The focus of work on FGM in Portugal over the last 15 years has been to raise awareness among the public, policymakers and professionals of an issue previously regarded as exotic, brutal and distant.

Early research by APF indicated that FGM was not on the national sexual health and sexual rights agenda. APF thus played a central role in establishing FGM as a recognised problem affecting women and girls in Portugal—one that required action by relevant institutions and legislation criminalising the practice.

A key result of this awareness-raising and advocacy work was the formation of the Intersectoral Working Group in 2008 and the First National Programme to Eliminate FGM in 2009, successfully putting FGM on the policymaking and technical agendas. Guidelines were adopted by the Health General Directorate, the High Authority for Child and Youth Protection as well as the Criminal Police. The Intersectoral Working Group is therefore an example of good practice, with the main objective of implementing, monitoring and evaluating national programmes to combat FGM.

The next phase was to implement sectoral and departmental guidelines in order to improve professionals’ skills in the area of FGM. Although good progress has been made to this end, much remains to be done. Many professionals are still unaware of FGM and, when faced with the practice, many are unsure how to proceed.

The three post-graduate courses co-organised by CIG, DGS, the Lisbon and Setubal Nursing Schools and APF have so far trained around 90 professionals from several health centres and hospitals, who are currently being evaluated. Many of these professionals became focal points, using their new skills to organise projects on FGM, or to include FGM in their service concerns and routines. New training activities are planned.

Another key action has been to improve knowledge of the problem of FGM in Portugal, and to implement mechanisms to identify affected and at-risk women and girls. Useful publications include a national study on FGM (Lisboa et al), qualitative studies (APF under the REPLACE project), and EIGE’s 2013 report, each of which has provided new data and greater understanding about FGM in Portugal.

Another important resource is the National Health Database (PDS), which, by collecting data on registered cases, is not only contributing to a better picture of the problem but also to improving the participation of health professionals.

However, real progresses cannot be achieved without the active involvement of FGM-practising communities. Over the last 5 years a number of NGOs, including several from the most-affected community of Guinea Bissau, have developed new projects on FGM, including developing networks, approaching formal and informal community leaders, organising discussion groups with women and youth, promoting changes in traditional values and distinguishing between good and harmful practices in terms of impacts on health and rights.

As a result, affected communities are increasingly becoming the main drivers of change.

However, great challenges remain for all those involved in the fight to eliminate FGM in Portugal and to improve knowledge of the practice. Going forward, work must focus on improving intersectoral and interdisciplinary procedures to identify and prevent cases of FGM, to help survivors and those at risk of FGM, and to involve affected communities and consolidate networks.