TY - JOUR T1 - Factors associated with female genital mutilation: a systematic review and synthesis of national, regional and community-based studies JF - BMJ Sexual & Reproductive Health JO - BMJ Sex Reprod Health DO - 10.1136/bmjsrh-2021-201399 SP - bmjsrh-2021-201399 AU - Zeinab El-Dirani AU - Leen Farouki AU - Christelle Akl AU - Ubah Ali AU - Chaza Akik AU - Stephen J McCall Y1 - 2022/03/09 UR - http://jfprhc.bmj.com/content/early/2022/04/27/bmjsrh-2021-201399.abstract N2 - Background This systematic review aimed to identify and describe the factors that influence female genital mutilation/cutting (FGM/C).Methods Searches were conducted in Medline, PsycInfo, Web of Science, Embase and the grey literature from 2009 to March 2020 with no language restrictions, using related MESH terms and keywords. Studies were included if they were quantitative and examined factors associated with FGM/C. Two researchers independently screened studies for inclusion, extracted data and assessed study quality. The direction, strength and consistency of the association were evaluated for determinants, presented as a descriptive summary, and were disaggregated by age and region.Results Of 2230 studies identified, 54 published articles were included. The majority of studies were from the African Region (n=29) followed by the Eastern Mediterranean Region (n=18). A lower level of maternal education, family history of FGM/C, or belonging to the Muslim religion (in certain contexts) increased the likelihood of FGM/C. The majority of studies that examined higher paternal education (for girls only) and living in an urban region showed a reduced likelihood of FGM/C, while conflicting evidence remained for wealth. Several studies reported that FGM/C literacy, and low community FGM/C prevalence were associated with a reduced likelihood of FGM/C.Conclusions There were several characteristics that appear to be associated with FGM/C, and these will better enable the targeting of policies and interventions. Importantly, parental education may be instrumental in enabling communities and countries to meet the Sustainable Development Goals. ER -