Psychological well-being and socio-economic hardship among AIDS orphans and other vulnerable children in Guinea

Abstract

Over the past decade, the effects of AIDS-related parental death on children's socio-economic, educational and psychological well-being have become apparent. Most studies, however, have compared the plight of so-called AIDS orphans with non-orphaned children only. Consequently, such study designs are unable to establish if the AIDS-related cause of death of the parents confers effects additional to those of parent-bereavement. We therefore conducted a cross-sectional survey to assess the psychological well-being and socio-economic hardship among 140 non-orphaned children, 133 children orphaned by causes other than AIDS (O) and 124 children orphaned by AIDS (O-A) in Conakry, N'Zérékoré and the villages around N'Zérékoré, Guinea. Multi-way analysis of variance and multiple (ordinal) logistic regression models were applied to measure the association between the orphan status and psychological well-being, school attendance, economic activities, frequency of going to bed hungry and sleeping commodity. After adjustment for confounding factors, the psychological well-being score (PWS) was significantly lower among AIDS-orphaned children than among O (P<0.001). Additionally, AIDS-orphaned children were more likely to be engaged in economic activities (adjusted odds ratio (AOR) = 3.04; 95% CI: 1.45–6.36) and to go to bed hungry on a daily basis (AOR = 2.73; 95% CI: 1.24–6.02) than other orphans. The differences in school attendance and the proportion of children with a bed or couch to sleep between AIDS-orphaned children and O were not statistically significant. This situation calls for sustainable and holistic approaches to ensure the psychological and socio-economic stability of AIDS orphans and other vulnerable children.

Keywords:

• AIDS
• orphans
• psychological well-being
• school attendance
• Guinea
• West Africa

Acknowledgements

Wim Delva was funded by the Institute for the Promotion of Innovation by Science and Technology in Flanders. An Vercoutere received a travel grant from the Flemish Interuniversity Council. We acknowledge the financial support from the Belgian Vocation Foundation. In addition, we are indebted to the research assistants of the Fondation Elizabeth Cathy in Conakry and the interviewers for their continued dedication: Rose Loua, Bernard Balla Loua, Moussa Kourouma, Elisabeth Haba, Boubacar Diaby, Elizabeth Loua, Angèle Haba, Moïse Hervé Malomou, Apollinaire Loua, Léon Camara Ouendeno, Naby Camara, Salifou Taban Camara, Julien Yombouno and Amadou Touré. Finally, we wish to express our sincere thanks to the key informants and households that participated in this study.