The health of a caregiver is the most important predictor of orphan health, according to a new study conducted by the Positive Outcomes for Orphans (POFO) Research Team. The study, conducted by an international research team, spans five culturally-and economically-diverse less-wealthy nations in Africa and Asia. More important than an orphan’s geographic location, living conditions, or past trauma, the study finds that an unhealthy caregiver likely means an unhealthy child.
The findings prompt researchers to call for international orphan policies to place greater attention on assessing and treating children and their caregiver’s health together, rather than focusing on children’s health in isolation.
Published in PLoS One today, the Duke University sponsored study of over 1300 randomly selected orphans and abandoned children from six diverse settings found that one in five was in fair or poor health and one in four had experienced symptoms of illness in the previous two weeks. Forty-five percent of the caregivers reported their own health to be fair or poor, and one in four caregivers reported symptoms like fever, cough and/or diarrhea in the last two weeks. Strong and consistent associations were found between poorer child health and poorer health among their caregivers. Children whose caregivers were more involved in their lives and well-being were less likely to be sick or unhealthy.
“This study produces strong evidence to inform policy and resource allocation relevant to the health of this large vulnerable child population worldwide,” said Nathan Thielman, lead author and associate professor of medicine and global health at the Duke Global Health Institute. “Specifically, policies that promote orphan well-being should include health assessments and interventions that target the caregiver-child dyad. ”
Researchers say a lack of economic resources may be a contributor to poor child health. Orphans are often cared for in households headed by females or the elderly; these households may have less money and are less likely to cover medical expenses associated with caregiver illness, further limiting their ability to provide adequate nutrition and access to health care for the child.
Researchers argue the study provides strong support for establishing more family-based clinics in resource-poor settings that offer services and treatment to both children and their caregivers. They also suggest adding comprehensive caregiver health assessments to existing tools used to measure the well-being of orphans.
The multi-site study included community-dwelling orphans ages 6-12 and their caregivers from six culturally- and economically-diverse sites across five countries: Cambodia, Ethiopia, India, Kenya and Tanzania. All of the children in the study have survived the death of one parent or were abandoned by both parents. Of 153 million children orphaned worldwide, 145 million reside in less -wealthy nations where high rates of HIV/AIDS and other diseases like malaria and tuberculosis claim thousands of lives every day.
This research was supported by a wide range of international partner organizations, including: ACE Africa, Bungoma, Kenya; Homeland Meahto Phum Ko’Mah in
Battambang, Cambodia; KIWAKKUKI and TAWREF, Moshi, Tanzania; SaveLives Ethiopia and Save the Vulnerables Organization, Addis Ababa, Ethiopia; and Sahara Centre for Rehabilitation and Residential Care in Delhi, Hyderabad and Nagaland, India.
This work was supported by the National Institute of Child Health and Development (NICHD), grant No. 5R01HD046345-04. The Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health also supported this study.