Shifting social norms, behavioural intentions and opposition to female genital mutilation: Effectiveness of layered community interventions in a high prevalence setting in Kenya.

Female genital mutilation (FGM) remains prevalent in parts of Kenya, sustained by social norms around marriageability and social belonging. Although community interventions to end FGM are widely implemented, quantitative evidence of their effectiveness remains limited. This study evaluated whether mixed-sex community dialogues and women-only reflection circles implemented through the Girl Generation-Africa-Led Movement Programme changed FGM-related beliefs, intentions, social norms, and opposition to FGM in Isiolo County, Kenya. We analysed cross-sectional survey data from 2,235 respondents aged 15-60 years (1,314 women and 921 men). Exposure was self-reported participation in community dialogues and, among women, women-only reflection circles. Outcomes were pro-FGM beliefs, intention to cut a daughter, belief that uncut girls are not marriageable, and opposition to FGM. Associations were estimated using logistic regression with generalized estimating equations, adjusting for socio-demographic covariates. Among women, predicted probabilities were estimated across four exposure combinations, while a survey-weighted generalized structural equation model assessed pathways linking community dialogues to opposition to FGM. Participation in community dialogues was associated with lower odds of pro-FGM beliefs (aOR 0.49, 95% CI: 0.40-0.60), intentions to cut a daughter (aOR 0.34, 95% CI: 0.27-0.45), and belief that uncut girls are not marriageable (aOR 0.40, 95% CI: 0.31-0.53), and with higher odds of opposing FGM (aOR 3.09, 95% CI: 2.27-4.22). Among women, reflection circles primarily reduced intentions to cut and increasing opposition to FGM. Combined exposure produced the strongest effects, reducing the predicted probability of intending to cut a daughter from 38.6% to 12.7% and increasing opposition to FGM from 61.9% to 86.0%. Approximately 95% of the effect of community dialogues on opposition to FGM was mediated through changes in beliefs, intentions, and marriageability norms, with intentions representing the strongest pathway. These findings demonstrate that layered, community-led social norms interventions can meaningfully accelerate abandonment of FGM in high-prevalence settings.