Family Composition and Stability for Orphans: A Longitudinal Study of Well-Being in 5 Low- and Middle-Income Countries.

Autor:	Gray CL; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.; Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States., Whetten K; Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States.; Sanford School of Public Policy, Duke University, Durham, NC, United States., Daniels JL; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States., Hudgens MG; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States., Pettifor AE; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States., Hobbie AM; Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States., Thielman NM; Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States.; Division of Infectious Diseases, Department of Medicine, School of Medicine, Duke University, Durham, NC, United States., Dubie ME; Stand for Vulnerable Organization, Addis Ababa, Ethiopia., Itemba D; Tanzania Women Research Foundation, Moshi, Tanzania., Madan I; Sahara Centre for Residential Care and Rehabilitation, New Delhi, India., Vann V; Development for Cambodian Children, Battambang, Cambodia., Wasonga AI; Ace Africa-Kenya, Bungoma, Kenya., Manongi R; Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Ostermann J; Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States.; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States., Whetten RA; Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States., Pence BW; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Jazyk:	angličtina
Zdroj:	International journal of public health [Int J Public Health] 2021 Dec 21; Vol. 66, pp. 1604057. Date of Electronic Publication: 2021 Dec 21 (Print Publication: 2021).
DOI:	10.3389/ijph.2021.1604057
Abstrakt:	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. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Gray, Whetten, Daniels, Hudgens, Pettifor, Hobbie, Thielman, Dubie, Itemba, Madan, Vann, Wasonga, Manongi, Ostermann, Whetten and Pence.)
Databáze:	MEDLINE
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