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      Exploration of pathways related to the decline in female circumcision in Egypt

      research-article
      1 , , 2
      BMC Public Health
      BioMed Central
      Female Circumcision, Adolescent health, Egypt

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          Abstract

          Background

          There has been a large decline in female genital circumcision (FGC) in Egypt in recent decades. Understanding how this change has occurred so rapidly has been an area of particular interest to policymakers and public health officials alike who seek to further discourage the practice elsewhere.

          Methods

          We document the trends in this decline in the newest cohorts of young girls and explore the influences of three pathways—socioeconomic development, social media messages, and women’s empowerment—for explaining the observed trends. Using the 2005 and 2008 Egypt Demographic and Health Surveys, we estimate several logistic regression models to (1) examine individual and household determinants of circumcision, (2) assess the contributions of different pathways through which these changes may have occurred, and (3) assess the robustness of different pathways when unobserved community differences are taken into account.

          Results

          Across all communities, socioeconomic status, social media messages, and women’s empowerment all have significant independent effects on the risk of circumcision. However, after accounting for unobserved differences across communities, only mother’s education and household wealth significantly predict circumcision outcomes. Additional analyses of maternal education suggest that increases in women’s education may be causally related to the reduction in FGC prevalence.

          Conclusions

          Women’s empowerment and social media appear to be more important in explaining differences across communities; within communities, socioeconomic status is a key driver of girls’ circumcision risk. Further investigation of community-level women’s educational attainment for mothers suggests that investments made in female education a generation ago may have had echo effects on girls’ FGC risk a generation later.

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          Most cited references8

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          Female genital surgeries: the known, the unknown, and the unknowable.

          This article reviews the literature on female genital surgeries and examines the extent to which available research supports commonly accepted "facts" about the prevalence and harmful effects of these practices, in particular their possible health complications, and their effect on sexuality. While information regarding the prevalence of female genital surgeries is becoming increasingly available, the powerful discourse that depicts these practices as inevitably causing death and serious ill health, and as unequivocally destroying sexual pleasure, is not sufficiently supported by the evidence. The article discusses some of the implications of research on female genital surgeries for the societies that are involved--not merely those where the practices are found, but also those whose gaze has been so intensely focused on the customs of others.
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            Like mother, like daughter? Female genital cutting in Minia, Egypt.

            Evidence that 97 percent of ever-married Egyptian women were circumcised in 1995 fueled interest to understand the levels, determinants, and consequences of this practice. Qualitative data suggest that ideologies of femininity, pressure to conform to behaviors characterizing womanhood, and constraints to other opportunities perpetuate women's support for female genital cutting in Minia, Egypt. While the practice remains prevalent in Minia, age-specific probabilities of genital cutting are lower among daughters than mothers and among younger than older daughters. A mother's education is negatively associated with, and her circumcision status positively associated with, her intent and decision to circumcise a daughter. Increasing reliance on doctors to perform the procedure is positively associated with urban residence and father's education, indicating a need to understand local meanings of modernity. Overall, increasing girls' access to higher education may contribute to further declines in female genital cutting in this setting.
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              Prevalence of female genital cutting among Egyptian girls.

              Female genital cutting (FGC) is the collective name given to traditional practices that involve partial or total cutting away of the female external genitalia whether for cultural or other non-therapeutic reasons. In Egypt, the result of the Demographic Health Survey in 2000 revealed that 97% of married women included in the survey experienced FGC. The aim of this study is to measure the prevalence of FGC among schoolgirls in Egypt. Multistage random technique was applied for site selection. First, Egypt was divided into five geographical areas; Greater Cairo, Lower Egypt, Upper Egypt, Sinai and Suez Canal Region. Second, from each governorate, two educational districts were selected randomly (except Luxor). In each of the selected districts, the schools were divided into primary, preparatory and secondary schools. In each education stage, the schools were divided into rural, urban, government and private. The total number of females interviewed was 38,816. The prevalence of FGC among schoolgirls in Egypt was 50.3%. The prevalence of FGC was 46.2% in government urban schools, 9.2% in private urban schools and 61.7% in rural schools. Educational levels of mother and father were negatively associated with FGC (P < 0.001). The mean age of the time of FGC was 10.1 +/- 2.3 years. FGC prevalence is lowering, yet more active education at the grass-roots level is needed to create change.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2013
                3 October 2013
                : 13
                : 921
                Affiliations
                [1 ]General Medical Disciplines, Stanford University School of Medicine, Palo Alto, CA, USA
                [2 ]Global Health Sciences, University of California, San Francisco, CA, USA
                Article
                1471-2458-13-921
                10.1186/1471-2458-13-921
                3835453
                24090097
                f72a96aa-ad1c-4ec3-b367-b2637592eb5e
                Copyright © 2013 Modrek and Liu; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 January 2013
                : 26 September 2013
                Categories
                Research Article

                Public health
                female circumcision,adolescent health,egypt
                Public health
                female circumcision, adolescent health, egypt

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