female genital mutilation in egypt - unicef data€¦ · female genital mutilation in gypt: ecent...

Female Genital Mutilation in Egypt: Recent trends and projections

February 2020

02 | Female Genital Mutilation in Egypt: Recent trends and projections

A NOTE ON DATA USED IN THIS PUBLICATION

The following analysis primarily features data collected in Egypt’s Health Issues Survey 2015. While the prevalence of female genital mutilation (FGM) may have changed slightly in the intervening years, there is no reason to believe that data collected today would yield dramatically different results.

FGM is a practice that has affected girls and women for generations. In practising communities, FGM can carry a strong cultural significance, making behaviours and attitudes around it resistant to change. While Egypt is beginning to see a reduction in FGM, population-level shifts in the prevalence will take time – and continued efforts – to become apparent.

Data from other countries that have seen declines in the practice reveal that progress tends to occur incrementally. Thus, data from 2015 can still be considered a reasonably close estimation of the current situation. For an illustration of observed and projected trends in FGM, see Figure 14.

03Female Genital Mutilation in Egypt: Recent trends and projections |

Female genital mutilation in the global development agendaFGM is a violation of human rights. Every girl and woman has the right to be protected from this harmful practice, a manifestation of entrenched gender inequality with devastating consequences. FGM is now firmly on the global development agenda, most prominently through its inclusion in Sustainable Development Goal (SDG) target 5.3, which aims to eliminate the practice by 2030.

SDG 5 TARGET 5.3 INDICATOR 5.3.2Achieve gender equality and empower all women and girls

Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation

Proportion of girls and women aged 15 to 49 years who have undergone female genital mutilation


Key Facts

Among girls and women aged 15 to 49 years, nearly 9 in 10 have undergone FGM; in the vast majority of governorates, at least 7 in 10 girls and women have experienced the practice

The prevalence of FGM is high across many population groups in Egypt, but the practice is somewhat more common in rural areas, in less wealthy households and among girls and women with less education

FGM is commonly performed by health personnel, and the practice has become increasingly medicalized. Girls under 15 years of age are four times more likely than women aged 45 to 49 years to have been cut by a medical professional

Just over half of Egyptians think FGM should continue, and a similar proportion believe the practice is required by religion

While progress is evident throughout much of the country, it is not even. In some governorates, the practice remains nearly universal

Egypt is not on track to reach the SDG target of eliminating FGM; compared to the rate of decline in the practice observed in the last 15 years, progress would need to be about 15 times faster to reach elimination by 2030

Notes: In this publication, unless otherwise noted, the latest data are from 2015. See note on inner cover regarding the recency of data. National data exclude North Sinai and South Sinai, as no recent data have been collected on these governorates.

There is evidence that FGM is becoming less common at the national level particularly after 2000


Eighty-seven per cent of girls and women aged 15 to 49 years have undergone FGM; levels are high throughout most of the country

u FIG.1 Percentage of girls and women aged 15 to 49 years who have undergone FGM

Current levels of female genital mutilation

Luxor

Qena

Aswan

Souhag

Beni Suef

Menoufia

Kalyubia

Sharkia

Kafr El-Sheikh

Ismailia

Red Sea

New Valley

Giza

Menya

Assuit

Fayoum

Behera

Gharbia

Suez

Dakahlia

Cairo

Alexandria

Damietta

Port Said

Matroh

Egypt

1000 20 40 60 80

99

98

98

98

97

96

93

92

91

90

90

90

90

89

87

87

87

84

83

82

81

79

63

61

61

40


u FIG.2 Percentage of girls and women aged 15 to 49 years who have undergone FGM, by residence, wealth quintile and education

The prevalence of FGM is high across

many population groups in Egypt, but the practice

is somewhat more common in

rural areas, in less wealthy households

and among girls and women with

less education

Ru

ral

Urb

an

Po

ore

st

Sec

on

d

Mid

dle

Fou

rth

Ric

hes

t

No

ed

uca

tio

n

Pri

mar

y

Sec

on

dar

y

Hig

her

th

an

seco

nd

ary

Residence Wealth quintile Education

100

60

20

80

40

0

93

77

9493 92

87

70

9896

87

71


1000 20 40 60 80

Information collected on FGM among girls under age 15 reflects their current but not final FGM status. Some girls who have not been cut may still be at risk once they reach the customary age for cutting.

