Child marriage is a well-recognized barrier to education, and exposes girls to an increased risk of violence along with other negative health and developmental outcomes. A quantitative survey was conducted with girls selected from 14 communities in South Kivu, Democratic Republic of the Congo (DRC). Data from 350 girls (ages 13-14) were analyzed using mixed effects logistic regression models. Findings revealed that child marriage was associated with lower levels of participation in formal education as well as higher rates of physical, sexual and emotional violence. In particular, when adjusting for age and girls’ level of participation in formal education, being married was associated with more than a three-fold (OR: 3.23) increased risk of experiencing sexual violence (p<0.001). Married girls were also significantly more likely to affirm the belief that they would be forced to marry their perpetrator in the event that they were raped (p=0.017), suggesting that a portion of girls within this sample may have experienced this occurrence. Although higher levels of participation in formal education were associated with a reduced risk of violence among non-married girls, these differences were not observed for girls who were married. Findings reveal that child marriage has a significantly negative effect on the relationship between girls’ level of participation in formal education and experiences with violence. Taken cumulatively, findings from this study suggest an overall harmful relationship between child marriage and girls’ safety, education and well-being, and that efforts to prevent its occurrence in the DRC and beyond are urgently needed.
Debbie Landis, Kathryn Falb, Ilaria Michelis et al.
Abstract Background Cameroon adopted a single-dose gender-neutral human papillomavirus (HPV) vaccination schedule in January 2023. Girls’ first-dose coverage rose sharply to 68% in 2023 before declining to 36% in 2024 and further to 30% in 2025, representing a net two-year decline of 38 percentage points from the 2023 peak. The central analytical question was what operational, policy, and system factors plausibly account for this trajectory. Methods We conducted a health policy analysis informed by Walt and Gilson’s health policy triangle and a root-cause-to-intervention logic model to address this question and propose an evidence-informed girls-first recovery framework. Primary data were WHO and UNICEF Estimates of National Immunization Coverage (WUENIC) 2025 revision estimates for Cameroon, including HPV first dose and completed series among girls from 2020 to 2025, and coverage for 11 comparator antigens with stable indicator definitions across the 2024 and 2025 revisions. WUENIC Estimate Descriptions and WHO/UNICEF 2025 revision notes were reviewed for documented stockout events and reporting-method context. Results Under the former two-dose schedule, dose-completion attrition was marked: estimated dropout was 76% in 2021 and 70% in 2022. An apparent 2023 supply paradox suggests a plausible role for policy, delivery, and demand-side factors: despite a four-month national and subnational stockout affecting the first and third doses of diphtheria-tetanus-pertussis-containing vaccine, HPV coverage nearly tripled that year. By 2025, all 11 comparator antigens had improved from 2024 while remaining substantially higher than HPV coverage; the HPV-specific coverage gap widened for every comparator antigen assessed. This pattern is consistent with an HPV/adolescent-specific delivery and sustainability barrier rather than general immunisation-system weakness. Conclusions The analysis suggests that renewed recovery may depend on reliable supply, protected school-based delivery, strategic communication, outreach for underserved girls, multi-year faith-sector engagement, and time-limited girls-first prioritisation until enabling conditions for gender-neutral vaccination are restored.
Introduction Childhood vaccination remains one of the most effective public health interventions, yet coverage is often lowest in settings affected by conflict and structural disadvantage. Cameroon has faced overlapping humanitarian crises in its Far North, North-West, and South-West regions, but evidence comparing determinants of full vaccination between conflict-affected and non-conflict regions remains limited. This study explores determinants of full vaccination status in 12–23 months children in Cameroon, stratified by conflict regions. Methods We conducted a secondary analysis of the 2018 Cameroon Demographic and Health Survey, including 1,824 living children aged 12–23 months. Full basic vaccination was defined as receipt of one dose of BCG, three doses of pentavalent vaccine, three doses of polio vaccine, and one dose of measles vaccine. Survey-weighted logistic regression was used to identify factors associated with full vaccination overall and by conflict status. Results Overall, 53.08% of children were fully vaccinated. Coverage was lower in conflict-affected than in non-conflict regions (45.29% versus 55.97%). In unadjusted analysis, conflict status was associated with lower odds of full vaccination, but this association was no longer significant in the adjusted model. At the national level, higher odds of full vaccination were associated with richer household wealth, maternal secondary or higher education, antenatal care attendance, and postnatal care. In conflict-affected regions, maternal secondary or higher education, postnatal care, and facility delivery remained significant predictors of full vaccination. Discussion Full vaccination coverage in Cameroon remains below desirable levels, with lower crude coverage in conflict-affected regions. However, after adjustment, conflict status was not independently associated with full vaccination, suggesting that socioeconomic conditions and contact with maternal health services are more important determinants. Strengthening antenatal and postnatal care and reducing socioeconomic barriers may improve vaccination coverage, especially in fragile settings.
Child marriage is defined as a formal or informal union before the age of 18. As in much of sub-Saharan Africa, the prevalence of child marriage remains high in the Republic of Congo (RoC), in part because educational attainment for girls is low. Based on qualitative fieldwork, this article looks at communities’ perceptions of child marriage and girls’ education and their suggestions for programs and policies that could improve outcomes for girls. The article also discusses potential implications for Catholic and other faith-based schools, as well as faith leaders.
Jean-Christophe Boungou Bazika, Wolf Ulrich Mféré Akiana, Quentin Wodon
Child marriage is defined as a formal or informal union before the age of 18. As in much of Sub-Saharan Africa, the prevalence of child marriage remains high in the Democratic Republic of Congo (DRC) in part because educational attainment for girls is too low. Based on qualitative fieldwork, this article looks at communities’ perceptions of child marriage and girls’ education and their suggestions for programs and policies that could improve outcomes for girls. The article also discusses potential implications for Catholic and other faith-based schools, as well as faith leaders.
Malnutrition is a major cause of childhood morbidity and mortality, affecting children’s growth and development. This study aimed to identify the factors associated with malnutrition among children aged 0 to 59 months at Bonassama District Hospital in Douala. A descriptive and analytical cross-sectional study was conducted from July 2025 to April 2026 among children aged 0 to 59 months seen in the pediatrics and immunization units. Data were collected using a questionnaire administered to parents. Nutritional status was assessed according to WHO standards, and associated factors were identified through multivariate analysis. Among the children studied, 82.2% had normal nutritional status and 17.8% were malnourished. After adjustment, the factors significantly associated with malnutrition were type of housing (modern house: AOR = 2.10; 95% CI: 1.03–4.01; p = 0.044), tenant status (AOR = 3.01; 95% CI: 1.53–6.78; p < 0.001), history of respiratory infection (AOR = 2.12; 95% CI: 1.20–5.35; p = 0.019), and occasional use of health services (AOR = 2.23; 95% CI: 1.05–5.21; p = 0.030). Mothers’ knowledge of essential food groups was not significantly associated with malnutrition. Malnutrition remains a significant problem among children under five years of age in Bonassama. Prevention strategies should incorporate health, socioeconomic, and environmental factors to improve screening and management of at-risk children.
Godfroy Rostant Pokam Djoko, Murielle Tsobgny Nguefack, Devis Sobnang
