Models of care for orphaned and separated children and upholding children’s rights

Cross-sectional evidence from western Kenya

Bibliographic Data

ID19517368
AuthorsLonnie Embleton (0000-0002-9415-8903, Moi University), David Ayuku (0000-0001-7401-1165, Moi University), Allan Kamanda (Moi University), Lukoye Atwoli (0000-0001-7710-9723, Moi University), Samuel Ayaya (Moi University), Rachel Vreeman (0000-0001-5460-8204, Indiana University – Purdue University Indianapolis), Winstone Nyandiko (0000-0002-7639-9287, Moi University), Peter Gisore (Moi University), Julius Koech (AMPATH), Paula Braitstein (0000-0003-0541-2955, Moi University, corresponding author)
Year2014
Volume14
Issue1
Pages9-9
Publication date2014-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMC International Health and Human Rights (JOURNAL)
Journal identifiersISSN: 1472-698X • E-ISSN: 1472-698X
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/1472-698x-14-9
PMID24685118
PMCIDPMC4021203
OpenAlexW2137997213
LanguageEN
Citations received19
References cited26

BACKGROUND: Sub-Saharan Africa is home to approximately 55 million orphaned children. The growing orphan crisis has overwhelmed many communities and has weakened the ability of extended families to meet traditional care-taking expectations. Other models of care and support have emerged in sub-Saharan Africa to address the growing orphan crisis, yet there is a lack of information on these models available in the literature. We applied a human rights framework using the United Nations Convention on the Rights of the Child to understand what extent children's basic human rights were being upheld in institutional vs. community- or family-based care settings in Uasin Gishu County, Kenya. METHODS: The Orphaned and Separated Children's Assessments Related to their Health and Well-Being Project is a 5-year cohort of orphaned children and adolescents aged ≤18 year. This descriptive analysis was restricted to baseline data. Chi-Square test was used to test for associations between categorical /dichotomous variables. Fisher's exact test was also used if some cells had expected value of less than 5. RESULTS: Included in this analysis are data from 300 households, 19 Charitable Children's Institutions (CCIs) and 7 community-based organizations. In total, 2871 children were enrolled and had baseline assessments done: 1390 in CCI's and 1481 living in households in the community. We identified and described four broad models of care for orphaned and separated children, including: institutional care (sub-classified as 'Pure CCI' for those only providing residential care, 'CCI-Plus' for those providing both residential care and community-based supports to orphaned children , and 'CCI-Shelter' which are rescue, detention, or other short-term residential support), family-based care, community-based care and self-care. Children in institutional care (95%) were significantly (p < 0.0001) more likely to have their basic material needs met in comparison to those in family-based care (17%) and institutions were better able to provide an adequate standard of living. CONCLUSIONS: Each model of care we identified has strengths and weaknesses. The orphan crisis in sub-Saharan Africa requires a diversity of care environments in order to meet the needs of children and uphold their rights. Family-based care plays an essential role; however, households require increased support to adequately care for children

Child health · Cross-sectional study · Environmental health · Family medicine · Public health · Socioeconomics · Sociology · Child Welfare and Adoption · Global Maternal and Child Health · Medicine · Nursing · Poverty, Education, and Child Welfare