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How do public procurement practices influence effective public financial management (PFM) in Africa? Notwithstanding the several public procurement reforms to improve PFM in Africa, outcomes have not been sustainable. Prior studies have failed to explain this phenomenon. With a descriptive case study design based on comprehensive datasets, this paper explains this situation with three key factors underlying the public procurement environment in three African countries: Ethiopia, Central African Republic, and Ghana. From the agency theory lenses, these factors affect the agency cost in public administrative systems necessary for addressing the agency problems in public procurement management towards desired PFM outcomes. [ABSTRACT FROM AUTHOR]

This paper investigates the geochemistry of bulk rock and infers the petrogenesis of ultramafic rocks in the Boali Precambrian terrane in Mbi Valley, in the North of the Central African Republic (CAR). The studied rocks comprise coarse primary olivine and orthopyroxene relics (dominant phase), magnesio-hornblende, magnetite, and antigorite. Whole-rock analysis indicates low SiO2 (average of 43.14 wt%) and high MgO (19.84–26.98 wt%) contents and their Mg number (Mg#) ranges from 74 to 82. They display high Ni (526–865 ppm), Cr (1500–3680 ppm) contents. AFM (Na2O-K2O)-FeO-MgO) and ACM (Al2O3-CaO-MgO) ternary diagrams have revealed that the studied samples correspond to arc-related ultramafic cumulates. Chondrite-normalized REE plots display an increasing trend from La to Sm (CeN/SmN: 0.74–1.81), weak negative to no Eu (Eu/Eu* = 0.72–1.05) and strong negative Ce (Ce/Ce* = 0.33–0.98) anomalies. Primitive mantle normalized of multi-element diagrams exhibit LREE enrichment and large ion lithophile elements (LILE) relative to high field strength elements (HFSE), and notable negative anomalies in Nb. This suggests the generation of the parent melt by slab dehydration and wedge melting processes. In addition, incompatible trace element composition and ratios assumed that the source magma had an enhanced mantle source associated with a prominent influence of continental crust. Metasomatism of mantle wedge by plate-dehydrated, LILE-rich fluids and the incorporation of sediments derived from subduction explain the enhancement of the source. Integrated major and trace element compositions jointly with the tectonic reconstruction of this region and LA-ICP-MS U–Pb data on zircon constrain the emplacement age at ca. 2099 Ma in a continental margin arc setting involving subduction of an oceanic plate beneath the continental lithosphere, dehydration of the slab and mantle wedge melting. This result intimate that the remnants of Paleoproterozoic oceanic crust or subduction event and subsequent basins closure extended from the Congo craton in Cameroon to CAR and NE Brazil. [ABSTRACT FROM AUTHOR]

Objectives: With a fourth of all under-five children affected, stunting remains one of the biggest health challenges worldwide. Even though the main underlying factors are known, the exact pathways to stunting varying in affected regions, and interventions thus need to be tailored to the local contexts. This study aimed assessing and comparing factors associated with stunting in two understudied sub-Saharan urban contexts with some of the highest stunting prevalence globally: Bangui, Central African Republic (~ 36%) and Antananarivo, Madagascar (42%). Methods: We performed a case–control study on 175 + 194 stunted and 237 + 230 non-stunted control children aged 2–5 years and matched for age, gender and district of residency. Factors associated with stunting were identified using a standardized, paper questionnaire delivered by trained interviewers. Statistical analysis was done using logistic regression modelling. Results: In both sites, formal maternal education lowered the risk of being stunted and restricted access to soap, suffering of anaemia and low birth weight were associated with higher risk of stunting. Short maternal stature, household head different from parents, diarrhoea and coughing were associated with an increased risk and continuing breastfeeding was associated with a lower risk of stunting in Antananarivo. Previous severe undernutrition and dermatitis/ fungal skin infections were associated with higher and changes in diet during pregnancy with lower risk of stunting in Bangui. Conclusions: Our results suggest maternal education, antenatal care, iron supplementation and simple WASH interventions such as using soap and infection control as general and breastfeeding (Antananarivo) or better nutrition (Bangui) as area-specified interventions. [ABSTRACT FROM AUTHOR]

