Background: Female genital mutilation (FGM) is a harmful traditional practice, and a violation of the human rights of girls and women. Despite international and national efforts to eliminate the practice, it is widely practiced mainly in Africa, especially in sub-Saharan Africa including Ethiopia. There are a number of studies on the prevalence of FGM in Ethiopia. However, little has been devoted to the spatial variation in FGM and the community level factors that affect FGM. Hence, this study aimed to explore the spatial pattern of female genital mutilation among girls in Ethiopia.

Methods: A spatial analysis of female genital mutilation among girls aged 0-14 years was conducted using the 2016 Ethiopia demographic and health survey data. A total of 6,589 girls aged 0-14 years nested in 603 enumeration areas were included. Global spatial autocorrelation was assessed using the Global Moran’s I statistic (Moran’s I) to evaluate whether the pattern expressed is clustered, dispersed, or random across the study areas. In the presence of positive global spatial autocorrelation, Kulldorff’s method of Poisson-based purely spatial scan statistic was employed to detect the local clusters of areas with high female genital mutilation.

Results: Spatial clustering of daughters’ circumcision was observed in Ethiopia (Global Moran’s I = 0.308, p-value < 0.001). Eight statistically significant SaTScan clusters of areas with high neonatal mortality rate (Hotspot clusters) were detected. The most likely primary SaTScan cluster was detected in Afar and Amhara regions (LLR=279.0, p-value<0.01), and the secondary cluster in Tigray (LLR=67.3, p-value<0.01 region. In addition, the third, fourth and fifth clusters were detected in Somali, Benishangul Gumuz, and Oromiya regions, respectively.

Conclusion: The female genital mutilation among girls in Ethiopia was spatially clustered. Clusters of areas with high female genital mutilation (hotspot clusters) were identified in some parts of Afar, Amhara, Tigray, Somali, Benishangul Gumuz, and Oromiya Regions. Hence, it is better if the Federal Ministry of Health of Ethiopia and other reproductive health programmers to give intervention priority for these hotspot areas of female genital mutilation.

Keywords: Circumcision, Female Genital Mutilation, Spatial Clustering, Ethiopia