Towards a better estimation of prevalence of female genital mutilation in the European Union : a situation analysis

Abstract

Background:Female genital mutilation (FGM) is a harmful cultural practice that is predominantly documented inAfrica, but also occurs in other parts of the world. Due to migration, women who have undergone FGM can also befound in the European Union (EU). Due to a lack of systematic representative surveys on the topic in EU, theprevalence of FGM and the number of women and children subjected to the practice remains unknown. However,information on the magnitude of the problem in the EU is necessary for policy makers to design and trackpreventive measures and to determine resource allocation.Methods:Between March 2015 and May 2015, we performed a situation analysis consisting of a critical interpretivesynthesis and SWOT-analysis of available at the time peer reviewed and grey literature document on nationalprevalence studies on FGM in the EU. Studies estimating the prevalence of FGM and the number of girls and womensubjected to the practice in the EU were mapped to analyse their methodologies and identify their Strengths,Weakness, Opportunities and Threats (SWOT). Distinction was made between direct and indirect estimation methods.Results:Thirteen publications matched the prioritized inclusion criteria. The situation analysis showed that both directand indirect methodologies were used to estimate FGM prevalence and the number of girls and women subjected toFGM in the EU. The SWOT-analysis indicated that due to the large variations in the targeted population and the availablesecondary information in EU Member States, one single estimation method is not applicable in all Member States.Conclusions:We suggest a twofold method for estimating the number of girls and women who have undergoneFGMinthe EU. For countries with a low expected prevalence of women who have undergoneFGM, the indirect method will providea good enough estimation of the FGM prevalence. The extrapolation-of-FGM-countries-prevalence-data-method, based on thedocumented FGM prevalence numbers in DHS and MICS surveys, can be used for indirect estimations of girls and womensubjected to FGM in theEU. For countries with a high expected prevalence of FGM in the EU Member State, we recommendto combine both a direct estimation method (e.g. in the form ofa survey conducted in the target population) and an indirectestimation method and to use a sample design as developed bythe FGM-PREV project. The choice for a direct or indirectmethod will ultimately depend on available financial means and the purpose for the estimation.