This paper examines how innovative skills and knowledge are transmitted and acquired among adolescents in two hunter-gatherer communities, the Aka of southern Central African Republic and the Chabu of southwestern Ethiopia. Modes of transmission and processes of social learning are addressed. Innovation as well as social learning have been hypothesized to be key features of human cumulative culture, enhancing the fitness and survival of individuals in diverse environments. The innovation literature indicates adult males are more innovative than children and female adults and therefore predicts that adolescents will seek out adult males. Further, the mode of transmission should be oblique (i.e., learning from adults other than parents). Thus, learning of innovations should be oblique or horizontal rather than vertical, with adolescents paying particular attention to "successful" innovative individuals (prestige bias). The social learning literature indicates that complex skills or knowledge is likely to be learned through teaching, and therefore that teaching will be an important process in the transmission of innovations. In-depth and semi-structured interviews, informal observations, and systematic free-listing were used to evaluate these hypotheses. The study found that (1) cultural context patterned whether or not adolescents sought out adult male or female innovators; (2) oblique modes of transmission were mentioned with greater frequency than horizontal or vertical modes; (3) knowledge and skill bias was notable and explicitly linked by the adolescents to reproductive effort; and (4) teaching was biased toward same-sex individuals and was an important but not an exclusive means of transmitting complex skills and social knowledge. [ABSTRACT FROM AUTHOR]

This paper analyses the efficiency of public spending in the education and health sectors of Cameroon, Chad and Central African Republic. It also examines the institution and economic factors influencing spending efficiency in these sectors in the countries selected for the period 2000-2012. The public sector efficiency scores are estimated in the first stage by using the non-parametric Data Envelopment Analysis (DEA) approach while in the second stage, the panel data Tobit and the Fractional Logit regression techniques are used to determine the effect of institutional and economic factors on public spending efficiency in the education and health sectors. The results from the estimation show that Cameroon is more efficient than Chad and Central African Republic in its public spending in education and health. Chad is least efficient in public spending in education, although it spends more on education as compared to the other countries in the study. The results also indicate that the quality of budgetary and financial management has a positive and statistically significant influence on efficiency while corruption has a negative and significant influence on public spending efficiency in the education and health sectors. The results put together recommend that efforts should be put in place to curb corruption and improve on the quality of budgetary and financial management. [ABSTRACT FROM AUTHOR]

While “Pygmy” hunter-gatherers have generally been assumed to be the original inhabitants of the central African rainforest, recent studies dispute the viability of subsistence in tropical rainforests through foraging alone. There are, however, few studies that are based on sound data of actual long-term foraging. This paper examines the viability of “pure” foraging in tropical rainforests, based on data from participant observation of a long-term foraging expedition among the Baka in the northwestern Congo Basin. The group was observed to subsist solely on wild food resources, particularly wild yams, for two-and-half months. The study was carried out during the dry season when food resources are generally thought to be scarce in tropical rainforests. [ABSTRACT FROM AUTHOR]

This paper examines the intracultural variability of parental and alloparental caregiving among the Aka foragers of the Central African Republic. It has been suggested that maternal kin offer higher frequencies of allocare than paternal kin and that maternal investment in infants will decrease when alloparental assistance is provided. Behavioral observations were conducted on 15 eight- to twelve-month-old infants. The practice of brideservice and the flexibility of Aka residence patterns offered a means to test the effect of maternal residence on parental and alloparental investment. There was a significant variation in the frequency of investment and who supplied care to infants depending on whether mothers resided with their kin or their husbands' kin. However, in spite of the variation in allocare, when all categories of caregivers were examined collectively, infants received similar overall levels of care.

The study aimed to estimate the prevalence and associated factors of undiagnosed hypertension (HTN) among adults in the Central African Republic (CAR). In the cross-sectional 2017 CAR (Bangui and Ombella M'Poko) STEPS survey, 3265 persons aged 25 to 64 years (non-pregnant and with complete blood pressure measurement), responded to an interview, biomedical and physical, including blood pressure, measurements. Undiagnosed HTN was classified as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg among adults who had never been told by a doctor or other health worker that they had raised blood pressure or hypertension and had not been taking antihypertensive medication. Binary logistic regressions are used to estimate factors associated with undiagnosed HTN. Among those with HTN (N = 1373), the proportion of undiagnosed HTN was 69.8% and 30.2% diagnosed HTN. In the adjusted logistic regression analysis, male sex (AOR: 2.12, 95% CI 1.39–3.23), current tobacco use (AOR: 1.58, 95% CI 1.03–2.42), and high physical activity (AOR: 1.93, 95% CI 1.00–3.71) were positively associated, and age (AOR: 0.75, 95% CI 0.59–0.96), and underweight (AOR: 0.58, 95% CI 0.37–0.90) were inversely associated with undiagnosed HTN. In addition, among men, ever screened for glucose (AOR: 0.07, 95% CI 0.02–0.27) was negatively associated with undiagnosed HTN, and among women, married or cohabiting (AOR: 1.20, 95% CI 1.00–1.44), current heavy drinking (AOR: 1.41, 95% CI 1.04–1.91) were positively associated with undiagnosed HTN. Seven in ten of the adult population with HTN had undiagnosed HTN in CAR. Efforts should be reinforced to screen for HTN in the general population. [ABSTRACT FROM AUTHOR]

