Date of Award

Spring 5-11-2018

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Richard Rothenberg

Second Advisor

Dr. Ike Okosun



The Association of Female Genital Mutilation in Sexual Behaviors and Marriageability, Ethiopia DHS 2016


Lemlem Eyob Mehari

INTRODUCTION: Female genital mutilation (FGM) is a public health issue affecting girls and women worldwide. FGM is practiced in many countries primarily in Africa. In Ethiopia, the prevalence of FGM has been decreasing nationally over the years. However, among different regions and ethnic groups the prevalence varies greatly. FGM is used as a tool to control female sexuality and believed to make girls and women more marriageable. There is limited research studying the relationship of FGM in sexual behaviors and marriageability in Ethiopia.

AIM: The purpose of this study is to determine the relationship of FGM in sexual behaviors and marriageability.

METHODS: This study used secondary data from the 2016 Ethiopia Demographic and Health Survey (EDHS). In this study the sample size of the study’s population included 7,151 women between the ages of 15 to 49 who have heard of female genital mutilation/cutting (FGM/C). Multiple lifetime number of sexual partners and early sexual debut were the dependent variables used to measure sexual behaviors. Premarital sex was another dependent variable created to evaluate marriageability since female virginity is considered a prerequisite for marriage. SAS 9.4 was used to run chi-square tests and logistic regressions. Chi-square tests were used to examine associations for categorical variables to compare background characteristics by circumcision status and the dependent variables. Bivariate and multivariate logistic regression were used to analyze the association of FGM to sexual behaviors and marriageability. Sociodemographic characteristics were controlled for during analysis.

RESULTS: In this study, the proportion of the women who knew about FGM and were circumcised was 71%. After controlling for sociodemographic characteristics, a multivariable logistic regression model showed that circumcised women were less likely to have multiple lifetime number of sexual partners (OR = .748; 95% CI = .566, .988). Although nonsignificant, FGM was protective against early sexual debut and premarital sex. The odds of multiple lifetime number of sexual partners increased among ages 24 to 49, non-educated women, Amhara ethnicity, Tigray ethnicity, urban, and in the regions of Tigray, Afar, Amhara, Oromia, Benishangula, Gambela, Addis Ababa, and Dira Dawa. Women who were circumcised, ages 15 to 19, Orthodox, Amhara ethnicity and Sidama ethnicity were more likely to have an early sexual debut. The chances of premarital sex increased among women who were circumcised, ages 20 to 49, Orthodox, and in the region Addis Ababa.

DISCUSSION: Although, FGM was shown to be protective against female sexuality, depending on the type of circumcision done such as Type III which is infibulation, are less likely to engage in sexual intercourse often which may have an effect on the results.

CONCLUSION: These findings suggest a need for more programs and strategies for FGM eradication to be specific for different regions and ethnicities as the prevalence varied based on these two factors. The study shows that further research is needed to show the effects of different types of circumcision has on controlling female sexuality.