Female Genital Mutilation in Guinea-Bissau: Insights from a … · Over 400,000 girls and women in...

Female Genital Mutilation in Guinea-Bissau: Insights from a statistical analysis

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© United Nations Children’s Fund (UNICEF), Division of Data, Analytics, Planning and Monitoring, March 2021

Acknowledgements

This data brief was prepared by the Data and Analytics Section of UNICEF (Claudia Cappa and Colleen Murray), with inputs from Munkhbadar Judger (Data and Analytics Section, UNICEF Headquarters), Lisa Fleming (independent consultant) and Sonia Polonio (UNICEF Guinea-Bissau).

Suggested citation

United Nations Children’s Fund, Female Genital Mutilation in Guinea-Bissau: Insights from a statistical analysis, UNICEF, New York, 2021.

Data sources and methods

FGM data are drawn from the Multiple Indicator Cluster Surveys (MICS) in 2006, 2010, 2014 and 2018-2019. Demographic data are from the United Nations, Department of Economic and Social Affairs, Population Division, World Population Prospects 2019, Online edition, 2019.

Confidence intervals are not shown in this publication. Caution is therefore warranted in interpreting the results since apparent differences among groups may not be significant. Key message titles for figures were developed in light of the confidence intervals for all values. Where the title indicates a difference among groups, it has been confirmed as statistically significant.

Photo credits

All photos: © UNICEF Guinea-Bissau/ 2020/ Prinsloo

1Female Genital Mutilation in Guinea-Bissau: Insights from a statistical analysis

Female genital mutilation in the global development agenda..………....2Ending FGM is one of the targets of Sustainable Development Goal 5

Key facts about FGM....................................…………………………………...3Summary of main findings detailed below

Current levels of FGM..................................……………………………….......4An overview of the practice in Guinea-Bissau, including the total number of girls and women affected, prevalence countrywide, and the population groups most at risk

Circumstances around FGM...................................………………………….11Details on the age at which girls are cut, the types of FGM most commonly performed, and the kinds of practitioners who carry out the procedure

Attitudes towards the practice…………………………………………………..16How girls and women in Guinea-Bissau view FGM, including whether they think it should continue

Generational trends…...……………………………………………………..……20How the practice of FGM has changed over the past several decades at the national and subnational levels

Looking ahead to 2030……………………………………………………………24Implications of trends in FGM in light of the 2030 target to eliminate it

Guinea-Bissau’s programmatic response to FGM.………...………..........25A summary of efforts to prevent FGM through national commitments, legislation and programming

Contents

Female genital mutilation in the global development agenda

Female genital mutilation (FGM) is a violation of human rights. Every girl and woman has the right to be protected from this harmful practice, a manifestation of entrenched gender inequality with devastating consequences. FGM is now firmly on the global development agenda, most prominently through its inclusion in Sustainable Development Goal (SDG) target 5.3, which aims to eliminate the practice by 2030.

SDG 5

TARGET 5.3 INDICATOR 5.3.2

Achieve gender equality and empower all women and girls

Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation

Proportion of girls and women aged 15 to 49 years who have undergone female genital mutilation

2 Female Genital Mutilation in Guinea-Bissau: Insights from a statistical analysis

KEY FACTSabout FGM

In Guinea-Bissau, over 400,000 girls and women have undergone FGM

Overall, 52 per cent of girls and women aged

15 to 49 years have been subjected to the practice

The prevalence of FGM has remained unchanged for at

least the last four decades

Girls and women from rural areas, with less education or who identify as Muslim

are at greater risk of FGM. The practice is highly concentrated in the Gabu and Bafatá regions

and in certain ethnic groups

Three quarters of girls and women in Guinea-Bissau think FGM should stop.

