Dropout from the pentavalent vaccine series among children aged 12-23months in the Central African Republic: prevalence, associated factors, and caregiver-reported barriers.

Sickle Cell Disease: Can genetic variability influence pregnancy outcomes?

With the ongoing global resurgence of COVID-19, it is crucial to better understand past transmission dynamics to strengthen national preparedness for future surges. Since its emergence in Wuhan, China, in December 2019, SARS-CoV-2 has caused multiple waves of infection worldwide. The World Health Organization (WHO) has identified several variants of concern, including Alpha, Beta, Gamma, and Delta. At the end of 2021, the Omicron variant emerged in South Africa and rapidly spread across the globe. While many studies have explored the evolution and transmission of these variants, data from the Central African Republic remained limited. This study aimed to identify and characterize SARS-CoV-2 variants circulating in Bangui to support genomic surveillance and COVID-19 prevention strategies. Characterizing circulating variants provides essential information for the early detection of emerging lineages, the anticipation of potential epidemic waves, and the adaptation of public health strategies. We conducted a retrospective, descriptive study in Bangui, Central African Republic (CAR), from January to August 2022. A total of 102 nasopharyngeal samples positive for SARS-CoV-2 (Ct ≤ 30), selected from the biobank of the Pasteur Institute in Bangui, were reanalyzed using multiplex qPCR to confirm their Ct values. Eligible samples were then sequenced using the MinION MK1C (Oxford Nanopore Technologies) platform, following the ARTIC Network protocol at the Institut Pasteur, Paris (CIBU). Bioinformatics processing using reads mapping to a reference genome, followed by consensus sequence generation, included standard steps of basecalling, demultiplexing, quality filtering, genome alignment, primer trimming, consensus generation, and variant calling. The different variants were described using the Nexstrain web application. The results revealed that 66.7% of sequenced genomes (n = 68) had high coverage ≥ 80%, all belonging to the Omicron variant. Four sub-lineages were identified according to the Pangolin classification: BA.1 (14.7%), BA.2 (35.3%), BA.4.1 (4.4%), and BA.5.1 (45.6%). These sub-lineages were present in all eight districts, with a predominance in the eighth district, and were most frequently diagnosed in June (fourth wave of the epidemic). Omicron was the only variant detected among successfully sequenced samples, although limited sampling and sequencing success restrict broader generalisation. It is crucial to establish continuous surveillance of SARS-CoV-2 to detect any emerging variants in real time, while strengthening sequencing capabilities at the national level. Continuous genomic surveillance is crucial to anticipate potential future COVID-19 waves and to enable timely public health responses.

The novel oral polio vaccine of serotype 2 (nOPV2) was engineered to prevent the emergence of revertant polio vaccine strains, which caused numerous outbreaks in the 2000s and 2010. Since 2021, it has been used in many countries, especially in Sub-Saharan Africa, to contain poliomyelitis outbreaks. In 2023, double recombinant nOPV2-derived isolates that had lost all the attenuation determinants were detected in the Central African Republic (CAR). Several of these were the first nOPV2 revertant isolates ever reported to the Global Polio Eradication Initiative, thereby demonstrating that the engineered modifications in nOPV2 do not entirely prevent reversion via recombination with non-polio enteroviruses of species Enterovirus coxsackiepol (EV-Cs). This study corroborates the increased genetic stability of nOPV2 compared to the historical vaccine strain but demonstrates that reversion through recombination with non-polio EV-Cs remains possible. This underscores the need for comprehensive EV-C surveillance alongside poliovirus monitoring, especially in Sub-Saharan Africa where EV-Cs are particularly abundant. In particular, assessing EV-C potential seasonal circulation patterns could inform the design of vaccination strategies tailored to minimize the risk of recombination between nOPV2 and non-polio EV-Cs.

