scholarly journals Evaluating changes in the prevalence of female genital mutilation/cutting among 0-14 years old girls in Nigeria using data from multiple surveys: A novel Bayesian hierarchical spatio-temporal model

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246661 ◽  
Author(s):  
Chibuzor Christopher Nnanatu ◽  
Glory Atilola ◽  
Paul Komba ◽  
Lubanzadio Mavatikua ◽  
Zhuzhi Moore ◽  
...  
Keyword(s):  
Female Genital Mutilation ◽  
Survey Methods ◽  
Deviance Information Criterion ◽  
Information Criterion ◽  
Demographic And Health Surveys ◽  
Bayesian Hierarchical ◽  
Genital Mutilation ◽  
Combining Data ◽  
Over Time ◽  
Female Genital

Female genital mutilation/cutting (FGM/C) is considered a public health and human rights concern, mainly concentrated in Africa, and has been targeted for elimination under the sustainable development goals. Interventions aimed at ending the practice often rely on data from household surveys which employ complex designs leading to outcomes that are not totally independent, thus requiring advanced statistical techniques. Combining data from multiple surveys within robust statistical framework holds promise to provide more precise estimates due to increased sample size, and accurately identify ‘hotspots’ and allow for assessment of changes over time. In this study, rich datasets from six (6) successive waves of the Nigeria Demographic and Health Surveys and Multiple Indicator Cluster Surveys undertaken between 2003 and 2016/17, were combined and analyzed in order to better assess changes in the likelihood and prevalence of FGM/C among 0-14-year old girls in Nigeria. We used Bayesian hierarchical regression models which explicitly accounted for the inherent spatial and temporal autocorrelations within the data while simultaneously adjusting for variations due to different survey methods and the effects of linear and non-linear covariates. Parameters were estimated using Markov chain Mote Carlo techniques and model fit assessments were based on Deviance Information Criterion. Results show that prevalence of FGM/C among 0–14 years old girls in Nigeria varied over time and across geographical locations and peaked in 2008 with a shift from South to North. A girl was more likely to be cut if her mother was cut, supported FGM/C continuation, or had no higher education. The effects of mother’s age, wealth and type of residence (urban-rural) were no longer significant in 2016. These results reflect the gains of interventions over the years, but also echo the belief that FGM/C is a social norm thus requiring tailored all-inclusive interventions for the total abandonment of FGM/C in Nigeria.

scholarly journals Analysing Normative Influences on the Prevalence of Female Genital Mutilation/Cutting among 0–14 Years Old Girls in Senegal: A Spatial Bayesian Hierarchical Regression Approach

2021 ◽  
Vol 18 (7) ◽  
pp. 3822
Author(s):  
Ngianga-Bakwin Kandala ◽  
Chibuzor Christopher Nnanatu ◽  
Glory Atilola ◽  
Paul Komba ◽  
Lubanzadio Mavatikua ◽  
...  
Keyword(s):  
Rural Areas ◽  
Female Genital Mutilation ◽  
Deviance Information Criterion ◽  
Information Criterion ◽  
Hierarchical Regression ◽  
Traditional Practice ◽  
Bayesian Hierarchical ◽  
Genital Mutilation ◽  
Female Genital ◽  
Normative Influences

Background: Female genital mutilation/cutting (FGM/C) is a harmful traditional practice affecting the health and rights of women and girls. This has raised global attention on the implementation of strategies to eliminate the practice in conformity with the Sustainable Development Goals (SDGs). A recent study on the trends of FGM/C among Senegalese women (aged 15–49) which examined how individual- and community-level factors affected the practice, found significant regional variations in the practice. However, the dynamics of the practice among girls (0–14 years old) is not fully understood. This paper attempts to fill this knowledge gap by investigating normative influences in the persistence of the practice among Senegalese girls, identify and map ‘hotspots’. Methods: We do so by using a class of Bayesian hierarchical geospatial modelling approach implemented in R statistical software (R Foundation for Statistical Computing, Vienna, Austria) using R2BayesX package. We employed Markov Chain Monte Carlo (MCMC) techniques for full Bayesian inference, while model fit and complexity assessment utilised deviance information criterion (DIC). Results: We found that a girl’s probability of cutting was higher if her mother was cut, supported FGM/C continuation or believed that the practice was a religious obligation. In addition, living in rural areas and being born to a mother from Diola, Mandingue, Soninke or Poular ethnic group increased a girl’s likelihood of being cut. The hotspots identified included Matam, Tambacounda and Kolda regions. Conclusions: Our findings offer a clearer picture of the dynamics of FGM/C practice among Senegalese girls and prove useful in informing evidence-based intervention policies designed to achieve the abandonment of the practice in Senegal.

