Health consequences associated with female genital mutilation (FGM), their excess annual risks in FGM-affected individuals and associated economic cost
| Complication | Costs and resource utilisation | Annual excess risks in FGM group* | ||||||||
| Commodity cost (2018) US$ | Outpatient consultations | Inpatient days | Childhood | Adult: non-reproductive | Adult: reproductive | Later life | One-time cost† | Applicable FGM types | References | |
| Acute consequences | ||||||||||
| Abscess on vulvar area | – | 1 | 1 | 1.3% | 0.0% | 0.0% | 0.0% | 1 | III | 95 |
| Excessive bleeding | – | 0 | 3 | 30.1% | 0.0% | 0.0% | 0.0% | 1 | III | 29 38 45 65 66 94 |
| Excessive bleeding | – | 0 | 3 | 18.6% | 0.0% | 0.0% | 0.0% | 1 | I/II | 29 38 39 56 74 76 78 94 |
| Infected wounds | – | 1 | 0 | 11.6% | 0.0% | 0.0% | 0.0% | 1 | I/II | 39 78 94 |
| Infected wounds | – | 1 | 0 | 5.2% | 0.0% | 0.0% | 0.0% | 1 | III | 39 94 |
| Genital ulcer | – | 1 | 0 | 1.6% | 0.0% | 0.0% | 0.0% | 1 | I/II/III | 88 |
| Urogenital complications | ||||||||||
| Bacterial vaginosis | 0.29 | 0.5 | 0.5 | 0.0% | 11.4% | 0.0% | 0.0% | 0 | I/II/III | 63 |
| Clitoral neuroma | – | 0 | 1 | 0.0% | 0.2% | 0.2% | 0.0% | 0 | I/II | 62 |
| Genitourinary tract (infection) | 0.29 | 0.5 | 0.5 | 0.0% | 0.6% | 0.6% | 0.0% | 0 | I/II/III | 21 |
| Keloids of labia | – | 0 | 1 | 0.0% | 0.6% | 0.6% | 0.0% | 0 | I/II | 62 |
| Menstrual difficulties | – | 2 | 0 | 0.0% | 2.4% | 0.0% | 0.0% | 0 | I/II/III | 46 48 72 96 |
| Recurrent UTIs | 0.29 | 0.5 | 0.5 | 1.9% | 1.9% | 1.9% | 1.9% | 0 | I/II/III | 63 |
| Kidney infection | 0.29 | 0.5 | 0.5 | 1.5% | 1.5% | 1.5% | 1.5% | 0 | I/II/III | 40 |
| Obstetric complications | ||||||||||
| Caesarean | 17.63 | 0 | 7 | 0.0% | 0.0% | 4.2% | 0.0% | 0 | I/II/III | 21 27 32 36 40 44 45 48 52 54 84 87 92 98 99 |
| Dystocy | 2.71 | 0 | 1 | 0.0% | 0.0% | 9.0% | 0.0% | 0 | I/II/III | 40 63 79 |
| Episiotomy | 0.07 | 0 | 0 | 0.0% | 0.0% | 25.4% | 0.0% | 0 | I/II | 51 62 93 101 |
| Episiotomy | 0.07 | 0 | 0 | 0.0% | 0.0% | 38.5% | 0.0% | 0 | III | 22 101 102 |
| Low birth weight | – | 0 | 0 | 0.0% | 0.0% | 2.0% | 0.0% | 0 | I/II/III | 22 80 102 |
| Obstructed labour | 2.71 | 0 | 1 | 0.0% | 0.0% | 4.0% | 0.0% | 0 | I/II/III | 40 72 98 |
| Perineal tear (second degree) | 0.07 | 0 | 0 | 0.0% | 0.0% | 12.3% | 0.0% | 0 | I/II | 93 |
| Perineal tear (third degree) | 0.07 | 0 | 0 | 0.0% | 0.0% | 5.3% | 0.0% | 0 | I/II | 93 |
| Perineal tear (first degree) | 0.07 | 0 | 0 | 0.0% | 0.0% | 10.7% | 0.0% | 0 | I/II | 93 |
| Perineal tear (third degree) | 0.07 | 0 | 0 | 0.0% | 0.0% | 10.0% | 0.0% | 0 | III | 99 |
| Urethral tear | 0.07 | 0 | 0 | 0.0% | 0.0% | 3.5% | 0.0% | 0 | III | 45 |
| Urethral tear | 0.07 | 0 | 0 | 0.0% | 0.0% | 4.3% | 0.0% | 0 | I/II | 93 |
| Newborn resuscitated | 0.49 | 0 | 2 | 0.0% | 0.0% | 4.4% | 0.0% | 0 | I/II/III | 40 84 |
| Psychological/sexual complications | ||||||||||
| Anxiety (moderate to severe) | 3.93 | 2 | 0.28 | 0.0% | 4.1% | 0.0% | 4.1% | 0 | I/II/III | 28 |
| Depression (moderate to severe) | 3.93 | 2 | 0.28 | 0.0% | 1.3% | 0.0% | 1.3% | 0 | I/II/III | 67 |
| Dyspareunia | – | 1 | 0 | 0.0% | 2.8% | 0.0% | 0.0% | 0 | I/II/III | 19 21 46 48 |
| Sexual dysfunction | – | 1 | 0 | 0.0% | 3.2% | 0.0% | 0.0% | 0 | I/II/III | 91 |
*Excess risk is the additional annual risk of each complication in an FGM-affected individual.
†1 if the cost is associated with the acute FGM event, 0 otherwise.