ABSTRACT The Central African Republic (CAR) is considered among the world’s poorest countries and is possibly the poorest. Despite substantial financial assistance since a civil war erupted 10 years ago, no significant recovery can be recorded. Scholars commonly explain CAR’s entrenched poverty with its status as an aid orphan, landlocked geography, unfavourable demographic profile and recurrent political crises. We provide an alternative argument after investigating peace and security, the private sector and public goods provision through combined bottom-up and top-down analysis of fieldwork, budgetary and development data. We find that rampant and continued poverty stems from a pronounced disconnect between the globally commodified market towards a locally subsistent communal economy. Politicians and foreign actors have broken their promises to the populace and continue to block the exchange of ideas and resources. The best intentions of international development actors to reform the state from the top down fail just as much as bottom-up attempts to strengthen local resilience. Rather, CAR’s trajectory to prosperity depends on reconnecting the centre and peripheries, elites and general population, and the local with the global. This will require resistance against structures and agents that are (at times unknowingly) perpetuating the disconnect.

The Central African Republic (CAR), a fragile and conflict-affected setting, has one of the highest maternal mortality ratios in the world. Complications of unsafe abortion, while preventable, are one of the major contributors. Legal abortion is authorized in limited circumstances before eight weeks but in practice, is unavailable. This study explored the experiences of patients hospitalized with severe postabortion complications at a Ministry of Health (MoH) maternity hospital supported by Médecins sans Frontières to understand women's challenges accessing appropriate care. We interviewed 18 purposively selected girls and women following medical treatment for near-miss or potentially life-threatening abortion complications. In-depth interviews were conducted to understand women's challenges accessing appropriate care. Data were analysed thematically to identify patterns in decisions, care-seeking trajectories, and factors that may have delayed seeking and receiving postabortion care. About two-thirds of participants reported that they had induced the abortion, either on their own or with assistance, before seeking postabortion care. Participants faced multiple barriers accessing abortion which led them to choose ineffective and harmful abortion methods, notably a lack of reliable information and access to safe abortion care services, compounded by individual, interpersonal and socio-economic constraints. When experiencing postabortion complications, the decision to seek care was delayed by limited knowledge and attempts at maintaining secrecy surrounding the abortion. Participants, including those not reporting induced abortion, described complex nonlinear care-seeking pathways, including attempts to self-manage symptoms and consulting closer health care facilities that weren't able to handle the complications due to lack of capacity. Postabortion complications were associated with taxing and potentially long-term physical, psychological, social and financial consequences, which often negatively impacted women, families and communities. Our findings highlight the urgent need for MoH and partners to implement strategies improving timely access to high-quality postabortion care, such as informing communities about danger signs of abortion complications, treatment locations, improving referral systems, and reducing financial barriers. Training informal and lower-level medical staff in the recognition and treatment of abortion complications and about respectful non-judgmental communication with patients would also be of benefit. Furthermore, creating a more supportive environment for the provision of postabortion and safe abortion care and information should be prioritized, including the decentralisation of care to primary care facilities.

