Caregiver-specific factors and orphanage-context factors contributing to maltreatment of children in institutional care: A multi-level analysis of 24 orphanages in Tanzania

Abstract

Background: High rates of maltreatment and low caregiving quality in institutional care settings have been identified in various low-and middle-income countries. Many studies have focused on children living in institutions. Objective: This study investigates the prevalence of maltreatment, caregiver-specific, orphanage-context factors, and their relation to maltreatment of orphans from the caregivers’ perspective. Participants and setting: In this cross-sectional study, 227 caregivers (67% female) with a mean age of 36.84 years ( SD age = 12.89) of 24 childcare centres in Dar es Salaam, Tanzania participated. Methods: The primary outcome was the maltreatment of children assessed through structured interviews of caregivers. Further information on individual (like work-related stress) and structural variables (working conditions) was gathered. Results: Caregivers’ work under extreme and exhausting conditions, with very high caregiver-child ratios, low salaries, and almost no possibility to recover. Results also showed significant differences in the maltreatment level and structural and individual factors (e.g., payment and days of entitlement) between the orphanages. Caregiver’s positive attitudes towards violence ( ƒ2attitudes = 0.19) and difficulties in the relationship with children ( ƒ2relationship = 0.05) significantly predicted maltreatment with moderate and small effects. Conclusions: The overall poor working conditions highlight the urgent need to reduce the caregivers’ burden. In addition to this, addressing caregivers’ positive attitudes and improving their interaction competencies with children may be a starting point to prevent maltreatment of children. Further investigation of structural factors contributing to maltreatment is essential to develop recommendations for the improvement and re-organization of childcare institutions.

Carer Burden and Burnout in Relation to Behavioral and Emotional Problems in Children’s Homes

“…Carers in government homes have other factors that might have exposed them to burnout such as more children to care for and a higher number of children with behavioral and emotional problems. Being exposed to long hours of interactions with challenging child behavior (Eastwood & Ecklund, 2008;Savicki, 2002) and work overload (Mkinga et al, 2022) contributes to the residential care workers' risk for burnout.…”

“…Previous studies done in assessing caregiver burden at an orphanage in rural South Africa showed approximately 40% of caregivers reported high levels of caregiving burden (Kidman & Thurman, 2014). Poor working conditions such as working under extreme and exhausting conditions of very high caregiver-child ratios and low salaries (Mkinga et al, 2022) may contribute to the development of burden.…”

The Role of Orphanages in The Welfare of Abandoned Children

“…The role of the Orphanage is so great for the survival of children who are neglected or do not get care or love from their own parents. So, some researchers are interested in researching orphanages from various perspectives (Mkinga, 2022).…”