Female genital mutilation/cutting (FGMC) is prevalent in Africa and the African diaspora, including the United States. Especially severe forms of FGMC may harm the sexual and reproductive health of women and girls. Despite a range of interventions, declines in prevalence are slow, potentially due to under- studied contextual factors.
Aim :
The aim of this project is to understand how community norms disfavoring FGMC and extra-marital opportunities for women may be directly associated with a girl's lower risk of FGMC and may condition the influence of maternal attitudes on the decision to cut a daughter. Data: The Demo- graphic and Health Surveys (DHS) are the main existing source of nationally representative data on FGMC. We propose to analyze DHS data from nine countries spanning West, North, Central, and East Africa: Burkina Faso, Chad, Cote d'Ivoire, Egypt, Gambia, Guinea, Kenya, Mali, and Nigeria. Countries vary in current prevalence of FGMC, forms of cutting, age at which FGMC usually occurs, and legal context for the practice. Sample countries were chosen based on the availability of DHS data since 2008 and appropriate measures from women and their daughters. The main sample for all surveys is women of reproductive age (15-49 y), who provide direct reports of their own experience with FGMC, including type and timing; experiences of FGMC among any daughters; and views about FGMC. Sample sizes of women are 9,142 - 38,948 across countries. We will analyze FGMC among daughters age 15 y or younger. Method: We will estimate multilevel event history models for each country to test the associations of community FGMC norms and women's extra-marital opportunities with a daughter's risk of experiencing FGMC. We also will test whether these community attributes moderate the effect of a mother's FGMC attitudes on the decision to cut a daughter. We will integrate the results of country-specific models to understand cross-national variation in FGMC, accounting for parent- /household- and community-level factors and to estimate variance in the effects of these factors across countries. We will adopt a Bayesian approach to assess the prospects of generalizing from our nine countries to African contexts. Innovation: Attention to the community influences on FGMC across countries in Africa is a key innovation of our project. We offer an integrated theory for the relevance of community FGMC norms and extra-marital opportunities for women. We propose rigorous multilevel methods to assess the direct influences of these community factors on the risk that a daughter is cut, and their moderating influence on the relationship of a mother's attitudes and FGMC status on the risk that her daughter is cut. Because we have rich, comparable data on FGMC for 9 countries in Africa, we also can assess whether national context accounts for additional variance in a daughter's risk of FGMC. Impact: This is the first rigorous, comparative study of the multilevel determinants of FGMC, offering unique evidence to inform national and cross-national decisions about promising social policies and community interventions to further the abandonment of FGMC in Africa.
In the proposed project, we will use data from nine countries in Africa to study the influence of social context on female genital mutilation/cutting (FGMC), focusing on collective beliefs about the importance of the practice and the availability of social and economic opportunities for women. We will apply a new theoretical framework and innovative methods to understand how local and national factors influence a mother's decisions about her daughter. Findings will inform social policies and community-based interventions to facilitate the abandonment of FGMC in Africa.