Therefore, the data on prevalence for girls under age 15 is an underestimation of the true extent of the practice.

Since age at cutting varies among settings, the amount of underestimation also varies (see Figure 4). This should be kept in mind when interpreting all FGM prevalence data for this age group.

Notes: Data were collected from female respondents aged 15 to 49 years about their daughters aged 6 months to 14 years at the time of the survey. Girls’ FGM status was reported by their mothers.

u FIG.3 Percentage of girls aged 6 months to 14 years who have undergone FGM, by governorate

Luxor

Aswan

Qena

Souhag

Red Sea

Assuit

Ismailia

Kalyubia

Menoufia

Beni Suef

New Valley

Gharbia

Sharkia

Giza

Cairo

Suez

Menya

Behera

Kafr El-Sheikh

Dakahlia

Fayoum

Alexandria

Matroh

Port Said

Damietta

Egypt

Across Egypt, 14 per cent of girls under age 15 years have undergone FGM

45

36

36

35

25

16

15

15

14

14

14

14

12

11

10

9

8

7

7

6

5

4

2

2

0

52


Circumstances around FGM Age at cutting, practitioners and medicalization

FGM in Egypt is commonly practised

by medical personnel: 6 in 10 girls were cut by

doctors, and 7 in 10 girls were

cut by medical practitioners overall

u FIG.5 Percentage distribution of adolescent girls aged 15 to 19 years who have undergone FGM, by type of practitioner

Doctor Nurse/other health provider Daya Barber Ghagaria Don’t know/missingPractitioner:

59 9 30 2 0.50.2

Note: Figures may not add up to 100 per cent due to rounding.

The majority of FGM occurs during early adolescence:

7 in 10 girls were cut between ages

10 to 14 years

u FIG.4 Percentage distribution of adolescent girls aged 15 to 19 years who have undergone FGM, by age at cutting

Before 5 years 5 to 9 years 10 to 14 years At or after 15 years Don’t know/missingAge at cutting:

2 24 71 1 1



100

60

20

80

40

0

Notes: Values presented here are based on at least 25 unweighted cases. Those based on 25 to 49 unweighted cases are shown in parentheses. Medical practitioners include doctors, nurses and other health providers. Data were collected from female respondents aged 15 to 49 years about their daughters aged 6 months to 14 years at the time of the survey. Girls’ FGM status was reported by their mothers. Some girls under age 15 who have not been cut may still be at risk once they reach the customary age for cutting, which should be kept in mind when interpreting data for this age group (see box on page 7).

u FIG.6 Percentage of cut girls and women aged 6 months to 49 years who underwent FGM by a medical practitioner, by age

FGM has become increasingly medicalized: Of those who underwent the practice, 4 in 5 girls under age 15 experienced FGM at the hands of a medical professional, compared to fewer than 1 in 5 women aged 45 to 49 years

45–4

9 ye

ars

40–4

4 ye

ars

35–3

9 ye

ars

30–3

4 ye

ars

25–2

9 ye

ars

20–2

4 ye

ars

15–1

9 ye

ars

10–1

4 ye

ars

5–9

year

s

6 m

on

ths–

4

year

s

17

23

30

42

48

57

68

78 78(80)


u FIG.7 Percentage distribution of girls and women and boys and men aged 15 to 49 years, by their attitudes about whether FGM should continue

More than half of girls and women as well as boys and men support the continuation of FGM

u FIG.8 Percentage of girls and women and boys and men aged 15 to 49 years who believe FGM is required by religion

