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    • Prevalence in an immigrant population refers to

    2018-10-26

    Prevalence in an immigrant buy Oxamflatin refers to the proportion of girls and women who migrated from the associated practicing country and have already been cut (European Institute for Gender Equality, 2013). Girls at risk of cutting refers to uncut girls aged 18 or younger who migrated from a practicing country or have at least one parent who migrated from a practicing country (European Institute for Gender Equality, 2016). Most estimates of prevalence and risk in immigrant populations are derived by extrapolating from prevalence data in countries of origin (European Institute for Gender Equality, 2013). These data typically come from representative surveys, including the Demographic Health Survey and the Multiple Indicator Cluster Survey, periodically implemented in the 29 or more countries where female genital cutting is traditionally practiced (Yoder, Wang, & Johansen, 2013). The simplest approach to extrapolation is to apply an estimate of prevalence from the country of origin to an immigrant population. For example, if an estimated 80% of Sudanese women in Sudan are cut, then an estimated 80% of female Sudanese immigrants in Switzerland are cut. Recently, however, a number of researchers have developed refinements that extrapolate while accounting for differences between an immigrant population and people in the associated country of origin (Exterkate, 2013; Leye, Mergaert, Arnaut, & Green, 2014). These refined methods consider, for instance, age-specific cutting rates, regional differences in cutting within a country of origin, or differences between first-generation and second-generation immigrants (Dubourg et al., 2011; Exterkate, 2013; Leye et al., 2014; Ziyada, Norberg-Schulz, & Johansen, 2016). These refinements have the potential to greatly improve estimates of risk and prevalence because they allow for the possibility that immigrants are not necessarily like the people who remained in the country of origin. For example, one of the challenges when estimating risk among immigrants is that the age of cutting varies greatly within and between practicing countries. Ignoring this fact can distort estimated risk considerably. To illustrate, assume that every girl in a country of origin is cut the day she turns five. For every female aged five or older, prevalence is thus 100%. Further assume that in Europe all female immigrants from this country immigrated before they turned five, and they are all now above five. If we ignore these subtleties, we might conclude that the prevalence among immigrants in Europe is 100%, when in reality it could be 0% because everyone arrived in Europe before the cutting age. Dubourg et al. (2011), Exterkate (2013), and Ziyada et al. (2016) accounted for subtleties of this sort with extrapolation methods that condition on age-specific prevalence in countries of origin. Nonetheless, even if we disaggregate prevalence data from countries of origin based on observables like age and region, extrapolation may still not fully account for selective emigration from a cutting country, and it cannot account for acculturation after immigration into a non-cutting country (Leye et al., 2014). For this reason, researchers have developed the “migration and acculturation impact factor” (Exterkate, 2013; European Institute for Gender Equality, 2016; Ortensi et al., 2015). The general idea behind this factor is to refine estimates of risk for immigrants by jointly accounting for selective migration out of the country of origin and for cultural and behavioral changes after immigrating to a new country (European Institute for Gender Equality, 2016). For example, if everyone in a particular immigrant group comes from a non-cutting area in the country of origin, the risk is zero, regardless of aggregate risk and prevalence in the country of origin. Analogously, if everyone in a particular immigrant population completely and immediately assimilates to the norms of their new home, the risk that any uncut immigrant will be cut is zero, regardless of aggregate risk and prevalence in the country of origin. Selective migration and acculturation are two very different but potentially important channels that can lead the risk of cutting among immigrants to diverge from the country of origin.