Assessing economic and societal costs
Research on the consequences and economic drivers of FGM is rare and an increase in focus on these areas would clearly be beneficial. Most of the current research focuses on medical care, primarily on obstetrics. The premises for a more systematic study of the economic drivers of FGM are gradually emerging.
A literature review from 2016 (Mpinga E.K., 2016) lays out that research carried out on the economic dimensions of FGM measures its financial cost through:
- the number of days of hospitalization
- the complications (especially long term ones) linked the practice of FGM
- the traumatic psychological consequences
- the operations dedicated to FGM
- the hospital services whose work is dedicated to FGM .
FGM: The development costs
The European End FGM EU Network has worked to identify indicators, the combination of which should make it possible to measure the economic costs of FGM (WHO, 2010). It groups them as follows:
Costs to society
- Health: medical complications resulting in additional treatment costs (AIDS, STI, reconstructive surgery, chronic infection, etc.)
- Education: increase in school dropout / dropout rate
- Work: long-term complications affecting women victims of FGM – they reduce the women’s performance and therefore their contribution to economic development
- Life expectancy: increased risk of death for the victim or for her child
Costs for the community:
- the pressure for the organization of large and expensive weddings incites families to marry off their daughters early, thus depriving them of a full participation in the economic development of the newly married woman
Costs in terms of social relationships:
- problems between couples linked to forced marriage as well as poor access to sex education but also the risk of stigmatization and isolation of women who are not cut
- Emotional and physical: both short and long-term including pain, shock, hemorrhage, trauma and psychological disorders, higher risk of contracting STIs and STDs including HIV
- Sexual and reproductive: difficulties in the victim’s sexual life and increased risk of complications at the time of pregnancy and especially during childbirth (for both the mother and the child)
- Material: lower participation in the socio-economic development of their communities and extremely slow sustainable growth linked to medical complications, early marriage and dropping out of school
Estimating the obstetric costs of FGM in six African countries
A first WHO study conducted in 2010 (3) attempts to estimate the costs of the long-term obstetric complications caused by the practice of FGM. It focused on 53 million women of reproductive age (15-49 years old) who have undergone FGM in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan. It only takes into account the costs related to cesarean sections, hemorrhages, long stays in hospital (more than 3 days), death during childbirth, neonatal resuscitation and episiotomy.
The study also tries to assess the years of life lost as a result of FGM. The objective is both to highlight the obstetric consequences of FGM and to estimate the cost for the health system and society as a whole.
The results of this WHO study indicate an expenditure of $3.7 million annually simply for the management of the obstetric complications listed above, or 0.1 to 1% of the total health budget allocated by the government to the health of women aged 15-45. They also estimate that the number of years of life lost by 15-year-olds who have undergone FGM to be close to 130,000 years, stressing the increased vulnerability of victims of type 3 FGM.
The 2016 literature review highlights the links between economic factors and FGM, both in terms of causalities and consequences (Mpinga E.K., 2016). Medical complications caused by FGM translate into an average of 13 (Nigeria) to 16,5 days (Somalia) of hospital stays, resulting in costs of $ 120 per person in Nigeria. A Sudanese hospital supposedly devotes 7% of its surgical operations to the treatment of direct complications of FGM.
What problems and what solutions do these estimates highlight?
It is obvious that FGM limits the economic capacity of a society by depriving it of the contribution of a large part of its population and hinders the achievement of a durable and sustainable growth. In this way, schooling and access to information as well as prevention campaigns against FGM are fundamental in the abandonment of the practice and have an influence on the empowerment of women. Nevertheless, to better understand the problem, further study of the cost-effectiveness of FGM programs by comparing them to their socio-economic costs is necessary.
« The Community of Practice on Female Genital Mutilation » is part of the « Building Bridges between Africa and Europe to tackle FGM » project, supported by the « UNFPA-UNICEF Joint Programme on the Elimination of FGM ».
The project is coordinated by AIDOS in partnership with GAMS Belgium.
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