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Meta-Analysis
. 2022 Feb;7(2):e004512.
doi: 10.1136/bmjgh-2020-004512.

Economic burden of female genital mutilation in 27 high-prevalence countries

David Tordrup  1   2 , Chrissy Bishop  3 , Nathan Green  4 , Max Petzold  5 , Fernando Ruiz Vallejo  6 , Joshua P Vogel  7 , Christina Pallitto  8
Affiliations
Meta-Analysis

Economic burden of female genital mutilation in 27 high-prevalence countries

David Tordrup et al. BMJ Glob Health. 2022 Feb.

Abstract

Background: Female genital mutilation (FGM) is a traditional harmful practice affecting 200 million women and girls globally. Health complications of FGM occur immediately and over time, and are associated with healthcare costs that are poorly understood. Quantifying the global FGM-related burden is essential for supporting programmes and policies for prevention and mitigation.

Methods: Health complications of FGM are derived from a meta-analysis and stratified by acute, uro-gynaecological, obstetric and psychological/sexual. Treatment costs are calculated from national cohort models of 27 high-burden countries over 30 years. Savings associated with full/partial abandonment are compared with a current incidence reference scenario, assuming no changes in FGM practices.

Results: Our model projects an increasing burden of FGM due to population growth. As a reference scenario assuming no change in practices, prevalent cases in 27 countries will rise from 119.4 million (2018) to 205.8 million (2047). Full abandonment could reduce this to 80.0 million (2047), while partial abandonment is insufficient to reduce cases. Current incidence economic burden is US$1.4 billion/year, rising to US$2.1 billion/year in 2047. Full abandonment would reduce the future burden to US$0.8 billion/year by 2047.

Conclusion: FGM is a human rights violation, a public health issue and a substantial economic burden that can be avoided through effective prevention strategies. While decreasing trends are observed in some countries, these trends are variable and not consistently observed across settings. Additional resources are needed to prevent FGM to avoid human suffering and growing costs. The findings of this study warrant increased political commitment and investment in the abandonment of FGM.

Keywords: child health; health economics; maternal health; obstetrics; public health.

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Figures

Figure 1
Figure 1
Adult prevalence of female genital mtutilation (FGM) in 27 high-burden countries across three scenarios: current incidence, 50% abandonment of FGM, and full abandonment of FGM.
Figure 2
Figure 2
Projected prevalent cases of female genital mutilation (FGM) and total adult female population over the model time horizon across three scenarios: current incidence (CI), 50% abandonment and full abandonment of FGM.
Figure 3
Figure 3
Total economic burden of female genital mutilation (FGM) by stage of life across three scenarios: current incidence, 50% abandonment of FGM and full abandonment of FGM.
Figure 4
Figure 4
The relative distribution of the total economic burden of female genital mutilation (FGM) across life stages and four types of complications: acute, uro-gynaecological, obstetric and psychological/sexual.
See this image and copyright information in PMC

References

    1. United Nations Children's Fund (UNICEF) . Female genital mutilation, 2021United Nations Children's Fund (UNICEF). Available: https://data.unicef.org/topic/child-protection/female-genital-mutilation/ [Accessed 16 November 2021].
    1. UNICEF . Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change. New York: UNICEF; 2013.
    1. World Health Organization . Health risks of female genital mutilation, 2021. Available: https://www.who.int/teams/sexual-and-reproductive-health-and-research-(s... [Accessed 16 November 2021].
    1. World Health Organization . Female genital mutilation: fact sheet. Geneva: WHO; 2020. https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation [Accessed 16 November 2021].
    1. United Nations Population Fund (UNFPA) . Bending the curve: FGM trends we AIM to change. New York: UNFPA; 2018. https://www.unfpa.org/sites/default/files/resource-pdf/18-053_FGM-Infogr... [Accessed 16 November 2021].

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