Abstract Luo orphaned children derive their conceptualization of home from historical ideologies of patrilineal kinship and the local discourses of belonging situated within properly constituted marriage. Contrary to older literature that presents home as a domestic spatial arrangement, orphans understand home as a relational pathway that safeguards growth. We show that orphans use their notion of home to express feelings of vulnerability and apply their agency against adult-initiated fosterage practices. The article contributes to an enhanced understanding of Luo sociality and promotes a dynamic anthropology of relationships and child anthropology by unpacking the facets of childhood vulnerability. Our analysis points to analytic themes of contradictions and paradox in Luo kinship values in relation to child support and ambivalence in how children's agency is exercised in fosterage arrangements.
Male circumcision (MC) is now recommended as an additional HIV preventive measure, yet little is known about factors that may influence its adoption, especially in non-circumcising communities with generalized HIV pandemic. This qualitative study explored factors influencing MC adoption in rural western Kenya. Twenty-four sex specific focus group discussions were conducted with a purposive sample of Luo men and women (15-34 years). Perceived barriers to circumcision were pain and healing complications, actual and opportunity costs, behavioral disinhibition, discrimination, cultural identity, and reduced sexual satisfaction; perceived facilitators were hygiene, HIV/STI risk reduction, ease in condom use, cultural integration, and sexual satisfaction. To enhance MC adoption, community education, and dialogue is needed to address the perceived fears.
The UN Convention on the Rights of the Child significantly strengthened the legal basis for recognising children as actors with agency and a voice. In contrast to this, children in displacement contexts are still commonly portrayed as victims without agency. Children are dependent on adults, but that does not mean that they have no right to participate in decisions that affect their lives. This policy brief sheds light on the active role that children in displacement situations can take in their daily lives to shape refugee–host interactions and local integration in camp settings. It discusses how the role of children in the social integration of refugees can be strengthened and supported, indicating potential areas for intervention. With 40 per cent of the displaced population worldwide being below the age of 18, children form a significant part of this group (United Nations High Commissioner for Refugees [UNHCR], 2023). However, there continues to be limited information on the perspectives and experiences of children in displacement situations, particularly those living in the Global South. Although there is some knowledge regarding interventions to support the integration of refugee children, not much has been said about their own initiatives with respect to social integration and mediating the circumstances that displacement and encampment entail. Children change the world around them and invariably impact the adult-dominated processes of migration and integration when they participate. Independently from adults, children negotiate and construct relations during their interactions in public and private spaces, such as in (pre-)schools, organised sporting events and in private meeting points. They develop friendships and share learning materials, food and language. Through their agency, children build relations that are critical for the process of integration. This can transcend adult-dominated notions about the safety and securitisation of displacement contexts, thus transforming the conflict rhetoric associated with refugee–host community relations. The role of children has become even more salient in view of efforts to facilitate integration through the Comprehensive Refugee Response Framework (CRRF), a key framework guiding refugee policy in many refugee-hosting countries in the Global South. At the same time, children's unique growth and developmental needs have to be adequately understood and incorporated into integration policies and programmes. In this policy brief, we call for a change in policy and pro¬gramming to recognise and support children's critical role in social integration. We make the following recommendations to host governments, international agencies and local partners active in refugee camp settings to: • Support more data collection and analysis of children's actions in building relations that can foster integration in different displacement contexts. • Ensure that children are included as a special category in policy frameworks. Their interests and needs should be taken into account by listening to their voices and providing platforms for exchanges with adults, policy-makers and practitioners. • Create more opportunities for refugee and host community children to interact inside and outside of school environments. • Support sensitisation programmes that bring together parents of refugee and host community children to understand the role of children in the integration process and to ensure that the views of adults as parents and guardians are also listened to and addressed. • Address negative stereotypes and open conflicts between refugee and host community children that restrict free and positive interactions. This can include fostering dialogue and peaceful means to resolve conflicts as well as facilitating cooperation.
