Key Factors, Drivers and Gatekeepers of Female Genital Mutilation in Ethiopia: A Meta-synthesis of National and Regional Studies

Female Genital Mutilation (FGM) is a harmful practice that consists of all procedures involving partial or total removal of the female external genitalia or other injuries to the female genital organs for non-medical reasons. This meta-synthesis aimed to identify and describe key factors, drivers, and gatekeepers of FGM practices in Ethiopia and was conducted using systematic searches in electronic databases (PubMed, PsycINFO, and Google Scholar) and grey literature published from 2012 to 2021. The main factors and drivers of FGM practices were cultural and traditional practices including marriageability and religious obligations. Other drivers were poor enforcement of laws against the practice including medicalization of FGM practice. The key gatekeepers included traditional birth attendants who were also mostly female circumcisers; mothers, grandmothers, and older women who were reported as major promoters, circumcisers, and key decision makers on the practice. Religious leaders and health workers also played pivotal role in the prevention of FGM as trusted source of information dissemination. It is therefore important that Programme and policy strategies to eliminate the practice are tailored to the local context, not only addressing these factors and drivers but involving the gatekeepers.