Opposition is most common in regions where FGM is

rarely practised

The SDG target of eliminating FGM by 2030 does not appear within

reach for Guinea-Bissau. If current trends continue, half of the country’s girls will still experience FGM in 2030

Most FGM is performed by traditional practitioners

and on girls under the age of 5. There is some evidence that the circumstances around FGM are changing, with trends towards less severe forms of cutting performed at younger ages


Notes: This map does not reflect a position by UNICEF on the legal status of any country or territory or the delimitation of any frontiers. The number of girls and women who have undergone FGM is calculated based on the population in 2019.


Over 400,000 girls and women in Guinea-Bissau alive today have experienced FGM. Overall, 52 per cent of girls and women aged 15 to 49 years have undergone the practice, varying from 96 per cent in Gabu region to 8 per cent in Biombo

FIG. 1 Percentage of girls and women aged 15 to 49 years who have undergone FGM

Current levels of FGM

GABUCACHEU

OIO

BAFATÁ

BIOMBO

AUTONOMOUS SECTOR OF BISSAU

(SAB)

BOLAMA/BIJAGÓS

QUINARA

TOMBALI

0

20

40

60

80

100


Residence Education Religion Wealth quintile

Rur

al

Urb

an

Non

e or

pres

choo

l

Bas

ic

Sec

onda

ry

Hig

h sc

hool

/ Pr

ofes

sion

al/

Tech

nica

l

Hig

her

Mus

lim

Eva

ngel

ical

Ani

mis

t

Cat

holic

Oth

er

relig

ious

gro

ups

No

relig

ion

Poor

est

Sec

ond

Mid

dle

Four

th

Ric

hest

0

20

40

60

80

100

59

43

72

44

26

21

14

90

64 3

7

41

62

70

54

38

59

43

72

44

26

21

14

64 3

7

2

41

62

70

54

38

90

Girls and women from rural areas and with less education are more likely to have experienced FGM, and the practice primarily occurs among those who identify as Muslim



Variation in prevalence across ethnic groups is dramatic: The practice is universal among some groups and virtually nonexistent in others


90

Man

ding

a

85

Bea

fada

36

Oth

er e

thni

c gr

oups

4B

alan

ta15

Man

canh

a

4

Felu

pe

1

Man

jaco

1

Pape

l

94

Fula

Ethnicity

Notes: Values presented here are based on at least 25 unweighted cases. Those based on 25 to 49 unweighted cases are shown in parentheses. Data for some ethnic groups are suppressed due to insufficient numbers of cases to perform the analysis.


Both ethnicity and location influence the likelihood of experiencing FGM The regions in which FGM is most common are home primarily to ethnic groups among whom the practice is nearly universal: the Fula, Mandinga and Beafada

FIG. 4a Percentage of girls and women aged 15 to 49 years who have undergone FGM

GABÚCACHEU

OIOBAFATÁ

BIOMBO BISSAU

BOLAMA/BIJAGÓS

QUINARA

TOMBALI

Total

Fula

Mandinga

Gabu

6

Total

Mandinga

Fula

Balanta

55

94

97

97 97

97

(97)

Oio

(85)

5

Total

Fula

Mandinga

Beafada

Balanta

Manjaco

Bafatá

(3)

96

96

Total

Mandinga

Beafada

Fula

Balanta

51

92

Tombali

2

(7)

Total

Beafada

Mandinga

Fula

Papel

Balanta

Manjaco

59

88

88

87

Quinara

8

(11)

´

99

99

Notes: Values presented here are based on at least 25 unweighted cases. Those based on 25 to 49 unweighted cases are shown in parentheses. Data for some ethnic groups are suppressed due to insufficient numbers of cases to perform the analysis.


