A statistical snapshot

Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change

note to printer: Outside right page (cover 1) How widespread is the practice of FGM/C?

FGM/C is concentrated in a swath of countries from the Atlantic Coast to the Horn of , with wide variations in the percentage of girls and women cut, both within and across countries Percentage of girls and women aged 15 to 49 years who have undergone FGM/C, by country and within countries

Iraq 8 Iraq 8 Egypt 91 Egypt 91 26 Mauritania Mali Senegal 69 89 Niger Mali Chad Yemen 26 Mauritania 2 88 69 89 Niger Gambia 44 23 Chad Sudan Yemen 76 2 88 Gambia 44 23 - 76 Bissau Ethiopia Somalia 27 Central 98 Guinea- Nigeria 50 African Republic 74 Bissau Ethiopia Somalia Sierra 27 Central 98 24 50 African Republic 74 Guinea Leone 1 Sierra 96 Uganda Djibouti Cameroon 24 88 1 Kenya Guinea Leone 1 93 96 Uganda Djibouti 27 Eritrea 88 1 Kenya 93 66 Burkina United 89 Liberia 27 Eritrea Côte Faso 4 13 Republic 66 Burkina Togo Benin United 89 76 of Tanzania Republic d'Ivoire Côte Faso 4 13 38 4 15 d'Ivoire 76 Ghana of Tanzania 38 4 15

Above 80% 51% - 80% Above 80% 26% - 50% 51% - 80% 10% - 25% 26% - 50% Less than 10% 10% - 25% FGM/C is not concentrated Less than 10% in these countries FGM/C is not concentrated in these countries

Notes: This map is stylized and not to scale. It does not reflect a position by UNICEF on the legal status of any country or territory or the delimitation of any frontiers. The final boundary between the Republic of the Sudan and the Republic of South Sudan has not yet been determined. Subnational data for Yemen could not be displayed due to discrepancies between the regional groupings in DHS and those available in the soft- ware used to create the map. Sources: DHS, MICS and SHHS, 1997-2012.

FGM/C prevalence levels among girls do not reflect those who have not yet been cut due to their young age Percentage of girls aged 0 to 14 years who have undergone FGM/C (as reported by their mothers)

Gambia 56 • Levels of FGM/C prevalence vary Mauritania 54 dramatically among ethnic groups

Sudan 37 • Although no causal link can be Egypt 17 established, FGM/C appears to be Nigeria 14 more common in rural areas

Burkina Faso 13 • In most countries, FGM/C 13 prevalence is lower among girls in Senegal 12 the wealthiest households

Central African Republic 1 • Daughters of uneducated mothers Uganda 1 are significantly more likely to have Ghana 1 undergone FGM/C

Togo 0.4 • While the majority of cut girls and

0 10 20 30 40 50 60 70 80 90 100 women are Muslim, other religious groups also practise FGM/C

Notes: Data for Senegal refer to daughters aged 0 to 9. Data for Egypt have been recalculated for daughters aged 0 to 14. Sources: DHS, MICS and SHHS, 2008-2011.

note to printer: Inside left page When and how is FGM/C performed?

Traditional practitioners perform most In half of the countries with available data, cases of FGM/C the majority of girls were cut before age 5 Percentage distribution of girls who have undergone FGM/C Percentage distribution of girls who have undergone FGM/C (as reported (as reported by their mothers), according to the type of person/ by their mothers), by age at which cutting occurred practitioner performing the procedure

Health personnel Traditional practitioners Others Don't know/missing 0-4 years 5-9 years 10-14 years 15+ years Don't know/missing

Senegal Central African Republic Niger Kenya Guinea-Bissau Somalia Gambia Egypt Côte d'Ivoire Togo Burkina Faso Chad United Republic of Tanzania Djibouti Central African Republic Guinea Eritrea Benin Guinea-Bissau Sierra Leone Sierra Leone Ethiopia Benin Mauritania United Republic of Tanzania Mali Côte d'Ivoire Chad Burkina Faso Yemen Niger Ghana Ethiopia Iraq Senegal Djibouti Mauritania Guinea Ghana Nigeria Kenya Eritrea Sudan Mali Egypt Nigeria

0 10 20 30 40 50 60 70 80 90 100 0 10 20 30 40 50 60 70 80 90 100

Sources: DHS, MICS and SHHS, 1997–2011. Sources: DHS and MICS, 2000-2010.

