“We see the same continuum of bad and good care in the group homes as we see in the family settings,” says Whetten.
For the last 12 years Whetten has been following 3,000 kids who were orphaned, abandoned or for some other reason separated from their biological parents. The professor of public policy and global health at Duke is conducting the study in five low- and middle-income countries. Half the kids are in institutions of some kind — government-run orphanages, private group homes. The other half have been placed with extended family members.
“What the kids really seem to need is a home-like environment,” Whetten says.
Journalist, Charles Pensulo, wrote a comprehensive article for “The Equal Times” about deinstitutionalization in Malawi and interviewed Dr. Kate Whetten about findings from the Positive Outcomes for Orphans (POFO) Study:
Speaking to Equal Times, Whetten adds: “There is no NIH study of older children that has found that they do poorly in orphanages or institutions. All of these rigorously peer-reviewed studies have found that children in need do as well or better in orphanages relative to family settings, and that orphanages can be the place where children who are going to drop out of school, have severe emotional difficulties and learn no job trade, are able to thrive.”
“The majority of the world’s population lives in low-income countries with extremely limited access to mental health care. This gap is largest in African nations, which have the world’s lowest ratio of mental health professionals: just 1.4 per 100,000 people.
For more than a decade, a multinational team of researchers has been exploring ways to close that gap for nearly 50 million orphans in Africa who are grieving the loss of one or both parents. HIV/AIDS and respiratory infections are the leading cause of death.
Being orphaned predicts other problems – problems like substance abuse, dropping out of school, or unemployment. Orphans are also more likely to engage in risky sexual behavior that may lead to new cases of HIV — and perpetuate a vicious circle.
Radical decision to close down country’s 34 institutions has been fraught with difficulties.
“Kathryn Whetten, a professor at Duke University in the US, followed 1,357 children in institutions, and 1,480 in families in Ethiopia and Tanzania, to compare the effect of living in orphanages with family care.
Whetten published her conclusions in the scientific journal PLOS ONE in 2014, saying that without substantial improvements in care and support, placing children back with families will not significantly improve their welfare.”
Chris Gray and the POFO team recently published an article titled, “Potentially traumatic experiences and sexual health among orphaned and separated adolescents in five low- and middle-income countries” in AIDS Care.
The study highlights the need for caregivers, program managers, and policymakers to promote condom use for sexually active OSC and identify interventions for trauma support services. Orphans living in family-based care may also be particularly vulnerable to early sexual debut and unprotected sexual activity.
Whole Child International (WCI) is a U.S.-based non-governmental organization focused on improving the caregiving environments for vulnerable children by effecting changes within child care centers and orphanages. The “National Evaluation of Quality of Childcare in El Salvador” project is an intervention of educational trainings (for local government officials, directors, and caregivers) and technical assistance within centers.
UNICEF reports “around 63 million adolescents between the ages of 12 to 15 years old are denied their right to an education, in addition to 58 million children of primary education that are out of school.” A new initiative between UNICEF and UNESCO Institute for Statistics with support from the Global Partnership for Education will ensure that children in more than 50 countries will have access to a good education, are ready to enter the classroom at the right age and are equipped to complete primary school.
Chris Gray, who is working with Brian Pence at CHPIR, just published “Gender (in) differences in prevalence and incidence of traumatic experiences among orphaned and separated children living in five low- and middle-income countries” in the Global Mental Health journal with her team.
Kate Whetten and team are at the 2015 Christian Alliance for Orphans conference in Nashville, Tennessee. Please check out this Q&A video from Kate Whetten and Charles Nelson’s presentation at the 2014 CAFO conference.