A collaborative investigation into FGM/C and child marriage prevention strategies in Ethiopia's pastoralist Afar region.

1. Strengthening the evidence base on
approaches to tackle FGM and child marriage
in Ethiopia’s pastoralist communities
Addis Ababa, May 2022
An adolescent girl from Afar and her family © Natasha Bertrams / GAGE 2018

2. Presentation overview
1
• Snapshot of existent evidence and gaps
2
•Overview of the objectives and methods of our research
3
•Preliminary research findings on girls and women and their contexts
4
• Overview of STC programming aimed at shifting restrictive gender norms
5
• Policy and programming implications
6
• Questions and comments

3. 1
• Snapshot of existent
evidence and gaps
Young adolescent girls in Afar, Ethiopia. © Natasha Bertrams / GAGE 2018

4. Afar and Somali regional contexts
Afar
•2.2 million population
•21% urban
•Increasing economic
inequality
•Poverty higher in rural areas
•<5 stunting rate = 43%
Somali
•6.6 million population
•15% urban
•Low economic inequality
•Poverty higher in urban
areas
•<5 stunting rate = 31%
Afar and Somali
•Primarily desert
•Livelihoods are pastoralist
•Vulnerable to climate change
•~ 25% poverty rate
•Primarily Muslim
•High population growth
•Limited access to services
•Recurrent violence
•Populations skewed towards
males

5. FGM/C and Child Marriage – what does the existing evidence base tell us?
What
do
we
know?
What
are
the
gaps?
 Nearly all girls 15-19 are cut
 91% Afar, 95% Somali
 Even girls under 15 are usually infibulated
 68% Afar, 33% Somali
 Strong attachment to FGM/C—which is seen as
required for marriage
1. How are practices shifting in terms of type, age, etc.
to ‘hide’ from the law?
2. What is the role of boys and men in FGM/C?
3. Who might champion elimination? Using what
messages?
4. How and when does defibulation take place?
5. Are high rates of infibulation related to the skewed
sex ratio?
 Most young women 20-25 married before age 18
 67% Afar, 55% Somali
 Between 2000 and 2016, the proportion of girls 15-
17 who were married increased 6%
 Marriage type varies by region
 89% arranged ‘absuma’ marriages in Afar, 64%
‘free choice’ in Somali
1. Is the incidence of child marriage really increasing? Or is
this related to reporting/shifts in type?
2. Is the age of marriage changing in tandem with shifts in
the age of menarche or the economics of climate
change?
3. What does ‘free choice’ mean in Somali?
4. How might communities be encouraged to abandon
forced and child marriage?
FGM/C Child Marriage

6. Education and Economic Empowerment – what does the existing evidence
base tell us?
What
do
we
know?
What
are
the
gaps?
 Enrolment lags far behind the national
average—esp. at secondary level
 Enrolment varies significantly by zone/
woreda
 Gender parity rates are far below
average
 Learning outcomes are especially poor
1. Are reported enrolment rates accurate?
(the census is 15 years old and so it is unknown how
many children live in Afar and Somali)
2. What proportion of students lack access to formal
education and have only ABE?
3. Why do Somali girls remain so starkly disadvantaged
compared to their male peers?
4. How might pastoralist communities be incentivized to
educate their children—esp girls?
 Girls and women in Afar and Somali (38%)
have less access to employment than
national average (50%)
 Women’s work reflects where they live:
livestock vs sales/trading
 Time poverty is extreme—given water
collection and childcare
 Women’s access to assets is negligible
 Migration is increasing—with girls more
likely to migrate than boys, esp. in Afar
Education Economic Empowerment
1. How do females exercise their rights to personal and HH
assets in a context where male ownership is a given?
2. Given cultural constraints, and time poverty, how can
we best support females’ economic empowerment?
3. How are pastoralist and sedentarised women’s access to
earning and spending diverging?
4. Is the PSNP impacting females’ empowerment? How?
18
26
23
33
68 64
0
10
20
30
40
50
60
70
80
Girls Boys
Afar Somali National
Primary school completion rate, by
gender and location (MoE, 2021)

7. SRH and Decision-making – what does the existing evidence base tell us?
What
do
we
know?
What
are
the
gaps?
 Girls’ lives are often restricted during menstruation--due
to taboos and pain
 Contraception is viewed unfavorably—resulting in
highest proportion of adolescent mothers 15-19
 23% Afar, 19% Somali
 Abortion prevalence rates vary by region
 10% Afar, 7% Somali
1. What do girls need to know about their developing
bodies and how to stay healthy-esp in the context of
infibulation? How might we de-stigmatise
menstruation?
2. What MHM supplies would meet girls’ needs—and
also be environmentally responsible?
3. How could we shift attitudes towards contraception?
Who should be targeted and with what messages?
 Women in Afar and Somali (62%) have less input into
personal and HH decisions than national average
(71%)
 Women in Afar are esp. unlikely to have control over
their own earnings (28%) and believe spousal violence
is OK (69%)
 In Somali, broader measures of women’s
empowerment fell between 2000 and 2016
1. How does education and employment contribute to
female decision-making? What else contributes?
2. How does programming aimed at adolescent girls and
boys support longer term gender equality and
empowerment for women?
3. What is driving differences between Afar and Somali?
Why does Somali appear to be backsliding?
SRH Decision-making

8. 2
•Objectives and methods
Adult community member in Afar village. © Natasha Bertrams / GAGE 2019

9. What are the aims of our research?
 Understand local adolescents’ lives—and
girls’ risk of FGM/C and child marriage.
 Understand what aspects of STC
programming local households are
participating in
 Our research is mixed methods—and
includes both quantitative and qualitative
components.
 There will be three rounds of data
collection—2022, 2024, and 2026.
 What factors are shaping the
perpetuation of FGM and child marriage
in these localities? Where are the entry
points for change?
 Is STC programming helping to shift
discriminatory gender norms in general
and specifically with regard to age of
marriage and the perpetuation of FMG?
 Is STC programming helping to reduce
FGM/C and child marriage? And if so
how? How could programming be
strengthened?
 Is programming helping to improve girls’
and women’s control over resources?
Baseline round Longitudinal questions

10. Where are we conducting research?
Afar
Zone 1
Aysaita
Zone 5
Samurobi
Hadelella
Somali
Fafan
Harshen
Goljano
Jarar
Daror

11. What does our quantitative sample look like?
 Our quantitative sample includes 2,042 households in 36 kebeles—
split equally between regions
 In each region we collected data in 18 kebeles—targeting 57
households per kebele
 In each household, we surveyed both an adolescent and a female
or male caregiver
 Adolescents included girls and boys, who were both in and out
of school
 Caregivers included those living in male-headed, female-
headed, and polygamous households
 Our sample includes kebeles and households who are not taking
part in programming—to act as controls against which to measure
progress
Note: Our sample size is
substantial – the EDHS
2016 sample size of 15-49
year olds for Afar was 549
and for Somali 685. For
caregivers asked about
their daughters it was 138
and 181 mothers,
respectively

