Comparison of vulnerability of orphaned adolecsents to non-orphaned adolescents in the rural Hlabisa district of South Africa

Thesis (MPH)--University of Limpopo,2011.

BACKGROUND In an era of HIV/AIDS many children are growing up without parents. In rural Hlabisa District, KwaZulu Natal the rate of orphanhood has increased with HIV prevalence rates. Orphanhood increases with age and peaks at the adolescent range of 15-18 years. 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This has led many to be in a vulnerable position and their very livelihood threatened. OBJECTIVES To determine the age-sex distribution of adolescent orphans to non-orphan adolescents and to compare their education level and drop-out from school; sexuality and pregnancy; socio-economic, employment and emigration; dependence on government grants and to determine the health of both groups especially their HIV status. METHODS A Cross-Sectional Data Analysis Design using data from a longitudinal surveillance system of Africa Centre Demographic Information System in Hlabisa was made available. Use of regression analysis was done to investigate the relative risk to pregnancy, drop-out of school, living in poorer households, migration and HIV infection of orphans relative to non-orphans in adolescents, aged 15-18 years. 15 RESULTS In 2006, the year of study, there were 8609 adolescents (aged 15-18 years) who constituted 22.87% of all children (0-18 years). The overall orphanhood prevalence was 10.37%. In the orphanhood group, the prevalence increased significantly with age peaking around 16 years. 45.24% were orphans in the group of study (15-18 years). Paternal orphans were highest, followed by dual and then maternal. Majority of all adolescents acquired Grade 9 education but there was a gradual drop in attaining higher education from Grade 10 to 12 with fewer orphans reaching matriculation to non-orphans (4.22% and 5.32% respectively). Majority of adolescents left school and did nothing (56.39% among orphans and 53.3% among non-orphans). Pregnancy accounted for a significant drop-out of school among adolescent females (12.71% non-orphans, 10.27% orphans). Adolescent orphans were more likely to have ever had sex while there was no statistical difference in the odds of ever being pregnant (female only) and fathering a child (male only). Orphans were poorer and out-migrated. Orphans had a higher prevalence of HIV infection and perceived their general health was poor. 4.53% of adolescent orphans were assessing government grants than non-orphans (1.16%). CONCLUSION Orphan adolescents lived in significantly different socio-economic circumstances than non-orphaned adolescents. The high percentage of adolescent orphans in the study group poses a significant public health problem. Being an orphan is associated with increased vulnerability to lack of support. Intervention programmes to improve the plight of orphans needs government and community commitment.