Family Contexts and Schooling Disruption among Orphans in Post-Genocide Rwanda

This study examines the relationship between orphan status and schooling disruption in post-genocide Rwanda. The results indicate that while non-orphans have more favorable schooling outcomes in two-parent than in single-parent families, the reverse is true among Rwandan orphans. In single-mother households, paternal orphans, i.e. orphans with only a living mother, have better outcomes than their orphan and non-orphan counterparts. In contrast, paternal orphans have worse outcomes than other children in two-parent households, especially in households headed by males. Maternal orphans are more likely to experience schooling disruptions than non-orphans regardless of family structure. The maternal-orphan disadvantage is nevertheless greater in female-headed than in male-headed households. As expected, non-related orphans are more disadvantaged than orphans related to their household heads. However, non-related orphans have a greater disadvantage in two-parent than in single-parent households. The results also suggest that within households, the provision of childcare to children below schooling age is an impediment to orphan’s schooling. These impediments are, however, greater for double-orphans than paternal or maternal orphans.     

Volunteerism and residential longevity in Saskatoon,Saskatchewan, Canada

This paper examines volunteerism across three neighbourhood types that are differentiated by socio-economic status (SES) in Saskatoon, Saskatchewan, Canada. The three neighbourhood types are defined as Low, Middle and High SES. The study used data collected from two telephone surveys (n = 968 in 2001, n = 997 in 2004) using random-digit dialling, together with in-depth interview data collected from a selected set of survey participants (n = 90). Neighbourhood type and length of residence are shown to have a strong bearing on volunteerism. The interview data illustrates that the quality of volunteer activity that residents engage in differs across neighbourhood types.

Orphans in Africa: parental death,poverty, and school enrollment

We examine the impact of orphanhood on children's school enrollment in 10 sub-Saharan African countries. Although poorer children in Africa are less likely to attend school, the lower enrollment of orphans is not accounted for solely by their poverty. We find that orphans are less likely to be enrolled than are nonorphans with whom they live. Consistent with Hamilton's rule, the theory that the closeness of biological ties governs altruistic behavior, outcomes for orphans depend on the relatedness of orphans to their household heads. The lower enrollment of orphans is largely explained by the greater tendency of orphans to live with distant relatives or unrelated caregivers.     

The impact of the HIV/AIDS epidemic on kinship resources for orphans in Zimbabwe

The extended family has been recognized as a major safety net for orphans in sub-Saharan Africa. However, the mortality crisis associated with HIV/AIDS may drastically reduce the availability of relatives and thus undermine traditional forms of mutual support. In this article, the microsimulator SOCSIM is used to estimate and project quantities such as the number of living uncles, aunts, siblings, and grandparents available to orphans. The model is calibrated to the setting of Zimbabwe, using data from demographic and Health Surveys and estimates and projections of demographic rates from the United Nations. The article shows that there is a lag of more than ten years between the peak in orphanhood prevalence and the peak in scarcity of grandparents for orphans. The results indicate that a generalized HIV/AIDS epidemic has a prolonged impact on children and orphans that extends well beyond the peak in mortality. A rapid increase in the number of orphans is followed by a steady reduction in the number of living grandparents for orphans. Consequently, the burden of double orphans (both of whose parents have died) is likely to shift to uncles and aunts. In Zimbabwe, the number of living uncles and aunts per double orphan decreased between 1980 and 2010, but it is expected to increase progressively during the next few decades. Changes in kinship structure have important social consequences that should be taken into account when seeking to address the lack of care for orphans.     

Māori Cultural Efficacy and Subjective Wellbeing: A Psychological Model and Research Agenda

Māori, the indigenous peoples of New Zealand, experience a range of negative outcomes. Psychological models and interventions aiming to improve outcomes for Māori tend to be founded on a ‘culture-as-cure’ model. This view promotes cultural efficacy as a critical resilience factor that should improve outcomes for Māori. This is a founding premise of initiatives for Indigenous peoples in many nations. However, research modeling the outcomes of increased cultural efficacy for Indigenous peoples, such as Māori, remains limited. We present cross-sectional data modeling the links, and possible causal direction, between Māori cultural efficacy and active identity engagement and levels of (1) satisfaction with personal circumstances and life versus (2) satisfaction with government and the state of the nation more generally (N = 93 Māori). Our data support an opposing outcomes model in which Māori cultural efficacy predicts satisfaction with personal aspects of life, but may simultaneously decrease satisfaction with the nation and methods of governance for Māori peoples. Possible mechanisms governing these opposing effects are discussed.     

