Health, Nutritional and Societal Factors Associated with Ethiopian Orphan and Vulnerable Children's School Performance

Background. Ethiopia is struggling to provide needed services to approximately 898,000 orphaned and vulnerable children (OVC) due to AIDS. Education provides OVC hope to improve quality of life and community development. This socio-ecological study addresses the need for understanding how health, nutritional and societal factors at the inter-personal, intra-personal, community and societal levels are associated with OVC's adequate school performance.

Methods. This cross-sectional study used data from the Caring Program for 816 Ethiopian OVC 7-18 year old from Oromiya, Tigray and Addis Ababa. Child Status Index measures were analyzed using univariate, bivariate and logistic regression statistics. Adequate school performance was defined as enrollment and attendance (regularly or irregularly) at school or a skills training program, or engagement in age-appropriate play, learning activity or job.

Results. 62.8% of OVC had adequate school performance. Compared to those residing in Addis Ababa, OVC from Oromiya were more likely (OR=10.37) and OVC from Tigray were less likely (OR=0.26) to have adequate school performance. OVC's adequate nutritional and growth status (OR=7.18), wellness (OR=4.17), emotional health (OR=1.30), support from an adult caregiver (OR=7.18), social behavior (OR=2.72), shelter (OR=2.63), access to health care services (OR=6.23), food security (OR=5.85); and legal protection (OR=5.50) were associated with adequate school performance.

Conclusions. Results suggest strategies for OVC educational programs should not only involve governments, communities and families but also be developed in synergy with support groups, counseling, medical care, psychosocial support, home-based health care, life skills training, and food distribution. These programs should also capitalize on adult mentorship models.