Abstract
Female Genital Mutilation (FGM) is a harmful practice with no benefits and considerable harm to girls and women who undergo it. In 2016, the United Nations Joint Program to Eliminate FGM, funded the development and subsequent validation of a monitoring and evaluation framework to understand the relationship between social norms and practicing FGM. Evidence on the framework was gathered through a pilot study in Ethiopia. This paper uses cross-sectional quantitative data from the pilot to operationalize the framework and determine what factors are associated with practicing FGM. A total of 554 and 481 participants answered the question “Have you undergone FGM?” and “Do you know a family member who has undergone FGM?” respectively. Overall, 65% of participants said they had undergone FGM and 32% said they knew someone in their family who had undergone FGM. Predictors of not undergoing FGM included most progressive attitudes vs. less progressive attitudes about FGM and relationship to identity [OR: 1.9 (95% CI: 1.1–3.3)]; region [Afar vs. Addis Ababa: OR: 0.09 (95% CI: 0.02–0.5); Southern Nations Nationalities and People's Regions vs. Addis Ababa: OR: 0.1 (95% CI: 0.05–0.3)], being 36 years old and above vs. 10–19 years (OR: 0.2 (95% CI: 0.1 to 0.7)) and being single, never married vs. married or engaged (OR: 2.8 (95% CI: 1.1–7.0)]. Predictors of knowing a family member who has not undergone FGM included: Higher knowledge vs. lower knowledge [OR: 0.3 (95% CI: 0.1–0.5)]; if the family expected you to abandon FGM, you had a greater odds of knowing a family member who had not undergone FGM [43.6 (95% CI: 2.7–687.8)]; coming from Southern Nations, Nationalities and People's Region was associated with a lower odds of knowing a family member who had not undergone FGM [0.3 (95% CI: 0.1–0.6)]. Being a female influential vs. female caregiver was associated with a higher odds of knowing a family member who had not undergone FGM [2.9 (95% CI: 1.01–5.2)]. This paper has allowed us to validate a theory and research based social norms framework, specifically examining how social and behavior change communication can be used as a mechanism for shifting norms around a given harmful practice. Now that this model has been developed and validated, it is likely to provide a foundation to study the direct and indirect impacts of social norms programming on changing harmful practices, such as FGM.
Highlights
Female Genital Mutilation (FGM) is a harmful practice with no benefits and considerable harm to girls and women who undergo it
Thereafter, seven multivariable analyses were conducted to determine the relationships portrayed in the conceptual model: 1. In the first two multivariable regressions, we looked at the relationship between knowledge and attitudes on interpersonal communication and social support
In the second to fifth multivariable regressions, we looked at the relationship between knowledge, attitudes, interpersonal communication, and social support on social norms
Summary
Female Genital Mutilation (FGM) is a harmful practice with no benefits and considerable harm to girls and women who undergo it. It is prevalent in 30 countries around the globe. An evidence brief prepared by the World Health Organization [WHO in 2019 reported that FGM continued to persist within families and communities due to cultural, religious, and social determinants [5]]. The lack of rigor and standardization in monitoring and evaluation has made it difficult to determine social and behavior change (SBC) that can be attributed to these norms shifting interventions [7]. Evidence on the framework was gathered through a pilot study in Ethiopia. The third section reports the results, which are followed by a discussion of the limitations of this work and recommendations for the future
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