Breaking the Cycle: A multilevel analysis of mother–daughter dynamics in female genital mutilation across West and East Africa
1
Economics, Mulungushi University, Kabwe, Zambia
2
Demography and Population Studies, The University of the Witwatersrand, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Female Genital Mutilation (FGM) remains a critical public health and human rights issue, disproportionately affecting women and girls in East and West Africa. Despite global eradication efforts, prevalence varies widely across regions. Intergenerational transmission-particularly from mother to daughter-continues to drive persistence, rooted in socio-cultural norms. This study examined how maternal FGM status predicts daughters’ likelihood of undergoing the practice, while accounting for individual, household, and community-level factors.
METHODS:
We analysed Demographic and Health Surveys (2020–2025) covering 132,761 women aged 15–49 years with at least one daughter across 11 sub-Saharan African countries. A multilevel logistic regression model was fitted, presenting fixed and random effects with 95% confidence intervals (CIs). Pairwise correlation preceded regression, and normalised survey weights ensured balanced representation.
RESULTS:
Maternal FGM status was a significant predictor of daughters’ risk (AOR = 17.5; 95% CI: 16.3–18.8), even after adjusting for socio-economic and contextual factors. Overall, 14.8% of daughters and 52.7% of mothers had undergone FGM, with prevalence highest in Mali (44.5% daughters; 90.6% mothers) and lowest in Tanzania (0.3% and 9.4%, respectively). Protective factors for daughters included lower maternal age, higher education, literacy, Christian affiliation, higher wealth, female-headed households, urban residence, and exposure to family planning messages. Conversely, media exposure emerged as a key driver of FGM.
CONCLUSIONS:
Maternal FGM status remains the strongest predictor of daughters undergoing the practice, reinforcing the urgency to break this intergenerational cycle. Programme implementers and policymakers should prioritise community-led interventions, education and empowerment for mothers and girls, and robust enforcement of anti-FGM laws. Investments in behaviour change communication and capacity building for local health systems are critical to accelerate progress.
Female Genital Mutilation (FGM) remains a critical public health and human rights issue, disproportionately affecting women and girls in East and West Africa. Despite global eradication efforts, prevalence varies widely across regions. Intergenerational transmission-particularly from mother to daughter-continues to drive persistence, rooted in socio-cultural norms. This study examined how maternal FGM status predicts daughters’ likelihood of undergoing the practice, while accounting for individual, household, and community-level factors.
METHODS:
We analysed Demographic and Health Surveys (2020–2025) covering 132,761 women aged 15–49 years with at least one daughter across 11 sub-Saharan African countries. A multilevel logistic regression model was fitted, presenting fixed and random effects with 95% confidence intervals (CIs). Pairwise correlation preceded regression, and normalised survey weights ensured balanced representation.
RESULTS:
Maternal FGM status was a significant predictor of daughters’ risk (AOR = 17.5; 95% CI: 16.3–18.8), even after adjusting for socio-economic and contextual factors. Overall, 14.8% of daughters and 52.7% of mothers had undergone FGM, with prevalence highest in Mali (44.5% daughters; 90.6% mothers) and lowest in Tanzania (0.3% and 9.4%, respectively). Protective factors for daughters included lower maternal age, higher education, literacy, Christian affiliation, higher wealth, female-headed households, urban residence, and exposure to family planning messages. Conversely, media exposure emerged as a key driver of FGM.
CONCLUSIONS:
Maternal FGM status remains the strongest predictor of daughters undergoing the practice, reinforcing the urgency to break this intergenerational cycle. Programme implementers and policymakers should prioritise community-led interventions, education and empowerment for mothers and girls, and robust enforcement of anti-FGM laws. Investments in behaviour change communication and capacity building for local health systems are critical to accelerate progress.
| eISSN: | 2654-1459 |
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