Discrepancies between UN models and DHS survey estimates of maternal orphan prevalence: insights from analyses of survey data from Zimbabwe

Laura Robertson · Simon Gregson · Claudius Madanhire · Neff Walker · Phyllis Mushati · Geoff P. Garnett +1 more

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Poverty, Education, and Child Welfare HIV/AIDS Research and Interventions Global Maternal and Child Health

Abstract

OBJECTIVES: Model-based estimates of maternal (but not paternal) orphanhood are higher than those based on data from demographic and health surveys (DHS). We investigate the consistency of reporting of parental survival status in data from Manicaland, Zimbabwe. METHODS: We compared estimates of paternal and maternal orphan prevalence in three rounds of a prospective household census in Manicaland (1998-2005) with estimates from DHS surveys and UNAIDS model projections. We investigated the consistency of reporting of parental survival status across the three rounds and compared estimates of adult mortality from the orphan data with direct estimates from concurrent follow-up of a general population cohort. Qualitative data were collected on possible reasons for misreporting. RESULTS: Paternal and maternal orphan prevalence is increasing in Zimbabwe. Mothers reported as deceased in round 1 of the Manicaland survey were more likely than fathers to be reported as alive in rounds 2 or 3 (33.3% vs 13.4%). This pattern was most apparent among younger children. The qualitative findings suggest that foster parents sometimes claim adopted children as their natural children. CONCLUSIONS: These results are consistent with misreporting of foster parents as natural parents. This appears to be particularly common among foster mothers and could partly explain the discrepancy between mathematical model and DHS estimates of maternal orphanhood.

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References

2007World Population Prospects The 2006 Revision 2009United Nations Population Division 2004Extended family's and women's roles in safeguarding orphans’ education in AIDS-afflicted rural Zimbabwe 1984Manual X: Indirect Techniques for Demographic Estimation.1991Measurement of Adult Mortality in Less Developed Countries: A Comparative Review 1981The Use of Hypothetical Cohorts in Estimating Demographic Parameters under Conditions of Changing Fertility and Mortality 2005Rising incidence and prevalence of orphanhood in Manicaland, Zimbabwe, 1998 to 2003 2004Comparison of household-survey estimates with projections of mortality and orphan numbers in sub-Saharan Africa in the era of HIV/AIDS

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2011The definition of true orphan prevalence: Trends, contexts and implications for policies and programmes 2009Orphanhood And The Living Arrangements Of Children In Sub-Saharan Africa 2020Trends in the prevalence and incidence of orphanhood in children and adolescents <20 years in rural KwaZulu-Natal South Africa, 2000-2014

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