Orphan prevalence and extended family care in a peri-urban community in Zimbabwe

Abstract

An orphan enumeration survey was conducted in 570 households in and around Mutare, Zimbabwe in 1992; 18.3% (95% CI 15.1-21.5%) of households included orphans. 12.8% (95% CI 11.2-14.3%) of children under 15 years old had a father or mother who had died; 5% of orphans had lost both parents. Orphan prevalence was highest in a peri-urban rural area (17.2%) and lowest in a middle income medium density urban suburb (4.3%). Recent increases in parental deaths were noted; 50% of parental deaths since 1987 could be ascribed to AIDS. Orphan household heads were likely to be older and less well-educated than non-orphan household heads. The majority of orphaned children were being cared for satisfactorily within extended families, often under difficult circumstances. Caregiving by maternal relatives represents a departure from the traditional practice of caring for orphans within the paternal extended family and an adaptation of community-coping mechanisms. There was little evidence of discrimination or exploitation of orphaned children by extended family caregivers. The fact that community coping mechanisms are changing does not imply that extended family methods of caring are about to break down. However, the emergence of orphan households headed by siblings is an indication that the extended family is under stress. Emphasis needs to be placed upon supporting extended families by utilizing existing community-based organizations. Orphan support programmes may need to be established initially in high risk communities such as low-income urban areas and peri-urban rural areas.

PIP: In 1992 in Zimbabwe, local women conducted interviews with 570 heads of household and focus group discussions with caregivers, community members, and teachers in and near Mutare (Zimunya, Sakubva, and Dangamvura) to determine the prevalence of orphans. 220 orphans (12.8% of all children surveyed) lived in 18.3% of all the households. The prevalence of orphans was lowest in the newly-developed, affluent suburb of Dangamvura and highest in the very low income, rural area of Zimunya (4.3% vs. 17.1%). It increased with age (4.9% for under-fives, 10.1% for 5-9 years, and 23.9% for 10-14 years). Most orphans (81.8%) had only lost their father. Based on verbal autopsy information, gender, age of parent at death, and year of deaths, researchers did not classify any deaths before 1987 as being caused by possible or probable AIDS. They identified 14 cases of possible AIDS and 14 cases of probable AIDS during 1987-1992, however. Only one household actually reported AIDS as the cause of death of a parent. AIDS was likely the cause of death for 32% of cases. The average age for parents dying before 1987 was 45.7 years compared to 34.3 years after 1987. A member of the maternal family headed up 84% of orphan households, while a member of the paternal family headed up only 16%. Yet, traditionally the father's side, especially the paternal aunt, cares for orphans. In three cases, the older sister aged 17-23 cared for younger siblings, suggesting that the extended family is under stress. Communities stigmatized and discriminated against orphans. Caregivers showed genuine concern for the orphans. Few differences in health, nutrition, and education between orphaned and nonorphaned children supported this concern. Community-based groups, particularly those in low income urban areas and periurban rural areas, should support extended families to prevent rupture of stressed community coping mechanisms.