Demographic and Care Profile of Orphans in an Antiretroviral Clinic in Northern Nigeria

Abstract

Background Although the HIV epidemic has mostly stabilized worldwide, the steady rise in the number of children orphaned by AIDS in sub-Saharan Africa currently accounts for an increase in the total population of orphans. The quality of alternative care will depend on the caregiver and the setting. Information on caregivers and the care settings for orphans could provide a basis for the formulation of appropriate strategic responses for their support.

The aim of the article is to describe the demographic characteristics and alternative care profiles of orphans among children attending a pediatric antiretroviral treatment facility.

Methods This was a cross-sectional study of consecutive children attending the antiretroviral therapy clinic of Ahmadu Bello University Teaching Hospital Zaria in Northern Nigeria. Demographic characteristics, HIV status, and caregiver information were obtained and recorded into a standardized structured proforma. Data were analyzed using SPSS software version 20 (IBM Corp., Armonk, New York, United States), and results presented as means, percentages, contingency tables and charts, with p values of < 0.05 considered as statistically significant.

Results Out of 441 children (mean age 73.5 ± 37.1 months), 53.3% were females, with 160 orphans and an orphan prevalence of 36.3%. Overall, 90 (56.3%) were paternal, 38 (23.8%) maternal, and 32 (20.0%) double orphans. Orphans were younger, with 59.4% also being HIV infected. Nearly half of these orphans (49.4%) were under the care of paternal relatives, with 39 (24.3%) being under the care of a grandmother.

Conclusion Family kinship network constitutes a vital secondary alternative for orphan care next to care by surviving parents. The need for priority support directed at alternative caregivers cannot be overemphasized.

Keywords

orphans - HIV/AIDS - children - alternative caregivers - demographic profile - Nigeria

