The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65740

Rachel Stevens, MPH, Kathryn Whetten, PhD, Amy Hepburn, MPP, and Karen O'Donnell, PhD. Health Inequalities Program, Duke University, 110 Swift Ave, Durham, NC 27705, 919-684-3368, rstevens@hpolicy.duke.edu

AIDS worldwide has orphaned more than 13 million children under the age of 15. By 2010 an estimated 25 million children will be orphaned due to AIDS. Studies concerning the effects of the placement of orphans have been largely limited to comparisons of orphanage versus community placement with the primary outcome variable being mortality. Duke University and Tanzanian investigators partnered with the community based organization, KIWAKKUKI (Women Fighting Vigorously Against AIDS in Kilimanjaro) to test the feasibility of conducting detailed testing of children orphaned by AIDS. 47 children ages 4 to 8 and their caregivers were assessed for: cognitive abilities and learning, behavioral health characteristics; health status; parental status; current living arrangements; and access to formal education. The final group included 22 children living in orphanages and 25 children orphaned and living in the community with one parent, relatives, or non-family community members. Of these 47 children, 21 had one or both parents die from HIV/AIDS; the parents of the other 26 were reported to have died from other diseases or events, many of which could be related to HIV/AIDS. We note the trends toward differences between the community based group and orphanage care, in favor of the former. 96% of those cared for in the community were “healthy;” 81.8% of those living in orphanages were “healthy.” Upon preliminary analyses, the Total Difficulty Score does not differ by orphanage versus community based care. The implications of this study suggest there are developmental differences in orphans associated with placement characteristics.

Learning Objectives:

At the conclusion of this session, participants will be able to:
• Identify why it is important to go beyond mortality in examining orphan care outcomes;
• Describe the cognitive and behavioral testing instruments utilized in this study;
• Discuss the results from one pilot study;
• Understand the importance being able to identify feasible characteristics of orphan caregiving.

Keywords: Child Health, International

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.