The majority of participants in the case group were 20–30 years old (63.1%), had a college education (43.8%), and were unemployed (45.4%). Regarding parents' occupation, their father occupied in self-employed (54.7%) and their mother had unemployed (85.5%) respectively. Both parents had elementary education levels of 50%, and 66.9% respectively.
Regarding family size, family monthly income, and housing status, they were in a family of 1–5 people (50.6%), moderately adequate income (49.2%), and personal ownership (81.5%). Regarding FGC family history, 77.7% of participants had a history of FGC in their family. The majority of participants in the control group were 20–30 years old (53.8%), had a college education (66.2%), and were studying (55.4%). Regarding parents' jobs, their father occupied in self-employed (47.7%) and their mother had unemployed 73.8%) respectively. Their father had a guidance education level of 31.5%, and their mother's education in elementary level 38.5 percentage respectively. Regarding family size, family monthly income, and housing status, they were in a family of 1–5 people (56.2%), moderately adequate income (48.5%), and personal ownership (73.1%). Regarding FGC family history, 30% of participants had a history of FGC in their family (Table 1). Forty-five percent of circumcised girls had been circumcised under the age of 5 years, and about half of them were the first child in the family. More than half of the girls had been circumcised by local women and more than 90 percentage circumcised at home. Sixty percent of circumcised girls had information about circumcision, and the Internet was their most common source of information. Most girls did not have pain in their circumcision area (Table 2).
Table 1
Comparison of demographic and socio-economic factors in term of two groups (N = 260)
Variables | Without FGC N (%) | FGC N (%) | OR | CI, 95% | P -value* |
Age(year) | < 20 | 33(25.4) | 37(28.5) | 2.75 | 1.18, 6.39 | 0.019 |
20–30 | 70(53.8) | 82(63.1) | 2.87 | 1.33,6.21 | 0.007 |
> 31 | 27(20.8) | 11(8.46) | ref |
Education | Elementary | 4(3.1) | 14(10.8) | 5.28 | 1.65, 16.85 | 0.005 |
Guidance | 20(15.4) | 27(20.8) | 2.03 | 1.04, 3.97 | 0.037 |
Diploma | 20(15.4) | 32(24.6) | 2.41 | 1.25, 4.69 | 0.008 |
Academic | 86(66.2) | 57(43.8) | ref |
Occupation status | Employed | 19(14.6) | 26(20.0) | 0.90 | 0.44, 1.85 | 0.784 |
Student | 72(55.4) | 45(34.6) | 0.41 | 0.23, 0.71 | 0.002 |
Unemployed | 39(30.0) | 59(45.4) | ref |
Father's job | Government's employee | 45(34.6) | 32(25.0) | 0.71 | 0.21, 2.40 | 0.584 |
worker | 17(13.1) | 20(15.6) | 1.12 | 0.34, 3.68 | 0.841 |
Self-employed | 62(47.7) | 70(54.7) | 1.17 | 0.32,4.33 | 0.807 |
Unemployed | 6(4.7) | 8(4.7) | ref |
Father's education | Elementary | 28(21.5) | 64(50.0) | 5.48 | 2.31, 12.97 | 0.001 |
Guidance | 41(31.5) | 26(20.3) | 1.52 | 0.62, 3.69 | 0.353 |
Diploma | 37(28.5) | 28(21.9) | 1.81 | 0.74, 4.40 | 0.187 |
Academic | 24(18.5) | 10(7.8) | ref |
Mother's job | Employed | 34(26.2) | 19(14.6) | 0.48 | 0.25, 0.90 | 0.022 |
Unemployed | 96(73.8) | 111(85.4) | ref |
Mother's education | Elementary | 50(38.5) | 85(66.9) | 6.96 | 1.87, 25.84 | 0.004 |
Guidance | 48(36.9) | 28(20.0) | 2.16 | 0.56, 8.37 | 0.262 |
Diploma | 20(15.4) | 14(10.8) | 2.80 | 0.66, 11.79 | 0.160 |
Academic | 12(9.2) | 3(2.3) | ref |
Family members size | 1–5 | 73(56.2) | 66(50.8) | 0.67 | 0.14, 3.14 | 0.620 |
6–10 | 54(41.5) | 60(46.2) | 0.83 | 0.17, 3.89 | 0.817 |
≥ 11 | 3(2.3) | 4(3.1) | ref |
Family monthly income | Less than adequate | 15(11.5) | 8(6.2) | 0.38 | 0.09, 1.59 | 0.187 |
Moderately adequate | 63(48.5) | 64(49.2) | 0.72 | 0.21, 2.40 | 0.600 |
adequate | 47(36.2) | 51(39.2) | 0.77 | 0.23, 2.61 | 0.681 |
More than adequate | 5(3.8) | 7(5.4) | ref |
Ownership residence status | Rental | 28(21.5) | 20(15.4) | 1.25 | 0.32, 4.85 | 0.747 |
Personal residence | 95(73.1) | 106(81.5) | 1.95 | 0.55, 6.87 | 0.298 |
Residence with family | 7(5.4) | 4(3.1) | ref |
Family history of FGC | Yes | 39(30.0) | 101(77.7) | 8.12 | 4.65, 14.19 | 0.001 |