Most girls who have undergone Type of FGM/C Cut, no flesh Cut, flesh Type not determined/ not FGM/C have had their genitalia Country removed/nicked removed Sewn closed sure/doesn’t know Benin 2 95 2 1 cut, with some flesh removed Burkina Faso N/A N/A 1 N/A Percentage distribution of girls who have undergone Central African Republic 24 61 6 9 FGM/C (as reported by their mothers), by type Chad 9 81 8 2 Côte d’Ivoire 7 82 6 5 Djibouti 15 53 30 3 • In Egypt, doctors, as opposed to other Egypt N/A N/A 2 1 health personnel, undertake most FGM/C Eritrea 52 6 38 4 procedures Ethiopia N/A N/A 4 N/A Gambia 0 86 12 1 • Most cases of FGM/C are performed at Ghana 8 68 17 7 home using a blade or razor Guinea 2 85 10 2 Guinea-Bissau 0 88 10 2 • More than one in five daughters have Kenya 3 79 17 1 undergone the most invasive form of Mali 16 71 3 11 Mauritania 6 80 N/A 14 FGM/C (involving the sewing of genitalia) Niger 0 63 35 2 in Somalia, Eritrea, Niger, Djibouti and Nigeria 16 69 6 9 Senegal Senegal N/A N/A 21 N/A Sierra Leone 1 70 12 17 • The type of FGM/C performed is often Somalia 5 25 63 7 linked to ethnicity United Republic of Tanzania 1 98 2 N/A

Sources: DHS and MICS, 1995-2011.

note to printer: inside middle page What are the prevailing attitudes towards FGM/C?

In most countries where FGM/C is practised, the majority of women and men think it should end Percentage distribution of girls and women aged 15 to 49 years and percentage distribution of boys and men aged 15 to 49 (or 59, see note) years who have heard about FGM/C, by their attitudes about whether the practice should continue

GirlsThink and WomenFGM/C should continue Think FGM/C shouldThink stop FGM/CSay should it depends/are continue notThink sure FGM/C shouldThink stop FGM/CSay should it depends/are continue notThink sure FGM/C should stop Say it depends/areBoys andnot sureMen

Benin Benin Benin Ghana Ghana Niger Togo Togo Cameroon Niger Niger United Republic of Tanzania Iraq Iraq Burkina Faso United Republic of Tanzania United Republic of Tanzania Senegal Cameroon Cameroon Uganda Uganda Côte d'Ivoire Burkina Faso Burkina Faso Nigeria Kenya Kenya Sudan Central African Republic Central African Republic Chad Senegal Senegal Sierra Leone Côte d'Ivoire Côte d'Ivoire Eritrea Nigeria Nigeria Ethiopia Ethiopia Guinea Guinea-Bissau Guinea-Bissau Egypt Djibouti Djibouti Mali Chad Chad Mauritania Mauritania Mauritania Yemen Yemen 0 10 20 30 40 50 60 70 80 90 100 Sudan Sudan Liberia Liberia Notes: The category of girls and women and boys and men who are unsure or responded that Eritrea Eritrea ‘it depends’ also includes those for whom data are missing. In Liberia, only cut girls and women Egypt were asked about their attitudes towards FGM/C; since girls and women from practising com- Egypt munities are more likely to support the practice, the level of support in this country as captured Gambia Gambia by the 2007 DHS is higher than would be anticipated had all girls and women been asked their opinion. Data from Benin, Burkina Faso, Cameroon, Egypt, Sierra Leone, Sudan and the United Somalia Somalia Republic of Tanzania refer to boys and men aged 15 to 49. Data from all other countries refer to Sierra Leone Sierra Leone boys and men aged 15 to 59. Data presented in these charts cannot be directly compared for all countries since data sources for girls and women are more recent than those for boys and men Guinea Guinea for some countries. Mali Sources for girls and women: DHS, MICS and SHHS, 1997-2011. Mali Sources for boys and men: DHS, MICS and SHHS, 1995-2010.

0 10 20 30 40 50 60 70 800 9010 10020 30 40 50 60 70 80 90 100 Many girls who are cut are daughters of women who oppose the practice Among daughters of cut girls and women, the percentage of girls aged 0 to 14 years who have undergone FGM/C (as reported by their mothers), by mothers’ attitudes about whether the practice should continue

100 Daughters whose mothers think FGM/C should continue 90 87 • Among girls and women, as well as boys and men, the Daughters whose mothers think FGM/C should stop 80 75 most commonly reported benefit of FGM/C is gaining 70 64 social acceptance 59 60 54 54 50 41 43 • Large percentages of women and men are unaware of 40 35 31 what the opposite sex thinks about FGM/C 30 24 23 20 15 17 15 11 10 9 • In 4 out of 14 countries, more than 50 per cent of girls 10 5 6 1 2 0 and women regard FGM/C as a religious requirement

Togo Sudan Ghana Egypt Gambia Nigeria Senegal • Girls and women who have been cut are more likely to Mauritania Burkina Faso Sierra Leone favour maintaining the practice

Central African Republic Notes: Data for Egypt have been recalculated for girls aged 0 to 14. Data for Senegal refer to girls • Many girls and women who have undergone FGM/C aged 0 to 9. Data for Uganda are not presented since they are based on less than 25 unweighted cas- want the practice to end es. Data for daughters whose mothers think FGM/C should continue for Ghana and Togo were based on 25-49 unweighted cases. Sources: DHS, MICS and SHHS, 2008-2011.

note to printer: Inside right page Is the practice of FGM/C changing?

