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International agencies and non-governmental organisations classify Quranic schoolboys who beg on behalf of their teachers as victims of child trafficking. The aim here is to understand why no Bissau-Guinean Fula religious leader, referred to as cerno, has been sentenced to prison, despite accusations of child trafficking. The findings show that community members hold religious leaders in high esteem for their role within the spiritual, educative, and social spheres. Community members, entrenched in complex discriminatory relations within their ethnic group and beyond, perceive them as their saviours, while politicians, high-ranking officers and traders compete for their endorsement. Criminalising the cernos is unsuccessful; to safeguard the interests of children, the children and their community members, including the cernos, should be put at the heart of the safeguarding measures. Despite complex layers of coloniality, the religious leaders are the masters of the game, and their imprisonment is challenging.

Balanced medical and criminal justice approaches addressing determinants of alcohol and other drugs (AOD) use are central to achieving the United Nations Sustainable Development Goals 3 and 16. However, data on AOD use in resource-poor settings are characterised by relative paucity and anecdote. This study aimed to describe and analyse AOD use susceptibility and its determinants among school-attending adolescents in the capital Bissau, Guinea-Bissau. Survey data were collected through a locally adapted Planet Youth questionnaire in June 2017 across 16 schools in Bissau. The 2039-strong sample was selected through a multi-stage, random cluster process. Participants’ lifetime alcohol use was 27.3%, smoking 10.8%, and cannabis use 3.6%. In each instance, the ‘15 years and above’ age bracket was the most common initiation period, signifying increased instigation in later adolescence. Subsequent Varimax Principal Component Analysis (PCA) of 312 variables captured data-driven models of AOD use susceptibility, implying imitated, polydrug use among initiates. Linear regression analysis revealed drinking, group violence, male gender, school dismissal and relationship breakdown as explanatory variables. Overlapping predictive variables suggest singular interventions may pre-empt myriad antisocial behaviours. PCA offers alternatives to singular, potentially myopic quantifications of drug use. PCA facilitates the creation of context-sensitive composite variables, enabling the identification of related outcome behaviours relevant to studies’ sociocultural settings.

BackgroundDespite tremendous progress on Ebola Virus Disease (EVD), challenges remain in the implementation of holistic strategies to quickly stop outbreaks. We investigated the effectiveness of a community-based confinement strategy to limit the spread of EVD during the tenth documented EVD outbreak in the Democratic Republic of the Congo (DRC), 2018 - 2020.MethodsWe did a community-based, open-label, two-group, unrandomized controlled intervention. Eligible participants were EVD contacts registered by epidemiological surveillance teams from November 2019 to May 2020 in the two last hotspots (Beni and Mabalako Health Zones). Intervention group participants were confined in specific community sites of their preference for the duration of their follow-up. Control group participants underwent CT without confinement and were allowed to continue their daily activities. The primary outcome was the number of confirmed secondary cases in the two groups. Secondary outcomes included delay between symptom onset and isolation, case fatality rate, survival rate, and vaccination rate. Data were analyzed using various quantitative methods.FindingsA total of 27,324 EVD contacts were included in the study. 585 contacts were confined and followed up (‘the intervention group’), and 26,739 were followed up without confinement. The intervention group generated 32 confirmed cases (5.5%) in the first generation, while the control group generated just 87 (0.3%). However, the 32 confirmed cases from the intervention contacts did not generate any onward transmission (R=0.00), whereas the 87 confirmed cases from the non-intervention group generated 99 secondary cases (R = 1.14). Results for the secondary outcomes showed significant difference between the two groups. The delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; pInterpretationThe community-based confinement strategy used in DRC is effective for the rapid cessation of EVD transmission, highlighting the importance of rapidly implemented, innovative and community-oriented control strategies.