12. Sample size determination
 n = required minimum sample size per survey round or comparison group
 The largest required sample size (i.e. 2040) is used.
 The average of FGM and child marriage in Afar and Somali (2016 DHS):
 FGM for age 15-49 = 0.968
 FGM 10-14 = 0.74
 FGM should continue= 0.529
 Marriage under 18 = 0.5330
Alpha=0.01 and power=0.90 Alpha=0.01 and power=0.95
Total sample Sample + 15%
Attrition
Total sample Sample + 15%
attrition
FGM prevalence (15-49 years) 444 510 530 610
FGM prev. among daughter (10-14 yrs) 1270 1460 1518 1746
FGM should be continued 1482 1704 1772 2037
Child marriage (under 18 years) 1482 1704 1774 2040
 Target (𝑃2): Assume a 10% percentage point reduction in FGM as well as underage marriage rates
after the programme

13. Overview of households in treatment and control kebeles per region
Treatment communities Control
communities
Adolescents and
caregivers are both
participating in
programming
Caregivers are
participating
Adolescents are not
Adolescents are
participating
Caregivers are not
Adolescents and
caregivers are not
participating
Total 340 HHs
across 6 kebeles
340 HHs
across 6 kebeles
340 HHs
across 6 kebeles
1020 HHs
across 18 kebeles
Somali 170 HHs
across 3 kebeles
170 HHs
across 3 kebeles
170 HHs
across 3 kebeles
510 HHs
Across 9 kebeles
Afar 170 HHs
across 3 kebeles
170 HHs
across 3 kebeles
170 HHs
across 3 kebeles
510 HHs
Across 9 kebeles

14. What do our surveys include?
 There are two separate surveys—one for adolescents and one for female
caregivers.
 Survey themes are largely the same and include:
 Adolescents’ access to education
 Adolescents' experiences with paid work and access to financial inclusion
 Adolescents’ access to mobility, decision-making, and role models
 Adolescents’ sexual and reproductive health, including MHM
 Girls’ experiences of FGM/C
 Adolescents’ marriage and relationships
 Personal gender attitudes and community gender norms
 Programme participation
 The caregiver survey also includes questions aimed at household socioeconomic
conditions, including participation in PSNP.

15. What is the focus of our qualitative tools?
• Prevalence and patterning of child marriage and FGM/C
• Structural factors and actors working to support stasis and change
With regional, woreda and kebele stakeholders and service providers:
• Opportunities for education and training
• Opportunities for work
• Opportunities for personal and household decision-making
• FGM/C, Child marriage attitudes, norms and practices
• Sexual and reproductive health, including MHM
• Sexual and gender-based violence
With adolescent and adult community members:
• Awareness of the programme
• Engagement in what type of programming components
• Views on programme roll out
With programme implementers and participants:
•place
•hold
•er
To ensure that we were capturing the type of FGM/C accurately, we used pictures.

16. What does our qualitative sample look like?
 Our qualitative sample was purposively selected from
the larger quantitative sample
 Our sample includes 589 individuals in 8 kebeles in 4
woredas—split equally between regions and treatment
and control
 Individual interviews:
 67 regional, zonal, woreda and kebele stakeholders
(government officials, clan and religious leaders, CSO
and women’s groups)
 19 local service providers (teachers, HEWs, DAs)
 4 STC programme implementers
 39 girls and 38 women taking part in STC
programmes
 Group interviews:
 71 FGDs with adolescent girls and boys, and adult
men and women
Afar
Woreda 1
Treatment Control
Woreda 2
Treatment Control
Somali
Woreda 1
Treatment Control
Woreda 2
Treatment Control

17. 3
•Preliminary findings
Girls from a pastoralist community in Afar. © Natasha Bertrams / GAGE 2018

18. Across regions and households, adolescents have much in common
 Households average 6.5 members
 Households live about 32 km from woreda town
 11% of HH heads are literate
 9% of HH heads ever attended formal education
 71% of HHs are monogamous married
 16% of HHs are polygamous
 20% of households are FH
 Households average 7.1 members
 Households live about 35 km from woreda town
 25% of HH heads are literate
 16% of HH heads ever attended formal education
 82% HHs are monogamous married
 7% of HHs are polygamous
 60% of households are FH—which indicates
polygamy is under-reported
Afar Somali
 Households are large, remote, headed by an illiterate person, and quite often polygamous
 Adolescents are on average 13.2 years old

19. But there are differences between Afar and Somali
 71% of household heads rear livestock
 1% of HH heads work in retail/ sales
 The poor are more likely to be in treatment
 49% of HHs have ever received PSNP
 7% are currently receiving
 Average age of sample adolescents is 13.3
 66%, 28%, and 6% of sample adolescents are in
the age range 10-14, 15-17, and 18-19,
respectively
 86% of sampled adolescents are girls
 42% of household heads rear livestock
 17% of household heads work in retail/ sales
 The wealthier are more likely to be in the
treatment
 13% of HHs have ever received PSNP
 10% are currently receiving
 Average age of sample adolescents is 13.1
 69%, 21%, and 10% of sample adolescents are in
the age range 10-14, 15-17, and 18-19,
respectively
 77% of sampled adolescents are girls
Afar Somali
 Households in the Afar sample are more dependent on livestock, are relatively better off, and are more
likely to have received PSNP
 Adolescents in Afar are disproportionately likely to be girls

20. But there are important contexts differences between and
within regions that also affect outcomes
Afar Somali
 In Semurobi woreda, Afar, the locust plague
negatively affected forests and the health of
goats.
 Within Afar major differences between the two
woredas – Asaita is more urbanised but also
much more politically powerful – previous
capital of the region and prestigious clan –
whereas Semurobi is more rural and remote,
and clan leaders are relatively marginalised
politically
 For residents in Daror and Harshin woredas,
they can easily move back and forth to
Harghesa in Somaliland for trade and education
purposes (even use Somaliland currency rather
than Ethiopian birr; do not worry about
citizenship in case of marriage as same clan
[Isaac])
 Many boys seek to migrate through Libya and
Sudan to Italy
 In Goljano, protracted conflict with regional
state and Ogaden National Liberation Front
(ONLF) led to limited access to education

21. Caregivers’ income sources: most are dependent on livestock raising and
some agricultural activities, especially in Somali
Livestock raising:
 61% male vs 47% female caregivers in
Afar
 53% male and 34% female caregivers in
Somali.
Homemaker:
 7% male vs 34% female caregivers in Afar
 No male and 34% female caregivers in
Somali
Farmer:
 11% male vs 2% female caregivers in Afar
 19% male and 6% female caregivers in
Somali
Woman in Afar selling tobacco
© Nathalie Bertrams 2018
Own shop:
 1% males in Afar and no female
caregivers
 8% males in Somali and 15%
female caregivers.
Agricultural laborer:
 10% males in Afar vs 2% female
caregivers
 2% males in Somali and 1%
female caregivers

