Poverty, AIDS and child health: Identifying highest-risk children in South Africa

Background: Identifying children at the highest risk of negative health effects is a prerequisite to effective public health policies in Southern Africa. A central ongoing debate is whether poverty, orphanhood or parental AIDS most reliably indicates child health risks. Attempts to address this key...

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Main Authors: Cluver, L., Boyes, Mark, Orkin, M., Sherr, L.
Format: Journal Article
Published: Health and Medical Publishing Group 2013
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/31997
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author Cluver, L.
Boyes, Mark
Orkin, M.
Sherr, L.
author_facet Cluver, L.
Boyes, Mark
Orkin, M.
Sherr, L.
author_sort Cluver, L.
building Curtin Institutional Repository
collection Online Access
description Background: Identifying children at the highest risk of negative health effects is a prerequisite to effective public health policies in Southern Africa. A central ongoing debate is whether poverty, orphanhood or parental AIDS most reliably indicates child health risks. Attempts to address this key question have been constrained by a lack of data allowing distinction of AIDS-specific parental death or morbidity from other causes of orphanhood and chronic illness. Objectives: To examine whether household poverty, orphanhood and parental illness (by AIDS or other causes) independently or interactively predict child health, developmental and HIV-infection risks. Methods: We interviewed 6 002 children aged 10 - 17 years in 2009 - 2011, using stratified random sampling in six urban and rural sites across three South African provinces. Outcomes were child mental health risks, educational risks and HIV-infection risks. Regression models that controlled for socio-demographic co-factors tested potential impacts and interactions of poverty, AIDS-specific and other orphanhood and parental illness status. Results: Household poverty independently predicted child mental health and educational risks, AIDS orphanhood independently predicted mental health risks and parental AIDS illness independently predicted mental health, educational and HIV-infection risks. Interaction effects of poverty with AIDS orphanhood and parental AIDS illness were found across all outcomes. No effects, or interactions with poverty, were shown by AIDS-unrelated orphanhood or parental illness.Conclusions: The identification of children at highest risk requires recognition and measurement of both poverty and parental AIDS. This study shows negative impacts of poverty and AIDS-specific vulnerabilities distinct from orphanhood and adult illness more generally. Additionally, effects of interaction between family AIDS and poverty suggest that, where these co-exist, children are at highest risk of all.
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spelling curtin-20.500.11937-319972017-09-13T15:17:09Z Poverty, AIDS and child health: Identifying highest-risk children in South Africa Cluver, L. Boyes, Mark Orkin, M. Sherr, L. paediatrics HIV/AIDS child health poverty Background: Identifying children at the highest risk of negative health effects is a prerequisite to effective public health policies in Southern Africa. A central ongoing debate is whether poverty, orphanhood or parental AIDS most reliably indicates child health risks. Attempts to address this key question have been constrained by a lack of data allowing distinction of AIDS-specific parental death or morbidity from other causes of orphanhood and chronic illness. Objectives: To examine whether household poverty, orphanhood and parental illness (by AIDS or other causes) independently or interactively predict child health, developmental and HIV-infection risks. Methods: We interviewed 6 002 children aged 10 - 17 years in 2009 - 2011, using stratified random sampling in six urban and rural sites across three South African provinces. Outcomes were child mental health risks, educational risks and HIV-infection risks. Regression models that controlled for socio-demographic co-factors tested potential impacts and interactions of poverty, AIDS-specific and other orphanhood and parental illness status. Results: Household poverty independently predicted child mental health and educational risks, AIDS orphanhood independently predicted mental health risks and parental AIDS illness independently predicted mental health, educational and HIV-infection risks. Interaction effects of poverty with AIDS orphanhood and parental AIDS illness were found across all outcomes. No effects, or interactions with poverty, were shown by AIDS-unrelated orphanhood or parental illness.Conclusions: The identification of children at highest risk requires recognition and measurement of both poverty and parental AIDS. This study shows negative impacts of poverty and AIDS-specific vulnerabilities distinct from orphanhood and adult illness more generally. Additionally, effects of interaction between family AIDS and poverty suggest that, where these co-exist, children are at highest risk of all. 2013 Journal Article http://hdl.handle.net/20.500.11937/31997 10.7196/SAMJ.7045 Health and Medical Publishing Group fulltext
spellingShingle paediatrics
HIV/AIDS
child health
poverty
Cluver, L.
Boyes, Mark
Orkin, M.
Sherr, L.
Poverty, AIDS and child health: Identifying highest-risk children in South Africa
title Poverty, AIDS and child health: Identifying highest-risk children in South Africa
title_full Poverty, AIDS and child health: Identifying highest-risk children in South Africa
title_fullStr Poverty, AIDS and child health: Identifying highest-risk children in South Africa
title_full_unstemmed Poverty, AIDS and child health: Identifying highest-risk children in South Africa
title_short Poverty, AIDS and child health: Identifying highest-risk children in South Africa
title_sort poverty, aids and child health: identifying highest-risk children in south africa
topic paediatrics
HIV/AIDS
child health
poverty
url http://hdl.handle.net/20.500.11937/31997