Abstract Background Controlling cholera remains a significant challenge in Sub-Saharan Africa. In areas where access to safe water and sanitation are limited, oral cholera vaccine (OCV) can save lives. Establishment of a global stockpile for OCV reflects increasing priority for use of cholera vaccines in endemic settings. Community acceptance of vaccines, however, is critical and sociocultural features of acceptance require attention for effective implementation. This study identifies and compares sociocultural determinants of anticipated OCV acceptance across populations in Southeastern Democratic Republic of Congo, Western Kenya and Zanzibar. Methods Cross-sectional studies were conducted using similar but locally-adapted semistructured interviews among 1095 respondents in three African settings. Logistic regression models identified sociocultural determinants of OCV acceptance from these studies in endemic areas of Southeastern Democratic Republic of Congo (SE-DRC), Western Kenya (W-Kenya) and Zanzibar. Meta-analytic techniques highlighted common and distinctive determinants in the three settings. Results Anticipated OCV acceptance was high in all settings. More than 93 % of community respondents overall indicated interest in a no-cost vaccine. Higher anticipated acceptance was observed in areas with less access to public health facilities. In all settings awareness of cholera prevention methods (safe food consumption and garbage disposal) and relating ingestion to cholera causation were associated with greater acceptance. Higher age, larger households, lack of education, social vulnerability and knowledge of oral rehydration solution for self-treatment were negatively associated with anticipated OCV acceptance. Setting-specific determinants of acceptance included reporting a reliable income (W-Kenya and Zanzibar, not SE-DRC). In SE-DRC, intention to purchase an OCV appeared unrelated to ability to pay. Rural residents were less likely than urban counterparts to accept an OCV in W-Kenya, but more likely in Zanzibar. Prayer as a form of self-treatment was associated with vaccine acceptance in SE-DRC and W-Kenya, but not in Zanzibar. Conclusions These cholera-endemic African communities are especially interested in no-cost OCVs. Health education and attention to local social and cultural features of cholera and vaccines would likely .
Abstract Background Cholera mainly affects developing countries where safe water supply and sanitation infrastructure are often rudimentary. Sub-Saharan Africa is a cholera hotspot. Effective cholera control requires not only a professional assessment, but also consideration of community-based priorities. The present work compares local sociocultural features of endemic cholera in urban and rural sites from three field studies in southeastern Democratic Republic of Congo (SE-DRC), western Kenya and Zanzibar. Methods A vignette-based semistructured interview was used in 2008 in Zanzibar to study sociocultural features of cholera-related illness among 356 men and women from urban and rural communities. Similar cross-sectional surveys were performed in western Kenya (n = 379) and in SE-DRC (n = 360) in 2010. Systematic comparison across all settings considered the following domains: illness identification; perceived seriousness, potential fatality and past household episodes; illness-related experience; meaning; knowledge of prevention; help-seeking behavior; and perceived vulnerability. Results Cholera is well known in all three settings and is understood to have a significant impact on people's lives. Its social impact was mainly characterized by financial concerns. Problems with unsafe water, sanitation and dirty environments were the most common perceived causes across settings; nonetheless, non-biomedical explanations were widespread in rural areas of SE-DRC and Zanzibar. Safe food and water and vaccines were prioritized for prevention in SE-DRC. Safe water was prioritized in western Kenya along with sanitation and health education. The latter two were also prioritized in Zanzibar. Use of oral rehydration solutions and rehydration was a top priority everywhere; healthcare facilities were universally reported as a primary source of help. Respondents in SE-DRC and Zanzibar reported cholera as affecting almost everybody without differentiating much for gender, age and class. In contrast, in western Kenya, gender differentiation was pronounced, and children and the poor were regarded as most vulnerable to cholera. Conclusions This comprehensive review identified common and distinctive features of local understandings of cholera. Classical treatment (that is, rehydration) was highlighted as a priority for control in the three African study settings and is likely to be identified in the region beyond. Findings indicate the value of insight from community studies to guide local program planning for cholera control and elimination.
