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We conducted a feasibility study of antibiotic stewardship promotion, monitoring and education through veterinary vocational schools using semi-structured interviews and Strength, Weakness, Opportunity, and Threats analysis. Seventeen of the 35 veterinary vocational schools of the Kongo Central Province were surveyed. We report four key results. First, all schools were government funded with personnel capable of promoting, monitoring and educating farmers and communities. Second, these schools were well distributed across the country which gives them access to a greater number of farmers. Third, faculty from these schools provided the bulk of veterinary services in their catchment areas. Fourth, vocational schools would benefit from support from universities. This support could focus on transfer of teaching skills and resources sharing.

Achieving sustainable, ethical food systems in support of human and planetary health is among the greatest challenges facing the global community. Globally, 815 million people are chronically undernourished, 108 million children and 604 million adults are obese, and more than two billion people are at risk of micronutrient deficiencies. Animal-source foods (ASFs), including milk, meat, fish, and eggs, provide high-quality protein and a variety of micronutrients in forms readily absorbed and used by the human body. Current research continues to explore the nutritional contributions of ASFs, their interactions with other dietary components, and their role in healthy human growth and development. This chapter uses the framework of the sustainable development goals (SDGs) to consider the value of ASFs in human diets across a range of settings. It discusses opportunities for multidisciplinary efforts that harness science, technology, and innovation (STI) to mitigate risks of foodborne disease, to promote the efficient management of natural resources, to reduce nutrient losses within livestock value chains, and to support gender- and culturally sensitive communication around livestock management and human nutrition. In support of the economic, social, and environmental dimensions of sustainable development, this chapter proposes opportunities to meet the nutritional needs of current and future populations while supporting biodiversity and conserving scarce natural resources.

Poultry are important for many poor households in developing countries, but there are many constraints to poultry production, including disease. One of the most important diseases of chickens is Newcastle disease (ND). Even though there are effective vaccines against this disease available in most countries, uptake by small-scale poultry keepers is often low. In this study, two areas in Kenya and Tanzania were studied, where some villages had received additional support to get vaccination and other villages had not. In Kenya, 320 households from 10 villages were interviewed, of which half of the villages had active promotion of vaccination through village-based advisors. In Tanzania, 457 households were interviewed, of which 241 came from villages that have had active support through either a project or government extension services. Knowledge about vaccines and the attitudes towards vaccinating against ND was evaluated using mixed multivariable logistic models. Results indicate that in Kenya, the most important determinants for understanding the function of a vaccine were having had support in the village and to have knowledge about ND signs, while in Tanzania gender and previous vaccine use were important in addition to having had support. Attitudes towards vaccination were mainly determined by knowledge, where more knowledge about how vaccines work in general or about ND contributed to more positive attitudes. Among Kenyan farmers that had never used the vaccine before, the amount of birds they lost to disease and predators also influenced attitudes. In conclusion, this study supports the notion that knowledge is a very important component of extension support and that simply making vaccines available may not be sufficient for high levels of uptake.

Poor dietary quality is an underlying contributor to the high rates of maternal and child undernutrition in Timor-Leste. The majority of households own livestock: however, the consumption of domestic animal-source food (ASF) is low, and there are few reports of the utilisation of non-domesticated species. This mixed-methods study was conducted in three villages from mid-2015 to mid-2017. Two hundred and three households with children under 24 months were enrolled in the quantitative study of maternal and child dietary diversity. To explore factors affecting household ASF consumption, 12 key informants were recruited for in-depth interviews and 312 participants, mostly mothers and fathers of young children, for focus group discussions. Participants expressed a desire to consume more ASF. Barriers to ASF consumption include having low income or limited income streams, high levels of small livestock morbidity and mortality leading to small or unstable flock or herd sizes, reserving livestock for sale and ceremonies, and living far from forested areas or where hunting is not allowed. Factors that enable greater ASF consumption include villages being located near forested areas with wild animal populations, those that observe a large number of ceremonies of long duration, households with a greater number of small livestock, and where women are able to make autonomous decisions about livestock assets. Findings suggest that policies and programs designed to achieve sustainable improvements in household nutrition would include a focus on women and improving the health and production of small livestock species frequently utilised by households.

