Prevalence, Knowledge, and Attitudes Regarding Female Genital Mutilation/Cutting Among Women in Mogadishu, Somalia A Cross-Sectional Study

<title>Abstract</title> <p>Background Female genital mutilation/cutting (FGM/C) remains highly prevalent in Somalia, yet city-specific evidence on its complications, and women's knowledge and attitudes regarding the practice, remains limited for Mogadishu. This study assessed the prevalence of FGM/C and its complications, and women's knowledge and attitudes, among women in Mogadishu, and examined associations with socio-demographic characteristics. Methods A cross-sectional survey was conducted among 384 women aged 15–49 years attending ten Maternal and Child Health centers across five districts of Mogadishu, using a three-stage sampling procedure (purposive district selection, convenience facility selection, and simple random respondent selection). Data were collected using a structured, interviewer-administered questionnaire. Descriptive statistics, chi-square tests, and multivariable binary logistic regression were used to examine associations and identify independent predictors of intention to continue the practice. Results FGM/C prevalence was 92.2% (n = 354/384), and 93.2% of affected women reported at least one complication. Knowledge of complications was moderate to high overall, though only 51.0% were aware of the FGM/C–HIV transmission link. Attitudes were predominantly ambivalent, and 60.4% of respondents reported definite intention to subject their own daughters to FGM/C. Contrary to expectation, women with high composite knowledge scores had significantly higher odds of intending to continue the practice than women with low knowledge (AOR = 3.40, 95% CI 1.75–6.64, p &lt; 0.001), while higher education and more favorable attitudes toward abandonment were independently protective. Conclusion FGM/C remains highly prevalent in Mogadishu, and knowledge alone does not reduce intention to continue the practice. Effective elimination strategies should engage mothers directly, address perceived social barriers, and partner with trusted community and religious leaders rather than relying on health education alone.</p>