Determinants of attitude towards female genital mutilation among women in the Gambia

Abstract

Female Genital Mutilation/Cutting (FGM/C), also known as female circumcision, is a harmful traditional practice (HTP) with profound health and social implications for women and young girls. The high prevalence of FGM in The Gambia is a pressing issue. This study investigated the determinants of women's attitudes towards FGM in The Gambia. The study used secondary data from the Gambia Demographic and Health Survey (GDHS) 2019/2020. A weighted sample of 5,632 women aged 15–49 was analyzed at univariate, bivariate, and multivariate levels. A binary logistic regression model was fitted at the multivariate level. About half (50%) of women reported that FGM should be continued. The study found that women with secondary (AOR=0.73, CI=0.62–0.87) or higher education (AOR=0.34, CI=0.25–0.49) had lower odds of supporting FGM compared to those with no education. Women engaged in agriculture (AOR=1.21, CI=1.01–1.43) and those from middle-income households (AOR=1.52, CI=1.23–1.87) were more likely to support FGM, while those from the richest households (AOR=0.64, CI=0.49–0.83) were less likely. Women from Christianity and other religions (AOR=0.13, CI=0.06–0.29) were less likely to support FGM continuation compared to those from Islam. Ethnicity and region also showed significant associations, with women from certain tribes and regions being more or less likely to support FGM. In conclusion, the comprehensive analysis of demographic, socio-economic, and cultural factors underscores the complex interplay influencing attitudes towards female genital mutilation. The practice is largely supported by women of low socio-economic status and remains strongly influenced by religion and culture, highlighting the need for multifaceted interventions. The study recommends strengthening education and awareness programs targeting both women and men to emphasize the health risks and human rights violations associated with FGM. Community-based advocacy involving religious and traditional leaders should be promoted to challenge cultural beliefs sustaining the practice. Furthermore, economic empowerment programs for women should be enhanced to reduce dependency on traditional practices as sources of identity or income, while policy enforcement and monitoring should be intensified to ensure effective implementation of the anti-FGM law. Subject keywords; Female genital mutilation, Gambia, Women