Vaccination coverage surveys (VCS) are essential for monitoring program performance, especially where administrative data are unreliable. While national and sub-national estimates are common, district-level data remain limited despite their value for local planning and equity monitoring. This study compared three alternative sampling approaches (ASAs)-Kinshasa School of Public Health VCS (KSPH-VCS), Geographic Information System (GIS)-based sampling, and Lot Quality Assurance Sampling (LQAS)-to the WHO Vaccination Coverage Cluster Survey (WHO-VCCS) in terms of validity and precision among children aged 12-23months at the health district (HD) level. A cross-sectional study was conducted in five HDs (urban and rural) in the Central African Republic (CAR) and the Democratic Republic of Congo (DRC). All four approaches were applied simultaneously. For 17 vaccination indicators per HD, comparability to WHO-VCCS was assessed using four metrics: (i) absolute difference in percentage points (pp) between each ASA and the WHO-VCCS estimates, (ii) inclusion within WHO's 95% confidence intervals (CIs), (iii) CI width ratio, and (iv) proportion of estimates outside WHO CIs. Survey-adjusted logistic regressions, design effects (DEFF), and intra-cluster correlation coefficients (ICC) were analyzed. Aggregated results at regional/national levels were also simulated. GIS showed the highest concordance (49.3% of estimates within 5pp.; 41.2% within WHO CIs) but had the widest CIs (median width ratio relative to WHO-VCCS: 2.2). KSPH-VCS had narrower CIs (1.7) and moderate validity (22.4% within 5pp), while LQAS had the highest proportion of estimates outside WHO CIs (median: 18.5pp). KSPH-VCS and GIS were statistically comparable to WHO-VCCS in 3 of 5 HDs; LQAS in 4. At aggregated levels, all ASAs performed similarly. KSPH-VCS and GIS offer viable options to WHO-VCCS, especially for producing aggregated estimates with acceptable precision. Further studies should assess cost, feasibility, and adaptability across settings.

ABSTRACT Monkeypox virus (MPXV) is a zoonotic pathogen known to be endemic to the Congo basin and West Africa, and which causes characteristic lesions disseminated on all skin surfaces of infected cases. Multiple MPXV outbreaks have been reported in the Central African Republic (CAR), a country in the Congo basin, at an increased frequency since 2020. The genomic history of these outbreaks in CAR is poorly characterized due to undersampling, with only a recent expansion in the number of sequences from CAR. Here, we report twenty-six new near-complete genomes from six prefectures of CAR, selected to represent outbreaks that occurred in the country between 2019 and 2024. Our analysis shows the sustained homogeneity of genomes in CAR, as all of them belonged to Clade Ia, but with an expansion of sub-lineages and therefore increased MPXV diversity within CAR. We highlight the introduction into CAR of a lineage previously known to occur only in Gabon and Cameroon, as well as the apparent regional clustering of MPXV genomes in CAR. Our analysis reveals limited APOBEC3-mediated activity, which is consistent with recent zoonotic origins and short human-to-human transmission chains observed in CAR. These analyses provide an in-depth view of the genomic diversity of MPXV in the Central African region.

Bacteria of the genus Salmonella are motile, Gram-negative bacilli belonging to the Enterobacteriaceae family. In sub-Saharan Africa, foodborne illnesses caused by Salmonella result in approximately 680,000 deaths annually. Previous studies have been conducted in the Central African Republic, but these studies did not incorporate specific molecular biology techniques. It is in this context that this study was undertaken, with the aim of determining the antibiotic resistance genes of Salmonella non-Typhi isolates circulating in the Central African Republic (CAR). This was a descriptive and analytical cross-sectional study conducted between 2019 and 2023. Serotyping and molecular characterization were partially performed on strains isolated from stool, urine, and blood samples from patients who came from different health facilities. A total of 72 Salmonella strains were selected, including 8.33% in blood, 15.28% in urine, and 76.39% in stool. The age of the patients ranged from 1 to 74 years, with an average of 30 years, the mode being 1 year with a standard deviation of 19.03. The 0-14 age group accounted for 30.56% and the >14 age group for 69.44%. Females were more represented, with a male/female sex ratio of 0.84. Salmonella enterica serotype Typhimurium was the most common, followed by Salmonella enterica serotype Enteritidis. The rate of resistance to chloramphenicol was high, followed by quinolones, B-lactams, and aminoglycosides. Molecular characterization of B-lactam resistance genes revealed a frequency of positivity for the blaCTX-M1, blaTEM, and blaSHV genes. The Salmonella enterica serotype Remo serotype showed a diversity of resistance genes for blaTEM, blaCTX-M1, and blaSHV. Molecular characterization of quinolone resistance genes revealed qnrB genes. BlaTEM genes were represented in the 0-14 age group. However, qnrB was detected in the >14 age group. blaTEM genes were detected in males, while blaCTX-M1 genes were detected in females. The results of this study showed that Salmonella strains possess qnrB genes for quinolone resistance and blaTEM, blaCTX-M1, and blaSHV genes for B-lactam resistance. Consequently, as these different antibiotic resistance genes are circulating in CAR, epidemiological investigations are needed to identify the link between the genes of isolates circulating in CAR and the food products consumed by the population, animals, and the environment, which could be sources of the emergence of salmonellosis.

