A Health Data Platform to monitor FGM cases (Portugal)
A Health Data Platform to monitor FGM cases
Portugal had until now three Action Programmes for the Elimination of Female Genital Mutilation (FGM).
All the Programmes of Action have been implemented by an intersectoral Group composed of the representatives of several bodies (public entities from the most relevant ministries, international organisations and NGOs) and coordinated by the Commission for Citizenship and Gender Equality (CIG).
In order to characterise, understand and act against FGM, the Ministry of Health has created a health database on this specific type of gender violence, which is a registration system of cases identified by health professionals.
The experience of the Programmes of Action for the prevention of FGM
The practice of female genital mutilation fits under Article 144 of the Portuguese Penal Code. Law no. 83/2015 (5 August), in compliance with the Istanbul Convention which determines it as an autonomous crime.
Considering that Portugal receives people originating from FGM-practising communities, the country has been incrementing, in the last few years, several policies aimed to prevent and combat FGM.
Under the work of an Intersectoral Group - composed of representatives from a number of Public Administration authorities, intergovernmental organisations and non-governmental organisations - three Action Programmes for the Elimination of Female Genital Mutilation have been developed:
- The I Programme of Action for the Elimination of Female Genital Mutilation (2007–2010) included in the III National Plan for Equality (2017–2010);
- The II Programme of Action for the Elimination of Female Genital Mutilation (2011–2013) included in the IV National Plan for Equality, Citizenship and Gender and Non-discrimination (2011–2013);
- The III Programme of Action for the Prevention and Elimination of Female Genital Mutilation (2014–2017), an integral part of the V National Plan to Prevent and Combat Domestic and Gender-based Violence (2014–2017).
- The III Programme of Action for the Prevention and Elimination of Female Genital Mutilation (2014–2017) foresees the adoption of 42 structured measures around the 5 following strategic areas: 1) Prevention; 2) Integration; 3) Training; 4) Acknowledgement; and 5) Cooperation.
Guidelines for health professionals
Since FMG is often identified within the context of the National Health Service (NHS) and considering the practice involves risks to physical and psychological health, health professionals must be aware of the characteristics of the phenomenon, as well as of the victims’ needs. To this end, the National Healthcare Service (NHS), overseen by the Ministry of Health, has adopted specific guidelines which create an obligation for healthcare professionals working in the NHS to record all cases of female genital mutilation.
Health Data Platform to monitor FGM cases
For the record purpose a database is being developed, aimed to generate a registration system of cases of FGM (Health Data Platform). It was created in 2012, by the Ministry of Health The Health Data Platform is a web platform where health information is recorded and shared, according to the conditions of the National Data Protection Commission. This clinical data repository is used for public health purposes by nearly 400 health institutions, covering all the Portuguese primary care services and all the public hospitals and has more than 35,000 views per day.
Used by all health professionals from the NHS, this database enables professionals to register the cases that are detected in medical acts in the Health Data Platform. Thus, health professionals, especially those who work at maternal and child health, must be able to identify and guide a child, a youth or a woman who has suffered from FGM, as well as to inform communities in order to prevent its practice in future generations. Moreover, within primary care, the risk or the existence of FGM must be identified in any clinical activity, namely those related to health care for children and youths, vaccination, family planning, community psychology and psychiatry and school health.
To monitor the Referral System for cases of FGM and the Health Data Platform (PDS) is one of the measures of the III Programme of Action for the Prevention and Elimination of Female Genital Mutilation (2014–2017). Thanks to its implementation, there is a better understanding of the reality of FMG in Portugal. In consequence, it is possible to increment actions adapted to victims’ needs. From April 2014 to December 2015, 99 cases were registered in the platform. The average age associated with the practice of FGM was 5.9 years old. 34% of the victims were exposed to type I, 62% to type II and 4% to type III. Victims were mostly from Guinea-Bissau.
Data obtained from public health system have been complemented with data from a study on FGM prevalence in Portugal. The main goals of the study, conducted by Manuel Lisboa et al. (2015), were to identify the number of girls and women victimised or at risk of excision, where FGM is practised, the age of girls, and other facts considered relevant to understand the phenomenon.
Several are the success factors that can associated to the health database on FGM: advance of knowledge on FGM reality, improvement of professional capacity for screening and intervention and amelioration of institutional articulation. The main obstacle concerning FGM characterisation is the victims’ resistance in share their victimisation stories, exposing their community practices and values.
Ministry of Health
Directorate-General of Health | Directorate of Disease Prevention and Health Promotion
Lisa Ferreira Vicente
Head of the Division of Infant, Youth, Reproductive and Sexual Health
Alameda D. Afonso Henriques, 45, 1049-005 Lisboa, Portugal
+351 21 843 07 29 (Fax)
Directorate-General of Health | Health Action for Children and Youth at Risk
Coordinator | Directorate-General of Health | Health Action for Children and Youth at Risk
Alameda D. Afonso Henriques, 45, 6. Piso | 1049-005 Lisboa, Portugal
+351 218430530 (Fax)