In lower-prevalence regions, FGM is still commonly practised among the Fula, Mandinga and Beafada, although not at universal levels; these regions are also home to ethnic groups that do not practise FGM

GABÚCACHEU

OIOBAFATÁ

BIOMBO BISSAU

BOLAMA/BIJAGÓS

QUINARA

TOMBALI

Total

Fula

Mandinga

Beafada

Mancanha

Felupe

Balanta

Manjaco

Papel

32

73

57

SAB

3

1

1

Total

Beafada

Fula

Mandinga

Mancanha

Balanta

Papel

9

(79)

79

78

Bolama/Bijagós

(0)

0

(4)

Total

Fula

Mandinga

Balanta

Felupe

Mancanha

Manjaco

Papel

12

71

67

Cacheu

1

(0)

5

5

(3)

0

0

(0)

Total

Fula

Mandinga

Mancanha

Manjaco

Papel

Biombo

1

(51)

2

(59)

FIG. 4b Percentage of girls and women aged 15 to 49 years who have undergone FGM

6

8

0

20

40

60

80

100

0–1410–145–90–4

21

34

39

30

Age in years

In Guinea-Bissau, 30 per cent of girls under age 15 have undergone FGM, with levels increasing as more girls reach the customary age for cutting

FIG. 5 Percentage of girls aged 0 to 14 years who have undergone FGM


Information collected on FGM among girls under age 15 reflects their current but not final FGM status. Some girls who have not been cut may still be at risk as they age. This is evident from the higher prevalence among girls age 5 and above compared to those under age 5, as shown in this figure. The prevalence in successively older cohorts of girls will increase until all girls have passed the risk period for FGM.

Therefore, FGM prevalence for girls under age 15 is an underestimation of the true extent of the practice. Since age at cutting varies among settings (see Figure 9), the amount of underestimation also varies. This should be kept in mind when interpreting all FGM prevalence data for this age group.

FGM in Guinea-Bissau is performed solely by traditional practitioners

FIG. 6 Percentage distribution of girls and women aged 15 to 49 years who have undergone FGM, by practitioner

Notes: Values do not add up to 100 per cent due to rounding. Data on the circumstances around FGM are presented in this chapter (pages 11 to 15), as measured among girls and women aged 15 to 49 years. While cutting tends to occur at young ages, the purpose of using data from a large age cohort, which includes women whose experience of FGM was long ago, is to allow for sufficient sample size to make meaningful comparisons across groups. When there is evidence of a change in the circumstances around FGM among younger girls, who were cut more recently, this is shown in a dedicated figure (as in Figures 8 and 10).


Circumstances around FGM

Traditional circumciser, 98

Traditional birth attendant, 2

Other traditional practitioner, 0.1

Don’t know/ Missing, 0.5

0

20

40

60

80

100

21

1

1

11 2

2

0

CacheuGabuBiomboQuinaraSABTombaliOioBafatá Boloma/Bijagós

Guinea-Bissau

74

99

9094

77

6662 61

51

21

4

1

19

18

1317

20

2

45

53

2624

16

3

43

1

1

0.40.7

11

1

1 2

2

18

7

Region

0.4

Note: Some values do not add up to 100 per cent due to rounding.

Three in four girls and women who underwent FGM in Guinea-Bissau experienced flesh removal. The most severe form of FGM, in which the vaginal opening is sewn closed, is common in Cacheu and Gabu

FIG. 7 Percentage distribution of girls and women aged 15 to 49 years who have undergone FGM, by type of FGM performed


Had flesh removed Were nicked Form of FGM not determinedWere sewn closed

There is a slight trend towards less severe forms of FGM in Guinea-Bissau; among those who experienced the practice, the share who were sewn closed has nearly halved among younger girls compared to older women

FIG. 8 Percentage of girls and women aged 10 to 49 who were sewn closed, among those who underwent FGM


0

20

40

60

80

100

26 2418 19 18 16 17 14

10–1415–1920–2425–2930–3435–3940–4445–49

2426

18 19 1816 17

14

Age in years

Estimates for girls under the age of 15 are not fully comparable to those for older women, as there is still some risk of undergoing FGM once girls reach the customary age


0

20

40

60

80

100

11 1 2 2

1

222

Biombo Bolama/Bijagós

QuinaraSABTombaliOioCacheuGabuBafatá

Guinea-Bissau

65

75

22

70

21

8

69

6158

51 50

38

20.5 0.4 2

21

30

9

30

11

37

9

15

26

19

27

15

18

1

27

44

18

11

1

16

15

26

8

1

Region

Note: Some values do not add up to 100 per cent due to rounding.

