Early life experiences, including those in utero, have been linked to increased risk for adult-onset chronic disease. The underlying assumption is that there is a critical period of developmental plasticity in utero when selection of the fetal phenotype that is best adapted to the intrauterine environment occurs. The current study is the first to test the idea that extreme maternal psychosocial stressors, as observed in the Democratic Republic of Congo, may modify locus-specific epigenetic marks in the newborn resulting in altered health outcomes. Here we show a significant correlation between culturally relevant measures of maternal prenatal stress, newborn birth weight and newborn methylation in the promoter of the glucocorticoid receptor NR3C1. Increased methylation may constrain plasticity in subsequent gene expression and restrict the range of stress adaptation responses possible in affected individuals, thus increasing their risk for adult-onset diseases.

In the last decade, scholars and humanitarians have rightly drawn attention to the high rates of gender-based violence in the eastern Democratic Republic of Congo (DRC), which are associated with the high levels of conflict in the country since 1996. However, this focus detracts from the general health problems that stem from the deterioration of the health sector, which began long before the outbreak of war. This article analyses local perceptions of the determinants of maternal health and illness in eastern DRC, and identifies ways in which women cope with barriers to health care that derive from an inadequate and/or absent health-care system. The article demonstrates that in both urban and rural locations in all four provinces of eastern DRC, women have organised to address their own vulnerabilities, which, according to them, amount to more than exposure to gender-based violence. The existence of these informal systems demonstrates the need to reassess the image of Congolese women as primarily passive victims and/or targets of violence. The article suggests that these culturally rooted indigenous solutions be evaluated as worthy recipients of development funding, which is often exclusively offered to international organisations.[« Vous dites viol, je dis hôpitaux. Mais qui parle le plus fort ? » : La santé, l'aide et la prise de décision dans la République Démocratique du Congo]. Durant la dernière décennie, les érudits et les humanitaires ont correctement attiré l'attention sur les taux élevés de violence sur la seule base du genre dans l'est de la République Démocratique du Congo (RDC), qui sont en lien avec les hauts niveaux de conflit dans le pays depuis 1996. Pourtant, cette attention sur les violences sexuelles détourne l'attention qui devrait être portée aux problèmes sanitaires généraux qui sont dus à la détérioration du secteur de la santé, qui a commencé longtemps avant l'émergence de la guerre. Cet article examine les perceptions locales des déterminants de la santé maternelle et de la maladie dans l'est de la RDC et identifie les manières avec lesquelles les femmes s'adaptent aux difficultés d'accès aux soins de santé qui résultent d'un système de santé publique insuffisant et/ou absent. L'article montre que dans les zones tant urbaines que rurales et dans les quatre provinces de l'est de la RDC, les femmes se sont organisées pour faire face à leurs propres vulnérabilités, qui, selon elles, représentent un problème plus important que l'exposition à la violence fondée sur le genre. L'existence de ces systèmes informels démontre le besoin de reconsidérer l'image des femmes congolaises comme étant en premier lieu des victimes passives et/ou des objets de violences. L'article suggère que ces solutions culturellement enracinées dans le modèle local pourraient être évaluées

HIV prevention is often implemented as if African culture were either nonexistent or a series of obstacles to overcome in order to achieve an effective, gender-equitable, human rights-based set of interventions. Similarly, traditional or indigenous leaders, such as chiefs and members of royal families, have been largely excluded from HIV/AIDS responses in Africa. This qualitative study used focus group discussions and in-depth interviews with traditional leaders and 'ritual specialists' to better understand cultural patterns and ways of working with, rather than against, culture and traditional leaders in HIV-prevention efforts. The research was carried out in four southern African countries (Botswana, Lesotho, South Africa and Swaziland). The purpose was to discover what aspects of indigenous leadership and cultural resources might be accessed and developed to influence individual behaviour as well as the prevailing community norms, values, sanctions and social controls that are related to sexual behaviour. The indigenous leaders participating in the research largely felt bypassed and marginalised by organised efforts to prevent HIV infections and also believed that HIV-prevention programmes typically confronted, circumvented, criticised or condemned traditional culture. However, indigenous leaders may possess innovative ideas about ways to change individuals' sexual behaviour in general. The participants discussed ways to revive traditional social structures and cultural mechanisms as a means to incorporate HIV-prevention and gender-sensitivity training into existing cultural platforms, such as rites of passage, chiefs' councils and traditional courts.

The need to reemphasize behavior change for hiv prevention in Uganda: A qualitative study

Whilst there are convincing theoretical arguments about the peace-building potential of the health sector, case studies documenting its interventions remain limited. This article contributes to the existing 'Peace through Health' literature by considering the model of HEAL Africa, a health-based non-governmental organization operating in Eastern Congo. Several of HEAL Africa's projects seek to prevent and reduce key risk factors; for conflict, and to contribute to longer term rehabilitation. Many of these interventions are born out of HEAL's emphasis on providing emergency health care--and the neutrality, legitimacy, access and longevity which this generates. However, this focus also tends to act as a limiting factor on the application and resourcing of its conflict prevention and reconstruction efforts. Whilst this case study warns against overstating the potential role of the health sector in promoting peace, HEAL's activities provide evidence of the types of positive contributions that can be made in practice. The role of the health sector, equipped as it is with useful tools for conflict transformation, should therefore be considered more proactively by the peace-building community.