Application of analytical hierarchy process and gis to delineate and map groundwater potential zones in Mambéré-kadéï prefecture environment, Southwest of Central Africa Republic, Central Africa

In conflict-affected settings such as South Sudan and the Central African Republic (CAR), fragile health systems face immense challenges in maintaining service delivery including essential health service access. Community engagement is a critical enabler across the Disaster Risk Management (DRM) cycle—preparedness, response, recovery, and resilience—by fostering trust, inclusivity, and local ownership. This qualitative study draws on data from the Advanced Partnership in Health (APiH) program (2019–2023), implemented by the Red Cross in CAR and South Sudan. Data were collected through 15 key informant interviews and 16 focus group discussions with community members, health workers, and program implementers. Framework analysis was used to explore the role of community engagement across each DRM phase. Community engagement was integral across all DRM phases—preparedness, response, recovery, and resilience. It enabled trust-building, inclusive participation, support for community health services, and local resource mobilization, contributing to more effective and sustainable health interventions in conflict settings. Community engagement is essential for sustaining healthcare delivery in conflict settings. Humanitarian health programs should institutionalize community engagement throughout the DRM cycle. Policies must prioritize inclusive planning, support for community health workers, and investment in local infrastructure to build resilient, community-driven health systems.

The emergence of variants in the wake of the COVID-19 pandemic has put a strain on healthcare systems in Africa. The Afroscreen project is strengthening national sentinel surveillance systems, combined with sequencing capabilities to identify potentially highly virulent variants of interest at an early stage. The aim of this article is to present the results of this project and discuss the related challenges. Surveillance was based on national surveillance sentinel systems, either hospital-based or peripheral, and RT-PCR diagnostic capabilities, coupled with sequencing in the event of positivity, from July 2022 to June 2024. In 11 African countries (Senegal, Guinea, Côte d'Ivoire, Togo, Benin, Niger, Cameroon, the Central African Republic (CAR), Burkina Faso, Madagascar and the Democratic Republic of the Congo), it was possible to demonstrate a decline in the circulation of SARS-CoV-2 over the surveillance period, with only the Omicron variant circulating. Setting up and coordinating a multicountry sentinel surveillance system during a pandemic period is a real challenge. This highlights the need to strengthen surveillance systems during interepidemic and pandemic periods and the question of their sustainability in line with emerging disease preparedness and response programs.

In conflict-affected settings such as South Sudan and the Central African Republic (CAR), fragile health systems face immense challenges in maintaining service delivery including essential health service access. Community engagement is a critical enabler across the Disaster Risk Management (DRM) cycle-preparedness, response, recovery, and resilience-by fostering trust, inclusivity, and local ownership. This qualitative study draws on data from the Advanced Partnership in Health (APiH) program (2019-2023), implemented by the Red Cross in CAR and South Sudan. Data were collected through 15 key informant interviews and 16 focus group discussions with community members, health workers, and program implementers. Framework analysis was used to explore the role of community engagement across each DRM phase. Community engagement was integral across all DRM phases-preparedness, response, recovery, and resilience. It enabled trust-building, inclusive participation, support for community health services, and local resource mobilization, contributing to more effective and sustainable health interventions in conflict settings. Community engagement is essential for sustaining healthcare delivery in conflict settings. Humanitarian health programs should institutionalize community engagement throughout the DRM cycle. Policies must prioritize inclusive planning, support for community health workers, and investment in local infrastructure to build resilient, community-driven health systems.

