The Impact of a Comprehensive Microfinance Intervention on Depression Levels of AIDS-Orphaned Children in Uganda

doi:10.1016/j.jadohealth.2011.08.008

Journal of Adolescent Health

Volume 50, Issue 4, April 2012, Pages 346-352

https://doi.org/10.1016/j.jadohealth.2011.08.008 Get rights and content

Abstract

Purpose

By adversely affecting family functioning and stability, poverty constitutes an important risk factor for children's poor mental health functioning. This study examines the impact of a comprehensive microfinance intervention, designed to reduce the risk of poverty, on depression among AIDS-orphaned youth.

Methods

Children from 15 comparable primary schools in Rakai District of Uganda, one of those hardest hit by HIV/AIDS in the country, were randomly assigned to control (n = 148) or treatment (n = 138) conditions. Children in the treatment condition received a comprehensive microfinance intervention comprising matched savings accounts, financial management workshops, and mentorship. This was in addition to traditional services provided for all school-going orphaned adolescents (counseling and school supplies). Data were collected at wave 1 (baseline), wave 2 (10 months after intervention), and wave 3 (20 months after intervention). We used multilevel growth models to examine the trajectory of depression in treatment and control conditions, measured using Children's Depression Inventory (Kovacs).

Results

Children in the treatment group exhibited a significant decrease in depression, whereas their control group counterparts showed no change in depression.

Conclusions

The findings indicate that over and above traditional psychosocial approaches used to address mental health functioning among orphaned children in sub-Saharan Africa, incorporating poverty alleviation-focused approaches, such as this comprehensive microfinance intervention, has the potential to improve psychosocial functioning of these children.

Section snippets

Suubi (hope)-Uganda Project

This article is based on a pilot study of a comprehensive microfinance intervention (MH076475-01) funded by the National Institute of Mental Health (2005–2008). The study received institutional review board approval from Columbia University (AAA5337) and from the Uganda National Council of Science and Technology (SS 1540).

The intervention served AIDS-orphaned adolescents who were in their last year or two before the transition to secondary school, as this is the time when children begin to be

Descriptive results

As indicated in Table 1, the mean age for the youth in the study was 13.71 years. Girls represented 57% of the study sample; 39% of the children were double orphans (with no biological father or mother living), 19% maternal orphans (without a biological mother living), and 42% paternal orphans (with no biological father living). Only 37% of the children's primary caregivers reported some form of formal employment. The rest (63%) were self-employed or worked in the informal sector. Parental

Discussion

This study reports the results of a comprehensive microfinance intervention, which provided AIDS orphans in Uganda with a matched savings account they could use to pay for secondary schooling or to invest in family businesses, financial and business training workshops, and a mentorship program.

Participants in the Suubi intervention group showed a significant reduction in depression over time, whereas participants in the control group did not. One potential concern is that, despite

Acknowledgments

Funding for the Suubi-Uganda study came from the National Institute of Mental Health (R21 MH076475-01). The study received IRB approval from Columbia University (AAA5337) and the Uganda National Council of Science and Technology (SS 1540). The authors are grateful to Ms. Proscovia Nabunya (at the University of Chicago), Reverend Fr. Kato Bakulu, and Ms. Stacey Alicea for monitoring the study implementation process. They also thank all the children and their caregiving families who agreed to

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Original articleThe Impact of a Comprehensive Microfinance Intervention on Depression Levels of AIDS-Orphaned Children in Uganda

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Suubi (hope)-Uganda Project

Descriptive results

Discussion

Acknowledgments

Lancet

Soc Sci Med

Lancet

World Dev

Soc Sci Med

J Adolesc Health

J Adolesc Health

Lancet

Relationships between poverty and psychopathology: A natural experiment

JAMA

What if we could eliminate child poverty?

Soc Psychiatry Psychiatr Epidemiol

Trajectories of poverty and children's mental health

J Health Soc Behav

Poverty and child development: Relevance of research in developing countries to the United States

Child Dev

Family poverty, welfare reform, and child development

Child Dev

Orphans in Africa: Parental death, poverty, and school enrollment

Demography

The psychological effect of orphanhood: A study of orphans in Rakai district

Health Transit Rev

The mental health of children orphaned by AIDS: A review of international and southern African research

J Child Adolesc Ment Health

The psychological well-being of children orphaned by AIDS in Cape Town, South Africa

Ann Gen Psychiatry

Problem behavior of adolescents whose parents are living with AIDS

Am J Orthopsychiatry

Psychological well-being of orphans in Dar el Salaam, Tanzania

Acta Paediatr

Assessment of orphans and their caregivers' psychological well-being in a rural community in Central Mozambique

Original article
The Impact of a Comprehensive Microfinance Intervention on Depression Levels of AIDS-Orphaned Children in Uganda