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Title: The psychosocial well-being of orphans in HIV/AIDS-afflicted eastern Zimbabwe
Author: Nyamukapa, Constance
ISNI:       0000 0001 3451 0306
Awarding Body: Imperial College London (University of London)
Current Institution: Imperial College London
Date of Award: 2008
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Almost 21% of Zimbabwe's population of roughly 13 million people live with HIV infection while 1.6 million children (23%) have been orphaned. The epidemic is further worsening children's lives by decreasing access to health services, education, shelter, clothing, vocational training, legal protection, psychosocial support, and care from family members. Understanding the psychosocial effects on children of being orphaned or made vulnerable by the epidemic is vital if further problems in childhood and later life are to be averted. Objectives: 1. To develop a theoretical framework for understanding the relationships between orphan experience, psychosocial distress, and child experiences and adult life chances; 2. To compare and contrast levels of psychosocial distress by form (i.e. paternal only, maternal only and double) and duration of orphanhood in Zimbabwe; 3. To assess the cumulative impact of psychosocial distress experienced in childhood on risky behaviour outcomes in adolescence and adult life experiences; 4. To assess how appropriate and sensitive the methods and tools used in the study were to the children's plight. Methods: Stata version 9.0 was used to conduct statistical analyses of data from three survey sources: the Zimbabwe Oye Baseline Survey 2004, the Manicaland Child Cohort Study, and the Manicaland HIV/SID Prevention Project. Qualitative data were collected and used to aid interpretation of the statistical results. Results: In the national ayC survey (ages 12-17 years), psychosocial distress was more common in females and younger children. Orphans overall and each form of orphan were at greater risk of developing psychosocial distress than non-orphans. In multivariate analyses, being resident in an urban area (Coeff, 0.16; 95% CI, 0.04-0.28), on a commercial farm (Coeff, 0.46; 95% CI, 0.08-0.84), in the poorest 20% of households (Coeff, 0.14; 95% CI, 0.04-0.24), in a household that had received external Support (Coeft', 0.21; 95% CI, -0.01-0.44) and not being related to the closest caregiver (Coeff, 0.14; 95% CI, 0.03-0.24) were associated with psychosocial distress. Being in a female-headed household (Coeff; -0.11; 95% CI, -0.19- -0.02) and receiving psychosocial support from the closest caregiver (Coeff, -0.05; 95% CI, -0.09- -0.01) had protective effects against psychosocial distress. Maternal and paternal orphans were significantly more likely than non-OYC to have engaged in sexual activity. These differences were reduced after controlling for psychosocial distress. In Manicaland, eastern Zimbabwe, paternal and double orphans were at increased risk of psychosocial distress. Orphans were more likely to have started sex and to have engaged in substance abuse. However, the only (borderline) significant result was increased likelihood of paternal orphans having engaged in substance abuse [p = 0.056]. Conclusion: Orphaned children in Zimbabwe suffer greater psychosocial distress which may lead to increased likelihood of sexual debut and HIV infection. The impact of strategies to provide psychosocial support should be evaluated scientifically.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available