Title: Female genital mutilation/cutting among girls aged 0-14: Evidence from the 2018 Mali
Demographic and Health Survey data
Version: 2 Date: 17 Jul 2023
Reviewer's report:
Thank you for the opportunity to review this manuscript, which delves into the topic of
female genital mutilation/excision, an area that appears to have limited documentation. The
observations, comments and questions below are intended to help improve the work already
done by the authors.
Abstract
• Line 62: Please complete the 95% confidence interval for the percentage of women whose
daughters have undergone genital mutilation/cutting.
• Lines 62-70: In the abstract, I suggest using "95% CI" instead of "CI" to refer to the 95%
confidence intervals.
Methods
• Before presenting the data source, describe your study setting (Mali).
• Lines 138-140: In the "Data Source" subsection, you mentioned using data from the 2018
Mali Demographic and Health Survey. You indicated that this survey had a two-stage random
sampling design. Please verify if it is not instead a two-stage stratified random sampling.
Furthermore, after briefly describing how the first-stage units were selected, nothing was
mentioned about the second stage.
• Why was the variable concerning the participants' region of residence (Kayes, Koulikoro,
Sikasso, Ségou, Mopti, Timbuktu, Gao, Kidal, and Bamako) not included in the study?
Results
• Begin by describing the baseline characteristics of your study population before presenting the
results related to female genital mutilation/excision.
• Lines 199-213: Please complete the 95% confidence intervals after presenting the proportion
of women with at least one circumcised daughter (overall and according to basic characteristics).
• Your study population consisted of women who had daughters. Therefore, in Figure 1, 52.5%
represents the proportion of women who had at least one daughter with genital mutilation, not
the percentage of girls with genital mutilation as the current title of Figure 1 suggests. Please
modify the title of Figure 1 ("Prevalence of FGM/C in girls in Mali") accordingly.
• For Table 2, please add a legend to describe the meaning of "*", "**", and "***".
Discussion
• Lines 235-237: You wrote, "The results indicate that more than half (52.5%) of women with
daughters had at least one daughter who has gone through circumcision. This is lower than the
90% reported in the 2012-2013 Mali DHS". How do you explain this decrease in just five years?
• Lines 261-266: You wrote, "The study revealed a significant association between media
exposure and FGM/C. Specifically, women who read newspapers or magazines at least once a
week had lower odds of getting their daughters circumcised as compared to those who never
read newspapers. This finding disagrees with an earlier study in Mali by Dalal et al. ([31], who
revealed that teenage girls who read newspapers/magazines had positive attitudes towards FGM/
C compared to those who did not read newspapers/magazines". Dalal et al. used the 2006 Mali
Demographic and Health Survey data. What was the specific context in 2006 that explained why
mothers exposed to the media had favourable attitudes towards FGM/C, unlike in 2018?
Thanks