# A robust cross-sectional assessment of the impacts of COVID-19 pandemic on the prevalence of female genital mutilation among 0–14 years old girls in Nigeria

## TL;DR

The study examines how the COVID-19 pandemic affected the prevalence of female genital mutilation (FGM) in Nigeria, finding mixed results at the national and regional levels.

## Contribution

This study provides a cross-sectional assessment of how the pandemic impacted FGM prevalence among 0–14-year-old girls in Nigeria using Bayesian hierarchical models.

## Key findings

- National FGM prevalence decreased from 19.5% to 12.3% between 2018 and 2021.
- FGM prevalence increased in some northern states like Katsina and Kano by up to 27%.
- Cultural factors were identified as key drivers of FGM, with individual factors outweighing community-level influences.

## Abstract

Female genital mutilation (FGM) is a human rights violation that still affects more than 3 million girls aged 0–14 years each year. To achieve the Sustainable Development Goal 2030 agenda, efforts have been made at the local, national and international levels to end the practice by the year 2030. However, the recent COVID-19 pandemic may have reversed the progress made due to increased rates of early marriage of girls, violence against children and school closures during lockdowns. Although some surveys have examined changes in FGM prevalence over the COVID-19 period, changes at the national and sub-national levels among 0–14 years old girls have not been quantified.

This study aimed to understand the potential impacts of the COVID-19 pandemic on the likelihood of FGM among girls aged 0–14 years, and whether it affected progress towards the elimination of FGM.

We used Bayesian hierarchical regression models implemented within the integrated nested Laplace approximations frameworks.

We modelled the likelihood and prevalence of FGM among girls aged 0–14 years before and after the COVID-19 pandemic in Nigeria, with respect to individual- and community-level characteristics, using Bayesian hierarchical models. We used the 2018 Demographic and Health Survey as the pre-COVID-19 period and the 2021 Multiple Indicator Cluster Survey as the post-COVID-19 period.

At the state level, FGM prevalence varied geographically and increased by 23% and 27% in the northwestern states of Katsina and Kana, respectively. There were 11% increase in Kwara and 14% increase in Oyo. However, at the national level, the prevalence of FGM was found to decrease from 19.5% to 12.3% between 2018 and 2021. Cultural factors were identified as the key drivers of FGM among 0–14 years old girls in Nigeria. The changes in the likelihood of girls undergoing FGM across the two time periods also varied across ethnic and religious groups following COVID-19 pandemic.

Our findings highlight that FGM is still a social norm in some states/regions and groups in Nigeria, thereby highlighting the need for a continued but accelerated FGM interventions throughout the country.

The impact of COVID-19 on the genital mutilation of girls in Nigeria

Female genital mutilation affects more than 3 million girls aged 0–14 each year. To end the practice, policymakers and non-profit organisations continue to implement community-based interventions. These interventions were interrupted during the COVID-19 pandemic as resources were diverted to care for those affected. In addition, the lockdown and closure of schools reduced the number of safe places available to girls, increasing violence against children and their vulnerability to perpetrators. Our aim was to assess the impact of COVID-19 on progress towards zero FGM. By building several statistical models, we found that while national prevalence declined over the COVID-19 period (from 19% to 12%), there were large disparities between states (+27% in Katsina in the north) and ethnic and religious groups. We also found that individual drivers of FGM for girls are more important than community drivers. Our findings support the continuation of FGM interventions across the country.