Surveillance of influenza infections and virus characterisation are essential to guide prevention strategies. In the Central African Republic (CAR), data on influenza viruses are patchy and poorly documented. To study the clinical, seasonal, genetic and phenotypic characteristics of influenza viruses circulating in the CAR population. From January 2015 to December 2018, the presence of influenza A and B viruses in patients presenting with influenza-like illness (ILI) symptoms or severe acute respiratory infections (SARI) was investigated by RT-qPCR. Influenza genetic diversity was evaluated by phylogenetic analyses, and antigenic properties were investigated by haemagglutination inhibition assays, whereas reduced susceptibility to neuraminidase inhibitors was assessed through the presence of known genetic markers and neuraminidase assay. The relationship between patients' clinical characteristics and infection status was investigated using statistical analyses. Over the surveillance period influenza viruses were detected in 9.7% of samples (n = 6134), with the highest intensity of circulation occurring in 2016 (15.8%), attributed mainly to A(H3N2). Periods of increased influenza transmission (June to October) generally coincided with rainy seasons; however, variations in terms of monthly distribution of cases between years were evident. Hospitalisation rates (SARI) were most frequent in infants (0-11 months, 37.9%) and young children (1-4 years, 24.8%), whereas influenza prevalences were highest in the 15-49 (12.0%) and ≥ 50 (15.2%) years old categories. A new A(H1N1)pdm09 6B.1 hemagglutinin subgroup characterised by amino acid substitutions S84N, S162N and I216T was detected in 2015, with associated antigenic drift, and subsequently, two of these viruses showed highly reduced inhibition by oseltamivir. This study showcases the value of local influenza sentinel networks to specifically inform vaccination strategies and highlights the need for improved strain characterisation in tropical regions.

This study is aimed at evaluating the inclusion of miniature anion‐exchange centrifugation technique (mAECT) in the diagnosis and fexinidazole as treatment of gHAT in Central African Republic (CAR) after capacity building. A cross‐sectional pilot study was conducted during a mass diagnostic campaign from 16 September to 22 October 2022 in Nola‐Bilolo, a historic focus in CAR. The serological test, card agglutination test for trypanosomiasis (CATT), was performed on whole blood and diluted plasma to screen participants, followed by a confirmatory parasitological test by capillary tube centrifugation (CTC) and mAECT. Positive cases were treated mainly with fexinidazole. A total of 2070 participants were screened, out of an estimated population of 3584, representing a participation rate of 58%. The seroprevalence of HAT was 1.6% (CI 95%: 77%–99%) (33/2070) by the CATT plasma end‐dilution titre ≥ 1:16. Blood from serological subjects was examined microscopically after concentration by CTC and mAECT was positive for trypanosomes in 48.48% (CI 95%: 31%–66%) (16/33) and 87.88% (CI 95%: 77%–99%) (29/33) of cases, respectively. The prevalence of microscopically confirmed HAT was 0.77% (CI 95%: 0.40%–1.15%) and 1.4% (CI 95%: 1%–2%) by CTC and mAECT, respectively. Twenty‐one (72.41%) patients were treated with fexinidazole with a 0% interruption rate. The introduction of fexinidazole (2021) and mAECT (2022) likely contributed to the rise in reported cases (from 45 in 2021 to 111 in 2024) and improved screening coverage in the study area, reflecting enhanced case detection and access to care. There is a necessity to establish diagnostic quality assurance and to reinforce the other control measures including vector control.