22. Land and asset ownership of caregivers
Total farmland in hectares:
 mean is 0.85 ha for male headed household
in Afar vs 0.49 for female headed
households
 mean is 1.33 ha for male headed household
in Somali r vs 0.69 for female headed
households
Total grazing land in hectares:
 mean is 0.07 ha for male headed household
in Afar vs 0.04 for female headed
households
 mean is 0.30 ha for male headed household
in Somali vs 0.26 for female headed
households
Number of oxen
 mean is 0.97 oxen for male headed household in Afar vs 0.63 for fhh
 mean is 0.56 oxen for male headed household in Somali vs 0.25 for fhh
Number of traditional cows
 mean is 4.53 traditional cows for male headed household in Afar vs 4.18 for
female headed households
 mean is 1.52 traditional cows for male headed household in Somali vs 0.92 for
female headed households
Number of camels
 mean is 2.96 camels for male headed household in Afar vs 2.17 for female
headed households
 mean is 1.63 camels for male headed household in Somali vs 1.37 for female
headed households
Number of goats
 mean is 16.49 traditional cows for male headed household in Afar vs 15.77 for
female headed households
 mean is 14.82 traditional cows for male headed household in Somali vs 12.21
for female headed households
Female headed households are systematically disadvantaged compared to male headed
households in both regions

23. Social assistance and major source of income: important differences
between male vs female headed households across regions
Afar
Social assistance
 Ever received PSNP (suggests community rather than
household-based targeting)
• Female hh: 46%
• Male hh: 50%
 Other assistance like health fee waiver
• Female hh: 44%
• Male hh: 45%
Major sources of income
 Own livestock
• Female hh: 77%
• Male hh: 69%
 Food crop production
• Female hh: 9%
• Male hh: 18%
 Petty trading
• Female hh: 6%
• Male hh: 1%
Somali
Social assistance
 Ever received PSNP (in line with weighting towards female
hh of PSNP design)
• Female hh: 16%
• Male hh: 9%
 Other assistance like health fee waiver
• Female hh: 12%
• Male hh: 8%
Major sources of income
 Own livestock
• Female hh: 38%
• Male hh: 43%
 Food crop production
• Female hh: 18%
• Male hh: 11%
 Petty trading
• Female hh: 23%
• Male hh: 14%

24. Gender differences in educational access are stark
 27% of adolescents have never enrolled
 27% of girls (vs 23% of boys)
 9% of adolescents have already dropped out
 10% of girls (vs 4% of boys)
 Enrolled adolescents have completed an average
of 4.3 grades
 Drop-outs left school at an average age of 12.9—
after completing 3.8 grades
 39% of adolescents have never enrolled
 43% of girls (vs 27% of boys)
 9% of adolescents have already dropped out
 10% of girls (vs 5% of boys)
 Enrolled adolescents have completed an average
of 4.3 grades
 Drop-outs left school at an average age of 12.6 --
after completing 3.8 grades
Afar Somali
 Many adolescents—especially girls—are not in school
 And nearly all adolescents are over age for grade

25. Education supports aspirations
 18% want to become teachers
 18% want to become accountant/manager
(salaried/not self-employed) workers
 11% want a government job
 10% want to be a HEW
 Only 4% want to farm (including livestock)
 30% want to become teachers
 20% want to become doctors
 14% want to be HEWs
 10% want a government job
 Only 2% want to farm (including livestock)
 13% want to farm
 13% want to become housewives
 13% want to become teachers
 12% want to become doctors
 12% want to open their own shops
Afar Somali
 41% want to become housewives
 13% want to farm
 9% want to be a housemaid
Of
ever-enrolled
adolescents
Of
never
enrolled
adolescents

26. However, qualitative interviews highlighted multiple and intersecting
barriers to educational access
•Teachers are often absent
Dearth of drinking water at skills is a disincentive for school attendance
Transportation in more remote kebeles is a major challenge for both teachers and students – and especially
for girls after grade 8
Lack of sanitary materials is a deterrent to school attendance for girls as they age
School feeding had been a motivating factor in Somali region but once stopped led to a decline in enrolment
Quality of education is a major concern among parents
Girls often start school late – e.g. 9 or 10 years – due to domestic work pressures so chances of reaching secondary
school are low; in particular girls face pressure to marry from early adolescence

27. Most adolescent girls have undergone FGM/C
 96% of girls have heard of FGM/C. Of these:
 97% of girls have been cut
 Girls were cut around the age of 1
 Of these, 83% of girls reported infibulation with
scar tissue
 3% of girls reported type 1 or sunna, 14%
reported type 2.
 Drivers: cultural identity (65%) religion (21%)
 78% of girls have heard of FGM/C. Of these:
 72% of girls have been cut
 Most of the girls were cut just after age 9
 1/3 of girl reported having some say about
FGM/C timing
 100% of girls reported type 3 infibulation with
suturing
 Drivers: cultural identity (54%) religion (33%)
 83% of FGM/C done by traditional cutters
 15% by parents
 Drivers: cultural identity (52%) and religion (41%)
Afar Somali
 89% of FGM/C done by traditional cutters
 10% by parents
 Drivers: cultural identity (67%) and religion (19%) and
girls’ behavior (10%)
 In the most remote communities, FGM/C is done at 1.5
years—in more central communities, soon after birth
‘If you have a female child, will you do FGM? I don’t know… I
may not cut her if the culture does not inhibit me…If I get
more information on FGM I may stop it but if the culture still
considers it [important] than I will circumcise her.’
(19, female, Afar)
While the 2016 EDHS has much higher prevalence rates overall, if
we disaggregate by age, 23.8% of girls in DHS sample are cut
between 10-14 years; accordingly many in our sample are likely yet
to be cut. Moreover, all the girls who have undergone FGM have
been subject to Type 3/ infibulation. Our qualitative findings also
suggest being uncut renders a girl unmarriageable.

28. Is the type of FGM changing in these contexts?
 Qualitative interviews suggest that the discourse is about shifting to the less invasive ‘sunna’ or type 1 FGM but further
probing underscored that in reality the shift has been towards type 3a rather than type 1 – so no stitching but still very
invasive and sealed up through scar tissue
 The discourse is framed in terms of men not being able to marry ‘open’ women – and ‘sunna’ is still equated with being
‘open’.
 Because of this interpretation of ‘sunna’, some advocates are now regretting their support of such a shift and calling instead
for elimination
 Some discussions with men with multiple wives reflecting on the effects of FGM on sexual relationship – positively compare
sunna type with type 3 – so there could be an entry point here for shifting support towards type 1 which at least has more
limited health and psychological effects
‘There is circumcision. It is “halal”. But it is not the suturing like the past.’
(Teacher, Somali region)
‘Boys want to marry a circumcised girl and no one will marry an uncircumcised girl because of our religious
views. Girls who are sewed are good, boys want them, believe that her dignity is protected and that of her
family since it is closed. We disregard sunna types.’
(FGD unmarried boys, Somali region)

