AB031. Design of a community-based intervention to the eradication of female genital mutilation in rural Tanzania: a narrative review and evidence-informed framework

Background: Female genital mutilation (FGM) persists in several rural regions of Tanzania, despite a gradual decline in its national prevalence. National surveys report an average prevalence of 10%, but this figure masks significant regional inequalities: in Manyara (57.7%) and Arusha (41%), the practice remains common. Recognized as a human rights violation and a serious public health problem, FGM is reinforced by deep-rooted cultural, economic, and gender norms. This paper presents a proposal for a community intervention based on a narrative review of evidence, aiming to inform the development and future implementation of strategies adapted to the sociocultural context of rural Tanzania.

Methods: A narrative review of scientific literature and reports was conducted to identify effective community-based interventions in reducing FGM in sub-Saharan Africa. The findings were classified thematically and used to build the Malaika model, which integrates community participation, trauma-focused psychosocial care, gender-transformative education, and economic empowerment.

Results: The most effective interventions combine education, active participation of women, religious leaders, and men, safe spaces, and sustained community work. The Malaika model integrates these components through a multidisciplinary and culturally adapted approach. It includes the implementation of a Safe House for at-risk girls offering psychological support, vocational training, sexual and reproductive health education, and community workshops. Financial sustainability is ensured by integrating Malaika as the social impact arm of Hakuna Rise, a purpose-driven social enterprise and tourism agency. All the income generated by volunteer programs linked to Malaika is reinvested in the Safe House; other programs contribute a proportional percentage.

Conclusions: Malaika represents a scalable, financially sustainable, and evidence-based model for addressing FGM in rural Tanzania. Founded on the principles of equity, local leadership, and planetary health ethics, it offers a community-based alternative that connects global solidarity with grassroots action.

Keywords: Female genital mutilation (FGM); community; intervention; Tanzania; equity