Estimating utility value for female genital mutilation

Cyrus Alinia,Ghobad Moradi,Amjad Mohamadi-Bolbanabad,Fariba Jahanbin,Hossein Safari,Fariba Farhadifar,Mohammad Ebrahimi,Ali Kazemi-Karyani,Bakhtiar Piroozi

doi:10.1186/s12889-020-08947-4

Abstract

BackgroundFemale genital mutilation/cutting (FGM/C) is a clear violation of women’s rights and can have adverse and irreversible health effects as well. Worldwide, more than 200 million women and girls have undergone FGM/C. Utility value of FGM/C has not been estimated yet, so we designed this study to extract the health utility value of FGM/C for the first time in the world.MethodsIn a cross-sectional study in Iran, 125 girls and women who underwent FGM/C procedure were examined by the trained midwives in order to determine its type. In addition, a questionnaire was completed for identifying the socio-demographic factors and extracting the health utility of these individuals. Health utility was measured using Time Trade-off method and also to determine the effects of the socio-demographic factors on the health utility a two-limit censored regression model was applied.ResultsThe mean and median of the health utility of women with FGM/C were 0.971 (SE: 0.003) and 0.968 (IQR: 1–0.95), respectively. Number of non-traders was 58 (46.4%) who reported perfect health utility. However, the mean of health utility among traders was 0.946 (SE: 0.002). Only type 1 (Clitoridectomy) and type 2 (Excision) FGM/C were seen in this study. Women with Type 1 FGM/C had significantly lower health utility value (Mean: 0.968, Median: 0.957) than their type 2 counterparts (Mean: 0.987, Median: 1.00). Moreover, women in the age group of 31–45 years (Mean: 0.962, Median: 0.956), single (Mean: 0.950, Median: 0.954), divorced (Mean: 0.951, Median: 0.950), employed (Mean: 0.959, Median: 0.956), and with supplementary insurance (Mean: 0.962, Median: 0.950) had significantly lower health utility than their counterparts.ConclusionFGM/C affects physical and psychological well-being of these individuals, resulting in a lack of personal and marital satisfaction, which ultimately leads to a 3% reduction in their health related quality of life. Therefore, preventing from this practice is very important and should be considered by health system policy makers more than before.

Highlights

Female genital mutilation/cutting (FGM/C) is a clear violation of women’s rights and can have adverse and irreversible health effects as well
Female Genital Mutilation/Cutting (FGM/C), which is considered as a global concern, is defined by World Health Organization (WHO) as “all procedures that involve the partial or total removal of external genitalia or another injury to the female genital organs for nonmedical reasons” [1]
A total of 125 women and girls who had a history of FGM/C participated in this study

Summary

Introduction

Female genital mutilation/cutting (FGM/C) is a clear violation of women’s rights and can have adverse and irreversible health effects as well. Female Genital Mutilation/Cutting (FGM/C), which is considered as a global concern, is defined by World Health Organization (WHO) as “all procedures that involve the partial or total removal of external genitalia or another injury to the female genital organs for nonmedical reasons” [1]. Estimates have shown that more than 200 million girls and women have experienced this counterhuman rights procedure [3]. The highest prevalence of FGM/C is seen in African countries such as Somalia (98%), Guinea (96%), Djibouti (93%), and Egypt (91%) [4]. It may be seen among some ethnic groups and immigrants living in developed European and North American countries and Australia [5]. The prevalence of the FGM/C is reported to be between 55.5 and 70% primarily in rural of these areas [9, 10]

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