Almost half of Egyptians think FGM is required by religion

Opinions on FGM

Girls and women Girls and women Boys and men Boys and men

54 59

38 28

914

4650

Think FGM should continue Think FGM should stop Say it depends/are not sure

100 100

60 60

20 20

80 80

40 40

0 0



100

60

20

80

40

0

u FIG.9 Percentage distribution of girls and women aged 15 to 49 years, by their attitudes about whether FGM should continue, by residence, wealth quintile, education and age

Rural Poorest No education 45–49 yearsUrban Richest Higher than secondary

15–19 years

Residence Wealth quintile Education Age

Think FGM should continue Think FGM should stop Say it depends/are not sure

37

63 65

28

74

32

65

38

55

28 25

63

19

62

29

46

89 10 8 7 6 6

17

Support for FGM is most common among girls and women in rural areas and the poorest households as well as those who are older and have less education



100

60

20

80

40

0

Generational trends in reducing FGM

The prevalence of FGM is lowest among the youngest age cohort, that is, adolescent girls aged 15 to 19 years in 2015.

Within this age group, the prevalence is 67 per cent among adolescent girls aged 15 to 17 years and 74 per cent among those aged 18 to 19 years. This difference is not statistically significant.

u FIG.10 Percentage of adolescent girls aged 15 to 19 years who have undergone FGM

There is evidence of a decline in the prevalence of FGM, particularly after 200019

85

1990

1995

2000

2005

2010

2015

Notes: This trend analysis is based on the prevalence of FGM across age cohorts, as measured in the Health Issues Survey 2015. See technical notes for details.

70

82

8993

959597


100

100

60

60

20

20

80

80

40

40

0

0

Notes: Values presented here are based on at least 25 unweighted cases. Those based on 25 to 49 unweighted cases are shown in parentheses.

u FIG.11 Percentage of adolescent girls aged 15 to 19 years who have undergone FGM, by region

Most regions of Egypt have seen a decline in FGM, with the strongest progress in the urban governorates and urban Lower Egypt

1985

1985

1985

1995

1995

1995

2005

2005

2005

1990

1990

1990

2000

2000

2000

2010

2010

2010

2015

2015

2015

Rural Upper Egypt98 9998 99 9899 97 96 96

84

Urban Upper Egypt98

93 94 9387

78

68

91 8893

82

72

57

42

Rural Lower Egypt

9693

84

76

(94)

83

71

87

77

65

57

Urban Lower EgyptFrontier governorates Urban governorates

94

85 85 83

74

65

45


100

100

60

60

20

20

80

80

40

40

0

0

Notes: Governorates presented here include those with a high prevalence of FGM and/or receiving programmatic interventions. Values presented here are based on at least 25 unweighted cases. Those based on 25 to 49 unweighted cases are shown in parentheses. Those with fewer than 25 unweighted cases are marked ‘n/a’ for ‘not available’.

u FIG.12 Percentage of adolescent girls aged 15 to 19 years who have undergone FGM in selected governorates

While strong progress in reducing FGM has occurred in some governorates, the practice remains nearly universal in others

1985

1995

2005

1990

2000

2010

2015

1985

1995

2005

1990

2000

2010

2015

1985

1995

2005

1990

2000

2010

2015

1985

1995

2005

1990

2000

2010

2015

1985

1995

2005

1990

2000

2010

2015

Luxor

(100) (100) (100) 96100 100 (99)

Qena

(100)(98) (99) 100 99 9995

Souhag

(100) (100) (100) 10096 96 95

(100) (100) (100) 10095

(78) 79

(99) (98) 96 94 96

8783

(97)

n/a

n/a

(98)90

93

63

(85)

9592

87 8881

70

52

Beni Suef

(100) (100) 98 96

88

99

Aswan

(100) (100) (100) 97 97 9893

SharkiaKalyubia Fayoum CairoAssuit

(100)(96)

(88)(82)