29. Perceived advantages of FGM/C outweigh risks
42.6% of caregivers reported FGM/C carries risks (No risk:
56.5; DK/Refusal: 0.9% ). Of those who say FGM has risks:
 21% infection, 50% more difficult sex, 95% more difficult
childbirth
44.5% of caregivers report FGM/C has benefits (No benefit:
54.5; DK/Refusal: 1% )
 91% ensure girls’ good behavior, 37% attract a good
husband
35.8% of caregivers reported FGM/C carries risks (No risk: 63.7%;
DK/Refusal: 0.5% ). Of those:
 95% infection , 33% more difficult sex
 53% more difficult childbirth
67.6% of caregivers report that FGM/C has benefits (No benefit:
31.8%; DK/Refusal: 0.006%)
 79% ensure girls’ good behavior, 50% attract a good husband
Only 22% of girls believe that FGM/C carries risks (mostly
infection)
55% of girls report that FGM/C has advantages. Of those:
 84% ensure girls’ good behavior
 27% attract a good husband
Afar Somali
Only 6% of girls believe FGM/C carries risks (mostly difficult
childbirth)
23% of girls report that FGM/C has advantages. Of those:
 89% ensure girls’ good behavior
 28% attract a good husband
‘The girls that’s not circumcised brings shame to the family... Circumcision doesn’t bring any bad thing for her.
The parents tell girls they will cut and close her.’
(13 year old girl, Afar)
Caregivers
Adolescent
girls

30. Perceived advantages of FGM/C outweigh risks
43% of caregivers reported FGM/C carries risks. Of those:
 21% infection
 50% more difficult sex
 95% more difficult childbirth
45% of caregivers report FGM/C has advantages
 91% ensure girls’ good behavior
 37% attract a good husband
36% of caregivers reported FGM/C carries risks. Of those:
 95% infection
 33% more difficult sex
 53% more difficult childbirth
68% of caregivers report that FGM/C has advantages
 79% ensure girls’ good behavior
 50% attract a good husband
Only 22% of girls believe that FGM/C carries risks (mostly
infection)
55% of girls report that FGM/C has advantages. Of those:
 84% ensure girls’ good behavior
 27% attract a good husband
Afar Somali
Only 6% of girls believe FGM/C carries risks (mostly difficult
childbirth)
23% of girls report that FGM/C has advantages. Of those:
 89% ensure girls’ good behavior
 28% attract a good husband
‘The girls that’s not circumcised brings shame to the family... Circumcision doesn’t bring any bad thing for her.
The parents tell girls they will cut and close her.’
(13-year-old girl, Afar region)
Caregivers
Adolescent
girls

31. FGM and life-course trauma
 Qualitative findings underscore that FGM is not about one-off painful experience but ongoing pain and suffering –
girls report minimising how much water they drink to limit need to urinate as it is painful; during menstruation it is
painful.
• The defibulation process at time of marriage is very painful – and in the case of Afar can be very violent/ involve
rape – as husband does so by force. This may also involve beating by friends of husband so the new bride does not resist
and if husband fails then he may ask a friend to have sex with her instead. Adolescent boys in Afar reported emerging
trend of using Viagra to help with consummating the marriage.
• By contrast in Somali region defibulation is carried out either by traditional cutters or increasingly by health professionals.
This has in part resulted from the unintended consequences of NGO training of traditional circumcisers in use of
anaesthetics to reduce pain and suffering of girls and women.
• However, now this is a new source of income and is encouraging the perpetuation of infibulation as it can be managed
during childbirth and first sex through medication. In Afar the pain is further prolonged as the scar tissue is resealed for
up to 4 pregnancies.
• Also emerging cases of death on marriage night where young men are using knives to defibulate their bride and
resulting in haemorrhaging and death.

32. Strong support for FGM/C—although some awareness of legal ban
 63% of caregivers believe FGM/C should continue.
 68% remote
 59% nearer
 This is higher than the 2016 DHS – 55% but sample
includes remote communities
 42% of caregivers have heard there is a law on FGM/C.
Of those:
 64% know that FGM/C is illegal
 10% believe that ‘sunna’ is allowed
 30% believe that only circumciser will be
penalized
 13% believe that only parents will be penalized
 19% believe that both circumciser and parents
will be penalized
 69% of caregivers believe FGM/C should continue.
 This is higher than the 2016 DHS – 52% but sample
includes remote communities
 34% of caregivers have heard there is a law on FGM/C
Of those:
 21% know that FGM/C is illegal
 80% believe that ‘sunna’ is allowed
 10% believe that only circumciser will be
penalized
 11% believe that only parents will be penalized
 16% believe that both circumciser and parents
will be penalized
 68% of girls believe FGM/C should continue.
 69% remote
 62% nearer
Afar Somali
 59% of girls believe FGM/C should continue.
 65% remote
 53% nearer

33. Norms are deeply entrenched; and resistance towards change is persistent
 Boys are socialised into associating girls who are
circumcised/ ‘closed’ as marriageable. In one community
they gave the example of a religious leader who married
off 3 of his 5 uncircumcised daughters on one day. All
three were returned to his home – no one in the
community wanted to marry his uncut daughters. His
daughters remained unmarried and he became
marginalised in the community and finally had to
migrate to Djibouti with his family.
 Even in case of promising practice approach in Afar
where mothers had delayed age of circumcision, parents
are accepting award but still planning on FGM for
daughters when they are older, pre-marriage as
uncircumcised girls are unmarriageable.
©UNICEF Ethiopia/2015/Bindra

34. The malleability and persistence of norms underpinning FGM is also
reflected in growing trend of medicalisation of FGM
‘My sister is 10 years old. She is not in school and she was circumcised in a hospital. They took her to hospital
and the nurse did the circumcision.’ (13-year-old girl, Afar)
‘In previous times, they were forced to commit
circumcision in a hidden way but now they do it
publicly in the health centres and even the
community health workers are responsible for the
Sunna way of doing it. Even the traditional ladies
are being trained by nongovernmental
organizations about the importance of the Sunnah
and the magnitude of danger that the pharaonic
method pose on lives of the young girls.'
(Kebele chair, Somali region)
 Medicalisation of FGM is also increasing in Somali region, and to a lesser extent in Afar. This practice is
happening in private pharmacies or nurses/ midwives are going to people’s homes to carry out the practice;
and in some cases it is being carried out at health clinics.
‘Previously, even boys were taken to the forests to be circumcised there,
but now instead they – girls and boys – are being taken to the hospitals
and health centres to be cut….Those working in the health centres,
female doctors. They assist women during delivery – how can they not
be involved in circumcising. …There are even males who are trained as
healthcare providers that assist women during delivery.’
(Fathers FGD, Somali region)

35. Child marriage is common—and can be quite young
 88% of female caregivers were married before age 18
 96% of 20-25 married before age 18 indicating age of
marriage is declining
 Female caregivers were married at 16.2 years
 97% of these marriages were arranged by parents
 38% of female caregivers reported that they were
ready to get married at the time
 58 % of female caregivers were married before age 18
 77% of 20-25 married before age 18 indicating age of
marriage is declining
 Female caregivers were married at 17.3 age
 74% of marriages were arranged by parents
 19% of marriages were decided by two partners in question
 77% of female caregivers were ready to get married at the
time
Afar Somali
 3% of adolescent girls are married (2% currently
married and 1% married before). Of these:
 Girls married at age 15.8
 22% of girls married before age 15
 87% of girls married before 18
 87% of girls were married by parental
arrangement
 35% of girls reported that they were ready to
marry at the time
 4% of adolescent girls are married (3% currently married
and 1% married before). Of these:
 Girls married at age 15.6
 22 % of girls married before age 15
 88% of girls married before age 18
 21% of girls were married by parental arrangement
 43% of girls reported they decided to marry
 97% of girls reported that they were ready to
marry

