Alemu Addisu Alehegn
College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Int J Womens Health. 2021 Jan 6;13:19-29. doi: 10.2147/IJWH.S287643. eCollection 2021.
Female genital mutilation (FGM) is a harmful practice that causes health-related problems in the life of the affected women and girls. Though FGM is declared as a human right violation, studies revealed it is being practiced throughout Ethiopia. Therefore, this study was conducted to assess the prevalence, trends, and predictors of FGM among reproductive-aged (1549 years) women in Ethiopia.
Trends of FGM among reproductive-age women were estimated using the three Ethiopian Demographic and Health Survey (EDHS): 2000 (n=15,367), 2005 (n=14,070) and 2016 (n=7248) data. Multilevel logistic regression analysis was conducted to identify both individual- and community-level factors of FGM using the latest (2016) EDHS. To adjust potential confounders, the analysis was conducted considering sample weighting, clustering, and stratifications using STATA-14 software.
The prevalence of FGM among women of reproductive age in Ethiopia decreased from 79.91% in 2000 to 70.37% in 2016. Similarly, FGM among daughters of circumcised mothers decreased from 56.16% in 2000 to 16.76% in 2016. Being Muslim (adjusted odds ratio [AOR] 5.48; 95% confidence interval [CI]: 4.23, 7.09), attending higher education (AOR 0.40; 95% CI: 0.29, 0.54), 45-49 years old (AOR 5.06; 95% CI: 3.38, 7.57), marriage at ≥ 18 years (AOR 0.80; 95% CI: 0.66, 0.96), not working (AOR 1.20; 95% CI: 1.02, 1.41), married (AOR 1.41; 95% CI: 1.12, 1.77) and residing in peripheral region (AOR 3.0.4; 95% CI: 1.96, 4.70) were determinants of FGM.
Though the reduction of FGM among women of reproductive age in Ethiopia was minimal, it was encouraging among daughters of circumcised women over the last 16 years. Education, religion, age, age at marriage, occupation, marital status, and geographical regions were determinants of FGM. Combined and integrated interventions based on the identified factors are recommended to abandon FGM in Ethiopia.
女性生殖器切割是一种有害行为，会给受影响的妇女和女孩的生活带来与健康相关的问题。尽管女性生殖器切割被宣布为侵犯人权行为，但研究表明，这种行为在埃塞俄比亚各地仍在实行。因此，本研究旨在评估埃塞俄比亚育龄（15至49岁）妇女中女性生殖器切割的流行率、趋势及预测因素。
利用埃塞俄比亚三次人口与健康调查（EDHS）的数据估计育龄妇女中女性生殖器切割的趋势，这三次调查分别为2000年（n = 15367）、2005年（n = 14070）和2016年（n = 7248）。使用最新的（2016年）EDHS数据进行多水平逻辑回归分析，以确定女性生殖器切割的个体和社区层面因素。为调整潜在混杂因素，使用STATA - 14软件，在考虑样本加权、聚类和分层的情况下进行分析。
埃塞俄比亚育龄妇女中女性生殖器切割的流行率从2000年的79.91%降至2016年的70.37%。同样，接受过切割的母亲的女儿中女性生殖器切割的比例从2000年的56.16%降至2016年的16.76%。穆斯林身份（调整优势比[AOR]5.48；95%置信区间[CI]：4.23，7.09）、接受高等教育（AOR 0.40；95% CI：0.29，0.54）、年龄在45 - 49岁（AOR 5.06；95% CI：3.38，7.57）、18岁及以上结婚（AOR 0.80；95% CI：0.66，0.96）、未工作（AOR 1.20；95% CI：1.02，1.41）、已婚（AOR 1.41；95% CI：1.12，1.77）以及居住在外围地区（AOR 3.04；95% CI：1.96，4.70）是女性生殖器切割的决定因素。
尽管埃塞俄比亚育龄妇女中女性生殖器切割行为的减少幅度很小，但在过去16年里，接受过切割的妇女的女儿中这种行为的减少令人鼓舞。教育、宗教、年龄、结婚年龄、职业、婚姻状况和地理区域是女性生殖器切割的决定因素。建议基于已确定的因素采取综合和一体化干预措施，以在埃塞俄比亚摒弃女性生殖器切割行为。
