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Background The objectives of this study were to determine the association between the vulnerability factors linked to human immunodeficiency virus (HIV) and other sexually transmitted infection among the young women who sell sex (YWSS) group (15–24 years) and adult sex workers, engaged in consensual sex for money (AFSW). Methods A cross-sectional study was conducted among AFSW involved in commercial sex transactions. Prevalence ratios (PR) analysis was carried out using log-binomial regression model. Results The prevalence of HIV-1 was 29.4% among YWSS compared to 19.6% among female sex worker (PR = 1.43 [1.07–1.91]). Consistent condoms use last 3 months were very low at 22.3% and 41.2%, respectively (PR = 0.52 [0.37–0.74]), the low education level among YWSS versus AFSW (PR = 0.55 [0.40–0.76]); YWSS having been a victim of sexual violence in the last 12 months (PR = 2.00 [1.52–2.63]), were also more likely to be HIV positive. Conclusions The YWSS had a high prevalence of HIV, experienced other socioeconomic vulnerabilities and remain a key population for comprehensive HIV programs. To reach all YWSS, programs need to consider many outreach programs and address the shared determinants of HIV risk. [ABSTRACT FROM AUTHOR]

The majority of the world's ultra-poor live in conflict-affected environments. Poverty reduction efforts are increasingly attempting to target the most vulnerable inhabitants of these settings. Few studies have so far examined their impacts. Against the backdrop of one of the largest humanitarian crises in recent years, survey data from the Central African Republic demonstrates that a year after the conclusion of a large social safety net program, the poorest female participants did not benefit proportionately to other women and men. We draw on 257 in-depth qualitative interviews in extremely difficult-to-access conflict-affected sites across the country to explore the puzzle of why the most vulnerable inhabitants of conflict-affected settings may fail to benefit equally from poverty reduction programs. We demonstrate that conditions of social isolation—rather than poverty itself—create two specific barriers to long-term benefits. First, social isolation means that the poorest women recipients lack the social support networks that permit others to respond to conflict-related shocks without draining all their new income on emergency spending. Second, small social networks create a shortage of labor and higher start-up costs for new revenue-generating activities, thereby preventing spending on investment opportunities. These factors highlight the social barriers to poverty reduction, which are often intensified by shocks born from war, that material aid alone fails to redress. [ABSTRACT FROM AUTHOR]

This article is about a young farmer named Linga and his encounter with a water spirit in Oubangui-Chari (present-day Central African Republic) in 1930. It is also about the telling and re-telling of Linga's encounter as the story was transcribed into Banda, translated into French, and rewritten as an ethnographic folktale. Responsible for these transformations were two Banda interpreters and a colonial administrator from the Caribbean. In the last two decades, historians of colonialism have turned increasingly to interpreters and other intermediaries. Often missing from this scholarship, however, are analyses of the granular details—of how colonial intermediaries used transcription, translation, and other methods to create new words, texts, and ideas. Linguistic anthropologists refer to such interventions as "entextualization," the process by which fragments of discourse are extracted from their immediate settings and rendered into detached texts. Drawing on this scholarship, I argue that tracing the granular processes of entextualization opens up new vantage points from which to study the role of colonial intermediaries in the production of knowledge. The article also illuminates a methodology for mapping otherwise invisible constellations of language, meaning, and colonial power. [ABSTRACT FROM AUTHOR]

One of the defining features of the crisis in the Central African Republic (CAR) since 2013 has been massive displacement. Currently, about a quarter of the country's population is displaced. People who have been forcibly displaced, whether internally or abroad, and people who stayed behind this time (but frequently have their own memories of displacement) provide particular kinds of information about war and its not particularly peaceful aftermath. In this article, based on interviews with a broad range of people affected by displacement, we show that Central African views about the prospects for peace are deeply affected by how displacement has shaped tensions over the political senses of distribution (who has a right to what, and on what basis). Who should pay for war, in senses both material and otherwise, and who should be compensated? However, distribution and belonging are not the issues prioritized in the aftermath of war, when elite deals, punitive justice and technocratic recovery plans crowd out treatment of the material justice and belonging questions that dominate neighbourhoods. The political dimensions of material justice in the aftermath of war require more thorough treatment, as listening to people who have experienced displacement makes abundantly clear. [ABSTRACT FROM AUTHOR]