We examine the opportunities children have for interacting with others and the extent to which they are the focus of others' visual attention in five societies where extended family communities are the norm. We compiled six video-recorded datasets (two from one society) collected by a team of anthropologists and psychologists conducting long-term research in each society. The six datasets include video observations of children among the Yasawas (Fiji), Tanna (Vanuatu), Tsimane (Bolivia), Huatasani (Peru), and Aka (infants and children 4–12 years old; Central African Republic). Each dataset consists of a series of videos of children ranging in age from 2 months to 12 years in their everyday contexts. We coded 998 videos and identified with whom children had opportunities to interact (male and female adults and children) as well as the number of individuals and the proportion of observed time that children spent with these individuals. We also examined the proportion of time children received direct visual gaze (indicating attention to the child). Our results indicate that children less than 5 years old spend the majority of their observed time in the presence of one female adult. This is the case across the five societies. In the three societies from which we have older children (Aka, Yasawa, Peru), we find a clear shift around 5 years of age, with children spending the majority of their time with other children. We also coded the presence or absence of a primary caregiver and found that caregivers remained within 2 ft of target children until 7 years of age. When they were in the company of a primary caregiver, children older than seven spent the majority of their time more than 2 ft from the caregiver. We found a consistent trend across societies with decreasing focal attention on the child with increasing child age. These findings show (1) remarkable consistency across these societies in children's interaction opportunities and (2) that a developmental approach is needed to fully understand human development because the social context is dynamic across the lifespan. These data can serve as a springboard for future research examining social development in everyday contexts. [ABSTRACT FROM AUTHOR]

It is still unclear to what extent animals possess knowledge of death. Primates display a large variety and often contradictory behaviors toward conspecific corpses, particularly those of infants (e.g., prolonged carrying and care). This study reports on reactions in a wild, habituated western gorilla group (Gorilla gorilla, 11–13 individuals) in the Central African Republic to an unanimated conspecific infant, and to an allospecific corpse. Individuals' reactions were compared to their usual behavior using both continuous focal animal sampling and 10-min instantaneous scan sampling. In the first observation, an infant gorilla fell out of a tree and looked dead. The mother retrieved it and remained unusually close to another adult female, until the infant started to move again, almost 1 h later. Cases of infants regaining consciousness after almost-fatal accidents may act as positive reinforcement for continued carrying by mothers, which might be socially learned. In the second case, three immature gorillas reacted to a dead red river hog. For 20 min they stared at the corpse from tree branches above, while chest beating, defecating, and urinating several times. They showed fear and did not approach the corpse. These observations show that non-predatory species, such as gorillas, may be able to acquire and develop some knowledge about death even though they do not kill other vertebrates. [ABSTRACT FROM AUTHOR]

