Female Genital Circumcision in Egypt: A GIS Approach to Identify Areas for Future Interventions

Background: In Egypt, female genital circumcision (FGC) is a widespread practice with estimates of up to 96% of the women being circumcised. Complications include hemorrhage, increased risk of maternal death, and psychosocial effects. In Egypt, contributing factors may include religious perceptions and the availability of hospitals. The purpose of this study is to analyze the spatial distribution of female genital circumcision and associated indicators like religious beliefs and hospital availability and to identify hotspots for future FGC interventions in Egypt. Methods: Utilizing data from the 2008 Egypt Demographic Health Survey, I used Geographic Information Systems (GIS) techniques to map the distribution of female genital circumcision across governorates in Egypt. I created an index and utilized hot spot analysis to identify high risk areas for focus of future interventions. Results: Female genital circumcision for women 15 to 49 years is above 70% for all governorates except Matroh and up to 99% of women circumcised in certain governorates. In most governorates, over 80% of women reported being circumcised before age 10. FGC occurs in Christian and Muslim areas and is frequently performed by traditional birth attendants despite hospital and physician availability. The hot spot analysis indicates that efforts should focus on New Valley, Kalyubia, Menoufia, Kafr El Sheikh, Aswan, Qena, Souhag, and Assuit working closely with the community to deal with the continued risk of FGC. Implications: The distribution of FGC and hotspots for risk of FGC can help policymakers, program planners, and community health workers create targeted interventions for specific communities.