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More than 230 million women and girls worldwide have undergone female genital mutilation (FGM), with the majority residing in Africa, according to a report released on Friday by the United Nations Children’s Fund (UNICEF).

Over the past eight years, approximately 30 million people have undergone the procedure, which involves the partial or complete removal of external genitalia, UNICEF estimated in the report, issued on International Women’s Day.

While the percentage of women and girls experiencing FGM is decreasing, UNICEF cautioned that efforts to eliminate the practice are not keeping pace with rapidly growing populations.

“The practice of female genital mutilation is declining, but not fast enough,” the report stated.

FGM, a harmful practice erroneously believed to control women’s sexuality, can lead to severe bleeding and even death. Girls undergo the procedure from infancy to adolescence.

In the long term, it can result in urinary tract infections, menstrual problems, pain, decreased sexual satisfaction, childbirth complications, as well as depression, low self-esteem, and post-traumatic stress disorder.

“We’re also seeing a worrying trend that more girls are subjected to the practice at younger ages, many before their fifth birthday. That further reduces the window to intervene,” said UNICEF Executive Director Catherine Russell.

The report indicated that 144 million women and girls in Africa have undergone FGM, followed by Asia and the Middle East with 80 million and 6 million, respectively.

Somalia leads the countries where the practice, also known as female circumcision, is prevalent, with 99% of females aged 15 to 49 having undergone the procedure.

Burkina Faso has made significant progress, reducing the proportion of circumcised women aged 15 to 49 from 80% to 30% over three decades.

The report also noted that 4 in every 10 survivors live in conflict-affected countries with high population growth rates, noting that political instability hampers efforts to prevent the practice and provide support to victims.

“Ethiopia, Nigeria, and Sudan account for the largest numbers of girls and women who have undergone female genital mutilation in conflict-affected countries,” the report said.

Although the report acknowledged progress in some countries, it warned that the world is not on track to meet the UN’s goal of eradicating the practice globally by 2030.

“In some countries, progress would need to be 10 times faster than the best progress observed in history to reach the target by 2030,” the report stated.

Nimco Ali, CEO of the Five Foundation, a UK-based charity fighting FGM, described the UNICEF estimates as “shocking” and “devastating,” emphasizing the urgent need for more funding to end the practice.

“We must use the last six years of this decade to finally get to grips with this abhorrent abuse of a girl’s human rights and save the next generation from the horrors of FGM,” said Ali, a Somali-born activist, author, and FGM survivor.