• References

• 1 World Health Organization, UNICEF, UNAIDS. HIV Treatment: Global update on HIV treatment; Results, impacts and opportunities. ISBN 978 92 4 150573 4. June 2013. Available at: http://www.who.int/hiv/data/global_treatment_report_presentation_2013.pdf . Accessed November 15, 2014
• 2 UNICEF. Children on the Brink 2004: A joint report of new orphan estimates and a framework for action. July 2004. Available at: http://www.unicef.org/publications/index_22212.html . Accessed November 01, 2014
• 3 World Health Organization. WWorld AIDS Day: Business Unusual. Time to end the AIDS Epidemic. December 2014. Available at: http://www.who.int/woman_child_accountability/ierg/news/ierg_statement_AIDS_1_december_2014/en/ . Accessed June 15, 2015
• 4 UNICEF. Protection, Care and Support for Children affected by HIV and AIDS. Available at: http://data.unicef.org/hiv-aids/care-support.html . Accessed November 10, 2014
• 5 UNICEF. Towards an AIDS-free Generation. Children and AIDS: Sixth Stocktaking Report. ISBN 978-92-806-4723. Available at: http://www.unicef.org/publications/index_70986.html . Accessed November 8, 2014
• 6 Oladokun R, Brown B, Aiyetan P, Ayodele O, Osinusi K. Comparison of socio-demographic and clinical characteristics of orphans and non-orphans among HIV-positive children in Ibadan, Nigeria. Int J Infect Dis 2009; 13 (4) 462-468
• 7 Chauhan RC, Singh N. Sociodemographic profile of HIV infected children accessing care at pediatric clinic of a tertiary hospital in North India. Int J Contemp Pediatr 2014; 1 (1) 20-23 . doi 10.5455/2349-3291.ijcp20140507
• 8 Bhattacharya M, Rajeshwari K, Saxena R. Demographic and clinical features of orphans and nonorphans at a pediatric HIV centre in North India. Indian J Pediatr 2010; 77 (6) 627-631
• 9 Monasch R, Boerma JT. Orphanhood and childcare patterns in sub-Saharan Africa: an analysis of national surveys from 40 countries. AIDS 2004; 18 (2) (Suppl. 02) S55-S65
• 10 Atwine B, Cantor-Graae E, Bajunirwe F. Psychological distress among AIDS orphans in rural Uganda. Soc Sci Med 2005; 61 (3) 555-564
• 11 United Nations. UN General Assembly Resolution, 64th Session, Article 29: Guidelines for Alternative Care of Children. Report of the Third Committee A/RES/64/142; A/64/434, Draft Res I. Available at: http://www.un.org/en/ga/64/resolutions.shtml . Accessed September 12, 2014
• 12 Beegle K, Filmer D, Stokes A, Tiererova L. World Bank Policy Report Research Working Paper No. 4898; 2009. Orphanhood and the living arrangements of children in sub-Saharan Africa. Available at: https://npin.cdc.gov/publication/orphanhood-and-living-arrangements-children-sub-saharan-africa . Accessed August 23, 2014
• 13 UNICEF. Social Policy and Social Protection Section, Eastern and Southern African Region. Working Paper. Alternative Care for Children in South Africa: Progress, Challenges and Future Directions, 2008. Available at: http://www.unicef.org/esaro/Alternative_care_responses_ESAR_06_2008.pdf . Accessed August 23, 2014
• 14 UNICEF, Maastricht Graduate School of Governance. Policy Brief. HIV/AIDS and its impact on orphans. June 2006. Available at: mgsog.merit.unu.edu/publications/briefs/policy_brief_01.pdf . Accessed September 15, 2014
• 15 Federal Ministry of Women Affairs and Social Development, Nigeria. National Plan of Action for Orphans and Vulnerable Children (OVC) 2006–2010 in Nigeria. Available at: http://www.africanchildforum.org/clr/policy%20per%20country/nigeria/nigeria_ ovc_en.pdf . Accessed 12 February, 2016
• 16 Federal Ministry of Women Affairs and Social Development, Nigeria. Monitoring and Evaluation Plan for Orphans and Vulnerable Children (OVC) Response in Nigeria. September 2009. Available at: http://ovcsupport.net/wp-content/uploads/Documents/Nigeria_OVC_NPA_M_E_Plan.pdf . Accessed February 12, 2016
• 17 USAID Project Research, Boston University Center for Global Health and Development, Initiative for Integrated Community Welfare in Nigeria. Country brief. Nigeria Research Situation Analysis on Orphans and other Vulnerable Children. August 2009. Available at: http://www.bu.edu/cghd/files/2009/12/Nigeria-Research-Situation-Analysis-Country-Brief.pdf . Accessed February 12, 2016
• 18 Federal Ministry of Health, Nigeria. National Guidelines for Prevention of Mother-to-Child Transmission of HIV (PMTCT). Fourth Edition. November 2010. ISBN 979-166-412-6. Available at: http://www.emtct-iatt.org/wp-content/uploads/2013/04/Nigeria_National-PMTCT-Guidelines_2010.pdf . Accessed February 14, 2014
• 19 Federal Ministry of Health, Nigeria. National Guidelines for Paediatric HIV and AIDS Treatment and Care. October 2010. ISBN 978-978-48611-0-6. Available at: http://www.emtct-iatt.org/wp-content/uploads/2013/04/Nigeria_National-Paediatric-HIV-Guidelines_2010.pdf . Accessed February 14, 2014
• 20 Taylor-Smith K, Tweya H, Harries A, Schoutene E, Jahn A. Gender differences in retention and survival on antiretroviral therapy of HIV-1 infected adults in Malawi. Malawi Med J 2010; 22 (2) 49-56
• 21 Jarrin I, Geskus R, Bhaskaran K , et al; CASCADE Collaboration. Gender differences in HIV progression to AIDS and death in industrialized countries: slower disease progression following HIV seroconversion in women. Am J Epidemiol 2008; 168 (5) 532-540
• 22 EveryChild and HelpAge International. Positive Care Choices: Working Paper 4. Prioritizing Support to Kinship Carers, especially Older Carers (2012). HelpAge International London 2012. Available at: http://www.everychild.org.uk/sites/default/files/docs/Familyfirst%20-%20kinshipcarepaper.pdf . Accessed 10 November, 2014
• 23 Foster G. Under the radar: Community safety nets for AIDS-affected households in sub-Saharan Africa. AIDS Care 2007; 19 (Suppl. 01) S54-S63