Factors associated with female genital mutilation: A systematic review and synthesis of national, regional, and community-based studies.

Zeinab El-Dirani, Leen Farouki, Christelle Akl, Ubah Ali, Chaza Azik, Stephen J McCall* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Background: This systematic review aimed to identify and describe the factors that influence FGM/C globally.
Methods: Searches were conducted in Medline, PsycInfo, Web of Science, Embase, and grey literature from 2009 to March 2020 with no language restrictions, using related MESH terms and keywords. Studies were included if they were quantitative and examined factors associated with FGM/C. Two researchers independently screened studies for inclusion, extracted data, and assessed study quality. The direction, strength, and consistency of the association were evaluated for risk factors, presented as a descriptive summary of the data, and were disaggregated by age and region.
Results: Out of 2,230 studies identified, 54 published articles were included. The majority of studies were from the African Region (n=29) followed by the Eastern Mediterranean Region (n=18). A lower level of maternal education, family history of FGM/C, or belonging to the Muslim religion increased the likelihood of FGM/C. The majority of studies that examined higher paternal education (for girls only)and living in an urban region showed a reduced likelihood of FGM/C, while conflicting evidence remained for wealth. Several studies reported that FGM/C literacy, the presence of grandmothers, and low community FGM/C prevalence were associated with a reduced likelihood of FGM/C.
Conclusion: There were several characteristics that appear to be associated with FGM/C, and these will better enable the targeting of policies and interventions. Importantly, parental education may be instrumental in enabling communities and countries to meet the Sustainable Development Goals.
Original languageEnglish
Pages (from-to)169-178
Number of pages10
JournalBMJ Sexual & Reproductive Health
Early online date28 Apr 2022
Publication statusPublished - 12 Jul 2022

Bibliographical note

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
We would like to acknowledge the assistance of Ms. Sandra Kahwaji and Ms. Jana Abu Ayash for their help in the title and abstract screening of articles. We thank Dr. Sawsan Abdulrahim for insightful comments and edits on preliminary drafts.


  • Female Genital Mutilation
  • Gender Inequality
  • sustainable development goal
  • risk factors
  • Systematic Review


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