Oddly enough, although educational level is a strong predicator of wealth status, the results revealed an inverse association between wealth status and reporting of FGM.…”

Section: Discussion and Policy Recommendationsupporting

confidence: 79%

“…According to previous reports, the prevalence ranged from 41% to as high as 62.9% at national and subnational levels (Okeke et al 2012;Obi 2004). These estimates are lower than Ethiopia (74%) (Setegn et al 2016) and Gambia (75.6%) (Kaplan et al 2013), but higher than Kenya (28.2%) (Achia 2014) and Tanzania (15%) (Awodele et al 2011). Apart from the high overall prevalence, there has been an increasing trend in FGM in Nigeria since 2003.…”

Section: Discussion and Policy Recommendationmentioning

confidence: 95%

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Female Genital Mutilation in Nigeria: A Persisting Challenge for Women’s Rights

Yaya

Bishwajit

2018

Social Sciences

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Although considered a violation of human rights, female genital mutilation (FGM) is a commonly accepted practice in Nigeria in the ritual and sociocultural context of the population. In recent years, there have been strong policy actions by Nigerian legislature to curb this practice. Despite that, FGM continues to be a widespread phenomenon. In this study, we aimed to report on the prevalence of FGM, women’s attitude towards this practice, and its association with selected sociodemographic factors. Methods: Nigeria Demographic and Health Surveys conducted in 2003, 2008 and 2013 provided the data for this study. The participants were married women aged between 15 and 49 years. Owing to the clustered nature of the data, a complex survey plan was created to account for cluster effects and sampling weights. Data were analysed using bivariate and multivariate regression techniques. Results: Overall prevalence of FGM was 38.9% (95% CI = 36.4–40.1), and that among their daughters was 17.4% (95% CI = 15.3–19.7). There has been a substantial increase in the prevalence of FGM in 2013 compared to its 2003 level. Respondents who had undergone circumcision were more likely to have their daughters circumcised. In all three surveys, almost all of the circumcisions were performed by traditional practitioners. In the regression analysis, respondent’s age, area and region of residency, religious affiliation, educational status, and household wealth appeared to be significant predictors of FGM. Conclusion: In Nigeria, FGM remains a widely prevalent phenomenon with an increasing number of women experiencing this practice. Important regional and socioeconomic disparities were observed in the prevalence which merit urgent policy attention.

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Section: Discussion and Policy Recommendationsupporting

confidence: 79%

Section: Discussion and Policy Recommendationmentioning

confidence: 95%

Female Genital Mutilation in Nigeria: A Persisting Challenge for Women’s Rights

Yaya

Bishwajit

2018

Social Sciences

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“…On the other hand, the practice is high as compared with similar survey reports of Egypt, 12% [34], Kenya, 3% [35], chad, 10% [33,36] Like other studies [24,39], this study identified maternal age, household wealth index, maternal education, number of living children, perceived religious believes to FGM/C, opinions of women towards the practice of FGM/C, and regular media exposure as individual level factors associated with the practice of FGM/C.…”

Section: Discussionmentioning

confidence: 66%

Hotspots of female genital mutilation/cutting and associated factors among girls in Ethiopia: a spatial and multilevel analysis

Geremew

Azage

Worku

2020

Preprint

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Background: Female genital mutilation/cutting (FGM/C) is a harmful traditional practice that violates the human rights of girls and women. It is widely practiced mainly in Africa including Ethiopia. There are a number of studies on the prevalence of FGM/C in Ethiopia. However, little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed to explore the spatial pattern and factors affecting FGM/C among girls in Ethiopia.Methods: A further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a total of 6,985 girls nested in 603 enumeration areas were included. Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Kulldorff’s spatial scan statistics were used to detect spatial clusters of FGM/C. Multilevel logistic regression models were fitted to identify individual and community level factors affecting FGM/C.Results: Spatial clustering of FGM/C was observed (Moran’s I=0.31, p-value < 0.01), and eight significant clusters of FGM/C were detected. The most likely primary cluster was detected in the neighborhood areas of Amhara, Afar, Tigray and Oromia regions (LLR = 279.0, p< 0.01), the secondary cluster in Tigray region (LLR=67.3, p<0.01), and the third cluster in Somali region (LLR=55.5, P<0.01). In About 83% variation in the odds of FGM/C was attributed to both individual and community level factors. At individual level, older maternal age, higher number of living children, maternal circumcision, perceived believes as FGM/C is required by religion, and supporting the continuation of FGM/C practice were factors to increase the odds of FGM/C, whereas, secondary/higher maternal education, better household wealth, and media exposure were factors decreasing the odds of FGM/C. Place of residency, Region and Ethnicity were the community level factors associated with FGM/C.Conclusions: Spatial clustering of FGM/C among girls was observed, and FGM/C hotspots were detected in Afar, Amhara, Tigray, BenishangulGumuz, Oromia, SNNPR and Somali regions including Dire Dawa Town. Both individual and community level factors play a significant role in the practice of FGM/C. Hence, FGM/C hotspots require priority interventions, and it is also better to consider both individual and community level factors.