In central Mozambique a wide range of aetiological explanations of illness are given by traditional healers. This article explores the different interpretations from an emic perspective. Healers who are not involved with any churches distinguish natural diseases from the ones that are ‘provoked’. The later constitute the vast majority. They can be ‘provoked’ by spirits from different origins or by a third person by means of witchcraft. Thus, most of the diseases have a relational origin and people protect themselves by respecting social rules. No known disease is life threatening if appropriate diagnostic treatment is carried out promptly. During the search for the cause of a disease, different interpretations may be given by different healers to the same patient. In the case of prolonged disease such as HIV/AIDS, different interpretations can also be given sequentially as the disease evolves. African tradition of healing gives meaningful explanation of the disease locating it within kin relations...

Resumo: Neste artigo são alinhavados olhares das mulheres do eixo Sul-Sul, suas aproximações e distanciamentos, a partir de categorias de análise que têm como marco a soberania e a Segurança Alimentar e Nutricional (SAN). Argumenta-se nessa reflexão acerca da importância da análise de gênero em perspectiva interseccional em dois cenários diversos. O primeiro cenário é a partir do ponto de vista das mukheristas, nome pelo qual são chamadas as mulheres moçambicanas que fazem o comércio entre Maputo (Moçambique) e Johannesburg (África do Sul). O segundo cenário é constituído pelas mulheres da aldeia Cinta Vermelha-Jundiba, que vivem na região do semiárido, no Vale do Jequitinhonha, no Brasil. Observar-se-á como, a partir de panos moçambicanos e sementes brasileiras, essas mulheres trançam suas sobrevivências. Abstract: In this article, we look at the South-South axis women, their approaches and distances, based on categories of analysis that have as a sovereignty and food and nutritional security. We defend the importance of an intersectional analysis both from the point of view of the Mukheristas, the way women who trade between Maputo, (Mozambique) and Johannesburg (South Africa) are called and from the perspective of women from the Cinta Vermelha-Jundiba village, living in the semiarid region of the Jequitinhonha Valley in Brazil. It will be observed how by trading clothesin the case of the Mozambican women andseeds for the Brazilians, these women braid their survival.

Poor dietary quality is an underlying contributor to the high rates of maternal and child undernutrition in Timor-Leste. The majority of households own livestock, however consumption of domestic animal-source food (ASF) is low, while few households report using non-domesticated species. Two hundred and three households with children under 24 months, in 3 villages, were enrolled in a quantitative study of maternal and child dietary diversity, alongside 12 key informants recruited for in-depth interviews and 312 participants, mostly mothers and fathers of young children, for focus group discussions. Participants expressed a desire to consume more ASF. Barriers to ASF consumption included having low-income or limited-income streams, high levels of small livestock morbidity and mortality leading to small or unstable flock or herd sizes, reserving livestock for sale and ceremonies and living far from forested areas or where hunting was not allowed. Factors that enabled greater ASF consumption included villages being near forested areas with wild animal populations, observance of a large number of ceremonies of long duration, households with a greater number of small livestock, and where women were able to make autonomous decisions about livestock assets. Policies and programmes designed to achieve sustainable improvements in household nutrition would include a focus on women and improving the health and production of small livestock species frequently utilised by households.

Most capacity building efforts to investigate and counter emerging infectious diseases have focused on supporting public health agencies. However, to improve the understanding of the epidemiology, and outcome of diseases, aid in their detection and treatment and increase public participation in prevention and control, gender roles must be considered. Gender plays a significant role in shaping infectious disease response. In the most recent Ebola Outbreak in the West African region, glaring gender disparities were apparent as Ebola spread through nations decimating families. Policy implementers, practitioners and researchers were slow to recognize the gender implications, ask why, and build responses accordingly. A report that examined the avian influenza crisis in South East Asia in 2008 concluded that women were clearly in the frontline defense against the disease both as caretakers of the poultry and the families, and yet strategies to combat avian influenza did not consider their roles and potential contribution to the prevention and response. Makerere University, Uganda with the support of Tufts University developed a Gender, One Health and Infectious Disease short course that allows public health specialists to address gender gaps, and explore how gender, the realm of emerging pandemic threats and One Health intersect and how policies can be developed and/or implemented to address those gaps. The week long short course targets in service personnel in multiple disciplines, the private sector, faculty and students from OHCEA institutions and Africa. The course themes apply gender analysis tools to disease surveillance, response, and control and address gender sensitive emergency response planning.