In most of the 29 countries, FGM/C is less common among adolescent girls than middle-aged women Percentage of girls aged 15 to 19 years and women aged 45 to 49 years who have undergone FGM/C

99 Somalia 97 • The practice is becoming less 94 common in more than half of Djibouti 90 the 29 countries. The decline 100 is particularly striking in some Guinea 89 moderately low to very low 89 Mali 88 prevalence countries 89 Sudan 84 • In a few countries, new data on 96 girls under 15 years of age seem Egypt 81 to confirm an important trend 96 Sierra Leone 80 towards the elimination of the 95 practice in recent years Eritrea 78 79 • Overall support for the practice is Gambia 77 declining, even in countries where 75 Mauritania 66 FGM/C is almost universal, such as 81 Egypt and Sudan Ethiopia 62 89 Burkina Faso 58 • The percentage of girls and 50 women who reportedly want Guinea-Bissau 48 FGM/C to continue has remained 85 constant in countries including Liberia 44 Guinea, Guinea-Bissau, Senegal 47 Chad 41 and the United Republic of 40 Tanzania Côte d'Ivoire 28 29 Senegal • In Egypt, the percentage of 24 girls cut by health personnel 25 Yemen 19 has increased dramatically. An 38 increasing trend towards the Nigeria 19 medicalization of FGM/C is also 34 observed in Kenya Central African Republic 18 49 Kenya 15 • Overall, little change is seen in the 16 type of FGM/C performed across Benin 8 generations 22 United Republic of Tanzania 7 • Age at cutting has remained 10 Iraq 5 fairly stable in most countries. 3 Where change has occurred, the Niger 2 most common trend is towards 6 younger ages Ghana 2 7 Togo 1

2 Women aged 45 to 49 years Uganda 1 Girls aged 15 to 19 years 2 Cameroon 0.4

0 10 20 30 40 50 60 70 80 90 100

Notes: Confidence intervals for Sierra Leone could not be calculated since the prevalence among girls aged 15 to 19 has been adjusted. Confidence intervals for Yemen could not be calculated since access to the dataset is restricted. Sources: DHS and MICS, 1997-2011. FGM/C: A human rights violation Implications for programming

Female genital mutilation/cutting (FGM/C) refers to “all • Take into account differences among population groups procedures involving partial or total removal of the female within and across national borders external genitalia or other injury to the female genital • Seek change in individual attitudes about FGM/C, but [i] organs for non-medical reasons.” FGM/C is a violation also address expectations surrounding the practice of girls’ and women’s human rights and is condemned by within the larger social group many international treaties and conventions, as well as by national legislation in many countries. Yet, where it is • Find ways to make hidden attitudes favouring the practised, FGM/C is performed in line with tradition and abandonment of the practice more visible social norms to ensure that girls are socially accepted and • Increase engagement by boys and men in ending marriageable, and to uphold their status and honour and FGM/C and empower girls that of the entire family. UNICEF works with governments and civil society partners towards the elimination of • Increase exposure to groups that do not practise FGM/C in countries where it is still practised. FGM/C

• Promote abandonment of FGM/C along with improved [i] World Health Organization, Eliminating Female Genital Mutilation: An status and opportunities for girls, rather than interagency statement, WHO, UNFPA, UNICEF, UNIFEM, OHCHR, UNHCR, advocating for milder forms of the practice UNECA, UNESCO, UNDP, UNAIDS, WHO, Geneva, 2008, p. 4.

Cover photos: Top: Fatima, who underwent FGM/C at the age of 1, sits on a bed in her home in the village of Contact: Karensa, in Amibara district, Afar , Ethiopia. UNICEF © UNICEF/NYHQ2009-2260/Holt Statistics and Monitoring Section Bottom: Photographs of girls who were not subjected to FGM/C adorn the walls of the Rohi-Weddu Division of Policy and Strategy Pastoral Women Development Organization office in the town of Awash Sabat Kilo, in Amibara district, Afar region, Ethiopia. The girls were spared the procedure because of Rohi-Weddu’s activities 3 United Nations Plaza in the region, which include advocacy, training and the promotion of community dialogue. These New York, NY 10017, USA kinds of holistic, human rights-based programmes are helping to change attitudes about harmful practices, with girls who are most affected playing an active role. Tel: +1 (212) 326-7000 © UNICEF/NYHQ2009-2256/Holt Email: [email protected]

note to printer: outsie middle page (back cover)