NEW YORK (Reuters Health) – The economic costs associated with female genital mutilation are high, World Health Organization researchers report.
An analysis of data from 27 countries in which female genital mutilation (FGM) is common reveals that the practice currently entails an economic burden of $1.4 billion per year, which will rise to $2.1 billion per year by 2047, according to a study published in BMJ Global Health.
“Female genital mutilation (FGM) leads to a range of health complications throughout the life course, and treating them costs an estimated 1.4 USD per year based on data from 27 high-prevalence countries,” said study co-author Dr. Christina Pallitto, a scientist and public health researcher at the World Health Organization.
“The study also projects that these costs would increase over the next 30 years unless efforts to abandon the practice are accelerated. Investment in prevention is urgently needed,” she told Reuters Health by email.
“While practice of FGM should be eliminated because it is a violation of human rights and a public-health issue, this study demonstrates the positive economic impacts of ending FGM,” Dr. Pallitto added. “FGM accounts for, on average, from 9% up to 30% of the current health expenditures per capita in the 27 included countries. These findings can be an important advocacy tool for countries to invest in prevention activities to reduce the health and economic burden of FGM.”
To examine the economic impact of FGM, Dr. Pallitto and her colleagues turned to a computer model with a horizon of 30 years that took into account the different life stages in which health complications from FGM may arise (childhood, reproductive age, periods of pregnancy and childbirth and later life).
The researchers estimated the annual risk of a woman being subjected to FGM using the prevalence of the practice in adult populations by country, recorded in Demographic and Health Survey (DHS) or the Multiple Indicator Cluster Survey (MICS) data.
Dr. Pallitto and her team estimated that the number of women who are subjected to FGM was 119.4 million in 2018 (the baseline year), which would rise to 205.8 million by 2047 if there were no changes.
Reducing the prevalence of FGM by 50% during childhood would lower the adult prevalence of FGM by a median of 24% over 30 years, whereas completely abandoning the practice would cause a 55% drop in adult prevalence over 30 years, according to the researchers’ calculations.
A 50% reduction in the practice would also slow the increase in economic costs, reaching $1.7 billion per year in 2047. A 100% reduction, according to the team’s calculations, would result in a gradual decrease in the annual economic burden from $1.4 billion in 2018 to $0.8 billion in 2047.
The new study offers a new and persuasive tool to use against FGM, said Dr. Nicole Warren, an associate professor at the Johns Hopkins University School of Nursing, in Baltimore, Maryland, who studies FGM.
“For years, we had a sense of the high costs of FGM but this study quantifies that impact and informs concrete discussions with health system stakeholders,” Dr. Warren told Reuters Health by email. “But, overall health system leaders are already committed to ending FGM and these data are unlikely to be meaningful to the people making the day to day decisions to cut their girls. And ultimately, that’s what needs to change. This means we must continue to partner with affected communities to understand and attempt to change the decision-making processes at the individual, family, and community levels.”
“Almost half of the included countries have persistently static FGM-prevalence rates,” Dr. Warren said. “This suggests the proposed reductions of 50% or 100% are purely aspirational. The authors attribute different levels of burden to different types of FGM: more severe types cause more harm, economic and otherwise.”
“Because a ‘zero tolerance’ is central to advocacy to end FGM, the authors’ do not explore the potential economic benefits of less severe forms of the practice, only complete abandonment,” Dr. Warren said. “Although shifts to less severe forms of FGM are not desirable, they are occurring in some settings. It seems reasonable to explore how such intermediary steps to abandonment may decrease both economic burden and suffering.”
While the findings might help motivate policy makers, prioritizing the economics “does risk missing the fact that female genital cutting and mutilation (FGCM) is largely a social phenomenon that is a replication of the patriarchy and control over women’s bodies,” said Mark Canavera, an associate with the Columbia University Mailman School of Public Health’s department of population and family health, who has worked in humanitarian aid and development in West Africa.
To achieve changes, you need to “understand the social norms that underpin the practice,” Canavera said. “You need to work in a culturally responsive way. A good model of that is the work of the organization TOSTAN,” an Africa-based organization working directly with rural communities leading their own development.
“In Senegal, they have used a community dialog model and have taken a long time to build relationships with the community by taking a very humble listening approach,” he added.
SOURCE: https://bit.ly/3B0HAGv BMJ Global Health, online February 2, 2022.
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