Percent of women 15-19 years old who have undergone FGC
This indicator refers to all forms of female genital cutting (FGC) described in the introduction. The question in the DHS module reads, “Have you yourself ever been circumcised?”
This indicator is calculated as:
(Number of women 15-19 who report having undergone FGC/ Total number of women 15-19 surveyed) x 100
Self-report; responses to question on survey; age of woman
Large-scale representative survey (e.g., DHS)
This indicator measures the prevalence of FGC among young women in a given area at the time of the survey, based on self-reported status. The indicator provides a measure of the effectiveness of programs and initiatives that aim to reduce the practice of FGC. Although the goal of eradication programs is to eliminate FGC entirely for all age groups, change can most readily be detected by focusing on the 15-19 year old group since almost all girls who are cut are done so by the age of 15. In most societies that practice FGC, the procedure is performed before or around puberty; thus, any reduction in the incidence of the practice will first be apparent among this age group (UNFPA, 2015).
If change occurs among this age group on this variable, evaluators can further analyze this change by education levels, geographic location, religion, and other variables that may help explain the change and may identify the innovators.
The measurement of this indicator relies on self-report, which may or may not be valid. Research has shown that the validity of the response varies by context. Several researchers have reported that FGC is under reported, but many of these studies refer to specific types of FGC rather than having undergone an FGC procedure or not. In some countries, where FGC has been legally banned, women may be likely to avoid reporting that they are cut due to fear of legal ramifications. In areas where there have been campaigns to reduce the practice, women may be reluctant to report having undergone FGC due to a perceived stigma associated with the practice.
Another important caveat relates to the sample used for the survey. In countries where the DHS is limited to married women (e.g., Egypt), drawing conclusions about trends in the practice of FGC may be misleading because those who marry as teenagers are more likely to be circumcised than those who marry later. In populations where FGC is declining, comparisons of DHS data on FGC across age cohorts will fail to show the changes that were actually taking place. In short, the sample must include all women 15-19 in estimating the prevalence of FGC with DHS or other survey data (Mensch, 2001).
Evaluation of FGC interventions require a long-term period of observation because the questions are asked about something which occurred many years earlier. Since FGC tends to be performed over a wide range of age groups, short-term evaluations may detect a delay in age at cutting rather than incidences of cutting averted.
A related indicator is the age at circumcision. In Ghana, laws prohibiting the practice may drive it underground, and one outcome may be circumcision at younger ages in life. Evaluation of programs to eradicate FGC should track this variable as a possible unintended consequence.
women’s status, female genital cutting (FGC), safe motherhood (SM), adolescent, violence
Mensch, B. 2001. Personal communication.
Bloom, S. 2008. Violence Against Women and Girls: A Compendium of Monitoring and Evaluation Indicators. USAID/East Africa, IGWG, MEASURE Evaluation.
UNFPA. 2015. Demographic Perspectives on Female Genital Mutilation. New York, NY.
Global Reproductive Health Indicators