Abstract:
ntroduction Female genital mutilation (FGM) remains
highly prevalent in parts of Kenya, including Narok County,
where marriageability expectations and social sanctions
continue to sustain the practice. Although community-
dialogue interventions are central to strategies to end FGM,
evidence on their effects and mechanisms of influence
remains limited.
Methods We conducted a cross-sectional survey of 2658
respondents (1272 women and 1386 men) aged 15–60
years in Narok County in 2024. The primary exposure
was participation in mixed-sex community dialogues
with participation in couples-only dialogues as secondary
exposure. Outcomes were measured using survey items
adapted from established FGM and social norms literature,
including a composite index of beliefs favourable to cutting
and single-item measures of intention to cut a daughter,
perceived marriageability expectations and opposition to
FGM. Analyses used generalised estimating equations,
predicted probabilities and generalised structural equation
models to assess mediation pathways.
Results Participation in community dialogues was
associated with more progressive norms, including lower
odds of endorsing pro-cutting beliefs (adjusted OR (aOR)
0.61, 95% CI 0.48 to 0.76), intending to cut a daughter
(aOR 0.49, 95% CI 0.37 to 0.64) and perceiving uncut
girls as unmarriageable (aOR 0.53, 95% CI 0.43 to 0.66),
and higher odds of opposing FGM (aOR 2.39, 95% CI 1.84
to 3.11). Couples-only dialogues had smaller and less
consistent associations. Predicted probabilities indicated
substantial positive associations among participants
exposed to community dialogues alone or combined with
couples’ sessions. Mediation analysis showed that 88%
of the effect of community dialogues on opposition to
FGM indirectly linked through shifts in pro-cutting beliefs,
intentions to cut and marriageability expectations, with
intentions representing the strongest linkages.
Conclusion Community dialogues are strongly associated
with shifts in the social expectations and intentions that
underpin FGM in a high-burden Kenyan context. These
findings provide support for dialogue- centred strategies
to eliminate FGM. Beliefs, intentions and marriageability
norms are key intermediate indicators for monitoring
normative change