scholarly journals Is there a relationship between female genital mutilation/cutting and fistula? A statistical analysis using cross-sectional data from Demographic and Health Surveys in 10 sub-Saharan Africa countries

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025355 ◽  
Author(s):  
Dennis Juma Matanda ◽  
Pooja Sripad ◽  
Charity Ndwiga
Keyword(s):  
Statistical Analysis ◽  
Female Genital Mutilation ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Common Belief ◽  
Cross Sectional ◽  
Genital Mutilation ◽  
Sub Saharan ◽  
Female Genital

ObjectivesLiterature on associations between female genital mutilation/cutting (FGM/C) and fistula points to a common belief that FGM/C predisposes women to developing fistula. This study explores this association using nationally representative survey data.DesignA secondary statistical analysis of cross-sectional data from Demographic and Health Surveys was conducted to explore the association between FGM/C and fistula.SettingSub-Saharan Africa.ParticipantsWomen aged 15–49 years in Burkina Faso (n=17 087), Chad (n=17 719), Côte d’Ivoire (n=10 060), Ethiopia (n=14 070), Guinea (n=9142), Kenya (n=31 079), Mali (n=10 424), Nigeria (n=33 385), Senegal (n=15 688) and Sierra Leone (n=16 658).Main outcome measuresFistula symptoms.ResultsMultivariate logit modelling using pooled data from 10 countries showed that the odds of reporting fistula symptoms were 1.5 times (CI 1.06 to 2.21) higher for women whose genitals were cut and sewn closed than those who had undergone other types of FGM/C. Women who attended antenatal care (ANC) (adjusted odds ratio (AOR) 0.51, CI 0.36 to 0.71) and those who lived in urban areas (AOR 0.62, CI 0.44 to 0.89) were less likely to report fistula symptoms than those who did not attend ANC or lived in rural areas.ConclusionsSevere forms of FGM/C (infibulation) may predispose women to fistula. Contextual and socioeconomic factors may increase the likelihood of fistula. Multisectoral interventions that concurrently address harmful traditional practices such as FGM/C and other contextual factors that drive the occurrence of fistula are warranted. Promotion of ANC utilisation could be a starting point in the prevention of fistulas.

scholarly journals Hierarchical modelling of factors associated with the practice and perpetuation of female genital mutilation in the next generation of women in Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250411
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
Imran Oludare Morhason-Bello ◽  
Yusuf Olushola Kareem ◽  
Erhabor Sunday Idemudia
Keyword(s):  
Female Genital Mutilation ◽  
Educational Status ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Genital Mutilation ◽  
Logistic Regression Models ◽  
Future Burden ◽  
Context Specific ◽  
Female Genital

Despite a total prohibition on the practice of female genital mutilation (FGM), young girls continue to be victims in some African countries. There is a paucity of data on the effect of FGM practice in two generations in Africa. This study assessed the current practice of daughters’ FGM among women living in 14 FGM-prone countries in Africa as a proxy to assess the future burden of FGM in the continent. We used Demographic and Health Surveys data collected between 2010 and 2018 from 14 African countries. We analyzed information on 93,063 women-daughter pair (Level 1) from 8,396 communities (Level 2) from the 14 countries (Level 3). We fitted hierarchical multivariable binomial logistic regression models using the MLWin 3.03 module in Stata version 16 at p<0.05. The overall prevalence of FGM among mothers and their daughters was 60.0% and 21.7%, respectively, corresponding to 63.8% reduction in the mother-daughter ratio of FGM. The prevalence of FGM among daughters in Togo and Tanzania were less than one per cent, 48.6% in Guinea, with the highest prevalence of 78.3% found in Mali. The percentage reduction in mother-daughter FGM ratio was highest in Tanzania (96.7%) and Togo (94.2%), compared with 10.0% in Niger, 15.0% in Nigeria and 15.9% in Mali. Prevalence of daughters’ FGM among women with and without FGM was 34.0% and 3.1% respectively. The risk of mothers having FGM for their daughters was significantly associated with maternal age, educational status, religion, household wealth quintiles, place of residence, community unemployment and community poverty. The country and community where the women lived explained about 57% and 42% of the total variation in FGM procurement for daughters. Procurement of FGM for the daughters of the present generation of mothers in Africa is common, mainly, among those from low social, poorer, rural and less educated women. We advocate for more context-specific studies to fully assess the role of each of the identified risk factors and design sustainable intervention towards the elimination of FGM in Africa.

