Multisectoral approach to address Female Genital Mutilation: a case study from Portugal : Raquel Vareda

ABSTRACT

Issue Female genital mutilation (FGM) comprises all procedures that injury female genital organs for non-medical reasons, with several health impacts. Due to global migration, FGM has been increasingly recognised as a healthcare issue in Europe, affecting nearly 1 million women. In Portugal it is estimated that 5483 migrant women have undergone FGM in the Lisbon region. Intervention is required to tackle this issue. Description Portugal launched the “Healthy Practices End of FGM”, a multiagency project targeting Lisbon and Tagus Valley region. Project implementation started in Nov 2018 at 5 local public health units (PHU) and was scaled-up to 5 more in Feb 2020. Project comprises 3 main axes 1) inclusion in public policy instruments;2) professionals’ education and awareness;and 3) community intervention. We describe inclusion of FGM in public policy, professionals training and changes in FGM recording before and after intervention. Results Between 2018-2022, inclusion of FGM in municipalities’ migration policies doubled. Between 2019-2021, 110 training sessions (n = 1722 professionals) were promoted. During pandemic years, only 344 (2020) and 202 (2021) were trained. Raising awareness and empowerment to risk communities happened mainly through local/online open sessions, workshops, flyer distribution, video projections. These occurred in all 10 PHU, mostly through partnerships with Non-Governmental Organizations and municipalities. According to the Portuguese Health Records, until 2018 there were only 300 women registered with FGM. Between 2019-2021, 363 more were added. Lessons The multisectoral approach allowed PHU professionals to collaborate directly with external organizations from different society sectors. COVID-19 pandemic posed a challenge to implementation, especially in the community intervention axis. Notification numbers increased after interventions, though causality could not be established and impact evaluation is yet to be performed. Key messages • Multisectoral projects for FGM intervention have specific implementation challenges, including how to justify and evaluate them, that must be considered in each setting. • Training health professionals might increase identification and notification of FGM, but the impact in preventing FGM in the Portuguese reality is still largely unknown.