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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Models of care for orphaned and separated children and upholding children's rights: Cross-sectional evidence from western Kenya
BMC International Health and Human Rights, Volume 14, No. 1, Article 9, Year 2014
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Description
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. © 2014Embleton et al.; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4021203/bin/1472-698X-14-9-S1.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC4021203/bin/1472-698X-14-9-S2.doc
Authors & Co-Authors
Embleton, Lonnie E.
Kenya, Eldoret
Moi University
Ayuku, David O.
Kenya, Eldoret
Moi University
Kamanda, Allan M.
Kenya, Eldoret
Moi Teaching and Referral Hospital
Atwoli, Lukoye
Kenya, Eldoret
Moi University
Ayaya, Samuel Omulando
Kenya, Eldoret
Moi University
Vreeman, Rachel Christine
United States, Indianapolis
Indiana University-purdue University Indianapolis
Nyandiko, Winstone Mokaya
Kenya, Eldoret
Moi University
Gisore, Peter O.
Kenya, Eldoret
Moi University
Koech, Julius K.
Kenya, Eldoret
Academic Model Providing Access to Healthcare
Braitstein, Paula K.A.
Kenya, Eldoret
Moi University
United States, Indianapolis
Indiana University-purdue University Indianapolis
Canada, Toronto
University of Toronto
United States, Indianapolis
Regenstrief Institute Inc
Statistics
Citations: 55
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1186/1472-698X-14-9
e-ISSN:
1472698X
Research Areas
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Kenya