Suboptimal breastfeeding practices, early initiation of complementary feeding, and monotonous cereal‐based diets have been implicated as contributors to continuing high rates of child undernutrition in sub‐Saharan Africa. Nutrition‐sensitive interventions, including agricultural programs that increase access to nutrient‐rich vegetables, legumes, and animal‐source foods, have the potential to achieve sustainable improvements in children's diets. In the quest to evaluate the efficacy of such programs in improving growth and development in the first 2 years of life, there is a role for mixed methods research to better understand existing infant and young child feeding practices. This analysis forms part of a longitudinal study assessing the impact of improvements to poultry health and crop production on diets and growth of 503 randomly selected children from eight rural communities in Manyoni District in central Tanzania. Using an explanatory sequential design, the quantitative phase of data collection was conducted between May 2014 and May 2016, comprising six monthly structured questionnaires, four monthly household‐level documentation of chicken and egg consumption, and fortnightly records of children's breastfeeding status. The subsequent qualitative phase involved in‐depth interviews with a subset of 39 mothers in October 2016. Breastfeeding was almost universal (96.8%) and of long duration (mean = 21.7 months, SD = 3.6), but early initiation of complementary feeding was also common (74.4%; mean = 4.0 months, SD = 1.8), overwhelmingly driven by maternal perceptions of insufficient milk supply (95.0%). Chicken and eggs were infrequently eaten, but close associations between maternal and child consumption patterns (p

Objective: In this article, we review insertion, application, and cleansing as they include the use of products other than water and have a number of harmful effects. Method: In 2007, a household survey of 919 women carried out in Tete Province, Mozambique, examined 8 vaginal practices. Results: Overall, 10% of the sexually active women reported regularly using these 3 vaginal practices concurrently. Of the women who practiced insertion, 65% used natural substances. A wider variety of products was used for applying substances on the external genitalia and for cleansing purposes. Conclusions: These findings have important implications for future HIV prevention, including in the use of microbicides.

Zambian women might doubt whether to stop or preserve labial elongation, which is a female genital modification instructed to the girl child as the first rite of passage into womanhood. We conducted a grounded theory research among Zambian men and women who had immigrated to Cape Town. Twenty women and seventeen men participated. Beliefs and perceptions around womanhood, gender roles and pleasure place elongation as a practice that is highly valued by Zambians in South Africa. Interventions to promote and improve women’s sexual health –such as capacity building of healthcare professionals and design of information, education and communication materials– can be informed by framing and documenting the implications for the Zambian migrant women’s sexual and social wellbeing of this practice.

Objectives: Labia minora elongation is a female genital modification in which some women in certain linguistic groups from Africa engage. One of the purposes is to enhance sexual pleasure for their male partners. Methods: The literature has been reviewed to describe how labia minora elongation serves for women to increase their sexual pleasure, both as an autoerotic method and in the context of homoerotic and heterosexual relationships. Results and Conclusions: This aspect deserves to be investigated, as there are narratives from some women practitioners of labial elongation that this practice might contribute to improve the sexual health of some of the women who engage in it.

Labia minora elongation has been documented as being practiced by 98.6% of the women in Tete province, Mozambique. Women engage in this procedure before the first menstruation. In this article we report on the findings from the male respondents from Tete province that participated in the qualitative component of the World Health Organization-supported multicountry Gender, Sexuality, and Vaginal Practices study. The men reported that the main motivation behind labia minora elongation is to enhance the sexual pleasure for both female and male partners. Researching what men know and perceive of labia minora elongation is crucial to understanding the contribution of this practice for sexual health. This knowledge is helpful to inform the development of new human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention technologies and culturally appropriate information, education, and communication interventions.

