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Open Access Highly Accessed Research article

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

Sepideh Modrek1* and Jenny X Liu2

Author 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

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BMC Public Health 2013, 13:921  doi:10.1186/1471-2458-13-921

Published: 3 October 2013

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.

Keywords:
Female Circumcision; Adolescent health; Egypt