How can we improve healthcare access and general self-rated health among orphans and vulnerable children? Findings from a Kenyan cross-sectional study
This study analyzes healthcare access and general self-rated health (GSRH) among orphan and vulnerable child (OVC) households enrolled in an empowerment program in Eastern Province, Kenya. Analyses investigate whether reported monthly income mediates the association between program participation and medical security. Predictors of GSRH are also investigated.
Cross-sectional survey data on families (n = 707) participating in a multisectoral empowerment program were collected in June 2012. Regression methods were used to investigate study aims.
Monthly income mediated 14.3 % of the total effect of program participation on healthcare accessibility. Program participation was not significantly associated with higher GSRH.
Increased reported monthly income predicted improved healthcare access, but only explained a portion of improved healthcare access in the study population. Partnerships between community-based empowerment programs and clinical providers might successfully target multiple outcomes among OVC, including improved healthcare access, though further research on potential synergies is required. GSRH was associated with increased access to food, medical care, literacy, safe drinking water and household income. Further research on GSRH among OVC should target measurement validity, potential sources of disparity in GSRH between OVC and non-OVC, and targets for improving GSRH among OVC.
KeywordsHealth care access General self-rated health OVC Kenya
- Amuyunzu-Nyamongo M, Taffa N (2004) The triad of poverty, environment and child health in Nairobi informal settlements. J Health Popul Dev Ctries, [online]. http://www.jhpdc.unc.edu
- Andrews G, Skinner D, Zuma K (2006) Epidemiology of health and vulnerability among children orphaned and made vulnerable by HIV/AIDS in sub-Saharan Africa 1 Paper presented at the OVC roundtable at the 7th AIDS Impact Conference, Cape Town, April, 2005. AIDS care 18(3):269–276Google Scholar
- Bain R, Wright J, Yang H, Pedley S, Gundry S, Bartram J (2012) Improved but not necessarily safe: water access and the Millennium Development Goals [GWF Discussion Paper 1225]. Canberra: global water forum. http://www.globalwaterforum.org/wp-content/uploads/2012/07/Improved-but-not-necessarily-safe_Water-access-and-the-Millennium-Development-Goals_GWF1225.pdf. Accessed 12 Mar 2015
- Goodman ML, Kaberia R, Morgan RO, Keiser, PH (2014) Health and livelihood outcomes associated with participation in a community-based empowerment program for orphan families in semirural Kenya: a cross-sectional study. Vulnerable Child Youth Stud 9(4):365–376. doi: 10.1080/17450128.2014.938142
- Hosseinpoor AR, Victora CG, Bergen N, Barros A, Boerma T (2011) Towards universal health coverage: the role of within-country wealth-related inequality in 28 countries in sub-Saharan Africa. Bull World Health Organ 89(12):881–889. doi: 10.1590/S0042-96862011001200011 PubMedCentralPubMedCrossRefGoogle Scholar
- Mishra V, Bignami-Van Assche S (2008) Orphans and vulnerable children in high HIV prevalence countries in sub-Saharan Africa. Calverton, Maryland: Macro International. http://www.measuredhs.com/pubs/pdf/AS15/AS15.pdf. Accessed 2 Jan 2015
- Ssewamala FM, Han CK, Neilands TB (2009) Asset ownership and health and mental health functioning among AIDS-orphaned adolescents: findings from a randomized clinical trial in rural Uganda. Soc Sci Med 69(2):191–198Google Scholar