Objectives: Labia minora elongation (LME) is a female genital modification practice categorized among the types included in the fourth group of female genital mutilation. In this article, we display the results of a systematic review of the evidence-based knowledge published on the health risks and benefits of LME as informed by African female respondents who are insiders of the practice. No other systematic review on this specific topic has been published before. Methods: A methodological bibliographic search was done in scientific databases by manual referencing and by contacting experts on this area of knowledge. Seventeen articles were eligible for this review, which corresponded to nine different studies. Eight of these studies were conducted in Eastern and Southern African countries and one was carried out in Italy. Results: This review concludes that pain at the beginning of the practice, nuisances related to the use of caustic herbs, and stigmatization in failing to comply with the practic...

A WHO-supported provincial-level population-based survey was conducted in 2007 to understand the determinants and implications for health of vaginal practices. A total of 919 women aged 18-60 were selected randomly for enrolment. This is the first population-based study of females in Tete Province, Mozambique. At some time over their lives, 98.8% of women had practiced elongation of their labia minora and a quarter (24.0%) had done so in the past month. Currently practicing women were more likely to have engaged in sex recently, and used contraceptives and condoms at last sex than women who had stopped labial elongation. Younger age, residence in rural areas and having two or more male partners were also determinants of current practice. Women commonly reported they practiced for no specific reason (62.8%). Discomforting itchiness and lower abdominal pain were more frequent in women who had stopped labial elongation than in women who were currently practicing. Although women may not report current vaginal ill health, it is possible that prospective cohort studies could uncover alterations in genital vaginal flora or other indicators of impact on women’s health. The findings of this study do not suggest that labial elongation is linked with high-risk behaviors for HIV transmission. (Afr J Reprod Health 2016; 20[2]: 111-121).Keywords: Labia minora elongation; vaginal practices; Mozambique; survey; cross-sectional studies

Vaginal practices have been linked with an increase in risk for HIV transmission and other harms. In 2007, a household survey of 919 women was conducted in Tete province, Mozambique, as part of the World Health Organization Multicountry Study on Gender, Sexuality, and Vaginal Practices. Women aged 18 to 60 years old were interviewed to determine prevalence and motivations for vaginal practices. A large range of frequently used practices was identified. Nearly 80% of women reported three or more current practices, and virtually all had used at least three practices in their lifetime. Elongation of the vaginal labia minora was universal (99% of women), while a quarter stated they had made small vaginal cuts or incisions at least once. Ninety-two percent of women also reported ever use of intravaginal cleansing, and insertion of substances in the vagina was practiced by 72%. Around half (48%) reported ingestion of substances to affect the vagina, mostly to heat, tighten, or loosen the vagina. Appli...

In South Africa, and especially in Johannesburg, apartheid’s “racial” paradigms are being transformed. Fifteen years after the end of apartheid and the elimination of all forms of inequity based on notion of “race,” including the abolition of the Immorality Act of 1949 that prohibited mixed marriages, the discourses of youth challenge preestablished boundaries. Today, the South African Constitution gives people the right to proclaim their sexual orientation and to shape their own identities. Through ethnographic observations carried out in Johannesburg and in-depth interviews with young people, this paper explores transforming notions of identity based on “race/color/ethnicity,” gender, class, and sexuality. The dynamics and challenges faced by young people with regards to mixed interactions in post-apartheid Johannesburg are analyzed and the paper looks at how “race,” gender, and sexuality interact in the various spaces in Johannesburg and how they affect young people’s lives, particularly their perceptions of risk, violence, and HIV/AIDS vulnerability.

The following paper analyses gender issues to be taken into consideration in Newcastle disease (ND) and Highly Pathogenic Avian Influenza (HPAI) control. Gender issues tend to be sidelined from discussions and gender disparities in economic and decision making matters are often neglected. The integration of the analysis of gender relations in the study of agro-economic characteristics is of major importance because the paradigms of access, control and benefits of the resources, and consequently of exclusion, are based on social relations between men and women. The understanding of gender relations and its implications to livestock rearing is therefore an imperative in the effective promotion of appropriate interventions in order to improve biosecurity.

