Female Genital Mutilation/Cutting across Africa: Dynamics of Change and Socioeconomic Variation

Background: The 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.

Methods: We use data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys for 23 African countries, collected between 2005 and 2015, and covering 293,170 women. We reconstruct long-term trends in FGM/C prevalence spanning 35 years. We compute absolute and relative rates of change 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.

Findings: FGM/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.

Conclusions: The 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.