36. “Most girls in
my community
marry before
the age of 18”
79 % of female
caregivers
54% of female
adolescents
No difference
between remote
and nearer
kebeles
Lebanon:
Comparatively more
information, although
much is not specific to
adolescents.
83% of female
adolescents
87% remote
80% nearer
87% of female
caregivers
AFAR SOMALI
Child marriage is believed to be typical

37. Age of marriage among married adolescent girls in the sample
is in mid-adolescence, with varying age gaps with spouses
0
1
2
3
4
5
6
7
14 15 16 17 18
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
14 15 16 17 18 20 22 26 29 30 35
Afar
12 13 14 15 16 17 18 19
Somali
0
2
4
6
8
10
12
14
13 14 15 16 17 18 19 20 21 22 25 28 34
Somali
Number of adolescent girls married by age
Afar
Age of adolescent girls’ first spouse at time of marriage
© UNICEF Ethiopia/2016/Martha Tadesse

38. Adolescent girls’ knowledge of the marriage law is limited but
strong preference for adult marriages
Nearly half of adolescent girls prefer adult marriage
 Only 7% of adolescents reported that they know the
legal age for marriage
 Only 2% of adolescents reported that they know the
legal age for marriage
Afar Somali
 Average age of the ideal age of marriage is: 19.0
 Ideal age of marriage is below 18: 29%
 Ideal age of marriage is 18 and above: 62%
 Don’t now and refusal: 9%
 Reasons for preferring adult marriage (18 and older)
include:
 to finish education (43%)
 adult women are more physically fit for marriage
(29%),
 everyone marries by this age (16%), and
 mental fitness (6%)
 Average of the ideal age of marriage is: 20.7
 Ideal age of marriage is below 18: 8.1%
 Ideal age of marriage is 18 and above: 52%
 Don’t know and refusal: 39.9%
 Reasons for preferring adult marriage (18 and older)
include:
 to finish their education before marriage (34%)
 others in the community married by this age
(19.3%)
 mental fitness for marriage (12%)
 physical fitness for marriage (10%)

39. However, despite the ideal and that marriage practices are changing, the age
of marriage remains low and appears to be declining in some communities
Afar
 In qualitative interviews, there were growing reports of girls reporting impending absuma marriages either to BOWSA
offices at woreda level or to teachers
 In light of IPV and growing divorce among young couples, some parents and especially religious leaders starting to
support marriage by choice rather than absuma marriage in Afar. Religious leaders arguing that nothing in Koran that
endorses absuma marriage.
 In Asaita, which is more urban, there were some cases of girls taking cases of impending absuma marriage to shariah
court and asking for it to be prosecuted
 Nevertheless religious leaders are supporting early marriage – so marriage is permissible after first marriage – typically at
15 years, as are clan leaders as it is desirable to get married young and to have many children for the clan
 To prevent girls from escaping there are friends of groom who are sent to provide surveillance so bride cannot escape
before wedding
‘Nowadays, absuma marriage culture is declining….The process is like if a girl reach’s puberty, then the parent
will start looking for a guy that can marry their child. They support (the groom and bride if they are first cousins
but if it is marriage by love it will be arranged between the girl and the guy who wants her. And then the
parents are usually not involved.’
(16-year-old girl, Afar)

40. Marriage practices are changing but age of marriage remains low and may
be declining in some communities (2)
Somali
 Almost all ‘voluntary marriage’ – this trend has come about due to high bride price (large numbers of camels) and with
rising drought and poverty voluntary marriage has increased to avoid this challenge. However, girls’ ‘choice’ may also be in
a context of pressure from parents.
 Religious leaders are in favour of marriage from first menstruation – focus on physical maturing rather than age
 No ratification of federal Family Law so difficult to frame discourse in terms of ban on ‘child marriage’ – hence little
activity by regional BOWSA; no intention by religious leaders to accept – opposed to both changes in age of marriage and
to permissibility of polygamy
 Increasing use of mobile phones are facilitating contact between adolescents and in turn voluntary marriage – especially
as pre-marital sex is taboo.
‘If a mother wants her daughter to marry but the daughter refuses, she would be pressured to marry... And if
the girl refuses adamantly, they might beat her up.’
(14-year-old girl, Somali region)
‘I think early marriage has increased now because of irresponsible adolescents. Before, early marriage
existed in villages where there was no formal education and adolescents were meeting in livestock keeping,
and not in the towns where adolescents was busy on education and wait until they complete it, but now it
has reached the towns. They don’t have other means to busy their selves and now mostly it exists the
villages and not that much in the town.’
(Religious leader, Somali region)

41. Marriage practices are changing but age of marriage remains low and may
be declining in some communities (3)
Somali
 Some observers also link early marriage to sunna type FGM which they argue does not inhibit girls’ sexual desires to the
same extent:
 With more sedentary population and less migration it is easier for adolescents to meet a partner; general consensus that
age of marriage is going down
 Grooms from Jijiga and Somali diaspora who are better off seek to lure young rural girls into marriage
 Some mothers are encouraging boys to marry early – as soon as son reaches adolescence– so that the family land can be
shared with son rather than the husband sharing with another wife.
‘Both circumcision and early marriage are interconnected. Early marriage is new to us and started now. In this
area, early marriage has increased now compared to previous. They are young … The sunna type of
circumcision may be the reason, we will ask the mothers. [Laughing]. I just heard about a young adolescent girl
that got married…. Previously, child marriage was not that much practiced in real life, and the community
believed that they should wait till they are responsible and old enough…It was considered that boys and girls
who marry at 18years old that they get married at a young age…. Early marriage has increased now.’
(School director, Somali region)

42. Girls’ experiences with menstruation vary by region
 32% of girls are menstruating
 Girls got their periods just after turning 14
 53% of girls use cloths (non-reusable rags)
 20% use reusable pads/cloths (home made)
 31% use disposable sanitary pads
 14% of girls report their normal activities are
impacted by menstruation
 Of those girls, the most common restrictions are no
school (40%) and no work (28%)
 47% of girls are menstruating
 Girls got their periods just before turning 13
 62% of girls use cloths (non-reusable rags)
 27% use reusable pads/cloths (home made)
 12% use disposable sanitary pads
 24% of girls report their normal activities are
restricted by menstruation
 Of those girls, the most common restrictions are no
fasting (79%) and no attending mosque (38%)
Afar Somali
 Only 13% of enrolling girls reported that the schools
have facilities/ resources for MHM
 46% of school enrolling girls reported that the schools
have separate toilets for girls and boys
 4% reported the schools have no toilets at all
 Only 12% of enrolling girls reported that the schools
have facilities/ resources for MHM
 72% of school enrolling girls reported that the schools
have separate toilets for girls and boys
 12% reported that schools have no toilets at all

43. Restrictive gender norms underpin HTPs
Restrictive
gender
norms
Limited
mobility
Poor self-
confidence
Few role
models
Time
poverty
Limited
education
Limited work
opportunities
Poor
health
Risk of
violence
Females are less
valued
Girls are not
supported to develop
their potential
Marriage is girls' only source of
social and economic protection
Girls who marry as children
are more likely to marry
'well'
Girls must undergo
FGM/C in order to be
marriageable

