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BackgroundIn Africa, approximately 25 million people live with HIV/AIDS and 12 million children are orphaned. Although evidence indicates that orphans risk losing opportunities for adequate education, health care, and future employment, the immediate effects of orphanhood on child nutritional status remain poorly understood.ObjectiveThis paper assesses the nutritional impact of orphanhood, with particular emphasis on taking account of various factors potentially confounding or masking these impacts.MethodsChild anthropometry and orphan status were examined in 23 Multiple Indicator Cluster Surveys and Demographic and Health Surveys throughout sub-Saharan Africa, which were subsequently merged into larger, region-specific datasets (East, West, and Southern Africa). To compare orphans and nonorphans, linear regression and probit models were developed, taking account of orphan status and type, presence of a surviving parent in the household, household structure, child age and sex, urban versus rural residence, and current wealth status.ResultsFew differences emerged between orphans and nonorphans in controlled and uncontrolled comparisons, regardless of orphan type, presence of surviving parent, or household structure. Age differentials did confound nutritional comparisons, although in the counterintuitive direction, with orphans (who were 8 months older on average) becoming less malnourished when age differences were taken into account. Wealth did appear to be associated with orphanhood status, although it did not significantly confound nutritional comparisons.ConclusionsOrphans were not consistently more malnourished than nonorphans, even when potential confounding variables were examined. Since household wealth status is likely to change after becoming affected by HIV, ruling out wealth as a potential confounder would require more detailed, prospective studies.

Combined data on micronutrient deficiencies (and underweight prevalences) were previously assembled for the Micronutrient Report in 2001 published by the Micronutrient Initiative and the International Development Research Centre. To update these data and understand recent trends we carried out a global survey of national micronutrient programs and survey results from 2001 to 2003 mainly through e-mail contact with governmental United Nations and nongovernmental offices in some 100 developing countries (referred to below as the "country survey"). The published literature and unpublished material were searched by various means including through on-line databases and web searching. The results described here were first used for the publication on "Vitamin and Mineral Deficiency" issued by Micronutrient Initiative and UNICEF in 2004 for which an early draft of the present results was provided. This document now presents the results on prevalences at the national regional and global (all developing countries) levels with further detail. Here the methods are recorded and the estimates are provided in tables figures and annexes. The information from countries responding to the questionnaire in the country survey (49 replied with new data) are available on file and certain of these have been transferred to the Web. (excerpt)

Background A 2004 UNICEF/UNAIDS/USAID survey in Blantyre, Malawi, examined methods to improve monitoring and evaluation of interventions aimed at orphans and vulnerable children. Objective A derivative of this larger study, the present study utilized the household data collected to assess differences in food security status among orphan households with the aim of helping food security programmers focus resources on the households most affected. Methods Orphan households were classified by number and type of orphans supported. Descriptive analyses and logistic regressions were performed to assess differential vulnerability to food insecurity according to these classifications. Results Multiple-orphan households and multiple-orphan households that cared for at least one foster child were 2.42 and 6.87 times more likely to be food insecure, respectively, than nonorphan households. No other category of orphan household was at elevated risk. Conclusions The food security impact of caring for orphans varied significantly among orphan households, requiring food security planners to focus resources on the households most heavily impacted by HIV/AIDS, including multiple-orphan households, rather than focusing on conventional designations of vulnerability, such as orphans and vulnerable children.