Academic journal article Demographic Research

Hotspots and Coldspots: Household and Village-Level Variation in Orphanhood Prevalence in Rural Malawi

Academic journal article Demographic Research

Hotspots and Coldspots: Household and Village-Level Variation in Orphanhood Prevalence in Rural Malawi

Article excerpt

Abstract

We explore the characteristics of households and villages in which orphans are resident in two areas of Malawi. We first review pertinent themes in qualitative data collected in our research sites. Then, using spatial analysis, we show how positive and negative clusters of orphans - which we term orphanhood "hotspots" and "coldspots" - can be found at the village and sub-village levels. In the third and longest section of the paper, and using multilevel analyses with both simple and complex variance structures, we evaluate the relationship between the presence of orphans and a range of individual, household and village-level characteristics, including households' spatial relationship to each other and to other local sites of significance. This series of analyses shows that the most important covariates of orphan presence are household size, wealth, and religious characteristics, with all measured simultaneously at both household and village-level. In addition, most of these have heterogenous effects across villages. We conclude by reviewing some difficulties in explaining causal mechanisms underlying these observed relationships, and discuss conceptual, theoretical and programmatic implications.

1. Introduction

Since the emergence of the AIDS pandemic, the fate of children of HIV+ adults has been on the academic and public policy radar, triggering research across a number of disciplines. Within demography and related fields, this research has predominantly been one of three types. The first has been concerned with estimating the scale of the orphanhood phenomenon (e.g., UNAIDS et al. 2002; Grassly et al. 2004). The second has focused on comparative outcomes of "AIDS orphans" and children whose parents are HIV-free, focusing in particular on morbidity, mortality, and schooling (e.g., Ainsworth and Semali 2000, Ainsworth and Filmer 2002, Bicego et al. 2003, Crampin et al. 2003, Case et al. 2004, Monasch and Boerma 2004, Mishra et al 2005, Sarker et al. 2005, Beegle et al. 2005, Ford and Hosegood 2005, Sharma 2005, Zaba et al. 2005, Andrews, Skinner and Zuma 2006). The third type of literature has looked more at the socio-cultural context within which AIDS-orphans' outcomes, like those of other types of orphans, are determined. In sub-Saharan Africa, this refers primarily to intrafamilial or communal systems of child-fostering (Seeley et al. 1993, Foster et al. 1997, Madhavan 2004, Nyamukapa and Gregson 2005).

Recently, this literature has also begun to benefit from the contribution of the geographical sciences. In particular, taking advantage of developments in Geographical Information System (GIS) capabilities, researchers have been laying the groundwork for mapping child-related outcomes, including mortality and orphanhood, whether as an end in itself, or as a means to more effectively direct health and educational infrastructure or other types of services (e.g., Balk et al. 2003, Abebe 2005, Erskine and Wilson 2005). In this paper we build on that emerging literature. We use a variety of data sources from two rural areas in Malawi in order to accomplish two specific aims. First, we describe the prevalence of orphanhood across the research area and, using geocoded household survey data, describe the spatial distribution of orphans at the household level in order to identify high- and low-prevalence orphanhood clusters. Second, in order to identify the characteristics of high- and low-orphan prevalence areas, we explore the association between orphan prevalence, changes in orphan prevalence, and several types of village- and household-level characteristics. Both aims, we suggest, address a missing empirical area in orphan-related research that, in turn, make it difficult to fully describe types of orphan trajectories or, more generally, to address the medium- and long-term consequences of orphanhood.

2. Setting and data

Malawi is an appropriate setting for this study for a number of reasons. …

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