Field Emission SEM (FESEM) textural observations, crystal size distribution (CSD) analyses, UV-excited luminescence imaging, and photoluminescence (PL) microspectroscopy excited by 488 nm laser were conducted on two texturally contrasting samples of carbonado, a kind of natural polycrystalline diamond from the Central African Republic (CAR). The investigated carbonado samples A and B show extremely different textures: sample A is made up of faceted crystals accompanied by abundant, small rectangular pores, whereas sample B has a granular texture with coarser crystals and scarce, large pores. Diamond crystals smaller than 2-3 µm are enriched in sample A but depleted in sample B. These textural features indicate that sample B diamonds were annealed under thermodynamically stable P-T conditions. The pore characteristics indicate that fluid permeability was higher for sample A than sample B. Photoluminescence (PL) spectra indicate that samples A and B correspond to Group A and B carbonados in the classification of Kagi et al. (1994), respectively, so that sample A reveals emissions from the H3 center without any N-V derived emission at 575 nm, whereas sample B shows emissions from the 3H center and the N-V defect. In addition, UV-excited luminescence images and photoluminescence spectra for sample B indicate that the rims of diamond crystals within several microns of a pore show luminescence features similar to those of Group AB carbonados (Kagi et al., 1994), indicating that this Group AB material was formed from Group B by irradiation from pore-filling, radioactive-element-bearing materials at a low temperature. The extent of the low-temperature irradiation is considered to depend on fluid permeability, and the Group A material was strongly irradiated due to its permeable texture whereas the Group B material was not significantly irradiated due to its less permeable granular texture. These results indicate that Group B carbonados have retained their original PL spectral features produced under high pressures and temperatures at mantle depths. [ABSTRACT FROM AUTHOR]

A review is presented of the ticks of the Central African Republic (C.A.R.), based on unpublished data and a literature review. We consider as established in the C.A.R. two species of Argasidae (one species of each of the genera Carios and Ornithodoros) and 49 species of Ixodidae: 5 Ixodes, 11 Amblyomma, 2 Dermacentor, 9 Haemaphysalis, 4 Hyalomma, and 18 Rhipicephalus species, 3 of which belong to the subgenus Boophilus. Two of these species, one Amblyomma and one Dermacentor, may by now have disappeared from the country together with their hosts, the black and white rhinoceroses. Moreover, four other species of Ixodidae have been recorded, but are not necessarily established in the country, and 6 species of Ixodidae have apparently been reported incorrectly; the data for the occurrence of three other species of Ixodidae are uncertain. Rhipicephalus species in the C.A.R. present the greatest difficulties in identification, on the one hand because of uncertainties in taxonomy, particularly in the capensis group, on the other hand because of individual variability, which means that individual specimens cannot always be reliably identified to species. Examining the dissected and cleared gonopore structure of females helps, but is very time-consuming where large numbers are involved. Some of the species of the genus Haemaphysalis are also difficult to identify with certainty. There are only a few species of Hyalomma in the country. We revised also some old records of ticks in C.A.R., which we consider as unreliable and should be disregarded because of subsequent changes in taxonomy and nomenclature, unless the material is still available for examination. [ABSTRACT FROM AUTHOR]

We compared paired plasma and dried blood spot (DBS) samples from 54 HIV-1-treated children living in Bangui, Central African Republic, for antiretroviral-resistance-associated mutations. All children displayed virological failure (HIV-1 RNA >3.70 logcopies/ml). Testing for resistance genotype was carried out in a reference laboratory in Paris, France. A successful test result was obtained in 54 (100%) plasmas and 25 DBSs (46%). Among the 732 resistance-associated mutations analyzed, 718 were identical, leading to a high concordance rate of 98.1%. Genotypic resistance tests on DBS samples were found to be highly feasible and accurate in a foreign reference laboratory, but with additional costs for shipping and decreased sensitivity. [ABSTRACT FROM AUTHOR]

Sex differences in physical and indirect aggression have been found in many societies but, to our knowledge, have not been studied in a population of hunter-gatherers. Among Aka foragers of the Central African Republic we tested whether males physically aggressed more than females, and whether females indirectly aggressed more than males, as has been seen in other societies. We also tested predictions of an evolutionary theory of physical strength, anger, and physical aggression. We found a large male bias in physical aggression. Controlling for anger, we found an adult female bias in indirect aggression. Physical strength predicted anger, which predicted hitting, although results were sensitive to the inclusion or exclusion of traditional healers, who were physically and emotionally distinct from other Aka. With some important caveats, our results generally support the predicted sex differences in physical aggression and indirect aggression, and the predicted relationships among anger, strength, and aggression. [ABSTRACT FROM AUTHOR]