Publisher's version (útgefin grein), Population movement is a major driver for infectious disease transmission and can impact the success of disease control and elimination strategies. The relationship between disease transmission and permanent migration is well documented, but fewer studies have considered how different types of population mobility affects disease transmission and control programmes. This qualitative study was conducted on two islands of the Bijagós archipelago, Guinea Bissau to understand spatial and temporal population movement, and reasons for these movements, within, between and away from the Bijagós islands. Data were collected on two islands using key informant interviews (n = 8), daily activity-location interviews (n = 30) and focus group discussions (n = 6). Data were analysed thematically using an adapted typology of mobility. Findings revealed that movement within and between islands, and from islands to the mainland, was a common feature of island life for men and women alike. It was usual for trips away from home to last for several months at a time. Five key reasons for travel were identified: subsistence activities; family events; income generating activities; cultural festivities and healthcare. These movements often occurred erratically all year round, with the exception of seasonal travel within and between islands for agricultural purposes. Our study characterised detailed patterns of human mobility in the Bijagós islands as a first step towards understanding the potential impact of different types of mobility on disease exposure, transmission and public health programmes. Short-term mobility may have a significant impact on the spread of infectious diseases with short incubation periods. Predictable movements, such as travel for seasonal agricultural work, should be taken into account for tailoring and increasing the reach of public health interventions. Further research is needed to understand the role of human behaviour and mobility in disease transmission and control across the archipelago., This work was supported by the Medical Research Council grantnumber MR/P023843/1 awarded to David Mabey at the London Schoolof Hygiene & Tropical Medicine.

Digital technology plays an important role in achieving many of the Sustainable Development Goals. However, access is uneven, with 80% of those in high-income countries being online compared to 20% of those in the 47 least developed countries. This study aimed to describe and analyse adolescents&rsquo, access to and usage of digital technology in Guinea-Bissau and its implications. In June 2017, a survey with a locally adapted Planet Youth questionnaire was implemented in the capital, Bissau, whereby classes in 16 secondary schools were surveyed on a variety of issues. In total, 2039 randomly selected students participated, the survey included ten questions specifically on the access to and use of digital technology. Half of the respondents had access to desktop/laptops, and one-third used mobile internet daily, about two-thirds had an experience of social media. Explanatory variables included educational institution, parental education, economic situation, and gender. Furthermore, students&rsquo, experience of social media was significantly linked to bullying, anxiety, depression, smoking and alcohol consumption. Many adolescents in Bissau have no experience of using digital technology, including for schoolwork. Access improvements are necessary so that young Bissau-Guineans are not to be left behind in developing their capabilities and can benefit from proficiency in the use of digital technologies. At the same time, potential harmful usage of the media requires the implementation of preventive measures.

This article treats repatriation of Bissau-Guinean Quranic schoolboys from Senegal where they beg for their teachers who are named marabouts. Data is based on fieldwork that occurred between 2009 a...

Aims With the Sustainable Development Goals 2016-2030 increased attention is given to adolescents’ health and well-being, and the multiple challenges they face related to their health and wellbeing with trajectories of importance for their later adult health. A recent trend within childhood and youth studies acknowledges commonalities of lived experiences of young people in middle- and low-income countries, where the majority of them lives, vis-a-vis high-income countries. In sub-Saharan Africa adolescents comprise 23% of the population compared to 12% in high-income countries. Here we describe and analyse the prevalence of smoking and use of alcohol by Bissau-Guinean adolescents aged 15-16 and compare to peers European cities. Methods Survey with locally adapted and pilot tested Planet Youth questionnaire was conducted in June 2017 in 16 secondary schools in the capital Bissau, Guinea-Bissau. It targeted adolescents aged 15-16 years in randomly selected classes with information that is comparable with data from eight European cities in 2015-2016. Results In Bissau, 871 adolescents aged 15-16 participated (52% girls and 46% boys) compared to 6,534 peers in eight European cities (49% girls and 51% boys). In total, 2.2% of the Bissau-Guineans reported daily smoking (boys=3.9%; girls=0.7%) compared to 11.3% of their European peers (boys=13.2%; girls=9,4%). About 1/3 of the Bissau Guineans had life-time experience of drinking alcohol compared to about 2/3 of the European ones, with no difference among boys and girls; 10,6% of Bissau-Guineans reported having been drunk during the last 30 days compared to 14% of the Europeans, the prevalence being slightly higher among boys compared to girls. Conclusions Bissau-Guinean adolescents aged 15-16 report less smoking and drinking than European peers. Against a background of intensive marketing of alcohol and tobacco in Guinea-Bissau, it is urgent to initiate health promotional activities in secondary schools in Bissau to inform and educate adolescents and teachers on the detrimental effect of such behaviours on their long-term health and wellbeing.

