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Factors affecting the psychosocial well-being of orphan and separated children in five low- and middle-income countries: Which is more important, quality of care or care setting?

Author

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  • Hy V Huynh
  • Susan P Limber
  • Christine L Gray
  • Martie P Thompson
  • Augustine I Wasonga
  • Vanroth Vann
  • Dafrosa Itemba
  • Misganaw Eticha
  • Ira Madan
  • Kathryn Whetten

Abstract

As millions of children continue to live without parental care in under-resourced societies in low- and middle-income countries (LMICs), it is important for policymakers and practitioners to understand the specific characteristics within different care settings and the extent to which they are associated with outcomes of orphan and separated children (OSC). This study was designed to (1) examine if the psychosocial well-being of OSC in under-resourced societies in LMICs is more dependent on the availability of certain components of quality of care rather than the care setting itself (i.e. the residential care-based or community family-based setting), and (2) identify the relative significance of certain components of quality of care that are associated with a child’s psychosocial well-being across different OSC care settings. This study drew from 36-month follow-up data from the Positive Outcomes for Orphans (POFO) Study and used a sample population of 2,013 (923 institution- and 1,090 community-based) OSC among six diverse study sites across five LMICs: Cambodia, India (Hyderabad and Nagaland), Kenya, Tanzania, and Ethiopia. Analyses showed that all four components of quality of care significantly predicted child psychosocial well-being. Child psychosocial well-being across “high” and “low” levels of quality of care showed negligible differences between residential- and community-based care settings, suggesting the important factor in child well-being is quality of care rather than setting of care. Practical and policy implications and future research are discussed.

Suggested Citation

  • Hy V Huynh & Susan P Limber & Christine L Gray & Martie P Thompson & Augustine I Wasonga & Vanroth Vann & Dafrosa Itemba & Misganaw Eticha & Ira Madan & Kathryn Whetten, 2019. "Factors affecting the psychosocial well-being of orphan and separated children in five low- and middle-income countries: Which is more important, quality of care or care setting?," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-12, June.
  • Handle: RePEc:plo:pone00:0218100
    DOI: 10.1371/journal.pone.0218100
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    References listed on IDEAS

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    1. Atwine, Benjamin & Cantor-Graae, Elizabeth & Bajunirwe, Francis, 2005. "Psychological distress among AIDS orphans in rural Uganda," Social Science & Medicine, Elsevier, vol. 61(3), pages 555-564, August.
    2. Nyamukapa, C.A. & Gregson, S. & Lopman, B. & Saito, S. & Watts, H.J. & Monasch, R. & Jukes, M.C.H., 2008. "HIV-associated orphanhood and children's psychosocial distress: Theoretical framework tested with data from Zimbabwe," American Journal of Public Health, American Public Health Association, vol. 98(1), pages 133-141.
    3. Aboud, Frances & Samuel, Mesfin & Hadera, Alem & Addus, Abdulaziz, 1991. "Intellectual, social and nutritional status of children in an Ethiopian orphanage," Social Science & Medicine, Elsevier, vol. 33(11), pages 1275-1280, January.
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    2. Fu, Yao & Jordan, Lucy P. & Hoiting, Iris & Kim, Thida & Wickramage, Kolitha, 2023. "‘We have similar sad stories’: A life history analysis of left-behind children in Cambodian residential care," Children and Youth Services Review, Elsevier, vol. 155(C).
    3. Rogers, Justin & Whitelaw, Robert & Karunan, Victor & Ketnim, Pryn, 2021. "Children’s experiences of alternative care in mainland Southeast Asia – A scoping review of literature," Children and Youth Services Review, Elsevier, vol. 120(C).

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