Psychological well‐being of orphans in Dar El Salaam, Tanzania

Abstract

Forty‐one orphans whose fathers and/or mothers had died from AIDS, and were living in the poor suburbs of Dar Es Salaam, Tanzania, were compared with 41 matched non‐orphans from the same neighbourhoods. The subjects were given an arithmetic test and a semi‐structured questionnaire concerning any internalizing problems, their attendance at school and their experiences of punishment, reward and hunger. The scale of internalizing problems comprised 21 items adapted from the Rand Mental Health and Beck Depression Inventories concerning mood, pessimism, somatic symptoms, sense of failure, anxiety, positive affect and emotional ties. Most orphans lived with aunts and uncles. Compared with non‐orphans, they were significantly less likely to be in school but those who did attend school had similar arithmetic scores. Significantly more orphans went to bed hungry. Orphans had markedly increased internalizing problems compared with non‐orphans (p < 0.0001) and 34% reported they had contemplated suicide in the past year. Multiple regression analysis indicated that the independent predictors of internalizing problem scores were sex (females higher than males), going to bed hungry, no reward for good behaviour, not currently attending school, as well as being an orphan. Conclusion: The orphans not only had unmet basic needs, but also had markedly increased internalizing problems, thus their long‐term mental health would be in jeopardy. There is an urgent need to expand and improve current intervention programmes not only to meet the basic needs but also to include psychosocial support, counselling services for the orphans, and training for their carers and teachers.

A Developmental Psychopathology Framework of the Psychosocial Needs of Children Orphaned by HIV

“…Previous studies have suggested a number of contextual factors that may potentially affect the mental health of children orphaned by AIDS Foster, 2002;Makame, Ani, & Grantham-McGregor, 2002). These factors include varied orphanhood experiences (e.g., double orphans, paternal orphans, and maternal orphans), different care-arrangements (home care, kinship care, or institutional care), and quality of care (e.g., caregiver-child relationship).…”

Care arrangements, grief and psychological problems among children orphaned by AIDS in China

“…Although mixed results about physical health and health care access have been reported among orphans as compared with non-orphans (Crampin et al, 2003;Lindblade, Odhiambo, Rosen, & DeCock, 2003;Masmas et al, 2004;Nyambedha et al, 2003a;Nyambedha et al, 2003b;Sarker, Neckermann, & Muller, 2005), psychological problems have been consistently observed among orphans (Atwine, Cantor-Graae, & Bajunirwe, 2005;Cluver & Gardner, 2006;Makame et al, 2002;Pelton & Forehand, 2005). Orphans have markedly increased internalizing problems and higher levels of anxiety, depression, anger, and depressive disorders, as compared with their counterparts (Atwine et al, 2005;Makame et al, 2002). In a study among African American children 6 to 11 years of age from New Orleans, in addition to internalizing problems, orphans were also found to have clinical levels of externalizing problems before their mother's death (Pelton & Forehand, 2005).…”

“…Although most orphans are frequently cared of by extended family members, these orphans are more likely to live in households with less favorable dependency ratios and greater experiences of financial hardship (Monasch & Boerma, 2004;Nyambedha, Wandibba, & Aagaard-Hansen, 2003a;Nyambedha, Wandibba, & Aagaard-Hansen, 2003b;Oleke, Blystand, & Rekdal, 2005;Safman, 2004). Orphans have lower school attendance, lower school completion rates, and/or are less likely than non-orphans to be at the age-appropriate grade level (Bicego, Rutstein, & Johnson, 2003;Makame et al, 2002;Monasch & Boerma, 2004;Nyambedha et al, 2003b;Nyamukapa & Gregson, 2005). Although mixed results about physical health and health care access have been reported among orphans as compared with non-orphans (Crampin et al, 2003;Lindblade, Odhiambo, Rosen, & DeCock, 2003;Masmas et al, 2004;Nyambedha et al, 2003a;Nyambedha et al, 2003b;Sarker, Neckermann, & Muller, 2005), psychological problems have been consistently observed among orphans (Atwine, Cantor-Graae, & Bajunirwe, 2005;Cluver & Gardner, 2006;Makame et al, 2002;Pelton & Forehand, 2005).…”

“…A substantial literature exploring the impact of orphanhood on the well-being of children has emerged in the past few years. A wide range of topics has been discussed in the literature, including living situation, physical health, schooling, bereavement process, and psychological well-being (Makame, Ani, & Grantham-McGregor, 2002;Masmas et al, 2004;Monasch & Boerma, 2004;Safman, 2004;Nyamukapa & Gregson, 2005;Sarker, Neckermann, & Muller, 2005;).…”

“…Orphans have lower school attendance, lower school completion rates, and/or are less likely than non-orphans to be at the age-appropriate grade level (Bicego, Rutstein, & Johnson, 2003;Makame et al, 2002;Monasch & Boerma, 2004;Nyambedha et al, 2003b;Nyamukapa & Gregson, 2005). Although mixed results about physical health and health care access have been reported among orphans as compared with non-orphans (Crampin et al, 2003;Lindblade, Odhiambo, Rosen, & DeCock, 2003;Masmas et al, 2004;Nyambedha et al, 2003a;Nyambedha et al, 2003b;Sarker, Neckermann, & Muller, 2005), psychological problems have been consistently observed among orphans (Atwine, Cantor-Graae, & Bajunirwe, 2005;Cluver & Gardner, 2006;Makame et al, 2002;Pelton & Forehand, 2005). Orphans have markedly increased internalizing problems and higher levels of anxiety, depression, anger, and depressive disorders, as compared with their counterparts (Atwine et al, 2005;Makame et al, 2002).…”