Psychological well-being of orphans in Dar El Salaam, Tanzania

Viola R. Makame · Cornelius C Ani · Sally Grantham‐McGregor

277 citations0/0 files storedActa Paediatrica

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Poverty, Education, and Child Welfare Child Welfare and Adoption Grief, Bereavement, and Mental Health

Abstract

UNLABELLED: Forty-one orphans whose fathers and/or mothers had died from AIDS, and were living in the poor suburbs of Dar Es Salaam, Tanzania, were compared with 41 matched non-orphans from the same neighbourhoods. The subjects were given an arithmetic test and a semi-structured questionnaire concerning any internalizing problems, their attendance at school and their experiences of punishment, reward and hunger. The scale of internalizing problems comprised 21 items adapted from the Rand Mental Health and Beck Depression Inventories concerning mood, pessimism, somatic symptoms, sense of failure, anxiety, positive affect and emotional ties. Most orphans lived with aunts and uncles. Compared with non-orphans, they were significantly less likely to be in school but those who did attend school had similar arithmetic scores. Significantly more orphans went to bed hungry. Orphans had markedly increased internalizing problems compared with non-orphans (p < 0.0001) and 34% reported they had contemplated suicide in the past year. Multiple regression analysis indicated that the independent predictors of internalizing problem scores were sex (females higher than males), going to bed hungry, no reward for good behaviour, not currently attending school, as well as being an orphan. CONCLUSION: The orphans not only had unmet basic needs, but also had markedly increased internalizing problems, thus their long-term mental health would be in jeopardy. There is an urgent need to expand and improve current intervention programmes not only to meet the basic needs but also to include psychosocial support, counselling services for the orphans, and training for their carers and teachers.

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References

1961An Inventory for Measuring Depression 1983The structure of psychological distress and well-being in general populations.1997Socioeconomic determinants of health: Stress and the biology of inequality 2000The capacity of the extended family safety net for orphans in Africa

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2007Psychological distress amongst AIDS‐orphaned children in urban South Africa 2006Strong foundations : early childhood care and education 2007Risk and protective factors for psychological well-being of children orphaned by AIDS in Cape Town: a qualitative study of children and caregivers’ perspectives 2004Extended family's and women's roles in safeguarding orphans’ education in AIDS-afflicted rural Zimbabwe 2009Cumulative risk and AIDS-orphanhood: Interactions of stigma, bullying and poverty on child mental health in South Africa 2007HIV-Associated Orphanhood and Children’s Psychosocial Distress: Theoretical Framework Tested With Data From Zimbabwe 2011Persisting mental health problems among AIDS‐orphaned children in South Africa 2006The psychological well-being of children orphaned by AIDS in Cape Town, South Africa

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