Abstract
BACKGROUND: Female genital mutilation (FGM) remains a critical global public health challenge, with over 230 million affected women and girls, predominantly in Sub-Saharan Africa. Despite the reduction in FGM in both countries, the proportion of women who had FGM are still considerably high. Therefore, the study seeks to examine the socio-economic/demographic determinants of FGM in Kenya and Tanzania to inform more targeted interventions. METHODS: A retrospective analysis of Demographic and Health Survey (DHS) data from 6,517 women aged 15-49 in Kenya and Tanzania (2008-2022) was conducted. Trends were assessed using weighted prevalence percentages and visualized via line graphs. Chi-square tests and multivariable logistic regression, adjusting for complex survey design, identified associations between FGM and socio-demographic, economic, and media-related determinants. RESULTS: Higher education (AOR = 0.25, p < 0.001), wealth (AOR = 0.62, p < 0.002), urban residence (AOR = 0.37, p < 0.001), and weekly radio exposure (AOR = 0.53, p < 0.001) significantly reduced FGM risks. Conversely, rural residence (AOR = 4.12, p < 0.001), religious mandates (AOR = 3.81, p < 0.001), and recent internet use (AOR = 2.40, p < 0.001) increased vulnerability. Contextual disparities emerged: Kenya's FGM was strongly associated with Muslim affiliation (AOR = 9.41, p < 0.001), while Tanzania's persistence stemmed from rural agrarian livelihoods and occupational inequities. Internet use paradoxically correlated with higher FGM prevalence, reflecting potential urban-rural divides in digital health messaging efficacy. CONCLUSION: Education, economic stability, urban living, literacy, and radio exposure lower FGM risks in Kenya and Tanzania, while rural poverty, limited education, religious justifications, and internet use increase them. FGM in Kenya is linked to Muslim practices, requiring faith-sensitive strategies, while in Tanzania, it is tied to rural ethnic traditions. Interestingly, higher internet use correlates with increased FGM prevalence, suggesting it may perpetuate harmful norms without targeted messaging. Effective interventions should integrate legal enforcement, community education, women's empowerment, and cultural partnerships, extending urban strategies to rural areas and combating misinformation through digital literacy. Limitations like cross-sectional design highlight the need for longitudinal research. Ongoing, context-driven efforts are crucial for eliminating FGM and advancing global gender equity.