Evaluating changes in the prevalence of female genital mutilation/cutting among 0-14 years old girls in Nigeria using data from multiple surveys: A novel Bayesian hierarchical spatio-temporal model (2021)
This study is a Descriptive research regarding All FGM/C with the following characteristics:
Author(s): Nnanatu CC,Atilola G,Komba P,Mavatikua L,Moore Z,Matanda D,et al
FGM/C Type(s): All
Health area of focus: None.
Objective: To assess how the prevalence and likelihood of female genital mutilation/cutting has changed over time with respect to the roles of socio-cultural norms (operationalized in terms of a woman’s FGM/C status and her support for the continuation of the practice),a girl’s geographical location and other key determinants in the persistence of FGM/C among 0-14-year-old girls in Nigeria,and identify spatial patterns and ‘hotspots’.
Study Population: combined rich datasets from six (6) successive waves of the Nigeria Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) undertaken between 2003 and 2016 using Bayesian hierarchical regression models which explicitly accounted for the inherent spatial and temporal autocorrelations within the data while simultaneously adjusting for variations due to different survey methods and the effects of linear and non-linear covariates. The different years datasets were combined to simultaneously investigate spatial and temporal trends in the practice of female genital mutilation/cutting (FGM/C) across the Nigeria 36 states and the federal capital territory (FCT). In addition,by combining the various datasets,we gained more statistical power to better estimate parameters with higher precision. It is hoped that the statistical evidence generated from the study would serve to facilitate the development and implementation of tailored programmatic interventions that would ensure the total eradication of FGM/C in Nigeria.
Findings: Results show that prevalence of FGM/C among 0–14 years old girls in Nigeria varied over time and across geographical locations and peaked in 2008 with a shift from South to North. A girl was more likely to be cut if her mother was cut,supported FGM/C continuation,or had no higher education. The effects of mother’s age,wealth and type of residence (urban-rural) were no longer significant in 2016. These results reflect the gains of interventions over the years,but also echo the belief that FGM/C is a social norm thus requiring tailored all-inclusive interventions for the total abandonment of FGM/C in Nigeria. Findings from this study have increased show the extent of success recorded in the fight against FGM/C in Nigeria in the recent years. They give insights on where more resources should be mobilised in order to achieve a permanent abandonment in a social norm driven FGM/C high prevalence community. Such abandonments must be collectively adopted by the community or groups. Other members of the community would then be expected to conform with the collectively adopted change not to have their daughters cut with conformers socially rewarded while defaulters would possibly face social sanctions. A successful intervention programme must,therefore,be all-inclusive and involve partnership with both parents,local governments,policymakers,and community and religious leaders. Notable examples of such programmes are the ‘FGM-Free Village Model’ in Egypt and the Tostan Community Empowerment programme in Senegal. The advanced statistical approach utilised in this study is an important contribution to literature and could be extended to other contexts where there is need to integrate data from multiple sources over large spatial and temporal scales to gain more statistical power.
Geographical coverage
Region(s):Western Africa
Country(ies):Nigeria