Factors associated with female genital mutilation: a systematic review and synthesis of national, regional and community-based studies

Abstract

BackgroundThis systematic review aimed to identify and describe the factors that influence female genital mutilation/cutting (FGM/C).MethodsSearches were conducted in Medline, PsycInfo, Web of Science, Embase and the grey literature from 2009 to March 2020 with no language restrictions, using related MESH terms and keywords. Studies were included if they were quantitative and examined factors associated with FGM/C. Two researchers independently screened studies for inclusion, extracted data and assessed study quality. The direction, strength and consistency of the association were evaluated for determinants, presented as a descriptive summary, and were disaggregated by age and region.ResultsOf 2230 studies identified, 54 published articles were included. The majority of studies were from the African Region (n=29) followed by the Eastern Mediterranean Region (n=18). A lower level of maternal education, family history of FGM/C, or belonging to the Muslim religion (in certain contexts) increased the likelihood of FGM/C. The majority of studies that examined higher paternal education (for girls only) and living in an urban region showed a reduced likelihood of FGM/C, while conflicting evidence remained for wealth. Several studies reported that FGM/C literacy, and low community FGM/C prevalence were associated with a reduced likelihood of FGM/C.ConclusionsThere were several characteristics that appear to be associated with FGM/C, and these will better enable the targeting of policies and interventions. Importantly, parental education may be instrumental in enabling communities and countries to meet the Sustainable Development Goals.

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility, and school-based studies

“…This systematic review and meta-analysis were part of a larger project on FGM/C prevalence and its determinants [ 6 , 17 ]. Cohort or cross-sectional studies that reported on FGM/C prevalence at the national level, using representative samples or population-based methods, were included in the systematic review and meta-analysis.…”

“…Nationally representative data show that there is a decline in the prevalence of FMG/C, but this is not universal across countries [ 1 , 4 , 5 ]. FGM/C persists due to religious, social, and cultural factors [ 6 ]. It is commonly believed to create better marriage prospects because of beliefs related to morality, hygiene, and aesthetics; FGM/C is also believed to curb sexual urges and maintain virginity [ 7 ].…”

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility and school-based studies

“…Inclusion and exclusion criteria. This systematic review and meta-analysis were part of a larger project on FGM/C prevalence and its determinants [7,19]. Cohort or cross-sectional studies that reported on FGM/C prevalence at the national level, using representative samples or populationbased methods, were included in the systematic review and meta-analysis.…”

“…Nationally representative data show that there is a decline in the prevalence of FMG/C but this is not universal across countries [1, 5, 6]. FGM/C persists due to religious, social, and cultural factors [7]. It is commonly believed to create better marriage prospects because it associates with morality, hygiene, and aesthetics; FGM/C is also believed to curb sexual urges and maintain virginity [8].…”

The importance of diverse and accurate descriptions of genital anatomy in textbooks

“…An extreme manifestation of this sense of female anatomy inadequacy is female genital mutilation (FGM). This is a deeply rooted practice, performed for complex sociocultural factors in some cultures, and has affected over 200 million people (El-Dirani et al, 2022;WHO, 2022). It involves the partial or total removal of external female genitalia for non-medical reasons.…”