When seeking to ensure financial sustainability of a health programme, existence of a line item in the Ministry of Health (MOH) budget is often seen as an essential, first step. We used immunization as a reference point for cross-country comparison of budgeting methods in Sub-Saharan African countries. Study objectives were to (1) verify the number and types of budget line items for immunization services, (2) compare budget execution with budgeted amounts and (3) compare values with annual immunization expenditures reported to WHO and UNICEF. MOH budgets for 2016 and/or 2017 were obtained from 33 countries. Despite repeated attempts, budgets could not be retrieved from five countries (Chad, Eritrea, Guinea Bissau, Somalia and South Sudan), and we were only able to gather budget execution from eight countries. The number of immunization line items ranged between 0 and 42, with a median of eight. Immunization donor funding was included in 10 budgets. Differences between budgeted amounts and expenditures reported to WHO and UNICEF were greater than 50% in 66% of countries. Immunization budgets per child in the birth cohort ranged from US$1.37 (Democratic Republic of Congo) to US$67.51 (Central African Republic), with an average of US$10.05. Out of the total Government health budget, immunization comprised between 0.04% (Madagascar) and 5.67% (Benin), with an average of 1.98% across the countries, when excluding on-budget donor funds. It was challenging to obtain MOH budgets in many countries and it was largely impossible to access budget execution reports, preventing us from assessing budget credibility. Large differences between budgets and expenditures reported to WHO and UNICEF are likely due to inconsistent interpretations of reporting requirements, diverse approaches to reporting donor funds, challenges in extracting the relevant information from public financial management systems and broader issues of public financial management capacity in MOH staff. [ABSTRACT FROM AUTHOR]

Sexual violence is commonly described as an epidemic in the Central African Republic (CAR) and other conflict settings. In response, the government and the international community have launched major efforts to combat sexual violence, including the investigation and prosecution of sexual crimes and offences by the ordinary justice system, the Special Criminal Court in the Central African Republic, and the International Criminal Court. Yet, little is known about how these efforts are perceived among the population and about their effectiveness at reducing exposure in a context of ongoing violence. This article builds on a unique series of four surveys conducted at six-month intervals between 2017 and 2018 with a total of 25,143 randomly selected adults. It assesses the magnitude of sexual violence and shows that respondents positively perceive efforts to combat sexual violence and increasingly understand and trust the justice system. Disclosure of sexual violence is increasing, but only one in five victims files a formal complaint with security and justice actors. Factors undermining disclosing or filing of complaints about these widespread events include fear of retaliation, re-traumatization, and stigmatization. Investigating sexual crimes in a context of insecurity is extremely challenging and the work of the various courts is hindered by practical, procedural, and social challenges detailed in this article, as well as the need to coordinate prosecutorial strategies. There is an urgent need to build capacity and to ensure appropriate and compassionate treatment towards those who have been assaulted. Monitoring perception of criminal justice efforts is an important step towards understanding their contribution to ending sexual violence and to peace. [ABSTRACT FROM AUTHOR]

Background This last decade's ongoing conflict in the Central African Republic (CAR) has led to gradual and continuous destruction of health services. With severe gaps in qualified health professionals, community health workers (CHWs) have become essential to ensuring health care access to the affected population. This article aims to evaluate the effectiveness of a 10-y CHW program in the CAR. Methods Routine case management data from CHWs were collected in the Paoua district from January 2012 to December 2017 and analysed. Structured interviews were conducted in the Paoua and Carnot health districts among individuals from three different groups (health service beneficiaries, CHWs and health facility managers). Results From 2012 to 2017, 353 948 people consulted for malaria suspicion with CHWs and 86% were found to be malaria positive after a rapid diagnostic test. Among those diagnosed patients, 98.5% received adequate treatment and nearly 1.5% were referred to health facilities. Also, 94.5% of respondents identified fever as the major malaria symptom. About 70% of the population could identify three malaria signs/symptoms and 84.4% accepted and used CHW services. Interviews with CHWs revealed that 45.8% of them received at least four training sessions per month as part of their capacity building. Conclusions CHWs can be a resourceful solution when other health professional are scarce. This study showed that CHWs are not only able to deliver curative and preventive health services, but they are also well accepted by the served communities. [ABSTRACT FROM AUTHOR]

