HIV/AIDS and well-being of children in sub-Saharan Africa: A cross-national comparative analysis
Lead Research Organisation:
City, University of London
Department Name: School of Social Sciences
Abstract
The scale and impact of HIV/AIDS on various aspects of development throughout the world are staggering. The impact is most profoundly reflected in the lives of children, whose very survival and development are at jeopardy. Despite the large number of on-going initiatives to address the crisis of AIDS orphans and vulnerable children in sub-Saharan Africa, responding to the crisis of children affected by HIV/AIDS has not yet received the global priority attention it deserves. Stronger data and evidence has been identified as one of the key challenges to global response. Although previous studies have made an important contribution to the understanding of the situation of children affected by AIDS in sub-Saharan Africa, consistent patterns are yet to emerge for various indicators. Furthermore, the adverse impact of the HIV/AIDS crisis is evolving very quickly, calling for up-to-date strong evidence to inform on-going global and national efforts. This study builds on evidence from previous work to carry out a comprehensive analysis of the link between HIV/AIDS and the well-being of children at different stages in life.
The study will take advantage of the recent international Demographic and Health Survey data on HIV/AIDS infection to incorporate analysis of the experiences of children whose parents are infected with HIV/AIDS, an area that has received little attention in previous large-scale studies. The comparative nature of DHS data, along with the availability of HIV/AIDS test data from recent surveys, provides a unique opportunity for a comparative study of the situation of children in different contexts with respect to the HIV/AIDS epidemic. The study will focus on the well-being of children with respect to: health and nutritional status during infancy and early childhood; educational experiences (from middle childhood); and sexual/reproductive health during adolescence. The application of advanced statistical approaches will help clarify the interplay of various factors involved, including contextual community-level and country-level factors, and variations across countries.
The findings will be widely disseminated through various channels to reach the diverse target audience. In addition to the scientific articles, 20 sets of policy briefs will report key findings in easily accessible format for policy makers. National policy briefs will focus on country-specific findings for each of the 19 countries with DHS HIV/AIDS data, while the final set of briefs will provide a broader cross-national picture for sub-Saharan Africa region, targeting primarily the international audience and global efforts to address the plight of children affected by HIV/AIDS.
The study will take advantage of the recent international Demographic and Health Survey data on HIV/AIDS infection to incorporate analysis of the experiences of children whose parents are infected with HIV/AIDS, an area that has received little attention in previous large-scale studies. The comparative nature of DHS data, along with the availability of HIV/AIDS test data from recent surveys, provides a unique opportunity for a comparative study of the situation of children in different contexts with respect to the HIV/AIDS epidemic. The study will focus on the well-being of children with respect to: health and nutritional status during infancy and early childhood; educational experiences (from middle childhood); and sexual/reproductive health during adolescence. The application of advanced statistical approaches will help clarify the interplay of various factors involved, including contextual community-level and country-level factors, and variations across countries.
The findings will be widely disseminated through various channels to reach the diverse target audience. In addition to the scientific articles, 20 sets of policy briefs will report key findings in easily accessible format for policy makers. National policy briefs will focus on country-specific findings for each of the 19 countries with DHS HIV/AIDS data, while the final set of briefs will provide a broader cross-national picture for sub-Saharan Africa region, targeting primarily the international audience and global efforts to address the plight of children affected by HIV/AIDS.
Technical Summary
The relationship between HIV/AIDS and the well-being of children is a complex one, encompassing a range of economic, psycho-social, demographic and health-related factors. Children may be affected by parents? HIV/AIDS infection in a number of ways: they themselves may become infected through vertical transmission;or may become caregivers when parents become ill; or become orphans when parent(s) die. These conditions are associated with various psycho-social and economic problems which may affect the well-being of children with respect to their health and nutritional status (during early childhood), education (from middle childhood), and sexual/reproductive health (during adolescence). The main objectives of the proposed study are to: determine factors associated with HIV/AIDS infection; examine the association between HIV/AIDS prevalence and orphanhood rates within communities; and examine the effect of orphanhood and HIV/AIDS status of parents on the health and well-being of children.
The proposed study is based on existing data from the international Demographic and Health Surveys (DHS) programme from different countries in sub-Saharan Africa. Data on HIV/AIDS infection are available from a total of 19 countries in sub-Saharan Africa where recent DHS have collected HIV/AIDS infection data from nationally-representative population-based samples. These datasets will form the focus of this study. The DHS data will be complemented with survey data from the 2004 Protecting the Next Generation (PNG): National Survey of Adolescents in Burkina Faso, Ghana, Malawi and Uganda project, for a more detailed examination of adolescent sexual and reproductive health in these settings.
This study will use regression models to investigate factors associated with HIV/AIDS infection, followed with an examination of the association between HIV/AIDS prevalence and orphanhood rates at community and country level, before focussing on the link between orphanhood status and HIV/AIDS infection on the one hand, and the well-being of children on the other. The latter will include comparisons of the relative disadvantage of different groups of orphans and vulnerable children, with particular reference to whether or not orphans are worse off than children whose parents are infected with HIV/AIDS. Throughout the analysis, emphasis will be placed on differences between boys and girls, as well as cross-national variations. Each set of analysis will begin with analysis of data for individual countries, before pooling data to examine patterns for the sub-Saharan Africa region. The analysis will feature multilevel modelling to take into account the hierarchical data structure (within and across countries) as well as examine contextual community-level and country-level factors.
The proposed study is based on existing data from the international Demographic and Health Surveys (DHS) programme from different countries in sub-Saharan Africa. Data on HIV/AIDS infection are available from a total of 19 countries in sub-Saharan Africa where recent DHS have collected HIV/AIDS infection data from nationally-representative population-based samples. These datasets will form the focus of this study. The DHS data will be complemented with survey data from the 2004 Protecting the Next Generation (PNG): National Survey of Adolescents in Burkina Faso, Ghana, Malawi and Uganda project, for a more detailed examination of adolescent sexual and reproductive health in these settings.
This study will use regression models to investigate factors associated with HIV/AIDS infection, followed with an examination of the association between HIV/AIDS prevalence and orphanhood rates at community and country level, before focussing on the link between orphanhood status and HIV/AIDS infection on the one hand, and the well-being of children on the other. The latter will include comparisons of the relative disadvantage of different groups of orphans and vulnerable children, with particular reference to whether or not orphans are worse off than children whose parents are infected with HIV/AIDS. Throughout the analysis, emphasis will be placed on differences between boys and girls, as well as cross-national variations. Each set of analysis will begin with analysis of data for individual countries, before pooling data to examine patterns for the sub-Saharan Africa region. The analysis will feature multilevel modelling to take into account the hierarchical data structure (within and across countries) as well as examine contextual community-level and country-level factors.
