Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study

Gray, Christine L.; Pence, Brian W.; Ostermann, Jan; Whetten, Rachel; O’Donnell, Karen; Thielman, Nathan M.; Whetten, Kathryn

doi:10.9745/ghsp-d-15-00093

Cited by 28 publications

(32 citation statements)

References 31 publications

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“…These studies complement existing research highlighting the increased risk of distress and maltreatment among orphaned and abandoned children [11, 12, 16, 17]. By accounting for parenting practices, this study provides additional context as to the mechanisms by which orphaned children and children living in foster families in Rwanda may exhibit greater levels of mental health distress and requires further research, both quantitative and qualitative, in other settings in SSA [16].…”

Section: Discussionmentioning

confidence: 55%

“…Often these children end up in informal foster care, child-headed households, or orphanages. Orphaned children living in foster families may face maltreatment or inequality in the household [11, 12], more engagement in child labor [13], school dropout [14] or falling behind in school [14, 15], poorer health outcomes, and greater psychological distress [16, 17]. In Rwanda, children living with HIV and children living with a caregiver with HIV have much higher rates of depression, anxiety, conduct problems and functional impairment compared with HIV-unaffected children [18].…”

Section: Introductionmentioning

confidence: 99%

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Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment

Nduwimana

Mukunzi

et al. 2016

AIDS Behav

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Fostering children is common in sub-Saharan Africa, but few studies examine these children’s mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10–17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes.

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment

Nduwimana

Mukunzi

et al. 2016

AIDS Behav

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“…Hermenau, Kaltenbach, Mkinga, and Hecker (2015; Tanzania) noted 93% reporting physical maltreatment at baseline. Gray et al (2015aGray et al ( , 2015b noted that 50.3% of 1053 children in institutional care across 5 countries reported physical or sexual abuse with no differences by gender, but more abuse among the younger age groups. Hermenau, Hecker, Elbert, and Ruf-Leuschner (2014) in Tanzania compared reports for children who were institutionalised from 0 to 4 years of age with those 5-14 years of age, and noted that 89% reported at least one experience of abuse, more so among those institutionalised at birth.…”

Section: Prevalence Of Abusementioning

confidence: 99%

“…Rus et al (2013) in a large sample of 1391 children aged 7-20 years, 39.5% recorded severe punishment or beatings by staff -80% of whom record that this occurred many times and with greater odds for males. In a large (n = 1053) 5 country study, Gray et al (2015a) predicted 50.3% [95% CI: 42.5, 58.0] of those children within institutional care experienced physical or sexual abuse. In a second study (Gray et al, 2015b) from the same group predicted prevalence of physical and sexual abuse for institutionalised children at age 13 was 49.4% of males and 51.3% of females and 13.6% for males and 12% for females when confined to the last 12 months.…”

Section: Prevalence Of Abusementioning

confidence: 99%

Child violence experiences in institutionalised/orphanage care

Sherr

Roberts

Gandhi

2017

Psychology, Health & Medicine

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Institutions are not necessarily good environments for children. In the face of challenges such as HIV, Ebola, poverty, conflict and disaster the numbers have grown rather than reduced. Some countries have closed institutions down -driven by findings that cognitive developmental delay is associated with institutional care. Yet insight into abuse and violence within institutionalised settings is neglected. Maltreatment -violence and abuse -may be an issue. This systematic review series addresses violence and abuse experiences in institutionalised care, exploring firstly the frequency of abuse/violence in institutions, secondly any interventions to reduce such violence or abuse and thirdly the perpetrators of such violence or abuse. The final systematic review updates the findings on cognitive delay associated with institutionalised care. With a violence lens, cognitive delay may well be considered under the umbrella of neglect. Maltreatment and abuse may be a driver of cognitive delay. The keyword search covered several electronic databases and studies were included for data abstraction if they met adequacy criteria. Eight studies were identified on the prevalence of abuse in institutions and a further three studies reported on interventions. Only one study was identified documenting peer on peer violence in institutions. Sixty-six studies were identified examining cognitive development for institutionalised children. All but two of these record cognitive deficits associated with institutionalisation. Only two asked about violence or abuse which was found to be higher in institutionalised children. Overall the abuse experiences of children in institutions are poorly recorded, and in one study violence was associated with high suicidal attempts. The major intervention pathway for ameliorating cognitive challenge seems to be placement out of the institutions which shows benefits and redresses some cognitive outcomes - yet not a total panacea. The single study providing training and monitoring of harsh punishment and maltreatment showed immediate and decided reductions. This data suggest, despite the paucity of studies, violence and abuse, by commission or omission is prevalent in institutions, has an effect on child well-being and is amenable to intervention. Simple training or more complex structures to place children within conducive alternative environments (or to avoid institutionalised placements in the first place) seem to be the main pathway of intervention.

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“…Evidence shows there are numerous negative outcomes associated with being an OSC in a low-resource society, including traumatic grief, compromised cognitive and emotional development, less access to education, and a greater probability of being exploited for child labor (Whetten et al 2009). Researchers widely acknowledge that orphans in low-resource societies are more likely to experience maltreatment in the forms of neglect, discrimination, malnutrition, and emotional, physical, and sexual abuse than their nonorphaned peers (Deininger et al 2003;Gray et al 2015;Makame et al 2002;Morantz et al 2013;Nichols et al 2014). OSC are in need of living environments that both protect them from further maltreatment and promote their well-being.…”

mentioning

confidence: 99%

Lessons Learned from High-Quality Residential Care Centers Around the World: A Visual Story

Huynh

2019

Int. Journal on Child Malt.

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Evidence shows that orphaned and separated children (OSC) in resource-poor societies are more likely to experience maltreatment in the forms of neglect, discrimination, malnutrition, and emotional, physical, and sexual abuse than their non-orphaned peers. As the number of OSC rapidly increases in low-and middle-income countries (LMICs), it is important not to discount high-quality residential care centers (RCCs) as suitable options on the continuum of alternative care for OSC. This statement should not be taken to mean that residential care is always the best care option for OSC but that all alternative care options should be carefully evaluated to determine the best and most suitable fit for a child and their current needs. This essay uses photos as well as empirical data and non-empirical observations from several modern-day high-quality RCCs in LMICs to gather lessons and best practices on how to address child maltreatment. In summary, the high-quality RCCs in LMICs observed typically focused on holistically enriching and improving their centers at the child, organizational, and environmental levels to the greatest extent possible. Keywords Residential care center. Group home. Institution. Orphanage. Orphan. Orphaned and separated children. Quality care. High-quality care. Child maltreatment According to UNICEF (2017), there are an estimated 140,000,000 children worldwide who have lost one or both parents and millions more who have been permanently separated from both parents (hereafter referred to as orphan and separated children [OSC]). High mortality among young adults from diseases and conditions such as malaria, tuberculosis, HIV/AIDS, pregnancy complications, and natural disasters are significantly responsible for the increasing number of orphans (Thielman et al. 2012).

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Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study

Cited by 28 publications

References 31 publications

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment

Child violence experiences in institutionalised/orphanage care

Lessons Learned from High-Quality Residential Care Centers Around the World: A Visual Story

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