Assessment of emotional status of orphans and vulnerable children in Zambia.

AbstractPurpose: To describe the emotional status of orphans and vulnerable children (OVC) in two communities in Zambia.Methods: The Health Ed Connect Adaptation Questionnaire (HECAQ) was used to interview 306 OVC and 158 primary caregivers in Zambia in 2010.Findings: Child participants and caregivers reported evidence of emotional distress behaviors in the majority of OVC.Conclusions: More research to evaluate the efficacy of intervention programs for loss and grief, normal and abnormal reactions to grief, and positive coping skills is needed to assist both children and their caretakers. In the population studied, caregivers and OVC could benefit from additional support for promoting emotional health and managing emotional distress in vulnerable children.Clinical Relevance: Healthcare professionals play a key role in promoting the emotional health of OVC through identification of deviant behaviors and the development of interventions to alleviate emotional and psychological distress.Key wordsOrphans and vulnerable children (OVC), AIDS orphans, OVC caregivers, psychological needs, Zambia, AfricaZambia is one of the world's poorest countries, with 68% of the population living below the international poverty line (World Bank, 2011). In addition to the challenges of poverty, the country is faced with caring for 1.3 million orphans 0 to 17 years of age (United Nations Children's Fund [UNICEF], 2009). With a total population of 12.9 million (UNICEF, 2009) there is one orphan for every nine people.The people in the Copperbelt Province of Zambia are challenged with the burden of orphaned children as well as major negative social and economic changes in the region. Although once a thriving mining province, the closure of the copper mines in the 1 980s, the evaporation of jobs, and the devastation caused by AIDS have left the small communities in the Copperbelt Province struggling to survive. Even though providing the basics of food and shelter for these orphans and vulnerable children (OVC) is a strain on the resources of the community, caregivers express concern about the unmet emotional needs of the children. The challenges and emotional needs of OVC and their caregivers in Chipulukusu and Kasompe, Zambia, have not been well documented. If the status of emotional health and distress were better understood, more efficacious programs and interventions could be developed that are specific for meeting the needs of this vulnerable population.The purpose of this study was to identify the emotional status of OVC in the communities of Chipulukusu and Kasompe, Zambia. The research questions addressed were: (a) What are the characteristics and background of the OVC in Chipulukusu and Kasompe? (b) How is emotional health expressed by the OVC? (c) What are the characteristics of the caregivers? and (d) What are the caregivers' perceptions of the emotional health of the OVC?For the purpose of this study, an orphan was defined as a child who had lost one or both parents through death. A vulnerable child was defined as a child whose well-being was significantly jeopardized through abandonment, who had a terminally ill parent, or who was living at a high level of poverty. The caregiver was defined as the person living in the same household who was the primary caregiver of the child (Family Health International, 2005).Evidence of Emotional and Psychological Distress in OVCPrevious studies of OVC have focused almost exclusively on the economic well-being of children orphaned by parents with AIDS. The few studies published on the psychological well-being of OVC found that children orphaned by AIDS displayed symptoms of high levels of anxiety, depression, and anger. The physical care and support given to them was not enough to manage these emotions (Atwine, Cantor-Graae, & Bajunirwe, 2005; Cluver & Gardner, 2007; Li et al., 2008; Murray, 2010; Nyamukapa et al. …