The impact of parental death on school outcomes: Longitudinal evidence from South Africa

We analyze longitudinal data from a demographic surveillance area (DSA) in KwaZulu-Natal to examine the impact of parental death on children's outcomes. The results show significant differences in the impact of mothers' and fathers' deaths. The loss of a child's mother is a strong predictor of poor schooling outcomes. Maternal orphans are significantly less likely to be enrolled in school and have completed significantly fewer years of schooling, conditional on age, than children whose mothers are alive. Less money is spent on maternal orphans' educations, on average, conditional on enrollment. Moreover, children whose mothers have died appear to be at an educational disadvantage when compared with non-orphaned children with whom they live. We use the timing of mothers' deaths relative to children's educational shortfalls to argue that mothers' deaths have a causal effect on children's educations. The loss of a child's father is a significant correlate of poor household socioeconomic status. However, the death of a father between waves of the survey has no significant effect on subsequent asset ownership. Evidence from the South African 2001 Census suggests that the estimated effects of maternal deaths on children's outcomes in the Africa Centre DSA reflect the reality for orphans throughout South Africa.     

Individual- and Neighbourhood-Level Indicators of Subjective Well-Being in a Small and Poor Eastern Cape Township: The Effect of Health,Social Capital,Marital Status,and Income

Our study used multilevel regression analysis to identify individual- and neighbourhood-level factors that determine individual-level subjective well-being in Rhini, a deprived suburb of Grahamstown in the Eastern Cape province of South Africa. The Townsend index and Gini coefficient were used to investigate whether contextual neighbourhood-level differences in socioeconomic status determined individual-level subjective well-being. Crime experience, health status, social capital, and demographic variables were assessed at the individual level. The indicators of subjective well-being were estimated with a two-level random-intercepts and fixed slopes model. Social capital, health and marital status (all p < .001), followed by income level (p < .01) and the Townsend score (p < .05) were significantly related to individual-level subjective well-being outcomes. Our findings showed that individual-level subjective well-being is influenced by neighbourhood-level socioeconomic status as measured by the Townsend deprivation score. Individuals reported higher levels of subjective well-being in less deprived neighbourhoods. Here we wish to highlight the role of context for subjective well-being, and to suggest that subjective well-being outcomes may also be defined in ecological terms. We hope the findings are useful for implementing programs and interventions designed to achieve greater subjective well-being for people living in deprived areas.     

“The Luggage that isn’t Theirs is Too Heavy…”: Understandings of Orphan Disadvantage in Lesotho

In Southern Africa, high adult HIV prevalence has fueled concern about the welfare of children losing parents to the epidemic. A growing body of evidence indicates that parental, particularly maternal, death is negatively associated with child outcomes. However, a better understanding of the mechanisms is needed. In addition, the way orphan disadvantage and the mechanisms giving rise to it are understood on the ground is essential for the successful translation of research into policies and programs. This study employs data from 89 in-depth interviews with caregivers and key informants in Lesotho, a setting where approximately one-quarter of adults is infected with HIV, to elaborate understandings of orphan disadvantage. Our analysis focuses on two questions: (i) Do local actors perceive orphans to be disadvantaged compared to non-orphans, and if so, in what ways; and (ii) How do they explain orphans’ differential disadvantage? Analyses suggest that orphans were widely perceived to be disadvantaged; respondents described this disadvantage in material as well as affective domains. Thematic analyses reveal five broad categories of explanation: poverty, love and kin connection, caregiver character, perceptions of orphans, and community norms related to orphan care. These results underscore the need for research and policy to address (i) multiple types of disadvantage, including deficits in kindness and attention; and (ii) the social embeddedness of disadvantage, recognizing that poverty, kinship, and community interact with individual attributes to shape caregiving relationships and child experiences. The findings suggest limited success for programs and policies that do not address the emotional needs of children, or that focus on child or caregiver support to the exclusion of community outreach.     

