Background Inadequate infrastructure, security threats from ongoing armed conflict, and conservative socio-cultural and gender norms that favour large families and patriarchal power structures contribute to poor sexual and reproductive health (SRH) outcomes in North and South Kivu provinces, Democratic Republic of the Congo (DRC). In order to expand contraceptive and post-abortion care (PAC) access in North and South Kivu, CARE, the International Rescue Committee and Save the Children provided technical support to the Ministry of Health and health facilities in these regions. Partners acknowledged that community leaders, given their power to influence local customs, could play a critical role as agents of change in addressing inequitable gender norms, stigma surrounding SRH service utilization, and topics traditionally considered taboo within Congolese society. As such, partners actively engaged with community leaders through a variety of activities such as community mapping exercises, values clarification and transformation (VCAT) activities, situational analyses, and education. Methods This manuscript presents findings from 12 key informant interviews (KIIs) with male political and non-political community leaders conducted in six rural health zones of North and South Kivu, DRC. Transcripts were analysed thematically to explore community leaders’ perceptions of their role in addressing the issue of unintended pregnancy in their communities. Results While community leaders in this study expressed overall positive impressions of contraception and strong support for ensuring access to PAC services following spontaneous and induced abortions, the vast majority held negative beliefs concerning women who had induced abortion. Contrasting with their professed opposition to induced abortion, leaders’ commitment to mediating interpersonal conflict arising between community members and women who had abortions was overwhelming. Conclusion Results from this study suggest that when thoughtfully engaged by health interventions, community leaders can be empowered to become advocates for SRH. While study participants were strong supporters of contraception and PAC, they expressed negative perceptions of induced abortion. Given the hypothesized link between the presence of induced abortion stigma and care-avoidance behavior, further engagement and values clarification exercises with leaders must be integrated into community mobilization and engagement activities in order to increase PAC utilization.

» qui à travers son projet « AFTP4A » a soutenu financièrement les travaux de recherche. RESUME A Kisangani, le kolatier, Cola acuminata est utilisé à des fins thérapeutiques et sociales et procure des revenus non négligeables aux personnes impliquées dans sa filière. Les produits de kolatier (noix, écorce, feuille) sont obtenus par des récoltes en forêt qui est pourtant menacée. Sa domestication est une nécessité. La présente étude avait pour objet de déterminer le diamètre et l'orientation des branches pour la multiplication végétative de kolatier. La technique de marcottage aérien a été utilisée. Trois classes de diamètre (2,0-2,9 ; 3,0-3,9 et 4,0-4,9 cm) et deux orientations (plagiotrope et orthotrope) des branches ont été investiguées pour leurs effets sur l'enracinement. Les résultats ont montré que les racines apparaissent à partir de la 6 e semaine après la pose des marcottes. Des taux d'enracinement de 82,2 ± 5,7% et 75,5 ± 6,4% ont été obtenus avec les branches orthotropes et plagiotropes respectivement. Les différentes classes de diamètre de branches ont donné 76,7 ± 7,8% ; 63,3 ± 8,9% et 43,3 ± 9,2% pour 4,0-4,9 cm ; 3,0-3,9 cm et 2,0-2,9 cm respectivement. Ces résultats indiquent que C. acuminata répond bien à la technique de marcottage, et que les branches orthotropes de diamètre compris entre 4 et 4,9 cm sont bien indiquées pour un enracinement meilleur des marcottes. La technique de marcottage peut de ce fait être utilisée pour la multiplication conforme des individus élites chez cette espèce.