Sub-Saharan Africa is home to approximately 53.6 million orphaned children, a majority of whom live in extreme poverty, often with relatives or guardians of limited means, and in households with many other dependent children. Children who live in poor households often do not have access to basic necessities such as shelter, food, clean water, health care, and education.
[Photo: Ms. Sylvia Shangani]
Orphaned and vulnerable adolescents (OVA) in sub-Saharan Africa are at greater risk for adverse psychological outcomes compared with their non-OVA counterparts. Poverty constitutes an important risk factor for adverse mental health outcomes among children, and those who live in the poorest households are more likely to experience negative psychological outcomes. To address poverty and its adverse child health and developmental consequences, economic incentives are increasingly used in African countries. Social interventions that provide cash transfers (CTs) have been shown to improve health outcomes among young people, but little is known about their impact on psychological wellbeing.
This study, supported by a grants from the NIH Fogarty International Center and the Eunice Kennedy Shriver National Institute of Child Health and Human Development and led by Sylvia Shangani, doctoral candidate in behavioral and social health sciences, assessed the association between living in a household that received monthly unconditional government CTs and psychological wellbeing.
Study authors examined the likelihood of depression, anxiety, post-traumatic stress symptoms, and positive future outlook among 655 OVA aged between 10 and 18 years who lived in 300 randomly selected households in western Kenya that either received or did not receive unconditional monthly CTs.
After adjusting for socio-demographic, caregiver, and household characteristics, and accounting for potential effects of participant clustering by sub-location of residence, OVA living in CT households were more likely to have a positive future outlook, less likely to be anxious, and less likely to have symptoms of post-traumatic stress. The study did not find statistically significant differences in odds of depression by CT group.
Because OVA in CT households reported better psychological wellbeing compared to those in households not receiving CTs, the study concludes that CT interventions may be effective for improving psychological wellbeing among vulnerable adolescents in socioeconomically deprived households. This study builds on the growing body of literature on how access to financial resources affects the psychological wellbeing of orphans and vulnerable children, especially in Africa where mental health care infrastructure and services remain highly inadequate.
This study was published in PLOS ONE, May 31, 2017.Brown