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

Thielman, Nathan

Ostermann, Jan

Whetten, Kathryn

Whetten, Rachel

O'Donnell, Karen

Positive Outcomes for Orphans Research Team

Moormann, Ann M

United States

2013-01-16T18:24:42Z

2012

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.

http://www.ncbi.nlm.nih.gov/pubmed/22719867

PONE-D-11-21940

1932-6203

https://hdl.handle.net/10161/6103

eng

Public Library of Science (PLoS)

PLoS One

10.1371/journal.pone.0038109

PLoS ONE

Caregivers

Child

Child, Orphaned

Developing Countries

Family Characteristics

Female

Health Status

Humans

Male

Multivariate Analysis

Poverty

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

Journal article

Thielman, Nathan|0000-0001-8152-2879

6

7

http://www.ncbi.nlm.nih.gov/pubmed/22719867

e38109

6

Clinical Science Departments

Duke

Faculty

Global Health Institute

Institutes and Provost's Academic Units

Medicine

Medicine, Infectious Diseases

Pathology

Sanford School of Public Policy

School of Medicine

School of Nursing

School of Nursing - Secondary Group

University Institutes and Centers

Published

7