Exploration of pathways related to the decline in female circumcision in Egypt

Sepideh Modrek,Jenny X Liu

doi:10.1186/1471-2458-13-921

Abstract

BackgroundThere has been a large decline in female genital circumcision (FGC) in Egypt in recent decades. Understanding how this change has occurred so rapidly has been an area of particular interest to policymakers and public health officials alike who seek to further discourage the practice elsewhere.MethodsWe document the trends in this decline in the newest cohorts of young girls and explore the influences of three pathways—socioeconomic development, social media messages, and women’s empowerment—for explaining the observed trends. Using the 2005 and 2008 Egypt Demographic and Health Surveys, we estimate several logistic regression models to (1) examine individual and household determinants of circumcision, (2) assess the contributions of different pathways through which these changes may have occurred, and (3) assess the robustness of different pathways when unobserved community differences are taken into account.ResultsAcross all communities, socioeconomic status, social media messages, and women’s empowerment all have significant independent effects on the risk of circumcision. However, after accounting for unobserved differences across communities, only mother’s education and household wealth significantly predict circumcision outcomes. Additional analyses of maternal education suggest that increases in women’s education may be causally related to the reduction in FGC prevalence.ConclusionsWomen’s empowerment and social media appear to be more important in explaining differences across communities; within communities, socioeconomic status is a key driver of girls’ circumcision risk. Further investigation of community-level women’s educational attainment for mothers suggests that investments made in female education a generation ago may have had echo effects on girls’ FGC risk a generation later.

Highlights

There has been a large decline in female genital circumcision (FGC) in Egypt in recent decades
There has been a large decline in female circumcision in Egypt in recent decades [5] and an increase in its “medicalization” in which the circumcision is performed by a health professional [6,7,8]
The empowerment score for household decision-making ranges from −3.5 to 1.4 (SD = 1.4) and the range for the empowerment index based on domestic violence questions is from −1.8 to 3.0 (SD = 1.7)

Summary

Introduction

There has been a large decline in female genital circumcision (FGC) in Egypt in recent decades. Understanding how this change has occurred so rapidly has been an area of particular interest to policymakers and public health officials alike who seek to further discourage the practice elsewhere. There has been a large decline in female circumcision in Egypt in recent decades [5] and an increase in its “medicalization” in which the circumcision is performed by a health professional [6,7,8]. Laws passed in 1959 and 1978 prohibiting female circumcision without a clear medical indication went largely unenforced [3,4] and concerted efforts to discourage FGC reemerged in the mid-1990s. Non-governmental organizations (NGOs) have been the most active in raising awareness and promoting anti-circumcision messages, which are included in most community development, health care, and women’s right programs in Egypt [12]

Methods

Results

Conclusion