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Exploring Women Empowerment and its Association with Female Genital Mutilation/Cutting in Sierra Leone: A Study Using 2019 Sierra Leone Demographic Health Survey

Koray MH, Kamara GN, Dushimirimana T, Baatiema L, Curry T et al. · 2 Dec 2024

Abstract

Abstract Background: Female genital mutilation/cutting (FGM/C), recognized as a severe form of gender-based discrimination, is a harmful traditional practice involving the non-therapeutic alteration of female genitalia. The practice is common in Sierra Leone, like other sub-Saharan African countries. It poses serious health risks, including fistula, bleeding, infections, childbirth complications, and increased perinatal mortality. The elimination of this practice requires strong will and empowerment, particularly among women. This study explores the prevalence of FGM/C in Sierra Leon and the link between women’s empowerment and FGM/C. Method: We employed a cross-sectional survey design, following the methodology of the 2019 Sierra Leone Demographic Health Survey (SLDHS). A total of 6,249 mothers with children age 0 – 14 years, who answered the survey question regarding FGM/C were included in the study. Descriptive statistics was used to the prevalence of FGM/C and the levels of women empowerment. Inferential statistics, Pearson’s chi-square and logistic regression were used to analyze the association between women empowerment levels and daughter’s FGM/C status. All analysis were conducted using STATA version 18, and ggplots package in R was used to draw the level of women empowerment. Results: the overall prevalence of FGM/C was 6.75%, with the North (9.43%) and Northwest (8.12%) reporting the highest prevalence. Based on the Survey-based Women's empowerment index, 45% of mothers exhibited high empowerment in their attitudes towards violence. However, a high proportion of mother, 48.63% and 43.41%, showed low empowerment levels in social independence and decision making, respectively. There was no significant association between women empowerment and FGM/C. Nonetheless, there was a strong association between age of mothers and FGM/C of daughters (p < .0001), with the odds of FGM/C increasing with increasing age of mothers. Also, mothers who were circumcised was also associated with their daughters being circumcised compared to those not circumcised. The. Odds of FGM/C among girls were also higher among Muslim mothers (aOR: 1.864; CI: 1.262 – 2.753), compared to Christian mothers. Conclusion: Our study explored the relationship between women's empowerment and the practice of FGM/C among daughters in Sierra Leone. While women's empowerment was examined across domains such as attitudes towards violence, social independence, and decision-making, no statistically significant association was found between these empowerment domains and the prevalence of FGM/C. This suggests that empowerment alone may be insufficient to influence the persistence of FGM/C, as the practice remains deeply embedded in cultural and religious traditions. This therefore calls for targeted interventions to eliminate this practice, as Sierra Leone moves towards accounting for the elimination of FGM/C by 2030 under SDG 5.