Document Type
Article
Abstract
Objectives: Many orphaned children in low- and middle-income countries live with family. Yet, their household composition and its stability are not well-characterized, nor is impact of stability on longer-term outcomes.
Methods: We used the longitudinal, multi-country Positive Outcomes for Orphans cohort to describe adult family living with orphans. Stability was measured by changes in presence of six familial relations over time, and related to three outcomes: 1) incident abuse, 2) cognitive functioning, 3) emotional difficulties. Associations were estimated using generalized linear models fit with generalized estimating equations. For abuse, Poisson regression estimated risk ratios. For continuous scores of cognitive functioning and emotional difficulties, linear models estimated mean differences (MDs) with 95% confidence intervals.
Results: Among 1,359 orphans, 53–61% reported living with their mother each year; 7–13% with father; nearly 60% reported ≥1 change in composition over follow-up. Compared to 0 changes, difficulties increased with 1 change [MD: 0.23 (−0.33, 0.79)], 2 changes [MD: 0.57 (0.00, 1.16)] and ≥3 changes [MD: 0.73 (0.18, 1.29)]. No associations were found with abuse or cognitive functioning.
Conclusion: Orphan well-being may be improved through supports stabilizing household composition or targeting emotional resilience
Digital Object Identifier (DOI)
Publication Info
Published in International Journal of Public Health, Volume 66, 2021.
Rights
© 2021 Gray, Whetten, Daniels, Hudgens, Pettifor, Hobbie, Thielman, Dubie, Itemba, Madan, Vann, Wasonga, Manongi, Ostermann, Whetten and Pence. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
APA Citation
Gray, C., Whetten, K., Daniels, J., Hudgens, M., Pettifor, A., Hobbie, A., Thielman, N., Dubie, M., Itemba, D., Madan, I., Vann, V., Wasonga, A., Manongi, R., Ostermann, J., Whetten, R., Pence, B., Guccio, C., Castro, M., Cl, G., & Jl, D. (2021). Owned by SSPH+ | Published by Frontiers. International Journal of Public Health, 66. https://doi.org/10.3389/ijph.2021.1604057