Techniques For Developing Health Quality of Life Scales for Point of Service Use

Clinical and health policy research frequently involves health status measurement using generic or disease specific instruments. These instruments are generally developed to arrive at several scales, each measuring a distinct domain of health quality of life (HQOL). Clinical settings are starting to explore how to integrate patient perspectives of HQOL outcomes into patient care. However, the length of many HQOL instruments poses a challenge in terms of patient burden, as well as clinic flow time. The most popular paradigm for scale construction utilizes classical test theory methodology and can lead to excessive and redundant items in an effort to bolster reliability measurements such as Cronbach’s alpha above levels of accepted reliability. This paper presents techniques for utilizing item response theory to arrive at single item scales that are diagnostically informative and short enough to have clinical utility. A danger of such dramatic scale reduction is that validity might be compromised. This danger is addressed in terms of criterion related validity and sensitivity to clinical changes over a 36 months period. The reduction methods are illustrated using selected scales from the Arthritis Impact Measurement Scales 2 (AIMS2) with data obtained from the study Pharmaceutical Care Outcomes: The Patient Role (PCOPR).     

Death and schooling decisions over the short and long run in rural Madagascar

This paper provides strong evidence that adult mortality has a negative impact on children educational outcomes, both over the short and the long run, in rural Madagascar. The underlying longitudinal data and the difference-in-differences strategy used overcome most of the previous cross-sectional study limitations, such as failure to control for child and household pre-death characteristics and unobserved heterogeneity. This paper also pays special attention to the heterogeneity, robustness, and long-run persistence of effects. Results show that orphans are on average 10 pp less likely to attend school than their nonorphaned counterparts, this effect being even more pronounced for girls and young children from poorer households. Results on adults further show that those orphaned during childhood eventually completed less education. These findings suggest that not only do households suffering unexpected shocks resort to schooling adjustments as an immediate risk-coping strategy, but also that adversity has long-lasting effects on human capital accumulation.     

Getting the first birth right: A retrospective study of outcomes for low-risk primiparous women receiving standard care versus midwifery model of care in the same tertiary hospital

BackgroundThere is national and international concern for increasing obstetric intervention in childbirth and rising caesarean section rates. Repeat caesarean section is a major contributing factor, making primiparous women an important target for strategies to reduce unnecessary intervention and surgeries in childbirth.AimThe aim was to compare outcomes for a cohort of low risk primiparous women who accessed a midwifery continuity model of care with those who received standard public care in the same tertiary hospital.MethodsA retrospective comparative cohort study design was implemented drawing on data from two databases held by a tertiary hospital for the period 1 January 2010 to 31 December 2011. Categorical data were analysed using the chi-squared statistic and Fisher's exact test. Continuous data were analysed using Student's t-test. Comparisons are presented using unadjusted and adjusted odds ratios, with 95% confidence intervals (CIs) and p-values with significance set at 0.05.ResultsData for 426 women experiencing continuity of midwifery care and 1220 experiencing standard public care were compared. The study found increased rates of normal vaginal birth (57.7% vs. 48.9% p = 0.002) and spontaneous vaginal birth (38% vs. 22.4% p = <0.001) and decreased rates of instrumental birth (23.5% vs. 28.5% p = 0.050) and caesarean sections (18.8% vs. 22.5% p = 0.115) in the midwifery continuity cohort. There were also fewer interventions in this group. No differences were found in neonatal outcomes.ConclusionStrategies for reducing caesarean section rates and interventions in childbirth should focus on primiparous women as a priority. This study demonstrates the effectiveness of continuity midwifery models, suggesting that this is an important strategy for improving outcomes in this population.     

