Trends and Determinants of Female Genital Mutilation Prevalence among Women of Reproductive Age in Tanzania and Kenya: A Demographic and Health Survey Analysis (2008-2022)

Background Female genital mutilation (FGM) remains a critical global public health challenge, with over 230 million affected women and girls, predominantly in Sub-Saharan Africa. Despite anti-FGM policies in Kenya and Tanzania, gaps persist in understanding longitudinal trends and socio-demographic determinants. This study examines FGM prevalence trends (2008–2022) and identifies key drivers to inform targeted interventions Methods A retrospective analysis of Demographic and Health Survey (DHS) data from 6,517 women aged 15–49 in Kenya and Tanzania (2008–2022) was conducted. Trends were assessed using weighted prevalence percentages and visualized via line graphs. Chi-square tests and multivariable logistic regression, adjusting for complex survey design, identified associations between FGM and socio-demographic, economic, and media-related determinants. Results FGM prevalence declined significantly in Kenya (27.9–16.0%) and Tanzania (17.6–8.9%). Higher education (AOR = 0.25, p  < 0.001) and wealth (AOR = 0.62, p  < 0.002) were protective, while rural residence (AOR = 0.37, p  < 0.001) and perceived religious mandates (AOR = 3.81, p  < 0.001) increased risks. Weekly radio exposure reduced odds (AOR = 0.53, p  < 0.001), but internet use correlated with higher prevalence (AOR = 2.40, p  < 0.001), potentially reflecting urban-rural divides. Conclusion Declining FGM prevalence underscores the effectiveness of education, economic empowerment, and media campaigns. Persistent cultural norms in rural and religious communities highlight the need for context-specific strategies, including faith leader engagement and legal enforcement. Sustained efforts must address systemic inequalities to accelerate FGM eradication in East Africa.