Ofori Michael Arthur, Bekalo Daniel Biftu, Mensah David Kwamena, Jha Niharika
School of Public Health, University of Memphis, Memphis, Tennessee, United States of America.
Department of Statistics, University of Cape Coast, Cape Coast, Ghana.
PLoS One. 2025 Jan 24;20(1):e0317966. doi: 10.1371/journal.pone.0317966. eCollection 2025.
Female Genital Mutilation (FGM) has become a global health concern. It is a deeply entrenched harmful practice involving partial or total removal of the external female genitalia for non-medical reasons. To inform effective policymaking and raise awareness about FGM's health risks, understanding socioeconomic and demographic factors influencing the timing of girls' circumcision is crucial. This study employed semi-parametric survival models to examine the association between residential status and time-to-circumcision of girls in Ethiopia. The data used in this study was the 2016 Ethiopian Demographic and Health Survey (EDHS) report, which was conducted by the Central Statistical Agency (CSA). The analysis revealed that residential status (rural vs urban, HR = 1.73: 1.35-2.70), religion (Muslim vs Christian, HR = 1.51: 1.38-2.70), mother's educational level (none vs higher, HR = 5.25: 2.23-12.36 or primary vs higher HR = 4.12: 1.25-9.68), father's educational level (none vs higher, HR = 1.65: 1.12-2.43), and mother's age (15-24 years vs 35 +, HR = 1.89: 1.21-2.95 or 24-34 years vs 35 +, HR = 1.55: 1.18-2.02) are significant risk factors for age at circumcision. Mother's age and family wealth index were time dependent risk factors. Effective interventions to reduce FGM prevalence would need to address multiple aspects simultaneously, including improving access to education (especially for girls and women), targeting both urban and rural areas with awareness campaigns, and considering culturally sensitive approaches that take into account religious and traditional beliefs while promoting the health and rights of girls and women.
女性生殖器切割已成为一个全球卫生问题。这是一种根深蒂固的有害习俗，涉及出于非医疗原因部分或全部切除女性外生殖器。为了为有效的政策制定提供信息并提高对女性生殖器切割健康风险的认识，了解影响女孩割礼时间的社会经济和人口因素至关重要。本研究采用半参数生存模型来检验埃塞俄比亚女孩的居住状况与割礼时间之间的关联。本研究使用的数据是由中央统计局（CSA）进行的2016年埃塞俄比亚人口与健康调查（EDHS）报告。分析表明，居住状况（农村与城市，风险比=1.73：1.35 - 2.70）、宗教信仰（穆斯林与基督教，风险比=1.51：1.38 - 2.70）、母亲的教育水平（无与高等教育，风险比=5.25：2.23 - 12.36或小学与高等教育，风险比=4.12：1.25 - 9.68）、父亲的教育水平（无与高等教育，风险比=1.65：1.12 - 2.43）以及母亲的年龄（15 - 24岁与35岁以上，风险比=1.89：1.21 - 2.95或24 - 34岁与35岁以上，风险比=1.55：1.18 - 2.02）是割礼年龄的重要风险因素。母亲的年龄和家庭财富指数是随时间变化的风险因素。减少女性生殖器切割流行率的有效干预措施需要同时解决多个方面，包括改善教育机会（特别是女孩和妇女的教育机会）、通过宣传活动针对城乡地区、并考虑在促进女孩和妇女健康与权利的同时兼顾宗教和传统信仰的文化敏感方法。