91 90

78


100

60

20

80

40

0

Notes: In the Health Issues Survey 2015, girls and women who answered ‘signed contract’ to the question about their marital status are considered to be never-married. Values presented here are based on at least 25 unweighted cases. Those based on 25 to 49 unweighted cases are shown in parentheses. Those with fewer than 25 unweighted cases are marked ‘n/a’ for ‘not available’. In each marital status group, the difference between girls aged 15 to 17 years and 18 to 19 years is not statistically significant, suggesting no additional decline within the youngest cohort.

u FIG.13 Percentage of adolescent girls aged 15 to 19 years who have undergone FGM, by marital status

Declines in FGM are most prominent among those who have not married

Ever-married adolescent girls Never-married adolescent girls

1985 1995 20051990 2000 2010 2015 1985 1995 20051990 2000 2010 2015

Data collected in Demographic and Health Surveys conducted in Egypt since the mid-1990s have been limited to ever-married women. Only two surveys, in 2008 and 2015, represented all women, including those who had never been married. Analysis based on previous surveys shows that levels of FGM have been persistently high, and that among ever-married women, they remain high even according to the latest data from 2015.

There does appear to be both a lower prevalence of FGM and a recent decline in the practice among women who have not married. This explains why the aggregate prevalence for all women (as shown in Figures 10 to 12) is dropping despite the consistently high levels of the practice among married women.n/a

9795

(86)

(96)9593

77

91

75

89

65

91

65


100

60

20

80

40

0

Looking ahead towards elimination

Note: See “How to read the projections” on page 19.

u FIG.14 Observed and projected percentage of adolescent girls aged 15 to 19 years who have undergone FGM

1985 1995 20051990 2000 2010 2015 2020 2030 20402025 2035 2045 2050

If the decline seen after 2000

continues, the prevalence of FGM

in Egypt would drop to 52 per cent

by 2030 and to 36 per cent by 2050

If progress is accelerated,

this proportion can be cut by half

Percentage of adolescent girls aged 15 to 19 years who have undergone FGM

Progress in the past 30 years continues

Percentage of adolescent girls aged 15 to 19 years who are expected to undergo FGM if:

Progress in the past

15 years continues

Progress is accelerated

97

47

36

18

39

58

52

63

59

66

70


0

4

5

3

2

1

u FIG.16 Observed and projected number of adolescent girls aged 15 to 19 years who have undergone FGM

Without an accelerated rate of reduction, it is possible that the number of adolescent girls experiencing FGM could increase by 2030 due to population growth

1985 1995 20051990 2000 2010 2015 2020 2030 20402025 2035 2045 2050

u FIG.15 Observed and projected female population under age 18

1985 1995 20051990 2000 2010 2015 2020 2030 20402025 2035 2045 2050

0

5

15

25

10

Mill

ion

s 20

30M

illio

ns

Note: See “How to read the projections” on page 19.

Number of adolescent girls aged 15 to 19 years who have undergone FGM


Number of adolescent girls aged 15 to 19

years who are expected to undergo FGM if:


Progress is accelerated

0

5

15

25

10

20

30


%

u FIG.17 Average annual rate of reduction (per cent) in the percentage of adolescent girls aged 15 to 19 years who have undergone FGM, observed and required for elimination, by region

How to read the average annual rate of reduction

The observed average annual rates of reduction quantify the rate of progress in reducing the prevalence of FGM over each period. A higher rate indicates faster progress. Required rates illustrate what would be necessary to eliminate the practice by 2030 and achieve SDG target 5.3. In urban Upper Egypt, for example, compared to the last 15 years, progress would need to be 14 times faster to eliminate FGM by 2030 (based on a 2.1 per cent observed annual rate of reduction compared to a 28.1 per cent required rate).

