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A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6-12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations

dc.contributor.author Messer, Lynne Corinne
dc.contributor.author O'Donnell, Karen Jones
dc.contributor.author Ostermann, Jan
dc.contributor.author Pence, Brian Wells
dc.contributor.author Thielman, Nathan Maclyn
dc.contributor.author Whetten, Kathryn
dc.contributor.author Whetten, Rachel
dc.date.accessioned 2011-06-21T17:31:27Z
dc.date.available 2011-06-21T17:31:27Z
dc.date.issued 2009
dc.identifier.citation Whetten,Kathryn;Ostermann,Jan;Whetten,Rachel A.;Pence,Brian W.;O'Donnell,Karen;Messer,Lynne C.;Thielman,Nathan M.;Positive Outcomes Orphans (POFO). 2009. A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6-12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations. Plos One 4(12): e8169-e8169.
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10161/4517
dc.description.abstract Background: Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6-12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests. Methodology: The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 institution-living and 1,480 community-living OAC ages 6-12, 658 of whom were double-orphans or abandoned by both biological parents. Survey analytic techniques were used to compare cognitive functioning, emotion, behavior, physical health, and growth. Linear mixed-effects models were used to estimate the proportion of variability in child outcomes attributable to the study site, care setting, and child levels and institutional versus community care settings. Conservative analyses limited the community living children to double-orphans or abandoned children. Principal Findings: Health, emotional and cognitive functioning, and physical growth were no worse for institution-living than community-living OAC, and generally better than for community-living OAC cared for by persons other than a biological parent. Differences between study sites explained 2-23% of the total variability in child outcomes, while differences between care settings within sites explained 8-21%. Differences among children within care settings explained 64-87%. After adjusting for sites, age, and gender, institution vs. community-living explained only 0.3-7% of the variability in child outcomes. Conclusion: This study does not support the hypothesis that institutional care is systematically associated with poorer wellbeing than community care for OAC aged 6-12 in those countries facing the greatest OAC burden. Much greater variability among children within care settings was observed than among care settings type. Methodologically rigorous studies must be conducted in those countries facing the new OAC epidemic in order to understand which characteristics of care promote child wellbeing. Such characteristics may transcend the structural definitions of institutions or family homes.
dc.language.iso en_US
dc.publisher PUBLIC LIBRARY SCIENCE
dc.relation.isversionof 10.1371/journal.pone.0008169
dc.subject difficulties questionnaire
dc.subject strengths
dc.subject attachment
dc.subject models
dc.subject eritrea
dc.subject romania
dc.subject africa
dc.subject malawi
dc.subject aids
dc.subject biology
dc.subject multidisciplinary sciences
dc.title A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6-12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations
dc.title.alternative
dc.type Other article
dc.description.version Version of Record
duke.date.pubdate 2009-12-18
duke.description.issue 12
duke.description.volume 4
dc.relation.journal Plos One
pubs.begin-page e8169


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