Introduction: Tuberculosis remains a major cause of morbidity, with infection affecting more than one-third of the world’s population, and mortality. The risk of transmission of pulmonary tuberculosis is determined by the presence of new cases. In The Central African Republic (CAR), the incidence of tuberculosis was first documented in 2014. The objective of this study was to determine the incidence of tuberculosis based on molecular screening carried out in the country’s health districts. Methodology: This was a descriptive cross-sectional study conducted at the National Laboratory of Clinical Biology and Public Health in Bangui over a six-month period from January to June 2025. The study sample consisted of patients screened for tuberculosis in thirty-two health districts during this period. Patients currently undergoing anti-tuberculosis treatment were excluded to ensure that the focus was on incident cases. The biological samples collected were analyzed using GeneXpert, a semi-quantitative automated test based on real-time amplification of Mycobacterium tuberculosis complex DNA and rifampicin resistance. This molecular biology technique enables rapid detection of Mycobacterium tuberculosis complex DNA. The data collected were entered into Excel and analyzed using Epi Info 7. Results: A total of 12,112 patients aged between 4 months and 100 years were registered in 32 of the 35 districts in the CAR. The median age was 35 ± 18 years and the most common age was 40 years. The male-to-female ratio was 1.8. The most represented age group was 15 to 49 years old, with a rate of 62.23%. The overall incidence of tuberculosis was 45.50 per 100,000 person-months. The highest incidence was found in June (10.67 per 100,000 person-months), among patients aged ≥ 50 years (323.50/100,000 person-semesters), men (57.99/100,000 person-months), and those in Bangui District 1 (319/100,000 person-months). Pulmonary tuberculosis was the most common location among cases (93.22%). High bacterial load (27.32%) and low bacterial load (25.29%) were more prevalent. Male gender (p = 0.0004) and place of residence (p Conclusion: Tuberculosis remains a major public health problem in the CAR due to its morbidity. New cases of pulmonary tuberculosis, which are a source of new infections, are not insignificant. There is a need to focus on prevention through awareness-raising.

Despite its considerable potential and growth rates, the African continent has not yet overcome its main challenge: con icts, which have become almost chronic in some countries. Given the tangible consequences of these con icts for both African countries and the rest of the world, establishing and maintaining peace and security in Africa remains a priority for the international community. The Central African Republic (CAR), one of the world’s poorest countries, landlocked but rich in natural resources, has experienced the full impact of endless coups, weak governance and con ict. Since the mid-1990s, more than a dozen peacekeeping operations have been conducted here. The CAR has become a kind of ‘laboratory’ for all possible types of intervention, including multidimensional stabilization operations, training, observation, advisory, military missions and peacekeeping and peacebuilding operations. The peacekeeping ‘marathon’ in the CAR involved a multitude of actors, including the United Nations (UN), the African Union (AU), the Economic Community of Central African States (ECCAS), the Economic and Monetary Community of Central Africa (CEMAC), the Common Market for Eastern and Southern Africa (COMESA) and the European Union (EU), as well as individual countries, such as France and, to some extent, Russia. Despite these interventions, the domestic political situation in the country remained unstable for a long time, representing the Central African security paradox. To study this issue, the dynamics of numerous peacekeeping operations since 1997 were examined, and three main stages of international intervention were identi ed based on qualitative changes in the security situation. The present study is based on a qualitative comparative analysis, which enables to identify stable combinations of factors that determine the e ectiveness or ine ectiveness of international missions in protracted con icts. The study reveals the main reasons for the limited e ectiveness of international peacekeeping in the CAR.

Peacekeeping operations in the 21st century have evolved beyond traditional stability mission to encompass more complex objectives, including civilian protection, conflict resolution, and the management of asymmetric threats. In this shifted paradigm, artificial intelligence (AI) and virtual reality (VR) technologies present unique prospects to improve operational effectiveness and safety of peacekeeping personnel. While there is substantial research on military applications of AI, there remains a striking lack of studies exploring the integration of AI within the UN's peacekeeping mission. This study aims to examine how AI and AI-enabled virtual reality (VR) simulations can enhance the preparedness and response of peacekeepers deployed in high-risk areas. This study is qualitative in nature and adopts phenomenological approach. This research explores the experiences of peacekeepers who were deployed in countries such as Democracy Republic of Congo (DRC), South Sudan, and Mali, and Central African Republic (CAR). It also includes perspectives from experts involved in peacekeeping training department. Findings indicate that AI technologies, particularly with respect to surveillance and intelligence gathering, have potential to enhance situational awareness and lessen the risks posed from emerging threats. Furthermore, AI-driven virtual reality (VR) training simulation creates opportunities for peacekeepers to exercise and enhance their skill of interacting with the community and assist in decision making. Nonetheless, the study also highlights challenges and concerns, including ethical consideration, potential violations of core peacekeeping principles and limitations in the resources required to build AI-based infrastructure. The research demonstrates the potential of AI and VR to transform and modernize peacekeeping, but stressed the need for responsible implementation, recognizing the fundamental cause of peace and stability.