Este artigo analisa as noções de estética e erotismo, e como estas moldam a maneira de as mulheres na província de Tete, em Moçambique, prepararem seu corpo. Grupos focais e entrevistas individuais permitiram constatar que as mulheres utilizam diferentes produtos naturais e sintéticos, tradicionais e modernos, por inserção na vagina ou por ingestão, para modificar a maneira de sentir seu corpo e se preparar para o ato sexual. Em adição, a maioria das mulheres alonga os lábia minora (pequenos lábios vaginais) desde a infância, modificando seu corpo de acordo com critérios estéticos, noções de feminilidade e de prazer sexual. Essas intervenções se inserem num processo de socialização cuja educação integra componentes de estética, sexualidade, reprodução e sobre a vida em geral. O artigo procura mostrar a importância das metáforas e das noções de fechado/aberto, seco/úmido, quente/frio, pesado/leve, vida/morte, riqueza/pobreza, doce/não-doce como simbolismo de gênero ligado ao erotismo, a reprodução e a concepções estéticas.This paper analyzes notions of aesthetics and eroticism and the ways these mould how women in Tete Province, in Mozambique prepare their body. Focus group and individual interviews allowed to assess that women use different products both natural and synthetic by insertion in their vagina or by ingestion to modify the way they feel their body and prepare themselves for the sexual act. In addition, the majority of women elongate their labia minora (small vaginal lips) since their childhood, modifying their body accordingly to aesthetic criteria, notions of femininity and sexual pleasure. These interventions are part of a process of socialisation integrating components on aesthetic, sexuality, reproduction and life in general. This paper aims at showing the importance of metaphors and of the notions of closing up/open, dryness/ wetness, hot/cold, heavy/light, life/death, wealth/poverty, sweet/ non-sweet as gendered symbols related to eroticism and aesthetic.

Labia minora elongation consists in the manual stretching of the inner lips of the external genitalia. This practice is documented in east and southern Africa. The experiences of African women in the diaspora practicing elongation are not thoroughly understood. The purpose of this qualitative study was to explore the health harms and benefits associated with this practice of Zambian women who have migrated to Cape Town, South Africa. Twenty women and seventeen men participated in this study. Between December 2013 and May 2014, in-depth interviews and natural group discussions were conducted with the participants. The focus of this article is to report on the emic of the women related to notions of health, hygiene, and well-being. Labial elongation is perceived as a practice involving minor, short-term adverse effects that can be prevented by following some basic hygiene. Overall, personal and social value is placed on this practice because of its reported benefits for the sexual health of men and women, and for women's femininity and self-image. Further research is necessary on how female genital modifications influence Zambians' sexual preferences to inform the development of culturally appropriate health promotion interventions.

A study on how Zambian migrants living in Cape Town perceive and experience the implications of labial elongation on women’s health was conducted. Labia minora elongation (LME) is a genital modification that some women in east and southern Africa practice. This tradition is not common in Western Cape province (southwestern part of South Africa). The aim of this article is to discuss the methodological choices made in the design and conduct of this study, in which a White European male interviewed the female study participants on the health implications of a practice that is considered a woman’s private issue. Constructivist grounded theory informed by a feminist perspective was chosen as the most suitable methodological approach to enable cogeneration of knowledge with the female participants. The methods and tools used by the lead investigator facilitated access to the participants’ emic views. Grounded theory methodology holds the potential to be an appropriate methodological approach for researchers who seek to erode the power imbalances influencing research processes that aim to explore the associated meanings and health implications of female genital modifications, such as LME, as narrated by the women who practice them.

Highly Pathogenic Avian In! uenza (HPAI) subtype H5N1 is now endemic in large parts of Indonesia and this situation has revealed, among other constraints, a lack of human resource capacity in many institutions especially in terms of understanding of, and experience in, the control of poultry diseases. Cost-ef" cient prevention and control of HPAI must be built on a sustainable poultry health programme that incorporates collaborative research and development activities involving the public and private sectors. The programme should provide appropriate education, communication and services to: all poultry producers, workers and traders; community animal health workers; " eld veterinarians, livestock of" cers and extension workers; and senior-decision makers at national, provincial and district levels. Lessons learnt in the production of effective education and communication materials that are readily accessible to each target audience are described.

