PREVALENCE ET FACTEURS ASSOCIES AUX MUTILATIONS GENITALES FEMININES CHEZ LES ADOLESCENTES DE 10 à 19 ANS DANS LES COMMUNES DE GUEDIAWAYE, KOLDA ET KAOLACK (SENEGAL) EN 2021

Résumé

Introduction 
Female genital mutilation (FGM) is a common traditional practice involving the partial or complete removal of a woman's external genitalia without therapeutic indication. Worldwide, three million girls are at risk of female genital mutilation (FGM). According to UNICEF, nearly two million girls and women underwent FGM in Senegal in 2019. It seemed appropriate to study the prevalence and factors associated with female genital mutilation among adolescent girls aged 10 to 19, and also to establish the epidemiological profile of the households concerned in the municipalities of Guédiawaye, Kolda and Kaolack in Senegal.

Methodology
This research used a mixed method with quantitative and qualitative components based on the sequential explanatory approach. It targeted adolescent girls aged 10 to 19 in the communes of Guédiawaye in the west of the country, Kaolack in the centre and Kolda in the south. The quantitative component was a cross-sectional survey based on a systematic random sample, stratified according to the age groups 10 to 14 and 15 to 19, after calculating the sample size on the basis of the prevalence of physical violence in the regions of the target municipalities. The qualitative component was based on a case study with a reasoned choice of adolescent girls and their parents as targets, applying the principle of diversification. The study was approved by the National Ethics Committee for Health Research (CNERS), reference number SEN21/48.

Results
The study involved 940 adolescent girls aged 10 to 19 years in the communes of Guédiawaye in the Dakar region and Kaolack and Kolda in the central and southern regions of the country, respectively. The majority of adolescent girls lived in rural areas (70.2%). Household heads were predominantly male (64.8%) and uneducated (40.7%). Most of the adolescent girls belonged to the Al Poular ethnic group (38.7%). The proportion of participants who had undergone excision was 29.7% in our sample as a whole, lower in Guédiawaye and Kaolack (6.8% and 3.7% respectively) than in Kolda (69.2%). The average age of female circumcision was 67 months. Female circumcision was related to the sex of the head of household, living environment, socio-economic level and ethnic group. The risk of FGC was higher in male-headed households (ORa=1.61 [1.04- 2.50]), in rural areas (ORa=15.2 [8.69- 28.0]) of Al Poular origin (ORa=12.5 [8.33- 20.0]) and in wealthy households according to welfare quintile (ORa=8.41 [4.51-15.69]).

Conclusion 
The prevalence of FGM among adolescent girls in Senegal has been constant for over twenty years. Awareness-raising strategies targeting poor rural households, headed by men but also of Al Poular origin, will be necessary to advance social norms in favour of abandoning FGM.