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<p><bold>Objectives</bold>: 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.</p><p><bold>Design</bold>:
Cross-sectional study.</p><p><bold>Setting</bold>: Two rural districts (sites) in
East Africa, Bungoma in Kenya, and Kilimanjaro in Tanzania.</p><p><bold>Participants</bold>:
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. </p><p><bold>Methods</bold>: 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.</p><p><bold>Main Outcome Measures</bold>:
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. </p><p><bold>Results</bold>: 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). </p><p><bold>Conclusion</bold>: 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.</p>
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