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Women Empowerment and its Effect on Female Genital Mutilation in Sub-Sahara Africa: A study using Recent Demographic Health Surveys

Koray, M. H.; Mugisha, J.

2024-09-04 sexual and reproductive health
10.1101/2024.09.03.24313034 medRxiv
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BackgroundWomen empowerment can enhance and improve women decsions and will power to negotiate and stand against sensitive issues that affect womens health and sexuality. Practices such as Female Genital Mutilation (FGM) are generally sensitive issues that requires education and holistic interventions to enable its eradication, particularly in sub-Sahara Africa (SSA), where the practice is still pervasive. This study investigated the effect of women empowerment, using the Survey-base Women Empowerment (SWPER) Global index, on FGM in selected countries in SSA. MethodsThe study employed cross-sectional design using the most recent Demographic Health Survey (DHS) data from 10 SSA countries. A total of 49501 women who were either married or living with a partner and have a daughter age 0 - 14 years who is either circumcised or not. Pearsons chi-square test was used to examine the association between women empowerment and daughter with FGM, and countries. Bivariate and multivariate logistic regressions were used to examine the predictors of FGM at a significance level of p [&le;] 0.05 and 95% confidence interval. Complex survey design was considered in the analysis. Results49,501 participants were included in the study and 47.96% exhibited a positive attitude towards violence. Empowerment in SWPER domains were significantly associated with FGM (p < 0.0001), with Kenya and Tanzania exhibiting high levels of women empowerments and low prevalence of FGM. Medium and highly-empowered mothers had significantly lower odds of having a child with FGM in the bivariate regression models (p < 0.0001), compared to mothers with low empowerment levels. When adjusted for confounders, increasing age is associated with higher odds of FGM with mothers age 45-49 mothers having more than 4 times higher odds (AOR: 4.265, 95%CI: 3.466 - 5.248). Muslim mothers also had higher odds of having a child with FGM (AOR: 6.046; 95%CI: 5.605 - 6.521) compared to Christian mothers. An increase in the wealth index was also a protective factor against FGM (p < 0.0001). Circumcised mothers were more likely to have their female child circumcised (AOR: 5.527; 95%CI: 5.113 - 5.975) and female household heads were found to be protective factors against FGM (AOR: 0.846; 95%CI: 0.774 - 0.925). ConclusionThe study highlights a connection between womens empowerment and FGM prevalence in SSA, highlighting the need to promote womens autonomy and reject violence. Traditional norms and cultural support for FGM persist, particularly in Western Africa. Targeted empowerment initiatives, education, and strengthening legal frameworks can help reduce FGM prevalence.

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