Most FGM is performed before age 5; cutting after age 15 is rare

FIG. 9 Percentage distribution of girls and women aged 15 to 49 years who have experienced FGM, by age at cutting

Before 5 years 5 to 9 years At 15 years or after Don’t know/ Missing10 to 14 years


Note: The two regions shown here are those in which there has been a statistically significant shift in the proportion of girls cut before age 5.

In the two regions where FGM is most common, there is a trend towards performing the practice at younger ages; compared to older women, adolescents were more likely to have experienced FGM before age 5

FIG. 10 Percentage of women aged 45 to 49 years and adolescent girls aged 15 to 19 years who were cut before the age of 5, among those who underwent FGM

15 to 19 years45 to 49 years

76

60

87

66

87

53

Gu

inea

-Bis

sau

Gab

uB

afat

á

Attitudes towards the practice


Opposition to FGM is common across population groups in Guinea-Bissau. Still, girls and women from urban areas, with more education, who identify as Christian, and who live in wealthier households are more likely to think the practice should end

FIG. 11 Percentage of girls and women aged 15 to 49 years who have heard of FGM and think the practice should be discontinued

Residence

Religion

Rural

Urban

Muslim

Other

No religion

Animist

Evangelical

Catholic

None or preschool

Basic

Secondary

High school/ Professional/ Technical

Higher

Poorest

Second

Middle

Fourth

Richest

69

69

64

88

84

93

62

95

95

70

97

89

86

87

81

67

98

78

Education

Wealth quintile


Opposition to FGM is most common in regions where FGM is rarely practised, although nearly all regions show a high level of opposition

FIG. 12 Percentage of girls and women aged 15 to 49 years who have undergone FGM (prevalence), and percentage of girls and women aged 15 to 49 years who have heard of FGM and think the practice should be discontinued (opposition)

BiomboBolama/BijagósCacheuSABTombaliOioQuinaraBafatáGabu

Guinea-Bissau Region

0

20

40

60

80

100

52

96

87

59

55

51

32

129 8

76

51

80

74

64

74

89 90

85

76

FGM prevalenceOpposition to FGM


There is some evidence of increasing opposition to FGM

FIG. 13 Percentage of girls and women aged 15 to 49 years who have heard of FGM and think the practice should be discontinued

59 57 81 76

MICS 2010 MICS 2018-2019MICS 2006 MICS 2014


FGM prevalence has remained unchanged for at least four decades

FIG. 14 Percentage of adolescent girls aged 15 to 19 years who have undergone FGM

Generational trends

0

20

40

60

80

100

2015 20202010200520001995199019851980

4549 48

Notes: Trends in the prevalence of FGM are calculated on the basis of all available survey data, from MICS 2006, 2010, 2014 and 2018-2019. While the total prevalence of FGM across these surveys has varied by 5 to 10 percentage points, the overall trend line (taking into account all available information) indicates no significant change. The difference between the national FGM prevalence in the MICS 2014 (45%) and MICS 2018-2019 (52%), for example, is not statistically significant.


Notes: Religious groups shown here are those for which data have been collected in a consistent manner across all available surveys. Data for some groups are suppressed (Evangelical, Protestant, other religious groups) as inconsistencies in data collection did not allow for comparable trend analysis.

Over time, FGM has been practised almost exclusively among the Muslim population in Guinea-Bissau


0

20

40

60

80

100

202020152010200520001995199019851980

Muslim

Catholic

Animist

No religion


The practice of FGM in all regions has remained steady over the past four decades, except in Bolama/Bijagós, where prevalence has dropped substantially


0

20

40

60

80

100

202020152010200520001995199019851980

Tombali

Quinara

Oio

Biombo

Bolama/Bijagós

Bafatá

Gabu

Cacheu

SAB

Note: The population of Bolama/Bijagós represents a small minority of the national population, thus the decline in FGM in this region is not visible in the national average.


