Female Genital Mutilation


How to use the cost calculator?

Start by choosing a country of interest from the dropdown menu. There are 27 countries included in the analysis. Once you’ve selected your country of interest, click on the ‘Calculate’ button.

You MUST click on the ‘Calculate’ button for the visualizations to appear.

The ‘Parameters’ dropdown menu allows you to adjust epidemiological metrics and prevention intervention effectiveness.

Country Dropdown Menu

A small pop-up window will appear stating that the model is calculating.

Once the model has run, scroll down to the three graphs below.

The current version of the tool does not allow the user to select more than one country at a time, however you can take screenshots of the graphs and then calculate another country to compare. The model is built on 30-year estimates. The x-axis highlights the 2030 point as an important year as the United Nations strives for its full abandonment by 2030, as articulated in the Sustainable Development Goal 5.

Graphic 1 Explanation

The name of the country you have calculated will display within the graph title to ensure the expected modeling is correct. The first graphic is a side-by-side comparison of prevalence. On the left, the graph displays the modeled projection of prevalence under the current situation (‘business as usual’). This model was calculated based on prevalence data and population growth projection at the country-level, displaying the current trajectory. The right graph displays the reduction in the projected prevalence of FGM in two circumstances: abandonment and reduction (partial). Our model suggests that elimination of FGM would result in a median reduction in adult prevalence of 55% (IQR 52-57% across countries) over 30 years.

Parameters Menu Explanation

Epidemiology Parameters

The prevalence of FGM is set to the country’s prevalence rates, by types, based on available data. You are able to adjust the overall baseline prevalence using the slider that is editable in the Parameters dropdown. Adjusting the baseline prevalence should be done in the case you wish to model a scenario, which differs from the available data. Please note that you can only change the overall prevalence and not the proportion of different types of FGM.
More information on the types of FGM can be found here (https://www.who.int/sexual-and-reproductive-health/types-of-female-genital-mutilation)

Prevention Parameters

Interventions are estimated on a scale of effectiveness from 0 to 1, which can be adjusted in the parameters dropdown menu. The parameter for partial abandonment is interpreted as a factor on the baseline incidence of FGM: Setting the parameter to 0 means “full abandonment”, while setting it to 1 means “business as usual”. A value of 0.75, for example, means the intervention results in a new incidence of 75% of the baseline incidence, or a reduction of 25%.

The evidence for effectiveness of interventions against FGM is limited, and consequently this tool considers the potential impact of hypothetical interventions on the burden of FGM. The scenarios assume that interventions to prevent FGM will result in a 50% (partial abandonment) and 100% (full abandonment) reduction of the incidence of FGM. Our model suggests the effect of an intervention with 50% effectiveness in reducing the incidence of FGM in childhood would reduce the adult prevalence of FGM by a median of 24% (IQR 22-26% across countries) over 30 years.

Want to know more about how prevalence was modeled?
The baseline adult prevalence of FGM is taken from best available sources, i.e. Demographic and Health Surveys, and Multiple Indicator Cluster Surveys. The prevalence of FGM in girls and women aged 15 and over was considered a cumulative incidence over the first 15 years of life, and rescaled to a one-year incidence.
Graphic 2 Explanation

Graph 2 displays the life course cost projections, by health complications associated with FGM. The economic costs and the presence of clinical outcomes differ as girls and women progress through the life course. The economic costs are displayed in Millions of USD and they are broken down into the following categories: immediate complications, uro-gynecological, obstetric and psychological and sexual complications.

Want to know more about the cost estimates?
The economic burden associated with FGM is based on a systematic review and meta-analysis of the scientific literature on clinical complications and outcomes associated with FGM. The additional risks for these complications in girls and women affected by FGM are modelled over the life course using United Nations population projections, and associated health care resource utilization (outpatient consultations, days of hospitalization and medications) are estimated for each complication.

Graphic 3 Explanation

The final graph displays the comparative healthcare costs with the same prevention intervention and epidemiological parameters as were used the first set of graphs.
The left graph displays the modeled healthcare costs of FGM on a country level annually at the present incidence levels. The y-axis scale is in Millions of USD. The graph on the right side displays the health care costs in two scenarios, abandonment of FGM and partial abandonment. You can re-adjust these parameters of the model by scrolling up to the parameters dropdown menu (same as shown above for the first set of graphs).