Female Genital Mutilation/Cutting (FGM/C) is a grave violation of human rights and a significant public health ethics challenge. In Somalia, where adult prevalence is near-universal, understanding the determinants of the practice among the youngest generation is critical for achieving Sustainable Development Goal 5.3. This study aimed to investigate the spatial distribution of FGM/C among daughters (aged 0–14) and identify the individual and community-level factors that perpetuate or protect against this harm.

This cross-sectional study utilized secondary data from the 2020 Somalia Health and Demographic Survey (SDHS). A final analytical sample of 11,930 daughters was analyzed. Geospatial techniques, including Global Moran’s I and Getis-Ord Gi*, were used to identify spatial clusters of risk. A multilevel mixed-effects logistic regression model was employed to identify associated factors, specifically adjusting for the daughter’s current age to eliminate "time-at-risk" bias.

The national weighted prevalence of FGM/C among daughters was 25.16% (95% CI [23.8, 26.5]). Significant positive spatial autocorrelation was detected (Global Moran’s I = 0.353, p = .024), revealing distinct hotspots of high prevalence in southern and central regions and cold-spots in the north. Multilevel analysis revealed that the daughter’s own age was the strongest predictor of status (10–14 vs. 0–4 years: AOR = 79.27). Nomadic residence (AOR = 2.70) significantly increased the odds of a daughter undergoing FGM/C. Conversely, higher maternal education (AOR = 0.63) and a mother being uncut herself (AOR = 0.25) were powerful protective factors. The model’s intra-cluster correlation (ICC) was reduced from 0.085 to 0.027 in the full model, indicating that the selected covariates successfully accounted for most community-level clustering.

The practice of FGM/C among daughters in Somalia is a spatially clustered phenomenon, suggesting that a girl’s risk is a "spatial lottery" governed by powerful community norms rather than individual choice alone. These findings demand ethically informed, geographically targeted interventions that prioritize nomadic populations and support maternal education as a primary pathway for intergenerational change.