Dynamics of Customary Land Rights and Its Impact on the Agronomic Choices for Small Farmers in the South Kivu province, Eastern DR Congo

In Africa, there is still observed a land related legal plurality despite innovations undertaken since colonial times. In DR Congo, while by law land remains the property of the State, it remains difficult to manage rural lands, ignoring customary practices. In fact, alongside the “modern” land administration, the majority of rural lands are covered by customary contracts. Meanwhile, these contracts have evolved due to different socio-political issues in the DRC and particularly in its eastern part. This study aimed at understanding these changes and thus the impact resulted in agricultural activities, especially the small farmers’ technology choice. The study is based on households’ surveys in the Mbinga Sud zone as well as from other stakeholders on land in the Kalehe territory, South Kivu province, eastern DRC. Through this study, it is noted that customary land contracts have sufficiently evolved due to the population growth, innovations taken in land administration in the country, the wars that occurred in the eastern DR Congo, the attractiveness of rural land by elites and rich businessmen leading to land concentration etc. Given this situation, some practices such as purchase and lease of land were thus developed to cope with weak customary land acquisition mechanisms, the land scarcity and / or land depletion and the fear of land grabbing by the strongest. These changes also have an impact on some agricultural practices, including the fertilization of farms, the choice of crops and varieties to grow as well as many other cultivation techniques. Received: 3 June 2021 / Accepted: 4 September 2021 / Published: 5 November 2021

The use of health facility data to assess the effects of armed conflicts on maternal and child health: experience from the Kivu, DR Congo

Background In conflict-affected settings, data on reproductive, maternal, newborn and child health (RMNCH) are often lacking for priority setting and timely decision-making. We aimed to describe the levels and trends in RMNCH indicators within Kivu provinces between 2015 and 2018, by linking conflict data with health facility (HF) data from the District Health Information System 2 (DHIS2). Methods We used data from the DHIS2 for the period 2015–2018, the 2014 Demographic and Health Survey, the 2018 Multiple Indicators Cluster Survey and the Uppsala Conflict Data Program. Health zones were categorised in low, moderate and high conflict intensity level, based on an annual conflict death rate. We additionally defined a monthly conflict death rate and a conflict event-days rate as measures of conflict intensity and insecurity. Outcomes were completion of four antenatal care visits, health facility deliveries, caesarean sections and pentavalent vaccine coverage. We assessed data quality and analyzed coverage and trends in RMNCH indicators graphically, by conflict categories and using HF data aggregated annually. We used a series of fixed-effect regression models to examine the potential dose-response effect of varying conflict intensity and insecurity on RMNCH. Results The overall HF reporting was good, ranging between 83.3 and 93.2% and tending to be lower in health zones with high conflict intensity in 2016 and 2017 before converging in 2018. Despite the increasing number of conflict-affected health zones over time, more in North-Kivu than in South-Kivu, we could not identify any clear pattern of variation in RMNCH coverage both by conflict intensity and insecurity. North-Kivu province had consistently reported better RMNCH indicators than South-Kivu, despite being more affected by conflict. The Kivu as a whole recorded higher coverage than the national level. Coverage of RMNCH services calculated from HF data was consistent with population-based surveys, despite year-to-year fluctuation among health zones and across conflict-intensity categories. Conclusions Although good in general, the HF reporting rate in the Kivu was negatively impacted by conflict intensity especially at the beginning of the DHIS2’s rolling-up. Routine HF data appeared useful for assessing and monitoring trends in RMNCH service coverage, including in areas with high-intensity conflict.

Inventory Reveals Wide Edible Insects’ Biodiversity in Selected Territories of South-Kivu Province, Democratic Republic of Congo

In response to growing food demand, edible insects are seen as a potential source to alleviate food insecurity. With its wide edible insects’ biodiversity, the Democratic Republic of Congo is one of the most important biodiversity hotspots in Africa. This study aimed at giving a first insight on the inventory showing diversity, perception, consumption, availability, host plants, harvesting techniques and processing techniques of edible insects in South-Kivu, DRC. It recorded twenty-three edible insects belonging to nine families and five orders, some of which are consumed in the larval, adult, egg and pupa stages. Rhyncophorus phoenicis, Alphitobius diaperinus, Macrotermes subhylanus and Acheta domesticus were the most preferred edible insects in Fizi Territory, Ruspolia differens and Apis melifera larvae in Kabare Territory, Imbrasia oyemensis, Imbrasia epimethea, Rhynchophorus ferrugineus and Rhyncophorus phoenicis in Mwenga Territory, Ruspolia differens, Macrotermes subhylanus, Gryllotalpa africana, Nsike, Nomadacris septemfasciata and Apis melifera larvae in Walungu Territory. R. differens, I. oyemensis, A. melifera larvae, G. africana and Nsike were preferred for their taste. A. domesticus, A. diaperinus and A. melifera larvae were abundant throughout the year, while the others were only available for 9 months or less per year. Numerous plants have been recorded as their hosts, including plants used for food and income. Harvesting strategies and period, processing methods and preservation techniques depend on insect species, local knowledge and practices. These findings suggest similar and thoroughly studies on entomophagy across the country, while encouraging the rearing of edible insects to address the high existing demand and environmental need.

