Civic engagement among orphans and non-orphans in five low- and middle-income countries.


BACKGROUND: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in resource-poor settings. Understanding whether and how OSC are engaged in civic activities is important for community and world leaders who need to provide care for OSC and ensure their involvement in sustainable development. METHODS: The Positive Outcomes for Orphans study (POFO) is a multi-country, longitudinal cohort study of OSC randomly sampled from institution-based care and from family-based care, and of non-OSC sampled from the same study regions. Participants represent six sites in five low-and middle-income countries. We examined civic engagement activities and government trust among subjects > =16 years old at 90-month follow-up (approximately 7.5 years after baseline). We calculated prevalences and estimated the association between key demographic variables and prevalence of regular volunteer work using multivariable Poisson regression, with sampling weights to accounting for the complex sampling design. RESULTS: Among the 1,281 POFO participants > =16 who were assessed at 90-month follow-up, 45 % participated in regular community service or volunteer work; two-thirds of those volunteers did so on a strictly voluntary basis. While government trust was fairly high, at approximately 70 % for each level of government, participation in voting was only 15 % among those who were > =18 years old. We did not observe significant associations between demographic characteristics and regular volunteer work, with the exception of large variation by study site. CONCLUSION: As the world's leaders grapple with the many competing demands of global health, economic security, and governmental stability, the participation of today's youth in community and governance is essential for sustainability. This study provides a first step in understanding the degree to which OSC from different care settings across multiple low- and middle-income countries are engaged in their communities.





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Publication Info

Gray, Christine L, Brian W Pence, Lynne C Messer, Jan Ostermann, Rachel A Whetten, Nathan M Thielman, Karen O'Donnell, Kathryn Whetten, et al. (2016). Civic engagement among orphans and non-orphans in five low- and middle-income countries. Global Health, 12(1). p. 61. 10.1186/s12992-016-0202-8 Retrieved from

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Christine L Gray

Assistant Research Professor of Global Health

Dr. Christine (Chris) Gray is an assistant research professor in the Center for Health Policy and Inequalities Research (CHPIR) in the Duke Global Health Institute. She earned her PhD from the Department of Epidemiology at the University of North Carolina at Chapel Hill (UNC-CH) and her MPH from Emory University. She has been working with CHPIR since 2014, when she began analytic work on the longitudinal Positive Outcomes for Orphans cohort study as a doctoral student.

Prior to her doctoral studies, Chris worked for nearly a decade in public health, including completion of a three-year, post-masters fellowship at the Centers for Disease Control and Prevention (CDC), and as a program manager and scientist with the Center for the Study of Traumatic Stress at the Uniformed Services University of the Health Sciences. During her doctoral studies, Chris also worked with the Environmental Protection Agency for four years examining how simultaneous exposure to multiple environmental domains affects human health. Broadly, her research examines the role of social-environmental structures that drive disparities in mental health and well-being in vulnerable populations, particularly pediatric populations.

As an epidemiologist, Chris has great appreciation for study design, analysis, and the capacity for data to inform public health policies and practice. As a human, she understands the importance of contextualizing quantitative data with lived experiences.

Jan Ostermann

Adjunct Associate Professor of Global Health

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