44. Caregivers report restrictive community norms
60
90
69
91
73
98
84
91
67
85
72
94
0 20 40 60 80 100 120
Most women have the same chance to work
outside the home as men
People control daughters' behaviour more
than sons to protect family reputation
Girls can only be sent to school if they are
not needed at home
Most boys and girls do not share HH tasks
equally
People do not interfere in IPV
Men make the decsions in their homes
Somali Afar
In my community…

45. Caregivers’ beliefs about gender roles are very conservative
62
93
88
51
74
98
97
64
91
89
67
54
91
84
0 20 40 60 80 100 120
If a family can afford to educate only one
child, it should be a boy
Families should control daughters' behavior
more than sons'
A boy should be raised to be tough
A woman in politics cannot also be a good
wife/mother
It is acceptable for a man to beat his wife to
mold her behavior
A woman should obey her husband in all
things
A woman's main role is to care for her home
and family
Somali Afar
A small minority of
caregivers reported
having ever thought
about how women’s
and men’s roles differ.
14% in Somali
10% in Afar
I agree that…

46. However, some caregiver beliefs show more openness
76
76
74
84
69
76
82
86
0 10 20 30 40 50 60 70 80 90 100
Our culture hampers girls'
goals more than boys'
Girls and boys should share
HH tasks equally
A girl's marriage should wait
until after secondary school
Women should have the
same chance as men to
work outside the home
Somali Afar
I agree that…

47. Adolescents share their parents’ gendered beliefs
Across regions,
only 1/5 of girls
and boys
reported that
they think
about how girls’
and boys’ roles
differ.
48
48
84
92
98
36
34
97
96
98
81
83
94
81
80
92
0 20 40 60 80 100 120
It is OK to tease a boy who acts like a girl
It is OK to tease a girl who acts like a boy
A boy should have the final say about
decisions with his girlfriend
A women should obey her husband in all
things
Families should control their daughters
more than sons
Somali boys Somali girls Afar boys Afar girls

48. National level law and policy is strong
LAWS PROHIBITING FGM & CHILD MARRIAGE
1995 Constitution
 Calls on the state to eliminate harmful customs against
women
2000 Family Code
 Sets the minimum age for marriage to 18
 Afar and Somali are yet to ratify this code
Criminal Code (2005)
• Criminalises child marriage, with imprisonment up to 7
years (if child is under 13)
• Criminalises FGM/C for both cutters and parents, with
imprisonment (for cutters) up to 10 years (for resultant
injury) and three months, with fines (for parents)
 Code does not protect those uncut from abuse and
exclusion
 Fines have rarely been raised since 2005
POLICY FRAMEWORKS AIMED AT TACKLING FGM & CHILD MARRIAGE
1993 National Policy on Ethiopian Women
 Calls for the elimination of HTPs
2010-2015 Growth and Transformation Plan
 Lays out targets for reduction of child marriage and FGM/C
2013 National Strategy and Action Plan on Harmful Traditional
Practices against Women and Children in Ethiopia
 Delineates how the GoE will work to eliminate HTPs
2015-2020 Growth and Transformation Plan
 Calls for the elimination of HTPs
 Sectoral plan for MoWCY calls for 50% reduction by 2020
2017 MoH bans medicalisation
 Ban effective at all private and public medical facilities, with personnel
subject to legal action
2019 National Costed Roadmap to End Child Marriage and FGM/C
 Calls for elimination by 2025
 Outlines specific strategies, interventions, and targets

49. However, there are important political economy challenges
 Cutters in Afar carry out FGM as part of a cultural
responsibility/ honour – it is not paid, indicating that
providing alternative livelihoods for the women cutters
involved is unlikely to be effective
 By contrast, in Somali there is a payment and traditional
cutters - who are typically from the Gaboye/ Madhiban
caste - still play an important role. However, in response
to awareness raising around physical risks, FGM is
increasingly carried out by health professionals. As we
know from other contexts, once the practice is
medicalised, eradication efforts become more complex.
 In general, key informant interviews underscored that it is
difficult to engage around the discourse of ‘elimination’ of
FGM in Somali, including for programme implementers
because the practice is so deeply entrenched culturally.
This extends to officials and programme implementers.
 In the case of forced marriage in the context of rape, the focus is not on the
survivor but on the clan; this is especially problematic in Somali region as clan
leaders receive a portion of the livestock penalty levied against the perpetrator.
There is also reportedly a lack of proper attention to reporting by Bureau of
Justice and follow up.
‘From the last four years, there is no information
about girls' circumcision and whether it has been
eradicated or they are hiding. No one knows. Before
five years, we from school, health workers, kebele
leaders and other members of the community used
to provide awareness creation on girls’ circumcision.
There was an incident where a woman in this kebele
that was circumcising girls was caught and arrested.
Before because of the awareness the information of
girl’s circumcision was available but now there is no
awareness and no information about circumcision.’
(Local government key informant, Somali region)

50. 4
•Save the Children
programming
Adolescent boys and community members, Afar © Natasha Bertrams / GAGE 2018

51. What is the programme trying to do?
• ‘Supporting Women and Girls in Ethiopia's lowlands to realize their
rights, and live healthy and productive lives free from violence and
abuse’
•The programme name provides clues:
• Reduce child marriage and FGM/C by economically and socially
empowering girls and women to advocate for their rights and
strengthening local mechanisms that protect girls and women
The programme aims to:
‘Without the financial support from SC and other NGOs, the one stop center in the town cannot
provide service to the survivors of SGBV.” (Sharia court vice present, Aysaita woreda)

52. How does the programme work?
 It takes an integrated approach
that uses six overlapping work
streams.
 Aims to reach 42,000 individuals,
70% of whom are caregivers and
girls, with at least one element of
programming.
 70% of beneficiaries will be female
•Girls’ education and training
Women’s and girls’ engagement
GBV protection
Capacity building and coordination
Community engagement
Economic empowerment

53. Awareness and participation differed across regions
Afar Somali
80% of caregivers had heard of STC programming. Of these:
 90% of those had taken part in one or more program
 80% cash transfer (8800 ETB)
 21% self help groups
 14% school material support
 2% radio listening groups
 59% of girls (out of total
429 girls) were aware of
programming
 84% of those had taken
part in one or more pro.
 12% gender clubs
 88% school
materials
 2% other
 76% of boys (out of 71
boys) were aware of
programming
 26% of those had taken
part
 7% gender clubs
 71% school
materials
 21% other
 42% of girls (out of total
387 girls)were aware of
programming
 84% of those had taken
part in one or more pro.
 19% gender clubs
 84% school
materials
 3% other
 70% of boys (out of 118
boys) were aware of
programming
 85% of those had taken
part in one or more pro.
 4% gender clubs
 99% school
materials
68% of caregivers had heard of STC programming. Of these:
 85% of those had taken part in one or more program
 57% cash transfer (one-off Covid-19 crisis transfer)
 31% self help groups
 5% school material support
 14% radio listening groups
In treatment communities:

54. Caregivers are positive about participation, esp. in Afar
93% ‘liked everything’
 49% enjoyed time with peers
 32% liked making new friends
 22% liked getting out of the house
 21% liked contributing to community
change
 20% liked learning new life skills/subjects
62% ‘liked everything’
 54% enjoyed time with peers
 32% liked learning new life
skills/subjects
 28% liked making new friends
 22% liked contributing to community
change
 18% liked getting out of the house
Afar Somali
 Only 2% reported not liking an aspect of
programming or where meetings took place
 14% felt they did not learn anything
useful
 13% reported meetings were at
inconvenient locations
 10% reported they did not feel safe at
meeting locations
“SC provided training
to teachers and
headteachers on how
to strengthen gender
clubs and to create
awareness of the risks
of FGM. However,
there is very little
supervision and
follow up. Because of
that we also do not
give attention to what
we learned during the
training”
(teacher, Somali).

