Poorer health and nutritional outcomes in orphans and vulnerable young children not explained by greater exposure to extreme poverty in Zimbabwe

Abstract

Summaryobjective To describe patterns of association between different groups of young orphans and vulnerable children (OVC) and their nutritional and health outcomes; and to develop a theoretical framework to analyse the determinants of child malnutrition and ill-health, and identify the different mechanisms which contribute to these outcomes in such children.methods We developed and tested a theoretical framework to explain why orphans and vulnerable children experience more ill-health and malnutrition based on statistical analysis of data on 31 672 children aged 0-17 years (6753 aged under 5 years) selected from the Zimbabwe OVC Baseline Survey 2004.results 28% of children aged 0-4 years at last birthday were either orphans or vulnerable children. They were more likely than non-vulnerable children to have suffered recently from diarrhoeal illness (age-and sex-adjusted odds ratio, AOR, 1.27; 95% CI 1.09-1.48) and acute respiratory infection (1.27; 1.01-1.59) and to be stunted (1.24; 1.09-1.41) and underweight (1.18; 1.02-1.36). After further adjustment for exposure to extreme poverty, OVC remained at greater risk of diarrhoeal disease (AOR 1.25; 1.07-1.46) and chronic malnutrition (1.21; 1.07-1.38). In 0-17-year-olds, OVC with acute respiratory infection were more likely not to have received any treatment even after adjusting for poverty (AOR 1.29; 95% CI 1.16-1.43).conclusion Differences in exposure to extreme poverty among young children by OVC status were relatively small and did not explain the greater malnutrition and ill-health seen in OVC.

Growing Up in the Era of AIDS: The Well-Being of Children Affected and Infected by HIV/AIDS in Sub-Saharan Africa

“…While Miller et al (2007Miller et al ( , p. 2482 found that "orphan status is a critical predictor of poor health", Kidman et al (2010) -who examine the impact of AIDS in the family and community on child health in Malawi -found that for a range of physical health indicators orphaned children were no worse off than non-orphaned children but children living with ill parents were significantly more likely to suffer serious morbidity. In contrast, in a study in Zimbabwe, Watts et al (2007) found that OVC were much more likely to suffer malnutrition and ill health than non-orphans and the difference could not be explained by differences in poverty. In the last five years or so, as a result of the introduction of NPAs (see section 2.2.2 below) the most vulnerable children are increasingly being given free access to health services (IATT, 2008).…”

“…Once parents die, orphans are more likely than non-orphans to lack basic material needs, especially food security. This results in OVC being more likely to be malnourished than non-orphans (Watts et al, 2007). Households caring for orphans have to spread resources between more people and may therefore experience lower levels of nutrition and health care and a lack of basic needs.…”

Does being an orphan decrease the nutritional status of Luo children?

“…UNICEF (2003) also reported that both maternal and paternal orphans were short for their age when compared with nonorphans. In Zimbabwe, orphans and vulnerable children were more likely to suffer from both illness and malnutrition (Watts et al, 2007). Research suggests that low food availability, which may result from low household socioeconomic status, can increase stunting in orphans (Deininger et al, 2003;UNICEF, 2003).…”

Morbidity profile of children residing in orphanages - A cross-sectional study in Chitradurga, Karnataka

“…Unfortunately, children living in such institutions face a wide variety of problems such as infectious morbidity, nutrition and growth, cognitive development, socio-affective development, and physical abuses. [8] Hence, there is a need to address the special needs of this vulnerable group. Very few studies have been conducted at national and international level on health problems of orphans and vulnerable children (OVC) in orphanage.…”