Bulletin of the World Health Organization

Estimating the obstetric costs of female genital mutilation in six African countries

Taghreed Adam, Heli Bathija, David Bishai, Yung-Ting Bonnenfant, Manal Darwish, Dale Huntington, Elise Johansen & for the FGM Cost Study Group of the World Health Organization

Volume 88, Number 4, April 2010, 281-288

Table 1. Prevalence of obstetric outcomes, by type of female genital mutilation, in a modelled cohort of women of reproductive age (15–45 years) in six African countriesa

Parameter Mean/median 95% CI Assumed distributionb
Caesarean section prevalence (FGM–0)c 0.07 Beta
Caesarean section RR
FGM–1d 1.03 0.88–1.21 Truncated normal of log(RR) (−2.5, 2.5)
FGM–2e 1.29 1.09–1.52
FGM–3f 1.31 1.01–1.70
Haemorrhage prevalence (FGM–0) 0.06 Beta
Haemorrhage RR
FGM–1 1.03 0.87–1.21 Truncated normal of log(RR) (−2.5, 2.5)
FGM–2 1.21 1.01–1.43
FGM–3 1.69 1.34–2.12
Inpatient stay prevalence (FGM–0) 0.06 Beta
Inpatient stay RR
FGM–1 1.15 0.97–1.35 Truncated normal of log(RR) (−2.5, 2.5)
FGM–2 1.51 1.29–1.76
FGM–3 1.98 1.54–2.54
Inpatient perinatal death prevalence (FGM–0) 0.04 Beta
Inpatient perinatal death RR
FGM–1 1.15 0.94–1.41 Truncated normal of log(RR) (−2.5, 2.5)
FGM–2 1.32 1.08–1.62
FGM–3 1.55 1.12–2.16
Resuscitated infant prevalence (FGM–0) 0.08 Beta
Resuscitated infant RR
FGM–1 1.11 0.95–1.28 Truncated normal of log(RR) (−2.5, 2.5)
FGM–2 1.28 1.10–1.49
FGM–3 1.66 1.31–2.10
Episiotomy prevalence (FGM–0) 0.29 Beta
Episiotomy RR
FGM–1 1.61 1.46–1.78 Truncated normal of log(RR) (−2.5, 2.5) except FGM3 (−2.9, 2.9)
FGM–2 1.99 2.20–1.81
FGM–3 9.87 11.29–8.64

CI, confidence interval; FGM, female genital mutilation; RR, relative risk.
a Burkina Faso, Ghana, Kenya, Nigeria, Senegal and the Sudan.
b Beta distributions were set such that the most likely value occurred slightly below the mean, and the maximum value was set at 0.10 to 0.24 for outcomes other than episiotomy.
c No FGM.
d Excision of the prepuce with or without total or partial excision of the entire clitoris.
e Excision of the clitoris with partial or total excision of the labia minora.
f Complete or partial excision of the external genitalia and stitching or narrowing of the vaginal opening (infibulation). Based on data from study by the World Health Organization.
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