55. Adolescents are positive about participation, but less so in Somali
94% ‘liked everything’
 36% enjoyed time with friends
 19% liked making new friends
 14% of girls liked getting out of the house
 12% liked learning new life skills/subjects
52% ‘liked everything’
 55% adolescents (51% of girls and 63% of
boys enjoyed time with friends)
 15% liked making new friends
 13% adolescents (16% of girls and 8% of
boys) liked learning lifeskills/subjects
 3% of girls liked getting out of the house
Afar Somali
 1% of boys reported not learning
anything useful
 21% of adolescents (17% of girls and 29%
of boys) reported learning nothing useful
 9% reported topics were inappropriate
 6% of adolescents (7% of girls and 3% of
boys) reported inconvenient locations
Woreda officials came to create awareness
on the risks related to child marriage and
FGM/C. But since the meeting was carried
out only once, students already forget the
details of the discussions at that meeting.”
(Adolescent boys FGD, Korodora, Afar).
SC distributed
education materials
to all students both in
primary and
secondary. After this,
may students,
especial girls, have
continued to attend
their education and
we observed that the
number of female
students in both
primary and
secondary have been
increasing this year”.
(school principal,
Somali region)

56. School enrolment is higher in treatment communities
Afar
70% enrolment in
control
communities
68% of girls
76% enrolment in
treatment
communities
77% of girls
Somali
39% enrolment in
control
communities
34% of girls
83% enrolment in
treatment
communities
81% of girls

57. Adolescents’ beliefs vary by community
 Girls in treatment communities are less likely to report
that FGM/C has benefits: 18% vs 29%
 Girls in treatment communities are less likely to
believe that FGM/C should continue: 54% vs 64%
 Adolescents in treatment communities are more likely
to believe that the ideal age of marriage is over 18:
53% vs 43%
Afar
Somali
 In Somali, girls’ beliefs about FGM/C do not vary
across communities
 Adolescents in treatment communities are more likely
to believe that the ideal age of marriage is over 18:
53% vs 40%
 Adolescents in treatment communities are more likely
to know the legal age of marriage: 4% vs 1%
FGM/C Child Marriage

58. Schools in treatment communities are better equipped for MHM
• Treatment communities are more likely to have separate toilets:
• 51% vs 39%
• Treatment communities are more likely to have MHM resources:
• 16% vs 11%
Afar
• Treatment communities are more likely to have separate toilets:
• 76% vs 59%
• Treatment communities are more likely to have MHM resources:
• 14% vs 8%
Somali

59. 5
Policy and programming implications
A Somali 8th grade girl in school. ©UNICEF Ethiopia/2019/Mulugeta Ayene

60. Conclusions What are the implications of this evidence?
 These research findings highlight that there have been some important attitudinal
advances regarding FGM and child marriage in line with the National Costed Roadmap
to End Child Marriage and FGM as highlighted by:
 The DHS does not ask about legal knowledge. This research adds value by asking
caregivers and our findings show that there is some knowledge by female
caregivers about laws on FGM and child marriage - although there is still room
especially in Somali for improvement
 Recognition by religious leaders of the risks of FGM as practised (so Type 3) and
an endorsement of less invasive practices (‘sunna’). While this is not elimination
in line with the National Action Plan to End Child Marriage and FGM/C, it does
highlight growing awareness about the significant health risks of Type 3
 Attitudinal preference by adolescent girls for adult not child marriages due to
desire to complete secondary education and due to maturity to enter marriage.
 Shifts in Afar towards marriage by choice rather than arranged absuma (cousin)
marriages in recognition of adolescent girls’ voice and agency
 However, widespread practice of FGM and of marriage before 18 years in both regions
underscores that there is still much to be done to tackle these harmful practices and
to empower girls and women. The findings point to a range of priority policy and
programming actions for national and regional actors alike

61. What are the policy and programming implications for sector actors? (1)
Work to ensure that all girls have access to education at least through the end of intermediate
school—and ideally through secondary school
• Scale up provisioning at least through 6th grade, even in remote communities (using mobile schools as needed)
• Improve teacher training
• Ensure mother-tongue instruction at primary school
• Provide school feeding
• Provide education materials to students from poor families
• Provide WASH at all schools—including MHM spaces and supplies
• Scale up tutorial support
• Provide participatory girls’/gender clubs for all students age 10+
• Offer curricular and extra-curricular education re gender norms—incl. CM, FGM/C, and SGBV
• Offer boarding opportunities for 7th grade +
• Use door-to-door outreach to enroll those out-of-school
• Fine parents of truants
• Strengthen supervision of schools by the woreda education office
• Incentivise teachers to reduce turnover and absenteeism
Education sector

62. What are the policy and programming implications for sector actors? (2)
Use social protection to incentivize uptake of education—and to delay child marriage
• Provide school feeding/ take home rations, esp. for girls
• Provide conditioned/ labeled cash support for education—tied to attendance/ girls’ marital
status
• Provide school material support—tied to gendered ‘plus’ programming for parents and
adolescents
• Provide asset transfers aimed at supporting girls and women to earn
Social Protection sector
(Bureau of Food Security)
Work with women and girls to improve their livelihood options
• Offer community-based female-only literacy and numeracy courses
• Scale up skills trainings for females—including animal husbandry and other occupational
skills, life skills, and financial and business skills
• Expand opportunities for females to save and borrow
Agriculture / labour sector

63. What are the policy and programming implications for sector actors? (3)
Raise awareness of the law and begin to penalise those who violate it
• Align regional legal codes with national law
• Work with the sharia court to improve girls' and women's rights to education, decision
making and control over resources.
• Work with local leaders to ensure that communities know that all forms of FGM/C are
illegal—esp. targeting traditional cutters and mothers
• Ensure that communities—adults and adolescents-- know that marriage before the age of 18
is illegal even if ‘chosen’ that adults involved in such marriages are subject to imprisonment
and fines
• Establish (anonymous) reporting mechanisms and use inputs to intervene in FGM/C and CM
• Set penalties on a community-by-community basis and enforce them
• Strengthen formal justice mechanisms-and oversight--at kebele level
• Work to raise awareness of SGBV, including IPV, with girls and women on when and how to
report and with boys and men on alternatives and penalties
Justice sector, including police