The Special Criminal Court in the Central African Republic can be viewed in two ways. The optimistic view is that it is a vindication of the idea that the international community should complement the efforts of states in the fight against impunity. The pessimistic view is that its establishment represents the International Criminal Court (ICC)'s failure to catalyze accountability at the national level. Against the backdrop of these two opposing narratives, this article examines the main legal features of this new 'hybrid' court and its relationship to the principle of complementarity enshrined in the ICC Statute. It addresses the following questions: the hybrid court's legal basis under Central African law, its jurisdictional mandate, the mixed composition of its staff, immunities and amnesties, and the Special Criminal Court's concurrent jurisdiction with the ICC. The article suggests that, although it is a promising example of international - national cooperation, the Special Criminal Court calls into question legal and systemic assumptions underpinning complementarity, the principle that gives states priority in prosecuting international crimes, which in turn raises questions about the relevance of complementarity in analogous conflict and post-conflict situations. [ABSTRACT FROM AUTHOR]

People seeking to understand the scope and scale of violence in the Central African Republic over the past two years have cited a variety of social grievances centring on the political manipulation of religion, belonging, and access to opportunities. Without denying that these factors have played a role, this article argues that the violence must be understood in the context of social practices of violence that long predate the war, especially in light of the diffuse and non-centralized mode of organization through which the ongoing war has played out. The article focuses on the prevalence of popular punishment and vengeance, which have long histories as elements of statecraft in the CAR and have become even more widespread amid the generalized insecurity and anomie that have set in over the past few decades. The article presents evidence of the workings of popular punishment from the intra-family level to that of the crowd and quartier, in both rural and urban locales. Though people have important reservations about popular punishment, they also see vengeance as an important tool for enforcing a circumscribed mode of empathy and a minimum set of standards for social behaviour. These experiences in the CAR suggest that those wishing to understand how wartime mobilization happens must consider not just fighters' grievances but also people's conceptions of the practical and symbolic efficacy of vengeance and popular punishment as elements of politics and the management of threats. [ABSTRACT FROM PUBLISHER]

Jean-Pierre Bemba is on trial before the International Criminal Court (ICC) based on the legal theory of command responsibility for crimes allegedly committed by Congolese soldiers deployed in the Central African Republic (CAR) at the request of the country’s President Ange-Félix Patassé during the 2002–2003 conflict. Various ICC actors, including prosecutors, judges, witnesses, defense lawyers and victim representatives, have uncritically adopted the term ‘Banyamulenge,’ ordinarily an ethnonym for an eastern Congolese community, to refer to the purported perpetrators of these crimes. This article digs into the origins of the collective labeling of Bemba’s combatants in the CAR. It also examines the possible impact that negative narratives associated with Banyamulenge in the Bemba case may have on the already explosive identity politics in (eastern) Democratic Republic of Congo. [ABSTRACT FROM AUTHOR]

However destabilizing illegitimate regime changes are for Africa, they have not caused China to change its policies. Examining five coups that occurred in Africa between 2003 and 2010, this article argues that China did not see the coups as major threats to its interests, but accepted instability as a part of doing business in Africa. China remained sceptical of democracy as an antidote to instability and deeply distrusted the effort of Western countries to promote liberal political standards. China therefore continued to display conservative self-restraint, a preference for unilateralism, and a pragmatic mercantilist policy intended to strengthen its economic presence. If China is guided by any strategy, it is the strategy of adapting to political realities, rather than trying to shape them. [ABSTRACT FROM PUBLISHER]

This article examines a neglected pattern of the regional crisis in Darfur, Chad, and the Central African Republic: the cross-border activities of combatants with fluid loyalties. The trajectories of Chadian 'ex-liberators' in CAR, which have been little documented, are used to illustrate the regional movements of armed men. The article explains how unemployed Chadian soldiers were recruited to fight with François Bozizé in CAR and why many of them joined other armed groups after Bozizé's takeover. The reconversions of armed combatants, who may easily shift allegiance and cross borders to carry on with their 'politico-military careers', is thus a structural characteristic of the current conflict, which has major implications both at the local and transnational levels. The article concludes that freelance military entrepreneurs' trajectories are crucial in understanding the unfolding of this regional crisis. [ABSTRACT FROM AUTHOR]