scholarly journals The socioeconomic dynamics of trends in female genital mutilation/cutting across Africa

2020 ◽  
Vol 5 (10) ◽  
pp. e003088
Author(s):  
Ewa Batyra ◽  
Ernestina Coast ◽  
Ben Wilson ◽  
Valeria Cetorelli
Keyword(s):  
Urban Areas ◽  
Female Genital Mutilation ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Opposite Pattern ◽  
Genital Mutilation ◽  
Urban Rural ◽  
Development Goals ◽  
Socioeconomic Differentials ◽  
Female Genital

BackgroundThe majority of women who undergo female genital mutilation/cutting (FGM/C) live in Africa. Although the UN Sustainable Development Goals call for intensified efforts to accelerate the abandonment of FGM/C, little is known about where in Africa the declines in prevalence have been fastest and whether changes in prevalence differ by women’s socioeconomic status.MethodsWe use data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys for 23 African countries, collected between 2002 and 2016, and covering 293 170 women. We reconstruct long-term cohort trends in FGM/C prevalence spanning 35 years, for women born between 1965 and 1999. We compute absolute and relative changes in FGM/C prevalence and differentials in prevalence by women’s education and urban-rural residence. We examine whether socioeconomic differences in FGM/C are converging or diverging.FindingsFGM/C prevalence has declined fastest (in relative terms) in countries with lower initial prevalence, and more slowly in countries with higher initial prevalence. Although better-educated women and those living in urban areas tend to have lower prevalence, in some countries the opposite pattern is observed. Socioeconomic differentials in FGM/C have grown in the majority of countries, particularly in countries with moderate-to-higher overall prevalence.ConclusionsThe documented relationship between absolute and relative FGM/C prevalence rates suggests that in settings with higher initial prevalence, FGM/C practice is likely to be more entrenched and to change more slowly. There is substantial variation between countries in socioeconomic differentials in prevalence and their changes over time. As countries change from higher to lower overall prevalence, socioeconomic inequalities in FGM/C are increasing.

The role of the SCPHN school nurse in raising awareness of female genital mutilation

2019 ◽  
Vol 14 (6) ◽  
pp. 283-288
Author(s):  
Emma Nicolaas ◽  
Dwynwen Spargo
Keyword(s):  
Support Services ◽  
Female Genital Mutilation ◽  
School Nurses ◽  
Community Leader ◽  
Evidence Based ◽  
Genital Mutilation ◽  
Raising Awareness ◽  
Over Time ◽  
Female Genital

Migration has resulted in specialist community public health nurses (SCPHN), specifically SCPHN school nurses, encountering female genital mutilation (FGM) more commonly in practice, requiring them to upskill to offer support and raise awareness ( Robinson, 2011 ). A policy was critically analysed, and a literature review conducted, to identify evidence-based strategies to enable the SCPHNSN to effectively raise FGM awareness to school-aged pupils. The findings highlighted three themes – Education, cultural influence and community leader and FGM survivor engagement, which translated into practice as a SCPHNSN-led FGM education project ( Diop and Askew, 2009 , Adeniran et al. 2015 , Galukande et al. 2015 , Raible et al. 2017 , Connelly et al. 2018 , Johnson et al. 2018 ). A project such as this would enable the SCPHNSN to raise pupil awareness, increase knowledge of support services, achieving practice decline over time.

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