A Profile of Female Genital Mutilation in Ethiopia...A Profile of Female Genital Mutilation in Ethiopia 05 Notes: The boundaries, names and designations used on the map do not imply

A Profile of Female Genital Mutilation in Ethiopia

Female genital mutilation in the national and global development agendaEvery girl and woman has the right to be protected from female genital mutilation (FGM), a manifestation of entrenched gender inequality with devastating consequences. FGM is a violation of human rights and has been prohibited in Ethiopia’s criminal code since 2004. 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 5.3.2

Achieve 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

02 | A Profile of Female Genital Mutilation in Ethiopia

KEY FACTSabout FGM

In Ethiopia, 25 million girls and women have undergone FGM, the largest absolute number in Eastern and Southern Africa

Overall, 65 per cent of girls and women aged 15 to 49 years have been subjected to FGM. Among adolescent girls aged 15

to 19 years, 47 per cent have undergone the practice

The risk of FGM depends on certain background characteristics. Girls

and women from rural areas and those with less education are

at greater risk

Most people in Ethiopia think FGM should stop. The

proportion of those opposing FGM has significantly increased

since 2000

Ethiopia’s progress towards ending FGM has been faster than other high-prevalence countries in Eastern and Southern Africa. Still, eliminating FGM by 2030 will require accelerated action. Progress must

be eight times faster than that observed in the past 15 years in order to reach SDG target 5.3

FGM is less common today than in previous generations, now affecting

5 in 10 adolescent girls aged 15 to 19 years compared to nearly 9 in 10 around

1970. Since 2000, the country has seen faster progress in abandoning the practice

03A Profile of Female Genital Mutilation in Ethiopia |

Meskerem Muleta, 16, is a Grade 7 student in SNNP region. She is well known in her neighbourhood for advocating against FGM.

Meskerem uses the gender club at her school to speak about her story of avoiding FGM, and her family’s transformation into advocates against the practice.

She wants to be a women’s rights activist, and hopes to find more platforms to speak against FGM and empower girls in Ethiopia.


Notes: The boundaries, names and designations used on the map do not imply official endorsement or acceptance by the United Nations. SNNPR stands for Southern Nations, Nationalities, and People’s Region. Due to rounding, individual figures may not add up to total.

Ethiopia is home to 25 million girls and women who have experienced FGM. More than half are in the regions of Oromia and Amhara. Overall, 65 per cent of girls and women aged 15 to 49 have undergone FGM. The highest prevalence is in the Somali (99 per cent) and Afar (91 per cent) regions

FIG. 1 Percentage of girls and women aged 15 to 49 years who have undergone FGM (map) and number of girls and women of all ages who have undergone FGM (circles)

Current levels of FGM

90 per cent or more

70 to 89 per cent

50 to 69 per cent

30 to 49 per cent

Less than 30 per cent

Addis Ababa

AfarAmhara

Benishangul-Gumuz

Dire Dawa

Gambela

Harari

Oromia

SomaliSNNPR

Tigray730,000

7 million

220,000

50,000

4 million

1 million

9 million

790,000

150,000

80,000

2 million

Across Ethiopia, 16 per cent of girls

under age 15 have undergone FGM.

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 this age group are an underestimation of the true extent of the practice. Since age at cutting varies among settings, the amount of underestimation also varies (see Figure 5).


Notes: M stands for million. The chart includes all countries in Eastern and Southern Africa with available data on the prevalence of FGM. See technical notes for details.

FIG. 2 Percentage of girls and women aged 15 to 49 years (bars) and number of girls and women of all ages (dots) who have undergone FGM in countries in Eastern and Southern Africa

Ethiopia does not rank among the countries with the highest levels of FGM in Eastern and Southern Africa, but it is home to the largest absolute number of girls and women who have undergone the practice in the region

100 9894

8783

65

21

10

0.3

60

20

80

40

0

Somalia EthiopiaSudan United Republic of Tanzania

Djibouti KenyaEritrea Uganda

6 M

0.4 M

14 M

1 M4 M

2 M

25 M

0.2 M


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

FIG. 3 Percentage of girls and women aged 15 to 49 years who have undergone FGM, by residence, wealth quintile, education and religion

Girls and women from rural areas, with less education or who identify as Muslim are more likely to have undergone FGM

100

65

82

73

66 6662

71

(58)(55)

(10)

50

70

51

5754

60

20

80

40

0

Residence Wealth quintile Education Religion

Ru

ral

Urb

an

Poo

rest

Sec

on

d

Mid

dle

Fou

rth

Ric

hes

t

No

ed

uca

tio

n

Prim

ary

Sec

on

dar

y

Hig

her

Mu

slim

Pro

test

ant

Cat

ho

lic

Trad

itio

nal

Ort

ho

dox

Oth

er

54

68


Note: Values on this page refer to the percentage of cut women aged 20 to 24 years who were cut by specific types of practitioners.

