Correlates of poor health among orphans and abandoned children in less wealthy countries: the importance of caregiver health.
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BACKGROUND: More than 153 million children worldwide have been orphaned by the loss of one or both parents, and millions more have been abandoned. We investigated relationships between the health of orphaned and abandoned children (OAC) and child, caregiver, and household characteristics among randomly selected OAC in five countries. METHODOLOGY: Using a two-stage random sampling strategy in 6 study areas in Cambodia, Ethiopia, India, Kenya, and Tanzania, the Positive Outcomes for Orphans (POFO) study identified 1,480 community-living OAC ages 6 to 12. Detailed interviews were conducted with 1,305 primary caregivers at baseline and after 6 and 12 months. Multivariable logistic regression models describe associations between the characteristics of children, caregivers, and households and child health outcomes: fair or poor child health; fever, cough, or diarrhea within the past two weeks; illness in the past 6 months; and fair or poor health on at least two assessments. PRINCIPAL FINDINGS: Across the six study areas, 23% of OAC were reported to be in fair or poor health; 19%, 18%, and 2% had fever, cough, or diarrhea, respectively, within the past two weeks; 55% had illnesses within the past 6 months; and 23% were in fair or poor health on at least two assessments. Female gender, suspected HIV infection, experiences of potentially traumatic events, including the loss of both parents, urban residence, eating fewer than 3 meals per day, and low caregiver involvement were associated with poorer child health outcomes. Particularly strong associations were observed between child health measures and the health of their primary caregivers. CONCLUSIONS: Poor caregiver health is a strong signal for poor health of OAC. Strategies to support OAC should target the caregiver-child dyad. Steps to ensure food security, foster gender equality, and prevent and treat traumatic events are needed.
Published Version (Please cite this version)10.1371/journal.pone.0038109
Publication InfoO'Donnell, Karen Jones; Ostermann, Jan; Positive Outcomes for Orphans (POFO) Research Team; Thielman, Nathan Maclyn; Whetten, Kathryn; & Whetten, Rachel (2012). Correlates of poor health among orphans and abandoned children in less wealthy countries: the importance of caregiver health. PLoS One, 7(6). pp. e38109. 10.1371/journal.pone.0038109. Retrieved from http://hdl.handle.net/10161/6103.
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My research interests are in early development risk: drug exposure, HIV infection, and iodine deficiency. I have ongoing research in developmental outcomes of children exposed prenatally to drugs and alcohol. They include the Infant Care Project (Pediatrics) and the Family Care Project (Psychiatry). I am co-investigator on a NIDA study of SIDS risk with prenatal cocaine exposure. I am involved at Duke and nationally in the study of the neurodevelopmental effects of pediatric HIV infecti
Adjunct Associate Professor of Global Health
Professor of Medicine
Broadly, my research focuses on a range of clinical and social issues that affect persons living with or at risk for HIV infection in resource-poor settings. In Tanzania, our group is applying novel methods to optimize HIV testing uptake among high-risk groups. We recently demonstrated that the Discrete Choice Experiment (DCE), a form of stated preference survey research, is a robust tool for identifying (a) which characteristics of HIV testing options are most preferred by different populati
Professor in the Sanford School of Public Policy
Director, Center for Health Policy and Inequalities ResearchResearch Director, Hart Fellows Program,Professor, Public Policy and Global Health Professor, Nursing and Community & Family Medicine Kathryn Whetten (PhD) is Chair of the Maternal, Adolescent and Child Health working group, and she is the Co-Chair of the University Diversity Task Force and the Sanford Diversity Committee. Kathryn Whetten is the Principal Investigator on
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