Assessing the "orphan effect" in determining development outcomes for children in 11 eastern and southern african countries

There are more than 45 million orphaned children in sub-Saharan Africa, 11.4 million because of AIDS - representing approximately 80% of all such orphans worldwide. Programming for orphans is therefore a major policy issue. This article uses the latest publicly available Demographic Health Survey data from 11 eastern and southern African countries to provide a snapshot of the distribution and demographic character-istics of orphans, and to test whether orphans have worse outcomes along a series of socioeconomic outcomes. While the analysis is primarily descriptive, multivariate ana-lysis is undertaken to determine whether orphan/non-orphan differences persist after controlling for age, region of residence and household wealth. Results show, among other things, that while orphan prevalence is higher in urban areas, the majority of orphans live in rural areas. Furthermore, while urban orphans appear to be more vulnerable than their urban peers the most vulnerable children in the region are, in fact, living in rural areas. Multivariate regression analysis also revealed that after control-ling for other cofounders, orphan status per se is not the most important negative determinant of children's wellbeing. Gender and region of residence are much more important predictors of poor schooling outcomes, and for all outcomes household wealth is the single most important correlate of better outcomes, with the threshold falling typically between the second and third quintiles. While orphanhood is clearly one important dimension of child vulnerability, other factors are not only important but in some cases have a much stronger quantitative association with child development (e.g. household poverty). Overall social policy as well as the targeting of specific interventions should recognize this fact, and approach child development in a holistic and integrated manner; for example combining specific orphan services such as psy-chosocial support within broader poverty alleviation and social protection program-ming such as social cash transfers, school bursaries and health service fee waivers.