If current trends continue, half of the country's girls will still experience FGM in 2030

Substantial efforts will be required to change course and bring Guinea-Bissau on track towards eliminating FGM

Looking ahead to 2030

Guinea-Bissau’s lack of progress in reducing levels of FGM over time means that the country is not on track to reach the SDG target of eliminating the practice by 2030

As Guinea-Bissau’s population increases, this could put a growing number of girls at risk of experiencing this harmful practice


Guinea-Bissau’s programmatic response to FGM

Guinea-Bissau’s programme to end FGM seeks to respond to the multidimensional drivers and consequences of the practice and contribute to the Government’s goal of ending it by 2030, while acknowledging that it is not on track to do so. The Ministry of Women, Family and Social Solidarity, through the National Committee for the Abandonment of Harmful Practices, leads the initiative, with contributions from line ministries; faith-based, community-based, non-governmental and civil society organizations (CSOs); and UN agencies. Article 37 of the 1984 Constitution, which articulates the right of every citizen to be protected from any physical or moral offence, underpins the drive for elimination. Guinea-Bissau enacted the Prohibition of Female Genital Mutilation Act 14/2011 and, in 2018, adopted a revised National Policy for the Eradication of FGM that has shaped the national programme. The country’s multisectoral and holistic approach is addressing the intersecting factors that contribute to the continuation of FGM, including discrimination, weak infrastructure, poverty, barriers to meaningful participation, and vulnerability to shocks and fragility in crises.

The programme relies on these evidence-based strategies:

1. Quality services: FGM-related services, including sexual and reproductive health services, are being expanded and improved, especially at the subnational level. The Ministry of Women, Family and Social Solidarity has no decentralized presence, so it relies heavily on CSOs to deliver protective services. A capacity-building programme for service providers seeks to improve FGM case management protocols and coordination (among the police, courts, hospitals, shelters and social workers). It is also enabling more girls, women and families to report cases and access services.

2. Community engagement: Education sessions and community dialogue to address FGM are being supported, along with public declarations to end this harmful practice. The establishment of a community surveillance system to monitor commitments is strengthening local capacity to prevent many forms of violence against children and women. In addition, transborder initiatives are encouraging communities in Guinea, Guinea-Bissau and Senegal to work together to eliminate FGM.

3. Girls’ empowerment programmes: Strengthening the capacity of girls and women to shift harmful social norms is a key strategy, which is being pursued through educational and life skills programmes. These are

carried out as part of a broader approach to promoting girls’ education and ending harmful practices, particularly in rural settings. Among other activities, girls are trained in leadership skills and are invited to engage in peer-group sessions, radio programmes and intergenerational dialogues.

4. Strategic partnerships: Key stakeholders, both at higher echelons of Government as well as the community level, are important allies in the promotion of positive social norms. Religious and traditional leaders, community elders and influencers (such as former practitioners of FGM), youth groups, medical associations, local and national media, the private sector and traditional artists are all active participants in social and community mobilization to end FGM.

5. Leadership and coordination: The National Committee for the Abandonment of Harmful Practices, a semi-autonomous government agency, ensures increased government and CSO accountability in implementing and monitoring the national strategy. The agency is represented in all nine of the country’s regions and coordinates 22 stakeholders, including Government and CSOs.

For information on FGM in Guinea-Bissau:

UNICEF Guinea-BissauUnited Nations Building PO Box 464, Bissau 1034

Tel: +245 955 797 953 Website: unicef.org/guineabissau

For information on the data in this brochure:

UNICEF Data and Analytics SectionDivision of Data, Analytics, Planning and Monitoring3 United Nations PlazaNew York, NY 10017, USA

E-mail: [email protected]: data.unicef.org

http://unicef.org

mailto:data%40unicef.org?subject=

http://data.unicef.org

Female Genital Mutilation in Guinea-Bissau: Insights from a … · Over 400,000 girls and women in...

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