2011 年至 2018 年伊拉克库尔德斯坦地区女性外阴残割流行率和趋势的变化。
Changes in the prevalence and trends of female genital mutilation in Iraqi Kurdistan Region between 2011 and 2018.
机构信息
Department of Community Medicine, Hawler Medical University, Erbil, Iraq.
出版信息
BMC Womens Health. 2021 Apr 1;21(1):137. doi: 10.1186/s12905-021-01282-9.
BACKGROUND
Female genital mutilation (FGM) is commonly practiced in Iraqi Kurdistan Region, where there are extensive efforts to combat the practice over the last decade. This study aimed to determine the trends and changes in the FGM prevalence in Iraq between 2011 and 2018 and assess their associated factors.
METHODS
Secondary data analysis of the Iraq Multiple Indicator Cluster Survey 2011 and 2018 was carried out to calculate the prevalence and the relative changes in the prevalence of FGM for 2011 and 2018 by governorate. The change in the prevalence was compared with the changes in other exposure variables such as age, education level, wealth, and area of residence over the same period.
RESULTS
The prevalence of FGM in 2018 was high in Erbil and Suleimaniya governorates (50.1% and 45.1%). The prevalence of FGM decreased remarkably from 2011 to 2018 in all governorates of the Iraqi Kurdistan Region. The decrease in the prevalence was statistically significant in Erbil and Suleimaniya. FGM prevalence declined remarkably in all age, education level, residence area groups, and most economic level groups. Such decline was associated with a significant increase in the education level, wealth, and urban residence. The decline was highest in the younger age groups, with a relative change of - 43.0% among 20-24 years and - 39.2% among 15-19 years. The decline was also highest in those with secondary and higher education (relative change = -32%). The decline was higher in rural areas than in urban areas (relative change = -35.3% and - 27.4%, respectively). The decline was higher among the poorest and second wealth quintile (relative change = -38.8% and - 27.2%, respectively).
CONCLUSION
The trend of FGM in Iraqi Kurdistan Region declined remarkably and significantly from 2011 to 2018. Further decline is predicted because of having lower rates and a higher decline in the younger age groups. However, the rates remained high in Erbil and Suleimaniya governorates that need further intensifying the preventive measures. The education level of women plays a primary role in decreasing the prevalence and should be considered in future efforts to ban the practice.
背景
女性外阴残割在伊拉克库尔德斯坦地区普遍存在，过去十年，该地区一直在努力打击这种做法。本研究旨在确定 2011 年至 2018 年期间伊拉克女性外阴残割流行率的趋势和变化，并评估其相关因素。
方法
对 2011 年和 2018 年伊拉克多指标类集调查的二次数据分析，按省计算 2011 年和 2018 年女性外阴残割流行率和流行率的相对变化。将流行率的变化与同期其他暴露变量（如年龄、教育水平、财富和居住地区）的变化进行比较。
结果
2018 年埃尔比勒和苏莱曼尼亚省的女性外阴残割流行率较高（分别为 50.1%和 45.1%）。伊拉克库尔德斯坦地区所有省份的女性外阴残割流行率从 2011 年到 2018 年显著下降。埃尔比勒和苏莱曼尼亚的流行率下降具有统计学意义。在所有年龄、教育水平、居住地区和大多数经济水平群体中，女性外阴残割流行率显著下降。这种下降与教育水平、财富和城市居住的显著增加有关。在年龄较小的群体中下降幅度最大，20-24 岁组相对变化为-43.0%，15-19 岁组相对变化为-39.2%。在接受中等和高等教育的人群中下降幅度最大（相对变化分别为-32%）。农村地区的下降幅度高于城市地区（相对变化分别为-35.3%和-27.4%）。最贫穷和第二富有五分位数的下降幅度更高（相对变化分别为-38.8%和-27.2%）。
结论
2011 年至 2018 年，伊拉克库尔德斯坦地区女性外阴残割的流行趋势显著且明显下降。由于年轻群体的比例较低且下降幅度较大，预计未来还会进一步下降。然而，埃尔比勒和苏莱曼尼亚省的比例仍然较高，需要进一步加强预防措施。妇女的教育水平在降低流行率方面发挥着主要作用，应在未来禁止这种做法的努力中加以考虑。
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