Title: Factors associated with Female Genital Mutilation/Cutting in Tanzania: Insights from
Tanzania Demographic and Health Survey 2022
Version: 4 Date: 07 Nov 2024
Reviewer:  Violet Kimani
Reviewer's report:
Manuscript Review
Corresponding Author: Pankras Luoga
Manuscript Title: Prevalence and Factors associated with Female Genital Mutilation/Cutting in
Tanzania: Insights from Tanzania Demographic and Health Survey 2022
Review of Manuscript
Introduction
Introduction of the subject of the manuscript is approached from a global perspective of public
health, dangers, and risk factors to women and girls who undergo female genital mutilation
(FGM).  According to the authors, there is limited empirical literature on the prevalence and
associated factors of Female Genital Mutilation and associated factors in Tanzania and the
manuscript is intended to determine this gap. The four types of female genital mutilation are
described.
There is no information regarding the most common types of FGM in Tanzania.
Survey Methods: The manuscript used secondary data from Tanzania Demographic Survey,
2022. A weighted sample of 7678 women and girls in the age group (15-49) years was analysed,
from a total population of 15,254.  The data was collected from a simple Yes or No codes,
without indication of any probing for details and reasons. Independent variables included age,
education levels, marital status, type of residence, geographical zones, and wealth quintiles,
current work status, distance to health facility , permission to access health care, frequency of
watching/listening to mass media, ever heard of Female Genital Mutilation, FGM required by
the Region, whether FGM should continue or be stopped
It is unclear whether the individual women and girls reported their data or whether a mother
reported on behalf of herself and the younger female members of the household.
Distance is also vaguely reported, for instance,  not a big problem
Analysis: Authors could consider further analysis such as zones against education levels, poor,
poorer, medium and rich, richer, richest
A number of these variables may not mean very much for readers not familiar with local terms
like Region, wealth
Unclear whether the team was party to data collection during the Tanzania Demographic and
Health survey
Results: Results are statistically significant, determined at a p-value below the 0.05 threshold.
These are presented in tables. Odds ratio etc. statistical significance yes but realistically.
The established prevalence was 8.2%, compared to the previous one in  1996 at  17.9%, with a
decline of 50%. At face value an excellent effort but unconvincing due to methodology etc.
Discussions:  Discussions in this manuscript are based on inferences from the statistics. A
participatory study would have updated information regarding reason for FGM decline, from a
representative sample of women and girls in the various regions.
Conclusions: The study established a national prevalence of (8.2%). Among women undergone
FGM, flesh removed was a dominant type of FGM practice by 89.2%. Women’s socio-
demographic factors associated with FGM include older age, rural residency, lower or no
education, poorest wealth quintile, and being married were associated with reporting to have
undergone FGM. Authors recommend that the government, in collaboration with stakeholders,
develop tailored programs targeting zones with high FGM prevalence aiming at empowering
women through initiatives such as increasing educational opportunities and improving their
economic status, enabling them to effectively combat FGM.
In my view the manuscript has not contributed anything new to knowledge on the subject of
FGM, beyond Tanzania.
Reviewer: Violet N Kimani