Wild foods and household food security responses to AIDS: evidence from South Africa

Wild foods may offer unique benefits to households afflicted by AIDS, providing a nutritious and freely available food source at minimal labour and financial costs. This article presents the results of food security assessments in two rural South African sites. Detailed household dietary recalls from 227 households, combined with qualitative work, explored the association of household AIDS proxies (recent morbidity, mortality and orphan fostering) with household food security and dietary composition. The study found that AIDS-proxy households were significantly more food insecure, and households fostering orphans were both poorer and more food insecure. Wild foods were evident in 40.3% of the 48 h recalls, with significantly greater likelihood of use in households with fostering paternal orphans, and/or with at least one AIDS proxy. Only paternal orphans were significantly associated with likelihood of using wild foods when controlling for household socio-economic status. Qualitative data suggests that households afflicted by AIDS might curtail their use of wild foods due to household labour shortages and stigma. This is unfortunate, as regressions indicate that households using wild foods may be more economically resilient. This may be particularly important for households registering AIDS proxies, due to a demonstrated negative correlation between accumulated household AIDS proxies and household income.     

Development challenges and opportunities confronting economies in transition

“Economies in Transition” (hereafter EIT or EITs) are countries in the process of shifting from “command” to “more open”, liberalized, free market economic systems. In addition to achieving major structural adjustments to their economies, the transformational process requires the introduction of a high degree of transparency in both the economic and political spheres of society. The transfer of state assets to private ownership is one part of the process as well, as is the creation or opening of “political space” that permits the emergence of private enterprise, multiparty political systems, and the introduction of a broad range of non-governmental organizations that carry out missions and functions which people themselves prefer to perform. Thus, the process of economic transformation requires a major socio-political-economic paradigm shift...one that places people and their needs at the center of the transformational process. The process is extremely difficult to achieve and is fraught with many dangers for countries that enter into it without substantial guidance from more economically advanced countries. This paper reports on the social development successes and failures of 31 economies in transition over the 15-year period 1990–2005. Included in the analysis are EITs located in East and South East Asia (N = 5), Central and Eastern Europe (N = 10), all 12 members of the Commonwealth of Independent States including the Russian Federation (N = 12), Turkey (N = 1), and the three Baltic States of Estonia, Latvia and Lithuania (N = 3). Using the author’s extensively pre-tested Weighted Index of Social Progress (WISP), the paper reports data at three levels of analysis: (1) WISP performances for all 31 EITs-as-a-group; (2) sub-regional performances on the WISP and its component sub-indexes for each of the six EIT sub-regions included in the analysis; and (3) country-specific performances on the WISP for each of the 31 countries included in the analysis. An earlier version of this paper was presented at the 2006 International Symposium and Lecture Series on Social Policy sponsored by the Chinese Academy of Social Sciences and held on the campus of Beijing Normal University, Beijing, China, 24–27 August, 2006.     

Does midwifery continuity of care make a difference to women with perinatal mental health conditions: A cohort study,from Australia

BackgroundPerinatal mental health (PMH) conditions are associated with an increased risk of adverse perinatal outcomes including preterm birth. Midwifery caseload group practice (continuity of care, MCP) improves perinatal outcomes including a 24 % reduction of preterm birth. The evidence is unclear whether MCP has the same effect for women with perinatal mental health conditions.AimTo compare perinatal outcomes in women with a mental health history between MCP and standard models of maternity care. The primary outcome measured the rates of preterm birth.MethodsA retrospective cohort study using routinely collected data of women with PMH conditions between 1st January 2018 – 31st January 2021 was conducted. We compared characteristics and outcomes between groups. Multivariate logistic regression models were performed adjusting for a-priori selected variables and factors that differ between models of care.ResultsThe cohort included 3028 women with PMH, 352 (11.6 %) received MCP. The most common diagnosis was anxiety and depression (n = 723, 23.9 %). Women receiving MCP were younger (mean 30.9 vs 31.3, p = 0.03), Caucasian (37.8 vs 27.1, p < 0.001), socio-economically advantaged (31.0 % vs 20.2, p < 0.001); less likely to smoke (5.1 vs 11.9, p < 0.001) and with lower BMI (mean 24.3 vs 26.5, p < 0.001) than those in the standard care group. Women in MCP had lower odds of preterm birth (adjOR 0.46, 95 % CI 0.24–0.86), higher odds of vaginal birth (adjOR 2.55, 95 % CI 1.93–3.36), breastfeeding at discharge (adj OR 3.06, 95 % CI 2.10–4.55) with no difference in severe adverse neonatal outcome (adj OR 0.79, 95 % CI 0.57–1.09).ConclusionsThis evidence supports MCP for women with PMH. Future RCTs on model of care for this group of women is needed to establish causation.     

