Examining the Non-Kin Support Networks of Orphaned Adolescents Participating in a Family-Based Economic Strengthening Intervention in Uganda

Background and Purpose: In sub-Saharan African (SSA) countries heavily affected by HIV/AIDS, the epidemic has had severe negative social, health and economic impacts on children, families and communities. As a result, economic strengthening and health promotion interventions are at the core of supporting families caring for orphaned children. However, the impact of participating in such interventions on the informal support networks of program participants is very limited. Yet, for orphaned children living in low resource communities with no public safety nets, where extended families are already overwhelmed by the increasing number of orphaned children and poverty, non-kin support networks- defined as relationship ties not based on blood or marriage, may be the only viable option to ensure children’s survival and wellbeing following the death of their parents. This paper examines the non-kin support networks for orphaned adolescents, and whether participating in a savings-led family-based economic strengthening intervention is associated with the identification and formation of non-kin support networks for orphaned adolescents living in HIV-impacted communities in Uganda.

Methods: Cross sectional data from a National Institute of Health (NIH) funded cluster randomized experiment for orphaned adolescents, called Bridges to the Future was analyzed. Participants (N=1321, 11-17 years) were randomly assigned to either the control condition receiving usual care services, or the treatment condition receiving usual care services PLUS a savings-led family-based economic strengthening intervention. Non-kin support networks were measured at 12-months post intervention initiation by: 1) identification of a supportive non-kin tie, 2) type of relationship, 3) frequency of contact, 4) time of receiving support, and 5) type of support received. Binary logistic regression analyses were conducted to examine the effect of participating in the intervention on each of the indicators of non-kin support networks, controlling for participants’ socio-demographic and household characteristics.

Findings: Results from the study indicate that: 1) social support networks for orphaned children are very small, limited, and usually consist of individuals with similar economic situations and challenges, 2) orphaned children are socially isolated and the threshold for non-kin supportive services is so low, that usual care services provided to the control condition appear instrumental in children’s survival and wellbeing, and 3) although participating in the intervention was not associated with non-kin support networks, availability of personal savings was associated with higher odds of identifying at least one supportive non-kin tie (OR=2.26, 95% CI=1.48, 3.44, p≤.001) and receiving support from non-kin ties following intervention initiation (OR=1.46, 95% CI=1.06, 2.0, p≤.05).

Implication and Conclusion: Findings from this study indicate that the extended family system is still the primary and a major source of social support to orphaned children in poor communities impacted by HIV. Therefore, in the absence of public safety-nets and public social welfare programs, building social assets over and above the provision of economic and financial resources that could support extended families increasingly taking in orphaned children is critical.