Many animals aggregate into organized temporary or stable groups under the influence of biotic and abiotic factors, and some studies have shown the influence of habitat features on animal aggregation. This study, conducted from 2002 to 2004 in the Dzanga-Ndoki National Park, Central African Republic, studied a herd of forest buffaloes ( Syncerus caffer nanus) to determine whether spatial aggregation patterns varied by season and habitat. Our results show that both habitat structure and season influenced spatial aggregation patterns. In particular, in open habitats such as clearings, the group covered a larger area when resting and was more rounded in shape compared to group properties noted in forest during the wet season. Moreover, forest buffaloes had a more aggregated spatial distribution when resting in clearings than when in the forest, and individual positions within the herd in the clearing habitat varied with age and sex. In the clearings, the adult male ( n = 24) was generally, on most occasions, located in the centre of the herd ( n = 20), and he was observed at the border only four times. In contrast, females ( n = 80) occupied intermediate ( n = 57), peripheral ( n = 14) and central positions ( n = 9) within the group. Juveniles ( n = 77) also occurred in intermediate ( n = 64) and peripheral positions ( n = 13). Based on these results, we concluded that habitat characteristics and social behaviour can have relevant effects on the spatial distribution of animals within a group. [ABSTRACT FROM AUTHOR]

Partial thyroidectomy under local anaesthesia was performed in 49 subsequent individuals in the Central African Republic. Because of the shortage of medical resources, all patients with goitre were scheduled for an operation under local anaesthesia. There were no inclusion or exclusion criteria applied for patient selection for the procedure. Before the operation, patients had received an oral sedation and antibiotic. For infiltration anaesthesia, 1% lignocaine was used. Subtotal bilateral thyroidectomy was performed in 37 patients; 12 patients underwent lobectomy or partial lobectomy of the affected portion of the gland. There were no intraoperative complications in any of the patients. The mean time of the procedure averaged 127 min. There were no postoperative complications noticed in the reported group, and this includes also complications related to laryngeal nerve injury. General condition of the operated on patients allowed for full self-dependency within 4 to 6 h postoperatively. Patients remained under medical surveillance for mean 3 days, and cutaneous stitches were removed on the first postoperative day. General condition of all patients on the day of discharge from hospital was good. Surgery for goitre under local anaesthesia may be a safe alternative where general anaesthesia is not available or contraindicated for medical reasons. [ABSTRACT FROM AUTHOR]

Several studies have suggested a matrilateral bias in allomaternal (non-maternal) infant and child caregiving. The bias has been associated with the allomother’s certainty of genetic relatedness, where allomothers with high certainty of genetic relatedness will invest more in children because of potential fitness benefits. Using quantitative behavioral observations collected on Ngandu 8- to 12-month-old infants from the Central African Republic, I examine who is caring for infants and test whether certainty of genetic relatedness may influence investment by allomothers. Results indicate a matrilateral bias in caregiving by extended kin members, but this does not affect the total level of care infants receive when fathers and siblings are included in the analysis. These results replicate a previous study done among an adjacent foraging population and emphasize the importance of examining children’s complete social environments when addressing caregiving and child development. [ABSTRACT FROM AUTHOR]

Though insectivory by large-bodied gorillas may be unexpected, researchers have reported it in all populations of gorillas studied to date. Our study of 2 well monitored groups of western gorillas ( Gorilla gorilla gorilla) at Bai Hokou in Dzanga-Ndoki National Park, Central African Republic provides information on frequency and variability of termite consumption (the most commonly eaten insect) as well as some of the first direct observations of the behavior. Pooled data from both groups indicate termite feeding on 34% and 83% of days, through fecal analysis and feeding trails, respectively. Direct observations revealed that termite feeding occurred on 91% of the days for 1 group, in which the silverback fed on termites during 13% of all feeding scans, making termites the most commonly observed food item. The group that had a higher density of termite mounds in its home range consumed termites more frequently than the other group did. A higher proportion of fecal samples from the silverbacks contained termite remains than the ones from adult females and juveniles. Termite consumption was lower during the dry season, but it does not correlate with rainfall, measures of fruit availability, or fruit consumption. Displacements at termite mounds occurred more than expected, indicating that they are a patchy, sought-after food resource. Gorillas did not use tools to extract termites, but they used 2 different techniques to remove them from the cells. Though culture or social traditions may cause the variation in termite consumption across sites, further investigation of termite availability and consumption is necessary to rule out ecological and methodological explanations for observed variations. [ABSTRACT FROM AUTHOR]