Investigating the Structural Validity of Ryff’s Psychological Well-Being Scales Across Two Samples

Ryff’s (1989b) Psychological Well-Being (PWB) scales measure six related constructs of human functioning. The present paper examined the validity of Ryff’s 6-factor PWB model, using data from a life events study (N = 401) and an organisational climate study (N = 679). Previous validation studies, using Confirmatory Factor Analysis (CFA), have identified alternative PWB models, but limitations include the use of shorter scale versions with items relating to a number of life domains within the same PWB factor, and failure to examine the influence of participants’ socio-demographic characteristics on PWB. In this study, Exploratory Factor Analysis (EFA) mostly found consistency in the PWB items and structure between the two studies whereby a 3-factor model delineated between items relating to Autonomy, Positive Relations and a super-ordinate factor comprising the other PWB factors. Using CFA, Goodness of Fit indices reached acceptable levels for the adjusted PWB model identified by the EFA, whilst differences between adjusted models of PWB previously identified in the literature were hardly evident. Post-hoc analysis by gender demonstrated socio-demographic effects on the structure and items that comprise PWB. Further development of PWB measures is needed to reflect its hierarchical and multi-dimensional nature. In the scales’ current form, the construct validation of the PWB factors will continue to be problematic and will fail to adequately evaluate the nature and impact of PWB.     

The Well-Being of 12 - to 16-Year-Old Adolescents and their Parents: Results from 1999 to 2003 Spanish Samples

This study adopts satisfaction with life as a whole and satisfaction with specific life domains as indicators to analyse the relationships between the well-being of 12 to 16-year-old adolescents and some related constructs such as self-esteem, perceived control and perceived social support. Well-being indicators from a 2003 Spanish sample using an 11-point scale (N = 1,634) are compared with an equivalent 1999 Spanish sample using a 5-point scale (N = 1,618). The different results obtained from the 2003 sample with a Principal Component Analysis (PCA) using a shorter and a longer list of life domains are also discussed. A sub-sample of the adolescents’ results from the 2003 sample are compared with their parents’ answers, using the same well-being indicators. Using a list of 8 life domains, and despite the change of scale used, overall results show no relevant changes in adolescents’ satisfaction with life domains between 1999 and 2003 in Spain and are in agreement with normative data expected from western societies [Cummins: 1998, Social Indicators Research 43, pp. 307–334; Cummins et al.: 2001, Australian Unity Well-being Index (Australian Centre on Quality of Life, Deakin University, Melbourne)]. Adolescents’ overall life satisfaction has been shown to correlate consistently with the other well-being related constructs. However, it clearly decreases with age over the period studied. The results also show that increasing the list of life domains has a major impact on the structure of the results obtained. When we compare results from parents with those from their own child, outstanding differences in well-being appear between generations: few domain satisfaction dimensions show significant correlation between parents and children and more than 20% of the population studied shows high discrepancies in the answers in four domains.     

