Improving estimates of the prevalence of Female Genital Mutilation/Cutting among migrants in Western countries

<b>Background</b>: Female Genital Mutilation/Cutting (FGM/C) is an emerging topic in immigrant countries as a consequence of the increasing proportion of African women in overseas communities. <b>Objective</b>: While the prevalence of FGM/C is routinely measured in practicing countries, the prevalence of the phenomenon in western countries is substantially unknown, as no standardized methods exist yet for immigrant countries. The aim of this paper is to present an improved method of indirect estimation of the prevalence of FGM/C among first generation migrants based on a migrant selection hypothesis. A criterion to assess reliability of indirect estimates is also provided. <b>Methods</b>: The method is based on data from Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS). Migrants' Selection Hypothesis is used to correct national prevalence estimates and obtain an improved estimation of prevalence among overseas communities. <b>Results</b>: The application of the selection hypothesis modifies national estimates, usually predicting a lower occurrence of FGM/C among immigrants than in their respective practicing countries. A comparison of direct and indirect estimations confirms that the method correctly predicts the direction of the variation in the expected prevalence and satisfactorily approximates direct estimates. <b>Conclusions</b>: Given its wide applicability, this method would be a useful instrument to estimate FGM/C occurrence among first generation immigrants and provide corresponding support for policies in countries where information from ad hoc surveys is unavailable