Family Composition and Stability for Orphans: A Longitudinal Study of Well-Being in 5 Low- and Middle-Income Countries

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Citation

Gray, Christine L.; Whetten, Kathryn D.; Daniels, Julie L.; Hudgens, Michael G.; Pettifor, Audrey E; .; Hobbie, Amy M.; Thielman, Nathan M.; Dubie, Misganaw E.; & Itemba, Dafrosa, et al. (2021). Family Composition and Stability for Orphans: A Longitudinal Study of Well-Being in 5 Low- and Middle-Income Countries. International Journal of Public Health, 66, 1604057. PMCID: PMC8724025

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.

URL

http://dx.doi.org/10.3389/ijph.2021.1604057

Reference Type

Journal Article

Year Published

2021

Journal Title

International Journal of Public Health

Author(s)

Gray, Christine L.
Whetten, Kathryn D.
Daniels, Julie L.
Hudgens, Michael G.
Pettifor, Audrey E
.
Hobbie, Amy M.
Thielman, Nathan M.
Dubie, Misganaw E.
Itemba, Dafrosa
Madan, Ira
Vann, Vanroth
Wasonga, Augustine I.
Manongi, Rachel
Ostermann, Jan
Whetten, Rachel A.
Pence, Brian W.

Article Type

Regular

PMCID

PMC8724025

Data Set/Study

Positive Outcomes for Orphans (POFO)

Continent/Country

LMICs

ORCiD

Pettifor - 0000-0002-3387-0817