Browsing by Subject "Orphans"
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Item Open Access An Assessment of Health Outcomes Among Orphans in the Positive Outcomes for Orphans Study in Rural Settings of Kenya and Tanzania(2011) Achwoka, Dunstan EugineObjectives: To compare measures of health and health quality between Orphans and Vulnerable Children (OVC) in different living arrangements-- institutional and community care; and to correlate different measures of OVC health and health quality using clinical, laboratory and quality of life instruments.
Design: Cross-sectional study.
Setting: Two rural districts (sites) in East Africa, Bungoma in Kenya, and Kilimanjaro in Tanzania.
Participants: 77 male and 45 female OVC aged 16-18 years (N=122). Participants, who had attained a minimum age of 16 at the date of interview, were selected from the larger sample of OVC in the Positive Outcomes for Orphans (POFO) study. POFO, a longitudinal study in five less wealthy countries that started in 2006, obtained its sample through cluster randomization.
Methods: To obtain self-ratings of OVC physical health, OVC responded to an interviewer administered SF-36 questionnaire, a multipurpose generic measure of health status. A neutral examiner then measured OVC physical health using 4 clinical variables: a physical health examination, body mass index, hemoglobin level, and the Harvard physical fitness score.
Main Outcome Measures: SF-36 scores presented as a two component score- the physical health and mental health composite sub-scores. For physical health, normal findings for age were considered as meeting the threshold for good physical health.
Results: Of the 122 OVC, 89 (73%) lived in the community while 33 (27%) lived in institutional settings. For the SF-36, the mean physical composite score for the entire study population was 50.6 (SD=6.2). Mean body mass index (BMI) was 19.3 (SD=2.4). Mean hemoglobin was found to be 13.2g/dl (SD=1.8). The average Harvard physical fitness score was found to be 40.7(SD=16.9). Pearson's correlations between SF-36 Physical Functioning and hemoglobin, BMI, and the Harvard Step-Test fitness score were 0.1, 0.1, and -0.1 respectively. There was no evidence that self-rating of OVC health outcomes differed by living arrangement. Using paired t-tests for continuous variables and chi-square tests for categorical variables, no significant p- values were obtained at the 95% level. Using a threshold of vision 20/20 for normal vision, 91.0% of community OVC and 78.8% of OVC in institutions had normal vision (p=0.07).
Conclusion: Although this study did not detect significant differences in self-reported measures of health among OVC in different living arrangements, physical examination revealed a slightly high incidence of poor vision among those living in institutions. In this sample, the correlations between SF-36 physical functioning sub-score and 3 physical health outcomes of BMI, hemoglobin, and the Harvard Step-test fitness score were weak.
Item Open Access Associations between Self-Stigma and Emotional Wellbeing Among Orphans(2022) Wilkerson, MadelineResearchers have been searching for ways to improve outcomes for orphaned and separated children (OSC) worldwide. OSC have a particularly high rate of mental health disorders and lower emotional wellbeing. Stigma has been shown to be a predictor of mental health disorders and emotional wellbeing for HIV and children in poverty. However, no research has been conducted with OSC examining the relationship between self-stigma and emotional wellbeing. Using Round 10 of the Positive Outcomes for Orphans (POFO) study with 2013 orphans from Kenya, Ethiopia, Tanzania, India, and Cambodia, a linear model was implemented to examine the association between self-stigma and emotional wellbeing. Through the building of a linear regression model, self-stigma was shown to be a strong predictor of emotional wellbeing as measured by the Strengths and Difficulties Questionnaire (SDQ). This indicates that self-stigma may be a significant factor to address when looking at ways to improve emotional wellbeing among orphans.