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“…It showed that age at circumcision for girls whose mothers lived in urban was prolonged by the factor of = 1.524 when rural is used as reference. A similar study that has been conducted in Ethiopia by Setegn et al (2016) revealed as the rural girls were more vulnerable towards circumcision than urban girls. The findings of this study also exposed that the educational level of girls mothers had a significant effect on the survival of age at circumcision with 5% level of significance and it prolonged age at circumcision by the factor of = 3.119 and 3.933 for secondary and higher education respectively when illiterate mothers was used as the reference category.…”

Section: Discussionmentioning

confidence: 58%

Modeling determinants of time-to-circumcision of girls: a comparison of various parametric shared frailty models

Bekalo

2019

Health Serv Outcomes Res Method

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Female genital mutilation (FGM), also known as female genital cutting or female circumcision, is one of the deeply rooted traditional practices, in which the external female genital organ is either partially or totally removed for non-medical reasons. In Ethiopia, FGM is widespread across the majority of regions and ethnic groups, having the highest national prevalence that leads them to various complications such as immediate urinary and genital tract infection, pain and hemorrhage, complications in childbirth and social, psychological and sexual complications. This study aimed to model and investigate the potential risk factors of time-to-circumcision of girls in Ethiopia using parametric shared frailty models where regional states of the girls were used as a clustering effect in the models. The data source for the analysis was the 2016 EDHS data collected from January 18, 2016 up to June 27, 2016 from which the survival information of 2930 girls on age at circumcision obtained. The gamma and inverse Gaussian shared frailty distributions with Exponential, Weibull and log-logistic baseline models was employed to analyze risk factors associated with age at circumcision using socio-economic and demographic factors. All the fitted models were compared by using AIC and BIC values from simulation study and actual dataset. The result revealed that about 22.4% of girls were circumcised and 77.6% were not circumcised. The median age at circumcision was 3 years. Based on AIC and BIC values from simulation experiment and graphical evidences, log-logistic model with inverse Gaussian shared frailty distribution preferred when compared with other models for age at circumcision dataset. The clustering effect was significant for modeling the determinants of time-to-circumcision of girls dataset. Based on the result of log-logistic inverse Gaussian shared frailty model, mothers and fathers educational level, place of residence and religion of parents were found to be the most significant determinants of age at circumcision of girls. The estimated acceleration factor for the group of mothers who had secondary and higher educational level were highly prolonged age at circumcision of girls by the factor of ϕ = 3.119 and ϕ = 3.933 respectively. The log-logistic model with inverse Gaussian shared frailty distribution described age at circumcision of girls better than other models and there was heterogeneity between the regions on age at circumcision. Improving parents access to education would be an important way approach for preventing girls' circumcision.

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Geographic Variation and Factors Associated with Female Genital Mutilation among Reproductive Age Women in Ethiopia: A National Population Based Survey

Cited by 62 publications

References 19 publications

Female Genital Mutilation in Nigeria: A Persisting Challenge for Women’s Rights

Female Genital Mutilation in Nigeria: A Persisting Challenge for Women’s Rights

Hotspots of female genital mutilation/cutting and associated factors among girls in Ethiopia: a spatial and multilevel analysis

Modeling determinants of time-to-circumcision of girls: a comparison of various parametric shared frailty models

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