64. What are the policy and programming implications for sector actors? (4)
Work with girls and women to shift the gender norms and practices that limit girls’ and
women’s lives
• Raise girls and women’s awareness of their personal rights and how to report violations
(esp re SGBV)
• Strengthen SGBV rehabilitation centres (one stop centres) by involving key stakeholders
• Create venues and opportunities for girls and women to grow their own skill-sets
(esp life skills) and incomes
• Address broader gender roles—and how they disadvantage girls and women and how mothers
can empower daughters and encourage alternative masculinities in sons
• Raise awareness of the importance of education—esp for girls—and how to practically support it
• Address child marriage—including decoupling puberty from ‘marriage readiness’,
misconceptions about girls’ sexuality, the disadvantages of child marriage, and the advantages of
adult marriage
• Address FGM/C including risks—esp. of infibulation—and also perceived advantages and how
women might work together to eliminate these
• Work with BoH officials to ensure girls and women whose health is compromised by FGM/C have
access to appropriate and affordable medical care
Women and social affairs sector

65. What are the policy and programming implications for regional
governments?
Regional government actors
Regional government actors in Afar and Somali regions
can also play critical roles in promoting social change for
girls and women. Priorities include:
• Identify champions to promote change, including influential
religious and clan leaders,
• Promote a coalition to advocate for and to ratify the Family
Law (on age of marriage) and the Criminal Code (which bans
undertaking or procuring FGM)
• Allocate sufficient human and budget resources to tackle these
widespread norms and practices that jeopardise girls’ and
women’s empowerment and enjoyment of their rights
• Invest in evidence-based monitoring and evaluation of
programme interventions and the impacts they are having
over time on child marriage and FGM with a particular focus
on remote communities where prevalence is highest
Jijiga, Somali. © Abiy Solomon 2018

66. How can religious leaders support change?
Work with religious leaders to promote abandonment of
FGM/C and CM and to shift gender norms that lead to
SGBV
• Address both the disadvantages of child marriage—and
the advantages of adult marriage
• Address the risks of FGM/C, the misconception that it is
a religious requirement, and build support to use
religion to promote abandonment
• Address broader gender norms—and the value that
girls and women add to families and communities—and
the importance of eschewing violence and treating
them well
• Address the importance of girls’ education—for girls’
own sake and for their future families
• Work to raise religious leaders’ awareness that it is
illegal for them to advocate for child marriage and
FGM/C and that they can be prosecuted for officiating
the marriages of those under age
Religious Councils
Religious leader, Somali Region.© UNICEF Ethiopia/2019/Tadesse

67. How can clan leaders support change?
Engage in community awareness raising—esp. with men and
boys—to shift the practices and gender norms that
disadvantage girls and women
• Encourage girls’ education—including how husbands can
better support wives to free daughters’ time
• Raise awareness about the risks of child marriage—and the
advantages of adult marriage—focusing on messages likely to
resonate (e.g. wives are stronger and better helpmeets)
• Raise awareness of the risks of FGM/C—esp infibulation—
and how men can prevent further injury to wives and protect
daughters
• Encourage more equitable household decision-making,
perhaps as a way to improved household economies
• Encourage less violent masculinities—esp in regard to SGBV--
inc. how fathers can support these in sons
• Work to ensure that communities know that all forms of
FGM/C are illegal and subject to imprisonment and fines—
esp. targeting traditional cutters and mothers
Clan leaders
Community elder, Somali Region. © UNICEF Ethiopia/2019/Kelly Lynch

68. What are priority actions for NGOs?
Work with adults and adolescents to shift the gender norms and practices that limit girls’ and women’s lives.
• Alongside local leaders/providers, raise community awareness about CM—including the delinking puberty and marriage,
the law, risks (esp. in terms of poverty and violence) and parents’ obligation to prevent adolescent-driven CM. In Afar,
work with clan leaders to discourage absuma marriage
• Alongside local leaders/providers, raise community awareness about FGM/C—targeting mothers esp.-- addressing the
law, misconceptions about girls’ sexuality, risks and perceived advantages, and how women can band together to
protect daughters
• Support women to learn about and access their rights---including helping them earn/improve their own incomes, input
into HH decision-making, and report SGBV--and link this to learning about CM and FGM/C
• Provide parent-education courses for mothers and fathers that directly address restrictive gender norms and how these
harm esp. girls
• Support girls to access and excel in education via awareness raising and providing material support (including MHM
supplies), tutorials, etc.
• Strengthen school-based girls’ and gender clubs and use them to address broader and harmful gender norms—working
to empower girls and encourage alternative masculinities in boys
• Engage with adolescents re FGM/C and CM—working (depending on context) to shift current practices and/or
encourage intergenerational change – including through the media, especially radio and SMS texts given increasing
access to mobile phones
• Ensure interventions are scaled for impact—so that tipping points are timely
Child and gender-focused NGOs

69. What are priority actions for advocacy coalitions?
• Work with regional level officials to expedite the passage of laws that prohibit child marriage and
FGM/C
• Work with regional and sub-regional BoJ officials to raise awareness—and improve enforcement—of
national law
• Work with BoWSA, BoE, and BoH officials to strengthen commitment to elimination and
services/oversight at the kebele level to support that
• Engage with religious and clan leaders to develop tailored actionable plans for elimination
• To reduce girls’ risk of child marriage, expand efforts to improve their access to education
• Support the expansion of school-based girls’ and gender clubs that directly address CM and FGM/C
• Support the development and scaling of income generating activities for women—and link these to
education re CM and FGM/C
• Support capacity building for journalists and media producers to address issues of harmful practices
and the impacts on girls’ and women’s lives through the media, ensuing a diversity of platforms
including radio, text messages and social media
Alliance to End Child Marriage and FGM/C

70. How can development partners play a catalytic role?
Invest in education
for all—even in
remote pastoralist
communities
Invest in sub-
national capacity,
working to improve
local services,
including through
strengthening
officials’ and
providers’ skill-sets
Invest in robust
longitudinal
monitoring, evaluation
and research to track
progress and to inform
deployment of scarce
resources and to
promote effective
programming
at scale
Invest in shifting
restrictive gender
norms—including
through the scaling of
empowering girls’ and
gender clubs and in
improved earning
opportunities for
women
Invest in social
protection for the
most vulnerable—
leveraging where
possible to improve
girls’ education (e.g.
school feeding or
cash for education)
Also consider
investments in
sentinel site
monitoring and
evaluation to better
understand hotspots

71. 6
•Questions and comments
A Somali grade 8 volleyball team captain. © UNICEF Ethiopia 2019 / Mulugeta Ayene

72. Contact Us
WEBSITE
www.gage.odi.org
TWITTER
@GAGE_programme
FACEBOOK
GenderandAdolescence
About GAGE:
 Gender and Adolescence: Global Evidence
(GAGE) is a nine-year (2015-2024) mixed-
methods longitudinal research programme
focused on what works to support
adolescent girls’ and boys’ capabilities in the
second decade of life and beyond.
 We are following the lives of 20,000
adolescents in six focal countries in Africa,
Asia and the Middle East.
EMAIL:
worknehyadete@gmail.com
n.jones@odi.org.uk