Family Composition and Stability for Orphans: A Longitudinal Study of Well-Being in 5 Low- and Middle-Income Countries.
Journal Article (Journal Article)
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.
Full Text
Duke Authors
Cited Authors
- Gray, CL; Whetten, K; Daniels, JL; Hudgens, MG; Pettifor, AE; Hobbie, AM; Thielman, NM; Dubie, ME; Itemba, D; Madan, I; Vann, V; Wasonga, AI; Manongi, R; Ostermann, J; Whetten, RA; Pence, BW
Published Date
- 2021
Published In
Volume / Issue
- 66 /
Start / End Page
- 1604057 -
PubMed ID
- 34992514
Pubmed Central ID
- PMC8724025
Electronic International Standard Serial Number (EISSN)
- 1661-8564
Digital Object Identifier (DOI)
- 10.3389/ijph.2021.1604057
Language
- eng
Conference Location
- Switzerland