Multilevel Analysis of Factors Determining Female Genital Mutilation Practice in Ethiopia: Evidence from the 2016 Ethiopian Demography and Health Survey

Abstract

The main objective of this study is to identify factors that determine female genital mutilation practice in Ethiopia. The study was based on the 2016 Ethiopian demographic and health survey (EDHS) which was conducted by the Central Statistical Agency (CSA) of Ethiopia. The statistical methods of data analysis were multilevel logistic regression models and the parameters were estimated by using maximum likelihood estimation method. The study confirmed that the prevalence of female genital mutilation (cutting) was 65% in Ethiopia. From these, the most common type of circumcision involved cutting and removing flesh, with 73% of circumcised women reporting this type of circumcision. Three percent of circumcised women reported that, they had no flesh removed, and seven percent of circumcised women reported that their genital area had been sewn closed (infibulated). In Ethiopia, however, the challenge is that most uneducated women, women with low wealth, and those with no media exposure still seem to be affected by female genital mutilation. Moreover, religion, education status, place of residence, wealth index, and media exposure all contribute to improving the awareness of women about the risks of female circumcision and other female health services. From the methodological aspect, it was found out that the multilevel random intercept model is better compared to empty (null) model and random coefficient model in fitting the data and in explaining the variations of the practice of female genital mutilation status across regional levels of Ethiopia. Additionally, the overall variance of constant term found in the random intercept model was statistically significant, suggesting that female genital mutilation is practiced differently in different region of Ethiopia.  Females of the same age and characteristics in two different regions have different circumcised status, which indicates that there is a clear regional difference.