Impact of Asset Accumulation in Subsidized Child Savings Accounts On AIDS-Orphaned Adolescents' Psychosocial Functioning in Uganda

Purpose: We use the cluster-randomized longitudinal experimental intervention study to 1) examine the effect of asset accumulation in subsidized child savings accounts on orphaned adolescents’ psychosocial functioning; and 2) examine whether reported savings by adolescents and their families in the course of intervention moderate the effect of the intervention on the indicated outcomes. The study is based on asset-based approach arguing that asset accumulation for adolescents is associated with reduced depression levels, higher self-esteem, and higher educational aspirations of adolescents (Han, Ssewamala, & Wang, 2013; Ssewamala & Ismayilova, 2009; Ssewamala, Neilands, Waldfogel, & Ismayilova, 2011).

Method: We use panel data from experimental intervention in which treatment group participants received matched savings accounts, financial training, and mentorship sessions. Data (N=346 dyads, that is adolescents and their caregivers) was collected at baseline, 12-month, and 24-month follow-up. Multilevel regression is used, and differential changes in outcome variables over time are measured at 12 months and at 24 months.

To measure adolescents’ psychosocial perceptions of themselves, we use Child’s Tennessee Self-Concept scale consisting of 20 items. To measure adolescents’ feelings about the future, we use Beck Hopelessness Scale consisting of 20 items. To measure adolescents’ educational aspirations, we use adolescents’ response to question “How far do you really believe you will go in school?”.

We use adolescent’s age and gender, caregiver’s age and gender, duration of adolescent living with current caregiver, household size, orphanhood status (whether adolescent reported mother not being alive, father not being alive, or both parents not being alive), adolescent’s physical health (excellent, good, fair, and poor), caregiver’s physical health, and caregiver’s HIV/AIDS status as control variables.

Results: Our findings demonstrate significant effect of asset accumulation in subsidized child savings accounts on orphaned adolescents’ psychological wellbeing. At Wave 3, adolescents in the treatment group reported higher scores on Tennessee Self-Concept scale (B= 3.5, 95% CI= 0.8; 6.2, p<0.01) and lower scores on the Beck Hopelessness Scale (B= -1.6, 95% CI= -2.3; -0.8, p<0.000), compared to adolescents in the control group. Adolescent’s gender, orphanhood status, and adolescent’s reported health status were among the statistically significant covariates.

In regard to education aspirations, the effect of intervention was significant at Wave 2—adolescents in the treatment group reported having higher education aspirations (B= 0.4, 95% CI= 0.002; 0.7, p<0.05), compared to adolescents in the control group. Results, however, did not hold at Wave 3.

Results demonstrate significant moderator effect of savings on adolescent’s reported self-concept.

Conclusion and Implications: Poverty stigma associated with vulnerability and living in poverty may lead to negative valuing of self through social comparisons, which, in its turn, decreases self-esteem. Our findings point to the importance of economic empowerment—over and above usual care for orphaned adolescents—in addressing AIDS-orphaned adolescents’ psychosocial functioning.

This is an important finding given that adolescents’ self-concept and self-esteem—while being an important indicator of psychological wellbeing—are strongly associated with their health outcomes, sexual risk-taking behavior, educational performance, and economic prospects during the adulthood.