Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108594

Brian H. Howard, MPH, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2056 K, Houston, TX 77030, 713-688-0893, brianhoward58@hotmail.com

Background: Africa is in an orphan-care crisis. In Zimbabwe, where one-third of adults are HIV-positive and almost one-fifth of children are orphans, AIDS and economic crash are straining the extended family's ability to care for its orphans. This study is the first to examine Zimbabwean caregivers' perceptions of barriers and incentives to fostering. Methods: As part of a baseline study for a program for families affected by AIDS, 371 caregivers of primary and secondary schoolchildren (212 caring for double orphans, 85 for single orphans, 74 for non-orphans) were interviewed about their economic circumstances, physical and emotional health, and experiences and attitudes regarding fostering. Results: Foster caregivers were disproportionately female, elderly, single, poor, stressed, and lacking in external support. Hunger and hardship were common in both orphan and non-orphan households, worst in single-orphan households headed by a widowed parent. The most important factors in a fostering decision were degree of kinship and financial capacity, but 98% of caregivers were willing to foster a child, 25% a stranger's child. Anxiety and stigma surrounding AIDS were high but not cited as an important barrier to fostering. Married non-fosterers, the most promising pool of potential extra-familial fosterers, expressed the greatest doubts about rewards and likely success of fostering. Conclusions: The greatest barriers to fostering are not problems of attitude but of money and organization. Incentives to fostering must focus on financial assistance, including free schooling, and the development of community mechanisms for supporting the extended family and prompting extra-familial fostering when necessary.

Learning Objectives: After this presentation, participants will be able to

• Describe who is providing orphan care in Zimbabwe and what they see as their greatest needs.
• Explain why financial assistance must not wait until single orphans become double orphans.
• Articulate why free schooling is essential to sustainable orphan care.
• Discuss why poverty and lack of organization are bigger barriers to orphan fostering than caregivers’ preference for fostering blood relatives.
• Prioritize policies to encourage sustainable orphan care.

Keywords: Children's Health, International Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Handout (.ppt format,