Factors associated with female genital mutilation/cutting in Tanzania: insights from Tanzania demographic and health survey 2022.

Background: Globally, female genital mutilation (FGM) remains a significant public health concern. The practice is disproportionately high in African countries. In Tanzania, FGM poses serious health risks to both women, girls and children. However, there is limited empirical literature on the factors associated with FGM in Tanzania. This study intended to fill the gap.

Methods: In this study, we analysed secondary data from a cross-sectional survey, involving a weighted sample of 7,678 women aged 15-49 from the 2022 Tanzania Demographic and Health Survey (TDHS). In this study, the binary dependent variable indicates whether the respondent is mutilated or not mutilated while the independent variables include various demographic characteristics of women, such as age, education level, socioeconomic status, and region of residence. Bivariate and multivariable logistic regression analyses were conducted. A threshold of p-value < 0.05 at 95% Confidence Interval (CI) was used to determine a statistically significant association.

Results: The prevalence of FGM in Tanzania is 8.2% and types I and II (a cut with or without removal of flesh) were the dominant types of FGM practice by 89.2%. After controlling for other variables, higher odds of being mutilated was reported in; older ages 45-49 years (adjusted Odds Ratio(aOR));3.09, 95%CI: 1.72, 5.54), in rural areas (aOR;2.30, 95%CI:1.4,3.6), in women in unions (aOR;1.60, 95%CI:1.20,2.10), in Northern zone (aOR;9.10, 95%CI: 4.60, 17.80), those who ever heard about FGM had 2.27 times (aOR; 2.27, 95%CI: 0.82, 6.29), those who said FGM required by religion had 8.3 times (aOR; 8.30, 95%CI: 4.30,16.03), those who supported FGM had 5.29 times (aOR; 5.29, 95%CI: 2.69, 10.40) higher odds of reporting having undergone FGM compared to those who said the practice should be stopped. Conversely, lower odds of experiencing FGM was reported in; women with at least secondary education (aOR;0.40, 95%CI:0.20,0.60), those from richest households (aOR;0.40, 95%CI: 0.20, 0.60) and those who said distance to a health facility was not a big problem (aOR;0.70, 95%CI: 0.50, 0.90).

Conclusion: Our study found that prevalence of FGM in Tanzania is 8.2%. The factors associated with experiencing FGM included woman's socio-demographic factors like older age, rural residency, lower or no education, poorest wealth quintile, supporting FGM to continue and being in unions. This calls for collaborative efforts between the government and other stakeholders to design targeted interventions as ending FGM require a multisectoral approach addressing aforementioned determinants across multiple levels including education and wealth creation programs particularly to uneducated and poorest women from rural areas.