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Correlates of poor health among orphans and abandoned children in less wealthy countries: the importance of caregiver health.

dc.contributor.author O'Donnell, Karen Jones
dc.contributor.author Ostermann, Jan
dc.contributor.author Positive Outcomes for Orphans (POFO) Research Team
dc.contributor.author Thielman, Nathan Maclyn
dc.contributor.author Whetten, Kathryn
dc.contributor.author Whetten, Rachel
dc.coverage.spatial United States
dc.date.accessioned 2013-01-16T18:24:42Z
dc.date.issued 2012
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/22719867
dc.identifier PONE-D-11-21940
dc.identifier.uri http://hdl.handle.net/10161/6103
dc.description.abstract 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.
dc.language eng
dc.relation.ispartof PLoS One
dc.relation.isversionof 10.1371/journal.pone.0038109
dc.subject Caregivers
dc.subject Child
dc.subject Child, Orphaned
dc.subject Developing Countries
dc.subject Family Characteristics
dc.subject Female
dc.subject Health Status
dc.subject Humans
dc.subject Male
dc.subject Multivariate Analysis
dc.subject Poverty
dc.title Correlates of poor health among orphans and abandoned children in less wealthy countries: the importance of caregiver health.
dc.type Journal article
duke.description.issue 6
duke.description.volume 7
dc.relation.journal PLoS ONE
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/22719867
pubs.begin-page e38109
pubs.issue 6
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Faculty
pubs.organisational-group Global Health Institute
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Infectious Diseases
pubs.organisational-group Pathology
pubs.organisational-group Sanford School of Public Policy
pubs.organisational-group School of Medicine
pubs.organisational-group School of Nursing
pubs.organisational-group School of Nursing - Secondary Group
pubs.organisational-group University Institutes and Centers
pubs.publication-status Published
pubs.volume 7
dc.identifier.eissn 1932-6203


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