An estimated 140 million women have undergone female genital mutilation/cutting (FGM/C) worldwide, and, in Africa alone, more than 3 million girls are at risk annually. The World Health Organization defines FGM/C as procedures involving the partial or total removal of the external female genitalia, or other injury to the female genital organs, for non-medical reasons. Keywords: Africa; feminism; women

Village poultry and their owners were frequently implicated in disease transmission in the early days of the highly pathogenic avian influenza (HPAI) H5N1 pandemic. With improved understanding of the epidemiology of the disease, it was recognized that village poultry raised under extensive conditions pose less of a threat than intensively raised poultry of homogeneous genetic stock with poor biosecurity. This paper provides an overview of village poultry production and the multiple ways that the HPAI H5N1 pandemic has impacted on village poultry, their owners, and the traders whose livelihoods are intimately linked to these birds. It reviews impact in terms of gender and cultural issues; food security; village poultry value chains; approaches to biosecurity; marketing; poultry disease prevention and control; compensation; genetic diversity; poultry as part of livelihood strategies; and effective communication. It concludes on a positive note that there is growing awareness amongst animal health providers of the importance of facilitating culturally sensitive dialogue to develop HPAI prevention and control options.

Women worldwide use various vaginal practices to clean or modify their vulva and vagina. Additional population-level information is needed on prevalence and motivations for these practices, characteristics of users, and their adverse effects.This was a household survey using multistage cluster sampling in Tete, Mozambique; KwaZulu-Natal, South Africa; Yogyakarta, Indonesia; and Chonburi, Thailand. In 2006-2007, vaginal practices and their motivations were examined using structured interviews with women 18-60 years of age (n=3610).Prevalence, frequency, and motivations varied markedly. Two thirds of women in Yogyakarta and Chonburi reported one or more practices. In Yogyakarta, nearly half ingest substances with vaginal effects, and in Chonburi, external washing and application predominate. In Tete, half reported three or four current practices, and a quarter reported five or more practices. Labial elongation was near universal, and 92% of those surveyed cleanse internally. Two third's in KwaZulu-Natal practiced internal cleansing. Insertion of traditional solid products was rare in Chonburi and Yogyakarta, but one tenth of women in KwaZulu-Natal and nearly two thirds of women in Tete do so. Multivariate analysis of the most common practice in each site showed these were more common among less educated women in Africa and young urban women in Asia. Explicit sexual motivations were frequent in KwaZulu-Natal and Tete, intended for pleasure and maintaining partner commitment. Practices in Chonburi and Yogyakarta were largely motivated by femininity and health. Genital irritation was common at African sites.Vaginal practices are not as rare, exotic, or benign as sometimes assumed. Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warranted.

This paper reports on a systematic review of qualitative research about vaginal practices in sub-Saharan Africa, which used meta-ethnographic methods to understand their origins, their meanings for the women who use them, and how they have evolved in time and place. We included published documents which were based on qualitative methods of data collection and analysis and contained information on vaginal practices. After screening, 16 texts were included which dated from 1951 to 2008. We found that practices evolve and adapt to present circumstances and that they remain an important source of power for women to negotiate challenges that they face. Recent evidence suggests that some practices may increase a woman's susceptibility to HIV and other sexually transmitted infections. The success of new female-controlled prevention technologies, such as microbicides, might be determined by whether they can and will be used by women in the course of their daily life.

Este artigo analisa as noções de estética e erotismo, e como estas moldam a maneira de as mulheres na província de Tete, em Moçambique, prepararem seu corpo. Grupos focais e entrevistas individuais permitiram constatar que as mulheres utilizam diferentes produtos naturais e sintéticos, tradicionais e modernos, por inserção na vagina ou por ingestão, para modificar a maneira de sentir seu corpo e se preparar para o ato sexual. Em adição, a maioria das mulheres alonga os lábia minora (pequenos lábios vaginais) desde a infância, modificando seu corpo de acordo com critérios estéticos, noções de feminilidade e de prazer sexual. Essas intervenções se inserem num processo de socialização cuja educação integra componentes de estética, sexualidade, reprodução e sobre a vida em geral. O artigo procura mostrar a importância das metáforas e das noções de fechado/aberto, seco/úmido, quente/frio, pesado/leve, vida/morte, riqueza/pobreza, doce/não-doce como simbolismo de gênero ligado ao erotismo, a reprodução e a concepções estéticas. This paper analyzes notions of aesthetics and eroticism and the ways these mould how women in Tete Province, in Mozambique prepare their body. Focus group and individual interviews allowed to assess that women use different products both natural and synthetic by insertion in their vagina or by ingestion to modify the way they feel their body and prepare themselves for the sexual act. In addition, the majority of women elongate their labia minora (small vaginal lips) since their childhood, modifying their body accordingly to aesthetic criteria, notions of femininity and sexual pleasure. These interventions are part of a process of socialisation integrating components on aesthetic, sexuality, reproduction and life in general. This paper aims at showing the importance of metaphors and of the notions of closing up/open, dryness/ wetness, hot/cold, heavy/light, life/death, wealth/poverty, sweet/ non-sweet as gendered symbols related to eroticism and aesthetic.