Egypt is not on track to reach the SDG target of eliminating FGM. Compared to the rate of decline in the last 15 years, progress would need to be about 15 times faster to eliminate the practice by 2030

Egypt Urban governorates

Frontier governorates

Upper Egypt Lower Egypt

Urban UrbanRural Rural

Observed in the past 30 years Observed in the past 15 years Required for elimination by 2030

Average annual rate of reduction:

1.11.9

28.3

2.41.2

0.5 1.0

2.91.71.5

0.9

4.5

2.6

4.1

2.1

25.4

28.1

29.6

24.8

28.9

26.9


To assess the prevalence of FGM, this analysis used SDG indicator 5.3.2 – the proportion of girls and women aged 15 to 49 years who have undergone female genital mutilation.

Confidence intervals are not shown in this publication. Caution is therefore warranted in interpreting the results since apparent differences among groups may not be significant. Key message titles for the charts were developed in light of the confidence intervals for all values. Thus, in cases where the title indicates that there is a difference among groups, it has been confirmed as statistically significant.

Data on circumstances around FGM in Egypt are presented here as measured among adolescent girls aged 15 to 19 years. In Egypt, cutting mainly occurs among girls under age 15 years; therefore, the cohort aged 15 to 19 years is the one that has most recently surpassed the customary age at cutting, allowing for the most recent assessment of circumstances around FGM without the risk of censoring. Data on types of FGM are not presented here as questions on type of cutting only differentiated infibulation from non-infibulating forms.

Trends in the prevalence of FGM (Figures 10 to 12) and the associated average annual rates of reduction (Figure 17) were calculated using an age-cohort analysis of data from the Health Issues Survey 2015. The results were validated against previous surveys (Demographic and Health Surveys from 1995, 2000 and 2005, and the 2008 and 2014 Health Issues Surveys).

How to read the projectionsFigures 14 and 16 show how the scale of the practice of FGM has changed since 1985, as well as various scenarios that could occur in the future. Figure 17 shows progress in the observed rate of reduction and the rate that would be required to meet elimination targets.

The projection scenarios build on existing trends. They show expected values if progress from the past 30 years (in blue) or the past 15 years (in purple) was to continue. Progress appears to have accelerated over the past 15 years, making this the more ambitious of the two scenarios. A third scenario (in light blue) illustrates what could happen if the rate observed over the past 15 years was to double.

The observed average annual rates of reduction quantify the rate of progress in reducing the prevalence of FGM over each period. A higher rate indicates faster progress. Required rates indicate what would be necessary to eliminate FGM by 2030 and achieve SDG target 5.3. For statistical purposes, ‘elimination’ is defined as a prevalence of less than 1 per cent.

The analysis in this publication is based on the Health Issues Survey 2015. Population data are from the United Nations Department of Economic and Social Affairs, Population Division, World Population Prospects 2019, Online Edition, 2019.

This data brief was prepared by the Data and Analytics Section of UNICEF (Claudia Cappa, Colleen Murray and Hyunju Park) with inputs from the Egypt Country Office (Reem Elsherbini, Shantanu Gupta, Manar Soliman and Saji Thomas).

United Nations Children’s Fund, Female Genital Mutilation in Egypt: Recent trends and projections, UNICEF, New York, 2020.

Technical notes Data Sources

Acknowledgements

Suggested Citation

Photo CreditsCover: ©UNICEF/UNI42927/Pirozzi

A social worker (centre) speaks about the dangers of FGM to a girl and her mother at their home in the village of Nazlet Ebeid in Minya Governorate in Upper Egypt.

Page 2: ©UNICEF/UNI42924/Pirozzi

A community educator speaks to a group of women about the dangers of FGM at the UNICEF-supported Kabbary Youth Centre for working children in Alexandria. The centre offers community education and outreach programmes, educational activities, vocational training, and psychosocial support and medical care for working children.

For information on FGM in Egypt:

UNICEF EgyptIntersection of Rd. 87 & 14,Sarayat Al GharbeyahMaadi, Cairo, Egypt

E-mail: [email protected]: unicef.org/egypt/

For information on the data in this brochure:

UNICEF Data and Analytics SectionDivision of Data, Analytics, Planning and Monitoring3 United Nations PlazaNew York, NY 10017, USA

E-mail: [email protected]: data.unicef.org

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