Universal Female Genital Mutilation and High Burden of Infibulation in Mogadishu: Cross-Sectional Study on Severity, Types, and Associated Factors Among Adolescent Girls in Somalia

Abstract

The study aimed to investigate the prevalence, determinants, types, severity, and perceived health consequences of Female Genital Mutilation (FGM) among adolescent girls aged 12–19 in Mogadishu, Somalia. The primary objective was to quantify the burden of different FGM types and identify socio‐cultural predictors. A community‐based, cross‐sectional study was conducted with 418 adolescent girls in four districts using a multi‐stage cluster sampling method between March 2024 and June 2024. Data were classified according to the World Health Organization (WHO) definition of FGM severity. Multivariable ordered logistic regression was used to identify factors associated with severity, reporting adjusted odds ratios (AOR) and 95% confidence intervals (CI). The results showed a universal FGM prevalence (100%, n = 418/418) among participants. The most common form was Type I (67.0%, n = 280/418), followed by Type III (infibulation) (24.9%, n = 104/418) and Type II (8.1%, n = 34/418). Multivariate analysis revealed that higher maternal education was a significant protective factor. Compared to daughters of illiterate mothers, those whose mothers had primary education (AOR = 0.35; 95% CI: 0.17–0.76; p = 0.008) or university‐level education (AOR = 0.42; 95% CI: 0.19–0.93; p = 0.03) had lower odds of undergoing more severe FGM. Conversely, adolescents reporting no peer influence regarding FGM had significantly higher odds of experiencing more severe types (AOR = 3.86; 95% CI: 1.75–8.52; p < 0.001). FGM is a universal practice among adolescent girls in Mogadishu, with a concerningly high prevalence of infibulation. Maternal education is a critical protective factor. Eradication efforts must prioritize female secondary and tertiary education and challenge the internalized social norms that sustain the practice, without external peer pressure.