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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
04 | Female Genital Mutilation in Egypt: Recent trends and projections
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
05Female Genital Mutilation in Egypt: Recent trends and projections |
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
06 | Female Genital Mutilation in Egypt: Recent trends and projections
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
07Female Genital Mutilation in Egypt: Recent trends and projections |
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
08 | Female Genital Mutilation in Egypt: Recent trends and projections
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
Note: Figures may not add up to 100 per cent due to rounding.
09Female Genital Mutilation in Egypt: Recent trends and projections |
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)
10 | Female Genital Mutilation in Egypt: Recent trends and projections
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
Note: Figures may not add up to 100 per cent due to rounding.
11Female Genital Mutilation in Egypt: Recent trends and projections |
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
Note: Figures may not add up to 100 per cent due to rounding.
12 | Female Genital Mutilation in Egypt: Recent trends and projections
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
13Female Genital Mutilation in Egypt: Recent trends and projections |
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
14 | Female Genital Mutilation in Egypt: Recent trends and projections
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
15Female Genital Mutilation in Egypt: Recent trends and projections |
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
16 | Female Genital Mutilation in Egypt: Recent trends and projections
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
17Female Genital Mutilation in Egypt: Recent trends and projections |
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
Progress in the past 30 years continues
Number 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
0
5
15
25
10
20
30
18 | Female Genital Mutilation in Egypt: Recent trends and projections
%
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
19Female Genital Mutilation in Egypt: Recent trends and projections |
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