We monitored the impact of habituation for tourism through changes in gorillas' behavior during the habituation process at Bai Hokou (Dzanga-Ndoki National Park, Central African Republic) from August 1996 to December 1999. From August 1998 onwards we focused on one gorilla group: the Munye. During the habituation process, it became increasingly easier to locate and to remain with the gorillas. Their initial reactions of aggression, fear and vocalization upon contact were replaced increasingly by ignoring us. Curiosity appeared to be an intermediate stage in the process. The way in which contacts with the Munye ended became more subdued over time. Regular daily contact is important in promoting habituation. Likewise, contacting gorillas while they are in a tree or in dense forest provides positive results compared to open habitat. Contacts within 10 m and contacts without forewarning the gorillas of observer presence, e.g., via tongue clacking, should be avoided. As of December 1999, habituation had progressed well; habituation of western gorillas is feasible. However, the gorillas experience negative effects during the habituation process, showing, for example, an increase in daily path length, and reactions of aggression, fear and vocalization upon contact. Impacts diminish over time. Given these and other potentially negative effects, the decision to begin habituation should not be taken lightly. [ABSTRACT FROM AUTHOR]

Presents the global and national Red List status of cycads known from mainland Africa. Seventy-four taxa (including five as yet undescribed taxa) occur in Angola, Benin, Central African Republic, Democratic Republic of Congo, Ghana, Kenya, Malawi, Mozambique, Nigeria, South Africa, Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. South Africa has the highest richness of cycad taxa (41). Fifty-two of the continent's cycads are confirmed country endemics, and 59% are globally threatened. One undescribed Encephalartos taxon is categorised as extinct (Malawi) and three, Encephalartos woodii Sander, E. relictus P.J.H. Hurter and another undescribed Encephalartos taxon (South Africa), are known only from material in cultivation. The nature and extent of threats to cycads appear to be different in the southern African region compared to the rest of the continent, and illegal collection is thought to be the primary factor. Taxa listed as data deficient primarily occur in war-torn and botanically under-explored areas. The results of the Red Lists are interpreted in terms of life-history strategies and threats. Continental-level conservation efforts are suggested for preserving wild stocks.

We report prevalences and eggs/protozoa per g (EPG; PPG) of helminths and protozoa in gorillas, chimpanzees, agile mangabeys, indigenous Ba'Aka and Bantu, and western researchers at a remote field site in the Central African Republic. We examined fecal samples for eggs, larvae, proglottids, cysts, amoeba, trophozoites, and flagellates. For helminths, strongylates were most prevalent, infecting 82–94% of nonhuman primates (NH) and 30–93% of human (H) groups, followed by ascaroids (14–88% NH; 0–15% H), and threadworms (0–22% NH; 0–29% H). For protozoa, Entamoeba histolytica (2–100% NH; 33–52% H) and trichomonads (11–88% NH; 0–54% H) were most prevalent. Among gorilla samples (n = 156) there were significant age/sex differences in EPG/PPG for strongylates, threadworms, Entamoeba histolytica , and trichomonads, with infants exhibiting the highest mean EPG/PPG for all parasites except trichomonads. Between group analyses revealed that the Ba'Aka had significantly higher mean EPG of strongylates, ascaroids and threadworms than all other primate groups, except the mangabeys. For Entamoeba histolytica, E. coli, Balantidium coli, and Iodamoeba butschlii , the agile mangabeys had significantly higher mean PPG than other groups; for trichomonads, the chimpanzees, and mangabeys had the highest mean PPG. Relative to other African ape sites, the gorillas and chimpanzees at Mondika appear to have high prevalences of intestinal parasites. This may be the result of the high proportion of swamp and seasonally flooded areas, which provide optimal viability for parasite eggs and ova. At Mondika, the significantly higher parasite levels of Ba'Aka probably result from more traditional methods of hygiene and lack of available medical treatment. All workers at research sites should be monitored and treated to minimize cross-transmission between humans and local fauna. [ABSTRACT FROM AUTHOR]

This study explores the association between female circumcision and infertility and fertility, using information from the Demographic and Health Surveys (DHS). In Côte d'Ivoire and Tanzania, circumcised women had lower childlessness, lower infertility by age, and higher total fertility rates than women who were not circumcised; the reverse pattern prevailed in the Central African Republic. In all three countries, however, circumcised women grouped by age at circumcision did not have significantly different odds of infertility nor of having a child than did uncircumcised women, when the effects of covariates were controlled. Thus we find evidence suggesting that the practice of female circumcision does not have a statistically discernible effect on women's ability to reproduce. [ABSTRACT FROM AUTHOR]