Feeding Patterns and Emotional Care in Breastfed Infants

A number of studies have suggested breastfed infants have improved bonding and attachment or cognitive development outcomes. However, mechanisms by which these differences might develop are poorly understood. We used maternal time use data to examine whether exclusively breastfeeding mothers spend more time in close interactive behaviors with their infants than mothers who have commenced or completed weaning. Mothers (188) participating in a time use survey recorded infant feeding activities for 24 h over a 7 day period using an electronic device. Tracking was conducted at 3, 6, and 9 months postpartum. Data was collected for maternal activities including infant feeding and time spent in emotional care. The mothers of exclusively breastfed infants aged 3–6 months fed them frequently and total time spent in breastfeeding averaged around 17 h a week. Maternal time spent in emotional care was also substantial, and found to correlate positively with time spent breastfeeding. Exclusively breastfed infants received greatest amounts of emotional care from their mother, and exclusively formula fed infants the least. Mixed fed infants received more emotional care time than formula fed infants, but less than fully breastfed infants. These findings may help explain the differential cognitive developmental outcomes reported in the medical literature for breastfed and non breastfed infants.     

Pets and Human Health in Germany and Australia: National Longitudinal Results

The German and Australian longitudinal surveys analysed here are the first national representative surveys to show that (1) people who continuously own a pet are the healthiest group and (2) people who cease to have a pet or never had one are less healthy. Most previous studies which have claimed that pets confer health benefits were cross-sectional. So they were open to the objection that owners may have been healthier in the first place, rather than becoming healthier due to owning a pet. In both countries the data show that pet owners make about 15% fewer annual doctor visits than non-owners. The relationship remains statistically significant after controlling for gender, age, marital status, income and other variables associated with health. The German data come from the German Socio-Economic Panel in which respondents have been interviewed every year since 1984 (N  = 9723). Australian data come from the Australian National Social Science Survey 2001 (N  = 1246).     

Subjective Quality of Life in Zhuhai City,South China: A Public Survey Using the International Wellbeing Index

The study of subjective quality of life and its connotations in the People’s Republic of China is at a preliminary stage. Although there is an emerging body of literature on this topic, there are few datasets representative of the general public, particularly in Mainland China. This paper reports the findings of a public survey (N = 449) conducted in Zhuhai City, South China using the International Wellbeing Index (IWI). There were four main aims: (1) to judge whether residents were satisfied with their lives; (2) to compare the data with recent findings from Hong Kong and Macau; (3) to investigate the equivalence of the IWI in terms of its psychometric properties; and (4) to determine the applicability of the ‘Theory of Homeostasis Wellbeing’. The data indicated a moderate level of personal (PWI score = 64.4.) and national (NWI score = 57.4) wellbeing, consistent with recent findings from Hong Kong and Macau. The PWI score was within the normative range for non-Western countries, which indicates that the residents were, on the whole, satisfied with their lives. Although previously reported objective measures of quality of life in Zhuhai are lower than in Hong Kong and Macau, this is not reflected in this study’s subjective measures. This finding was interpreted in terms of the ‘Theory of Subjective Wellbeing Homeostasis’, and the specific situation in Zhuhai, as there seems to be an absence of factors (i.e., no harsh economic or social situation) which could drive subjective wellbeing below normal. Last, that the IWI demonstrated good psychometric performance in terms of its reliability, validity, and sensitivity, and concurred with previous published reports, it seems that the scale’s robustness generalises to Chinese samples.     

Did Australia’s Baby Bonus Increase Fertility Intentions and Births?

In May 2004, the Australian government announced a “Baby Bonus” policy, paying women an initial A$3,000 per new child. We use household panel data from the Household, Income and Labour Dynamics in Australia Survey (N = 14,932) and a simultaneous equations approach to analyze the effects of this bonus on fertility intentions and ultimately births. The results indicate that opportunity costs influence intentions and births in predictable ways. Fertility intentions rose after the announcement of the Baby Bonus, and the birth rate is estimated to have risen modestly as a result. The marginal cost to the government for an additional birth is estimated to be at least A$3,000 per new child. We use household panel data from the Household, Income and Labour Dynamics in Australia Survey (N = 14,932) and a simultaneous equations approach to analyze the effects of this bonus on fertility intentions and ultimately births. The results indicate that opportunity costs influence intentions and births in predictable ways. Fertility intentions rose after the announcement of the Baby Bonus, and the birth rate is estimated to have risen modestly as a result. The marginal cost to the government for an additional birth is estimated to be at least A126,000.