Circumstances around FGM Practitioners, types of FGM, and age at cutting

Nearly all FGM in Ethiopia is performed by traditional practitioners (89 per cent), while medical personnel rarely perform the practice (2 per cent)

SNNPR is the only region in which there is some involvement of medical personnel: 1 in 10 women who underwent FGM there were cut by a doctor, nurse, midwife or other health professional

How to read this figure: Among young women in Ethiopia who have been cut, 7 per cent were sewn closed, 73 per cent were cut with flesh removed, 3 per cent were nicked, or cut with no flesh removed, and for the remaining 17 per cent the type of cutting was not determined.


Notes: Values presented here are based on at least 25 unweighted cases. Data for some regions and religious groups are suppressed due to insufficient numbers of cases to perform the analysis. Due to rounding, individual figures may not add up to 100.

FIG. 4 Percentage distribution of women aged 20 to 24 years who have undergone FGM by type of FGM performed, by region and religion

Removing flesh is the most common form of FGM in Ethiopia. The most severe form of FGM, in which the vaginal opening is sewn closed, is common in the Somali and Afar regions, but rare elsewhere

HarariSomaliAfar Amhara Dire Dawa Addis Ababa ProtestantSNNPR Benishangul- Gumuz

MuslimOromia Orthodox

ReligionRegionEthiopia

Cut, no flesh removed/nicked Don’t know/not determinedSewn closedType of FGM: Cut, flesh removed

17

3

73

7

21

62

35

62

6

86

3

5

91

4

6

69

2136

4

5

56

11

4

5

80

14

2

13

71

7

2

3

88

28

4

3

65

28

3

2

68

27

5

1

67

14

1

85

How to read this figure: Among young women in Ethiopia who have been cut, 44 per cent were cut before age 5 years, 22 per cent were cut between ages 5 and 9 years, 18 per cent were cut between ages 10 and 14 years, 11 per cent were cut at age 15 years or older, and for the remaining 5 per cent the age at cutting was unknown.


Notes: Values presented here are based on at least 25 unweighted cases. Data for some regions and religious groups are suppressed due to insufficient numbers of cases to perform the analysis. Due to rounding, individual figures may not add up to 100.

FIG. 5 Percentage distribution of women aged 20 to 24 years who have undergone FGM by age at cutting, by region and religion

Nearly half of cut women underwent FGM when they were younger than 5 years old, whereas nearly 3 in 10 were cut after age 10; age at cutting varies substantially by region and religion

Addis AbabaAfarAmhara Dire Dawa Oromia Somali MuslimBenishangul- Gumuz

SNNPR OrthodoxHarari Protestant

ReligionRegionEthiopia

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

5

11

44

22

31

96

3

7

84

32

83

8

10

65

21

9

6

28

30

9

18

25

25

3

12

22

33

2

21

54

7

1

10

45

63

75

13

5

14

29

26

4

13

27

31

18

64

4

27

23

31

24

36

4

2726


Alemnesh Bekele, gender club leader, with club members during a discussion on ending harmful practices affecting girls at Gesa Primary School, Hula Woreda, SNNP region.


One in four girls and women and one in six boys and men believe FGM is a religious requirement. This belief is most likely among older women, and in the Afar and Somali regions. It is more common among Muslims than Christians.

Note: Data on opinions by age cohort should not be interpreted as trends, since they represent opinions at the moment of the survey that are subject to change through a respondent’s lifetime.

FIG. 6 Percentage of girls and women and boys and men aged 15 to 49 years who have heard of FGM and think the practice should stop, by age

The majority of Ethiopians think FGM should stop

Opinions on FGM

15 to 49 years

15 to 19 years 15 to 19 years

45 to 49 years 45 to 49 years

Girls and women Boys and men

15 to 49 years79%

85% 87%

71% 83%

87%


FIG. 7 Percentage of girls and women and boys and men aged 15 to 49 years who have heard of FGM and think the practice should stop, by residence, wealth quintile and education

Opposition to FGM is common across population groups, though those in urban areas, in richer households and with more education are most likely to oppose it

