Abstract

BackgroundFemale 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.MethodsA further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a total of 6985 girls nested in 603 enumeration areas were included in this analysis. Global 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.ResultsSpatial clustering of FGM/C was observed (Moran’s I = 0.31, p-value < 0.01), and eight significant clusters of FGM/C (hotspots) were detected. The most likely primary SaTScan 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 the final best fit model, 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 beliefs as FGM/C are required by religion, and supporting the continuation of FGM/C practice were factors to increase the odds of FGM/C, whereas, secondary or higher maternal education, better household wealth, and regular media exposure were factors decreasing the odds of FGM/C. Place of residency, Region and Ethnicity were also among the community level factors associated with FGM/C.ConclusionsIn this study, spatial clustering of FGM/C among girls was observed in Ethiopia, and FGM/C hotspots were detected in Afar, Amhara, Tigray, Benishangul Gumuz, 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 if the targeted interventions consider both individual and community level factors.

Highlights

  • Female genital mutilation/cutting (FGM/C) is a harmful traditional practice that violates the human rights of girls and women

  • Four in five (80%) mothers of the daughters had a history of circumcision, and about 3 in 10 women (30%) believed that FGM/C is required by their religion

  • The results of this study showed that the daughters of women with secondary or higher educational status had lower odds of experiencing FGM/C compared to the those who had no education, and it is supported by other studies conducted in and out of Ethiopia [24, 39]

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Summary

Introduction

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. Female genital mutilation/Cutting (FGM/C), known as “female circumcision”, refers to “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons” [1]. It is a violation of girls’ and women’s right to life, right to physical integrity, and right to health, as it damages healthy genital tissue and can lead to severe consequences for girls’ and women’s physical and mental health [2, 3].

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