No | 91(70.0) | 29(22.3) | ref |
FGC: Female Genital Circumcision; OR: Odds Ratio; CI: Confidence Interval. |
*Univariate logistic regression model |
Table 2
Descriptive characteristics of circumcised girls (n = 130)
Variables | | Frequency | % |
Age of circumcision (yr.) | 1–4 | 59 | 45.4 |
5–9 | 52 | 40 |
≥ 10 | 19 | 14.6 |
Birth order | First order | 50 | 38.5 |
second | 32 | 24.6 |
Third | 21 | 16.2 |
fourth≥ | 27 | 20.8 |
Circumciser | Rural women | 73 | 65.2 |
Rural midwife | 18 | 13.8 |
Educated midwife | 7 | 5.4 |
Relatives | 5 | 3.8 |
Others | 27 | 20.8 |
Place of circumcision | Home | 122 | 93.8 |
Hospital | 4 | 3.1 |
Health center | 4 | 3.1 |
Awareness of FGC | yes | 78 | 60.00 |
No | 52 | 40.00 |
Source of information about FGC | Book | 26 | 20 |
Internet | 31 | 23.8 |
Mother | 9 | 6.9 |
sister | 6 | 4.6 |
Friends | 5 | 3.8 |
Doctors | 14 | 10.8 |
No response | 39 | 30 |
Pain in scars | Yes | 14 | 10.8 |
No | 116 | 86.2 |
Using the univariate regression model, the relationship between each demographic and socio-economic variable with the circumcision status was investigated. The results showed that the variables of age, education, job, parents' education, mother's job, and previous history of circumcision in their family were related to an increase in the chances of circumcision. Multivariate Logistic Analysis using the backward method, after adjusting the participants' job, father's job, father's education, mother's job, family size, family monthly income, housing status, showed that the age, education, mother's education, and the family history of circumcision were the predictive variables of circumcision. Accordingly, the chances of circumcision in girls under the age of 20 and then in the age group of 20 to 30 years were 5.77 [CI 95%; 1.86–17.84], and 8.55 [CI 95%; 3.09–23.62] times higher than those over 30 years, respectively. This chance in girls with elementary education was 6.6 [CI 95%; 1.34–33.22] times higher than those with a college education. The chances of girls being circumcised with mothers with elementary education were 5.75 [CI 95%; 1.23–26.76] times higher than girls with university-educated mothers. Also, the family history of circumcision increased the chances of female circumcision by 9.90 [CI 95%: 5.03–19.50] times (Table 3).
Table 3
The socioeconomic - related disparities in female genital circumcision
Variables | | OR | CI95% | P-value* |
Age | < 20 | 5.77 | 1.86,17.84 | 0.002 |
20–30 | 8.55 | 3.09,23.62 | 0.001 |
> 31 | ref |
Education | Elementary | 6.68 | 1.34,33.22 | 0.020 |
Guidance | 2.25 | 0.80,6.29 | 0.120 |
Diploma | 2.20 | 0.95,5.09 | 0.065 |
Academic | ref |
Mother's education | Elementary | 5.75 | 1.23,26.76 | 0.026 |
Guidance | 1.41 | 0.29,6.79 | 0.665 |
Diploma | 2.35 | 0.44,12.64 | 0.316 |
Academic | ref |
Family history of FGC | Yes | 9.90 | 5.03,19.50 | 0.001 |
No | ref |
* Multivariate Logistic analysis backward method (Occupation, Father's job, Father's education, Mother's job, Household members, Family income, housing status variable(s) removed on step 9) |
The socio- economic related factors in term of age of FGC, circumciser, and place of circumcision were examined. The results showed that age of circumcision was significantly related to the housing status of the family, so that circumcision of girls under the age of 5 years in the families with the personal house was more than other groups (P = 0.034). Circumcision by local women was also significantly higher in those whose father’s education level was elementary (P = 0.003), and whose family income was relatively adequate (P = 0.011). The place of the circumcision was significantly related to the father's job and education status, so that the girls whose father's level of education was elementary (P = 0.034), and retired (P = 0.024), were more likely to be circumcised at home. Mother's job and mother's education had no significant relationship with the three circumcision performance related variables (P > 0.05).