Girls and women Boys and men

Rural

Urban

Poorest

Sec

ond

Middle

Fourth

Richest

No education

Prim

ary

Secon

dary

Higher

78

62

74

94

96

76

91

8593

83

79

84

8289

91

9370

78

8487

94

99

Residence

E

duca

tion

Wealth quintil

e


FIG. 8 Percentage of girls and women aged 15 to 49 years who have heard of FGM and think the practice should stop, by age

2000 2000 2000

15 to 49 years 15 to 19 years 45 to 49 years

100

60

20

80

40

0

While only 3 in 10 girls and women opposed FGM in 2000, 8 in 10 girls and women in 2016 reported the practice should stop

29

23

36

2005

63

54

72

2016

79

71

85

2005 20052016 2016


Hasna Ahmed, 16, Lek’o Ali, 19, and Fatuma Ali, 15, attend an adolescent gender club in Afar, discussing harmful practices. Lek’o says, “I want to teach the public. FGM has to end in my community.”


Note: See technical notes for details.

FIG. 9 Percentage of adolescent girls aged 15 to 19 years who have undergone FGM

The prevalence of FGM among adolescent girls aged 15 to 19 has dropped from nearly 9 in 10 to fewer than 5 in 10 since the 1970s, with an acceleration after 2000

Generational trends in reducing FGM

As shown in Figure 5, about 11 per cent of cutting occurs after age 15.

Thus the percentage of adolescent girls aged 15 to 19 years who have undergone FGM is unlikely to reflect the complete prevalence of the practice among this cohort, as some girls are still at risk of FGM.

100

60

20

80

40

0

1970 1975 2000 20051980 1985 2010 20151990 1995

8783 83

74

82

65

77

59

77

47


Notes: This figure includes all countries in Eastern and Southern Africa with nationally representative data on the prevalence of FGM. Countries are ranked from highest to lowest according to the 30-year average annual rate of reduction.

FIG. 10 Average annual rate of reduction and current prevalence of FGM, i.e. the percentage of girls and women aged 15 to 49 who have undergone FGM

Ethiopia’s progress towards ending FGM in the past three decades has been faster than other high-prevalence countries in Eastern and Southern Africa

Country Average annual rate of reduction of FGM (%) Current prevalence of FGM (%)

Uganda 4.6 0.3

United Republic of Tanzania 4.6 10

Kenya 4.3 21

Ethiopia 1.7 65

Eritrea 1.0 83

Sudan 0.4 87

Djibouti 0.4 94

Somalia 0.1 98


Benishangul- Gumuz

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

The greatest reduction in the prevalence of FGM has been in Oromia and Addis Ababa; levels have not changed significantly in Afar, Somali, SNNPR and Gambela

Notes: 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 at one or both points in time are suppressed. Regions identified in the title as having no significant change have values for the two points in time that are not significantly different from one another.

100

60

20

80

40

0

Afar Somali Oromia Dire Dawa Amhara Addis Ababa SNNPR Tigray Gambela

(100) (100)

88

95 95

76

(92)

63

(75)(78)

42(40)

46

50

61

50

39

43

19

24

1991 2016


Note: See technical notes for details.

FIG. 12 Observed and projected percentage of adolescent girls aged 15 to 19 years who have undergone FGM

If progress in the past 15 years continues, the prevalence of FGM could fall to beneath 30 per cent by 2030

Looking ahead towards elimination

100

60

20

80

40

0

19851970 19901975 2015 2020 2045 205019951980 2000 2025 20302005 2010 2035 2040

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

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

8782

74

47

26

36

15

29

5

18

How to read the projections

Figures 12 to 14 show how the prevalence of FGM has changed since around 1970, as well as scenarios that could occur in the future. Figure 12 highlights how the percentage of girls and women who have undergone FGM has changed and could continue to change through 2050. Figures 13 and 14 show progress in observed rates of reduction and rates required to meet elimination targets.

In Figure 12, the projections build on existing trends to show expected values if progress from the past 30 years continues (in light blue), or if progress from the past 15 years continues (in purple). The slower progress in the past 30 years makes this the less ambitious of the two scenarios. A more ambitious scenario (in dark blue) projects an acceleration at twice the rate of progress observed over the past 15 years.

In Figures 13 and 14, the observed average annual rates of reduction quantify the rate of progress over each period. A higher rate indicates faster progress. Required rates are calculated to illustrate what would be necessary to eliminate the practice by 2025 – the Government of Ethiopia’s target – or by 2030, target 5.3 of the SDGs. In each case, the rate required to eliminate the practice by 2025 is higher than the corresponding rate for 2030, since a faster rate would be needed to reach the same level in a shorter period.