Item Open Access Child Valuation in Contemporary China: Abandonment, Institutional Care, and Transnational Adoption(2020-04-17) Marlow, JessicaIn this thesis, I contend that orphaned and relinquished children’s positionality in Chinese society reveals a complex entanglement between changing domestic and international policies and popular Western perceptions of China. Initially inspired by my personal experiences evaluating the mental health of children in institutional care centers in Delhi, India, this thesis focuses on socio-political and economic factors which influence how children in institutional care are valued on the state and individual level. The orphaned child’s value within economic, moral, and political spheres is not objective or easily quantifiable; rather it is determined in relation to factors which extend far beyond the reach of the individual. Nevertheless, these value-decisions have tangible effects on children’s lived experiences. Key questions I will address in subsequent chapters are as follows: (1) To what extent do adult economic concerns and expectations influence the abandonment and/or adoption of children and their status in alternative care?; (2) What are the moral considerations of care in alternative care environments and how do these differ for domestic workers, international volunteers, and potential adoptees?; and (3) How do international perceptions of the China’s orphan care influence transnational adoption narratives and transnational adoption, and how do these perceptions intersect with the China’s political development of soft power overseas? This thesis foregrounds the complex, intercultural nature of institutional care in the contemporary period which are influenced by socio-historical and political changes in China and beyond.Item Open Access Civic engagement among orphans and non-orphans in five low- and middle-income countries.(Global Health, 2016-10-11) Gray, Christine L; Pence, Brian W; Messer, Lynne C; Ostermann, Jan; Whetten, Rachel A; Thielman, Nathan M; O'Donnell, Karen; Whetten, KathrynBACKGROUND: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in resource-poor settings. Understanding whether and how OSC are engaged in civic activities is important for community and world leaders who need to provide care for OSC and ensure their involvement in sustainable development. METHODS: The Positive Outcomes for Orphans study (POFO) is a multi-country, longitudinal cohort study of OSC randomly sampled from institution-based care and from family-based care, and of non-OSC sampled from the same study regions. Participants represent six sites in five low-and middle-income countries. We examined civic engagement activities and government trust among subjects > =16 years old at 90-month follow-up (approximately 7.5 years after baseline). We calculated prevalences and estimated the association between key demographic variables and prevalence of regular volunteer work using multivariable Poisson regression, with sampling weights to accounting for the complex sampling design. RESULTS: Among the 1,281 POFO participants > =16 who were assessed at 90-month follow-up, 45 % participated in regular community service or volunteer work; two-thirds of those volunteers did so on a strictly voluntary basis. While government trust was fairly high, at approximately 70 % for each level of government, participation in voting was only 15 % among those who were > =18 years old. We did not observe significant associations between demographic characteristics and regular volunteer work, with the exception of large variation by study site. CONCLUSION: As the world's leaders grapple with the many competing demands of global health, economic security, and governmental stability, the participation of today's youth in community and governance is essential for sustainability. This study provides a first step in understanding the degree to which OSC from different care settings across multiple low- and middle-income countries are engaged in their communities.Item Embargo Marginalized Voices and Nontraditional Pathways in Higher Education in the Late Roman Empire(2023) Küppers, SinjaThis study analyzes marginalized voices and nontraditional pathways of higher education in the late Roman Empire and diversifies our notion of who was part of “the” educated elite in ancient higher education. I focus on upper-class learners who did not have access to the family’s wealth or faced difficulty with pursuing the discussed traditional paths of schooling designed for young men from wealthy families. The discussed marginalized voices include fatherless students, women, late learners, autodidacts, and disabled students. Since most sources on Roman education were authored by elite men who mention marginalized voices in passing, I piece together the experiences of nontraditional learners and marginalized members of Roman education from an array of literary and epigraphic sources, including letters from teachers to students and families, church historians and Christians commenting on women, orations, tomb stones and legal documents. Most sources discussed are dated to the fourth century C.E., highlighting a period in which girls and women from the upper-class gained a voice in ascetic communities, as educational leaders and philanthropes and in which educational mobility across the Roman Empire flourished. Using Bourdieu’s theory of capital, I analyze how diverse family and educational backgrounds impacted the educational paths of students, discuss the student voices often overlooked in scholarship and bring attention to the challenges that nontraditional and marginalized students have experienced in higher education.
Item Embargo Predictors of Early Alcohol Use Initiation and Recent Adolescent Alcohol Use Among Orphaned and Separated Children in 5 Low- and Middle-Income Countries(2023) Parsons, AlyssiaBackground: Alcohol use accounts for over 3 million deaths each year and causes negative mental and physical health outcomes. Both adolescent use and early use initiation are associated with future dependence and alcohol-related harm. Orphaned and separated children (OSC) in low- and middle-income countries (LMICs) are particularly vulnerable to alcohol use. Methods: A cross-sectional analysis was used to explore predictors of adolescent alcohol use and early alcohol initiation among a sample of OSC in 5 LMICs. Bivariable logistic regression models were used to evaluate associations between age, gender, education, care setting, OSC status (single orphan, double orphan, neither), behavior and emotional health, the experience of potentially traumatic events (PTEs), social support, and participation in chores or work and the outcomes of early initiation and recent alcohol use. Variables with p-value <0.15 were included in a multivariable model for that respective outcome and evaluated through multivariable logistic regressions. Results: In multivariable regressions, age [OR 1.28 (1.11-1.48)], community-based setting [OR 2.74 (1.57-5.02)], non-abuse trauma [OR 5.23 (2.51-12.10)], and physical or sexual abuse [OR 1.27 (0.75-2.11)] were associated with recent use. Non-abuse trauma [OR 12.86 (3.83-80.12)] and work [OR 1.72 (0.91-3.12)] were associated with early use. Conclusions: Interventions targeting alcohol use among OSC may be more effective if they target predictors identified in this study, such as a community care setting.