Between 2005 and 2006, we investigated vaginal practices in Yogyakarta, Indonesia; Tete, Mozambique; KwaZulu-Natal, South Africa; and Bangkok and Chonburi, Thailand. We sought to understand women's practices, their motivations for use and the role vaginal practices play in women's health, sexuality and sense of wellbeing. The study was carried out among adult women and men who were identified as using, having knowledge or being involved in trade in products. Further contacts were made using snowball sampling. Across the sites, individual interviews were conducted with 229 people and 265 others participated in focus group discussions. We found that women in all four countries have a variety of reasons for carrying out vaginal practices whose aim is to not simply 'dry' the vagina but rather decrease moisture that may have other associated meanings, and that they are exclusively "intravaginal" in operation. Practices, products and frequency vary. Motivations generally relate to personal hygiene, genital health or sexuality. Hygiene practices involve external washing and intravaginal cleansing or douching and ingestion of substances. Health practices include intravaginal cleansing, traditional cutting, insertion of herbal preparations, and application of substances to soothe irritated vaginal tissue. Practices related to sexuality can involve any of these practices with specific products that warm, dry, and/or tighten the vagina to increase pleasure for the man and sometimes for the woman. Hygiene and health are expressions of femininity connected to sexuality even if not always explicitly expressed as such. We found their effects may have unexpected and even undesired consequences. This study demonstrates that women in the four countries actively use a variety of practices to achieve a desired vaginal state. The results provide the basis for a classification framework that can be used for future study of this complex topic.

This paper analyses two female sexual practices in Tete Province, Mozambique: (1) the practice of elongating the labia minora and (2) what is sometimes called ‘dry sex’ involving the insertion of natural and/or synthetic products into the vagina or the ingestion of these products orally. These practices are fundamental to the construction of female identity, eroticism and the experience of pleasure. Notions such as ‘closed/open’, ‘dry/damp’, ‘hot/cold’, ‘heavy/light’, ‘life/death’, ‘wealth/poverty’ and ‘sweet/not sweet’ are central to local understandings of sexual practices and reproduction. These notions may affect the women's sexual health because they influence preferences for sex without a condom. These practices may also be associated with the alteration of the vaginal flora and vaginal lesions that may make women more vulnerable to sexually transmitted infections.

The ecohealth approach is a core concept integrating environmental aspects with human and animal health (domestic and wild animals). Zoonotic and emerging diseases affect human health and impact negatively on food security. Although both the risk of contracting a disease and the subsequent impacts vary between different genders, age groups, cultures and social conditions, very little research has been done on this and few guidelines or interventions focus adequately on these aspects. This paper is based on a conceptual framework identifying the relationship between gender inequalities and the risk of contracting a disease in an ecohealth perspective. It looks at the varying impacts of plant, animal and human diseases and identifies four contributing factors. This paper first discusses the socially defined roles including social, economic, cultural, legal and political factors that often determine which place men and women occupy in society, which animals and plants men or women have accumulated knowledge of, which they have control of and which they benefit from and consequently the impact men and women have on the environment due to these specific roles. Secondly, it analyses the gender differences in risk of infection. It also analyses cultural differences that influence practices connected to animal, plant and human diseases and discusses respective preventions and treatments. Thirdly, it also identifies the ways men and women are impacted by the diseases of human, plants and animals in different ways. Lastly, this paper assesses the biological factors that influence the differences in exposure, infection rates and mortality rates between men and women during their life cycle. These four factors contribute to gender variations in relation to animal, human, plant and ecological health.