Progress in the past

30 years continuesProgress in the past

15 years continuesProgress is accelerated


FIG. 13 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

Compared to the rate of decline in the last 15 years, progress would need to be eight times faster to eliminate the practice by 2030, and 13 times faster to eliminate the practice by 2025

500 10 20 30 40

30 years

2030

15 years

2025

Observed in the past:

Required for elimination by:

1.7

3.3

27.5

42.8

60

How to read this figure: In Amhara, for example, progress would need to be 15 times faster than the rate observed over the past 15 years in order to eliminate FGM by 2030.


FIG. 14 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

Ending FGM by 2030 calls for accelerating progress in all regions; however, the least acceleration willbe needed in Tigray, Gambela and Addis Ababa, and the most acceleration will be needed in Somali, Afar and Dire Dawa

Required for elimination by 2030Required for elimination by 2025Observed in the past 30 years Observed in the past 15 years

10

20

30

40

50

60

0Acceleration of

progress needed to eliminate FGM

by 2030, compared to progress in the

past 15 years

Even though their prevalence levels are not among the highest in the country, some populous regions are home to large numbers of affected girls and women (Figure 1). They will need urgently to address FGM for Ethiopia to reduce the total number of affected girls and women.

6

Tigray

2.63.4

21.1

32.8

6

Gambela

1.63.6

22.8

35.5

8

Addis Ababa

2.23.2

26.1

40.7

9

Benishangul- Gumuz

1.93.0

26.9

41.9

6

Oromia

2.44.8

27.4

42.6

13

SNNPR

0.82.1

27.9

43.4

15

Amhara

1.41.8

27.9

43.4

11

Harari

1.2 2.8

29.3

45.5

19

Dire Dawa

1.4 1.6

29.4

45.7

93

Afar

0.4 0.3

32.0

49.8

101

Somali

0.2 0.3

32.5

50.6


Ethiopia’s programme to end FGM contributes to the national commitment to end child marriage and FGM by 2025, and to achieve SDG target 5.3 by 2030. The programme is led by the Ministry of Women, Children and Youth as well as the National Alliance to End FGM and Child Marriage, which engages other ministries, civil society, non-governmental organizations and UN entities. Building on the country’s Constitution and strong legal framework to promote and protect girls’ and women’s rights, a National Costed Roadmap to End Child Marriage and Female Genital Mutilation/Cutting (2020-2024) was developed. It has five evidence-based strategies:

Ethiopia’s programme to end FGM

1. Empowering adolescent girls to express and exercise their choices, and their families to protect their children from FGM. Through clubs and platforms for girls in and out of school, adolescent girls are supported to improve their legal literacy, knowledge and life skills, and aquire information on the harmful social and health impacts of FGM. This will help ensure that they have support networks and role models who increase their confidence, voice and agency to resist harmful practices.

2. Strengthening community engagement (including faith and traditional leaders) for increased social action to support girls and generate shifts in social expectations relating to the elimination of FGM. This is done through interpersonal and community-level communication, mass media outreach on the adverse health and social impacts of FGM, and approaches that address the root causes of gender inequality and advance the rights of girls. Community elders and religious leaders, institutions, the social service workforce, health extension workers, teachers, women’s groups and community-based organizations are mobilized to reach families and caregivers. Boys and men are specifically engaged on positive masculinities and healthy relationships. Eventually these efforts should be reflected in communities’ readiness to abandon harmful practices as assessed by the Ministry. Such gender and social norms change within communities is critical to prevent the practice from going underground given its criminalization.

3. Enhancing systems, accountability and services across sectors that are responsive to the needs of girls at risk of or affected by FGM. This includes access to adolescent-friendly health and sexual and reproductive health and rights information and services, and to services including legal,

psychosocial support and referral linkages for survivors. Mothers, especially adolescent mothers, should be engaged and supported to access learning opportunities. The capacity of service providers to respond to cases of FGM and to act as advocates against FGM is also strengthened.

4. Creating and strengthening an enabling environment that protects the rights of girls and supports national efforts to end FGM. Law enforcement is reinforced with efforts to raise legal awareness and prosecute those who violate the law. These measures are supported by effective multi-sectoral coordination and accountability mechanisms at all levels (from federal to kebele), including through platforms such as Anti-Harmful and Traditional Practices committees, community surveillance mechanisms and women’s development groups, which contribute to following newborn girls to ensure that they remain uncut, and to report cases. At the federal level, this includes the National Alliance to End FGM and Child Marriage. Increased budget allocations and enhanced expenditure tracking systems are also promoted. Given the cross-border dimensions of FGM, engagement with neighbouring countries is important.