BackgroundImproving data quality and use is a priority identified by the World Health Organization (WHO) to reduce stillbirths and newborn deaths; however, few studies have documented newborn and stillbirth data use in the African Region. To address this gap, we conducted a cross-sectional study from November 2022 to July 2024 in 12 regions and four city administrations across the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda.MethodsWe collected data using Every Newborn – Measurement Improvement for Newborn & Stillbirth Indicators (EN-MINI) tools, through direct observation, and from routine electronic and/or paper-based forms and reports. We analysed both the overall and country-level samples following the Performance of Routine Information System Management User’s Kit.ResultsWe assessed 142 sites, comprising 93 health facilities and 49 data offices. Enabling factors, such as electronic systems, guidelines, annual plans, and feedback mechanisms, were highly available in Ethiopia (n/N = 22/30), moderately available in Uganda and Tanzania (n/N = 15/30 and n/N = 12/30), and scarce in the CAR (n/N = 1/30), with key indicators in all countries being ≥80%. Key data-use indicators showed similar patterns across countries, but lower frequencies (Ethiopia: n/N = 15/66; Uganda: n/N = 14/66; Tanzania: n/N = 5/66; the CAR: n/N = 1/66). Decisions documented in meetings rarely focussed on healthcare quality improvement, particularly at the district level (47.1% in Tanzania vs. 44.4% in Uganda vs. 30% in Ethiopia vs. 0% in the CAR). Data dissemination to public representatives was also subpar (40.8% in facilities, 71.4% in subnational offices). Among 141 end-users, 100% of respondents in the CAR, 75–82.4% in Tanzania and Uganda expressed the need to improve the newborn and stillbirth data use compared to 16.7–21.7% in Ethiopia.ConclusionsNewborn and stillbirth data use was low, despite variations across countries and health system levels. Evidence-based decision-making in health service delivery remains a priority action to reduce stillbirths and newborn deaths. This study identified context-specific, sustainable, and scalable interventions co-created with end-users to ensure wider newborn and stillbirth data use.

BackgroundAlthough the Central African Republic (CAR) has adopted a National Strategy document to fight gender-based violence (GBV), the number of cases of sexual violence remains high year after year. Female Sex workers (FSW) are among the populations most vulnerable to GBV.MethodsThis was a cross-sectional analytical survey. Respondent Driven Sampling (RDS) is a peer recruitment method often used to create a sample from seeds. Risk factors for GBV were assessed using multiple logistic regression.ResultsAge group under 20 is more affected by GBV and sexual exploitation. The main determinants associated with sexual violence among FSW were: age under 20 years: (aOR = 2.69 [1.93–3.28]; p = 0.001); regular alcohol consumption: (aOR = 2.58 [1.39–4.78]; p = 0.003); sex work is the main source of income: (aOR = 2.13 [1.94–3.08]; p = 0.001) and having a sexual partner (customer) military or police: (aOR = 3.57 [2.81–5.23]; p = 0.001).ConclusionsRegular use of alcohol and having a military or police client were associated with a high probability of experiencing gender-based violence. The development of specific interventions to reduce these risks is crucial for the protection of the rights and physical integrity of this highly vulnerable segment of the population.