Spatial distribution and determinant factors of Female Genital Mutilation among reproductive age women in Ethiopia, 2016; Based on Ethiopian National Demographic and Health Survey

Abstract Background : Though condemned and considered as a crime by the countries government, Female Genital Mutilation (FGM) remains a common public health problem in Africa and Ethiopia as well. Thus, this study was aimed to assess the spatial distribution and associated factors of female genital mutilation in Ethiopia based on the Ethiopian demographic and Health survey 2016 data. Method: This is a secondary data analysis of Ethiopian Demographic and Health Survey (EDHS) 2016 data based on 7,163 women who were included for FGM interview. The data was weighted using sampling weight as recommended by the program. The MS excel and ArcGIS 10.3 softwares were used for data cleaning and spatial analysis respectively. Global and local level clustering was assessed. For the none spatial data and the determinant factors, data cleaning and analysis was done using STATA 14. Multi-level mixed effect logistic regression model was fitted. Variables with P-value <0.25 in the bi-variable analysis were fitted in the multi-variable analysis. Finally, variables with p-value <0.05 with 95% CI of adjusted odds ratio were reported as a statistically significant determinants of FGM. Result : Female genital mutilation was spatially clustered (Global Moran’s I: 0.46, p<0.001). Significant hot spot clusters were found in Amhara, Oromia, Southern Nations Nationalities and Peoples (SNNP) regions. Mothers age >30 (AOR=2.41, 95% CI: 1.78,3.26) years, never in union (AOR=0.31, 95%CI: 0.22, 0.44), currently not working (AOR=0.71, 95%CI: 0.55, 0.92), women who considered FGM to be continued (AOR=2.86, 95%CI: 1.75, 4.68), not heard of FGM (AOR=0.22, 95%CI: 0.08,0.62), had no formal education (AOR=1.67, 95% CI: 1.03, 2.71), muslim (AOR=3.90, 95%CI:2.5, 6.09) and protestant (AOR=1.76, 95%CI: 1.25, 2.97), and those who thought of FGM as required by religion (AOR=1.99, 95%CI: 1.31,2.99) were found to be significant determinants of female genital mutilation. Conclusion: Female genital mutilation was spatially clustered with hotspot areas located. in Amhara, Oromia, and SNNP regions . Age of the mother, religion, occupation, educational level, marital status, information about Female genital mutilation, and intention about FGM to be stopped or continued were significant determinants of female genital mutilation Key words : Female Genital Mutilations, Spatial analysis