Comparative analysis of the health status of the population in six health zones in South Kivu: a cross-sectional population study using the WHODAS

Background The eastern Democratic Republic of Congo (DRC) has experienced decades-long armed conflicts which have had a negative impact on population’s health. Most research in public health explores measures that focus on a specific health problem rather than overall population health status. The aim of this study was to assess the health status of the population and its predictors in conflict settings of South Kivu province, using the World Health Organization Disability Assessment Schedule (WHODAS). Methods Between May and June 2019, we conducted a community-based cross-sectional survey among 1440 adults in six health zones (HZ), classified according to their level of armed conflict intensity and chronicity in four types (accessible and stable, remote and stable, intermediate and unstable). The data were collected by a questionnaire including socio-demographic data and the WHODAS 2.0 tool with 12 items. The main variable of the study was the WHODAS summary score measuring individual’s health status and synthesize in six domains of disability (household, cognitive, mobility, self-care, social and society). Univariate analysis, correlation and comparison tests as well as hierarchical multiple linear regression were performed. Results The median WHODAS score in the accessible and stable (AS), remote and stable (RS), intermediate (I) and unstable (U) HZ was 6.3 (0–28.6); 25 (6.3–41.7); 22.9 (12.5–33.3) and 39.6 (22.9–54.2), respectively. Four of the six WHODAS domain scores (household, cognitive, mobility and society) were the most altered in the UHZs. The RSHZ and IHZ had statistically comparable global WHODAS scores. The stable HZs (accessible and remote) had statistically lower scores than the UHZ on all items. In regression analysis, the factors significantly associated with an overall poor health status (or higher WHODAS score) were advanced age, being woman, being membership of an association; being divorced, separated or widower and living in an unstable HZ. Conclusions Armed conflicts have a significantly negative impact on people’s perceived health, particularly in crisis health zones. In this area, we must accentuate actions aiming to strengthen people’s psychosocial well-being.

Impact of rural versus urban setting on kidney markers: a cross-sectional study in South-Kivu, DRCongo

Background Most studies of chronic kidney disease (CKD) in Sub-Saharan Africa (SSA) have been conducted in urban settings. They relied on GFR estimated from serum creatinine alone and on the inexpensive, convenient urinary dipstick to assess proteinuria. The dipstick for proteinuria has not been directly compared with the gold standard albumin-to-creatinine ratio (ACR) in a large-sized study in SSA. We hereby assessed the influence of rural versus urban location on the level, interpretation, and diagnostic performance of proteinuria dipstick versus ACR. Methods In a cross-sectional population-based study of CKD in both urban (n = 587) and rural (n = 730) settings in South-Kivu, Democratic Republic of Congo (DRC), we assessed the prevalence, performance (sensitivity, specificity, positive predictive value and negative predictive value) and determinants of a positive dipstick proteinuria as compared with albuminuria (ACR). Albuminuria was subdivided into: A1 (< 30 mg/g creatinine), A2 (30 to 299 mg/g creatinine) and A3 (≥ 300 mg/g creatinine). Results The overall prevalence of positive dipstick proteinuria (≥ 1+) was 9.6 % (95 % CI, 7.9–11.3) and was higher in rural than in urban residents (13.1 % vs. 4.8 %, p < 0.001), whereas the prevalence of albuminuria (A2 or A3) was similar in both sites (6 % rural vs. 7.6 % urban, p = 0.31). In both sites, dipstick proteinuria ≥ 1 + had a poor sensitivity (< 50 %) and positive predictive value (< 11 %) for the detection of A2 or A3. The negative predictive value was 95 %. Diabetes [aOR 6.12 (1.52–24.53)] was a significant predictor of A3 whereas alkaline [aOR 7.45 (3.28–16.93)] and diluted urine [aOR 2.19 (1.35–3.57)] were the main predictors of positive dipstick proteinuria. Conclusions ACR and dipstick proteinuria have similar positivity rates in the urban site whereas, in the rural site, dipstick was 2-fold more often positive than ACR. The poor sensitivity and positive predictive value of the dipstick as compared with ACR makes it unattractive as a screening tool in community studies of CKD in SSA.

Prevention of HIV infection among adolescents and young people in South Kivu: challenges and prospectives

Background : It’s worldwide established that interventions to combat HIV are being carried out, but most of them target adults and leave out adolescents and young people, who constitute one of the most exposed sections of the population.Methods : A cross-sectional and qualitative study on prevention of HIV among adolescent and young people conducted from 15 and 30 June 2019 in seven health zones of South Kivu in the democratic republic of Congo. All interviews and focus groups were transcribed in full, the obtained corpus; a thematic manual analysis was carried out.Results : Several stakeholders are involved in the fight against HIV/AIDS among adolescents and young people, in spite, available services are not sufficiently accessible to adolescents and young people due to many constraints: political, organisational, legal, economic-financial, socio-cultural and religious. Prevention services for adolescents and young people are, according to them, inadequate, insufficient and not user-friendly.Conclusions: Stakeholders should use findings of this study as a basis for reflection for the implementation of more effective interventions for adolescents and young people to reverse the current trend of the HIV epidemic in South Kivu province.