Aims Following the adoption of the Sustainable Development Goals (SDGs) 2016-2030, the health and wellbeing of adolescents are in focus for global health policy. Comprehensive investment in adolescents’ health and wellbeing, including education, is estimated to generate high economic and social returns, in particular in resource-poor countries. Here the aim was to identify socio-economic determinants for school attending Bissau-Guinean adolescents aged 14-19 years. Methods In June 2017, a survey with locally adapted and pilot tested Planet Youth questionnaire was conducted in the capital Bissau. School classes in 16 schools, both public and private, were weighted by size and randomly selected from a special registry of 114 classes with 4.470 students aged 14-19 years. Results In total, 2,039 students completed the questionnaire (52% girls), and 52% attended public schools. The mean age of girls was 16,3 years compared to 16,4 years (median 17) for boys; girls were 1.29 times (95% CI 1.08-1.55) more likely to attend a private school compared to boys. Adolescents from better-off families were 2.10 times (95% CI 1.49-2.95) more likely to attend private school compared to those worse off. Further, those who reported speaking Portuguese (official language) in their homes were 4.13 times (95% CI 2.65-6.44) more likely to attend a private school compared to participants speaking other languages, including the lingua franca Creole. There was no statistically significant difference between adolescents in the two types of schools to report absence from school because of illness during the last months before the survey. Nonetheless, participants in public schools were 2.22 times (95% CI 1.64-2.99) more likely to skip classes one or more days in the same period compared to participants in private schools. Conclusions In a setting of political instability, and socioeconomic hardship, better-off parents choose private schools to give their children better educational opportunities than are on offer in public schools that are frequently on strike. The Bissau-Guinean ‘SDG generation’ needs support through better public school infrastructure and staff to improve their educational opportunities and thereby allow them to attain their full potential as adults.

Inequality in access to quality education is wide-ranging across and within countries. This study examines determinants for adolescents’ school enrolment in private and public schools in Bissau, Guinea-Bissau, including 2,039 randomly selected school-attending adolescents. The survey methodology was built on the Planet Youth collaboration and is the first of its kind in the setting. The critical determinant for attending a private school rather than a public one reflects parental socioeconomic background, i.e., education, employment status, and financial resources, not gender. Overage class enrolment is common, particularly in public schools and among boys rather than girls. National and international collective action and innovative education policies are needed for Bissau-Guinean adolescents to enjoy their right to the quality education they are entitled to.

Parents of trafficked children are mostly ignored or represented in mass media and reports published by international institution and NGOs as desperately poor, ignorant or indifferent. This article gives voice to Bissau-Guinean Fula parents who are descendants of former slaves aiming to raise their social status by sending sons to Quran schools in Senegal. No parent argued they did so because of poverty. Concerned with discrimination, they sent their favourite son abroad hoping he would ‘become somebody’. At the same time, parents mentioned the importance of religious commitment, piety and serving Allah. To their outrage, global institutions and NGOs classify the practice of sending boys to Quran schools in Senegal as child trafficking. Anti-trafficking activities are ongoing, including repatriation of boys from Senegal, something seen as degrading and criminalising. Repatriation of their chosen son is seen as the worst outcome and proof of discrimination. Nonetheless, the parents are resistant and contin...

Publisher's version (útgefin grein), [No abstract available], The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

The Palermo Protocol is the outcome of bargain and lobbying with global institutions, NGOs and government representatives embattling to enforce their interests. The outcome is the concept of trafficking that embraces the struggles against prostitution, slavery and child labour. This broad concept has allowed various local cultural practices and survival strategies of those who live under difficult conditions to become classified as trafficking. While such definition may facilitate fundraising there are adverse consequences to be considered. Firstly, hazardous conditions of children that obviously are not trafficking tend to become ignored. Second, the victims of “real” trafficking become invisible by the excessive number of children allegedly trafficked. Third, the broad definition of trafficking has contributed to criminalization of whole communities and consequent conflicts between NGOs engaged in anti-trafficking activities and the communities involved. Such a situation is not in the best interest of the children involved. Rather than spending huge amount of resources on the conventional anti-trafficking measures there is a need to address the root causes of whatsoever unacceptable condition a child is suffering from.