5. Increasing data and evidence generation and use for advocacy, programming, learning and tracking progress to end FGM. This includes implementing a comprehensive monitoring and evaluation framework encompassing administrative data collection, the Ethiopian Demographic and Health Surveys, and the development and application of measurement tools to monitor social norms change at the community level. Partnerships with research entities and basic and applied research are supported for documentation, publication and dissemination of good practices.


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 the practice.

The number of girls and women who have undergone FGM is calculated based on the population in 2018. Data presented according to religion are based on self-reported religious identities of respondents, including those who identify their religion as ‘traditional’. 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 figures were developed in light of the confidence intervals for all values. Where the title indicates that there is a difference among groups, it has been confirmed as statistically significant.

Data on the circumstances around FGM in Ethiopia are presented here as measured among women aged 20 to 24 years. Yet cutting can occur well into adolescence, so any estimates among girls or women under age 20 would exclude populations that tend to perform FGM when girls are older.

Data on attitudes towards FGM from DHS 2000 and 2005 have been recalculated to exclude the opinions of women who have never heard of the practice, thus results may differ from those presented in the DHS reports.

Trends in the national prevalence of FGM in Figures 10 and 13 were calculated with data from the Ethiopia Demographic and Health Surveys in 2000, 2005, 2011 and 2016. Calculations of the average annual rate of reduction over the last 30 years and the last 15 years in Figures 14 and 15 relied on an age-cohort analysis based on data from the latest available Demographic and Health Survey in 2016.

Projected values based on a continuation of observed progress apply the average annual rate of reduction in the prevalence of FGM, or the percentage of girls aged 15 to 19 years who have undergone FGM, over the past 30 years and over the past 15 years. The acceleration scenario assumes a doubling of the observed annual rate of reduction over the past 15 years. For statistical purposes, ‘elimination’ is defined as a prevalence of less than 1 per cent.

Technical NotesFGM data are from the Demographic and Health Surveys in 2000, 2005, 2011 and 2016. Demographic data are from the United Nations, Department of Economic and Social Affairs, Population Division, World Population Prospects 2019, Online Edition, 2019, and the Federal Democratic Republic of Ethiopia Population Census Commission, Report of the 2007 Population and Housing Census: Population Size by Age and Sex.

This data brief was prepared by the Data and Analytics Section of UNICEF (Claudia Cappa, Colleen Murray and Hyunju Park) with inputs from the Ethiopia Country Office, the Ministry of Women, Children and Youth, and members of the National Alliance to End FGM and ECM.

United Nations Children’s Fund, A Profile of Female Genital Mutilation in Ethiopia, UNICEF, New York, 2020.

Cover: © UNICEF/UN0140827/MershaAisha Ousman,14 years old, is from Erubti Woreda in Afar. Aisha has been cut and infibulated. She is the oldest girl in her family, and among her sisters, it is only Aisha who was cut. After Aisha suffered severe medical complications, her parents decided not to subject her sisters to FGM.

Page 4: © UNICEF Ethiopia/2019/TadessePage 8: © UNICEF/UN0140859/MershaPage 11: © UNICEF Ethiopia/2019/TadessePage 14: © UNICEF Ethiopia/2019/Tadesse

Data Sources

Acknowledgements

Suggested Citation

Photo Credits

FDRE Ministry of Women, Children and Youth

For information on the data in this brochure:

UNICEFData and Analytics SectionDivision of Data, Analytics, Planning and Monitoring3 United Nations PlazaNew York, NY 10017, USAE-mail: [email protected]: data.unicef.org

For information on FGM in Ethiopia:

Ministry of Women, Children and YouthNational Alliance to End FGM and ECMP.O. Box 1293Addis Ababa, EthiopiaTelephone: +251 11 8591421 or +251 11 8269293E-mail: [email protected]: https://www.facebook.com/Ministry-of-Women-and-Children-Affairs-1574468536107434/

UNICEF EthiopiaP.O. Box 1169Addis Ababa, EthiopiaTelephone: +251 11 5184000E-mail: [email protected]: unicef.org/Ethiopia

Documents

A Profile of Female Genital Mutilation in Ethiopia...A Profile of Female Genital Mutilation in Ethiopia 05 Notes: The boundaries, names and designations used on the map do not imply