Department of Public Health Sciences, UNC Charlotte, 9201 University City Blvd., Charlotte, NC 28223, USA.
Matern Child Health J. 2012 Aug;16(6):1232-40. doi: 10.1007/s10995-011-0849-y.
The objective of this study is to examine the relationship between a vulnerable child's family composition (family size and primary caregiver) and three child well-being indicators (immunization status, access to food, educational security). Using 2006-2009 intake data from a Kenyan non-governmental aid agency, this cross-sectional study evaluated a population of 1,424 children in two urban slum settlements in Nairobi. Logistic regression was used to obtain adjusted odds ratios and 95% confidence intervals to examine the relationship between family composition measures and child well-being. Multivariate results were also stratified by orphan status. Vulnerable children who live in household sizes of 4-6 members and vulnerable children who live with non-relatives had greater odds of inadequate immunization (OR = 1.51, 95% CI: 1.13-2.01, OR = 9.02, 95% CI: 4.62-17.62). Paradoxically, vulnerable children living with non-relative caregivers were at lower risk for inadequate food (OR = 0.19, 95% CI 0.07-0.33). Single orphans with an HIV positive parent were less likely to be fully immunized than single orphans with an HIV negative parent. The results provide information on specific groups which could benefit from increased attention related to childhood immunization education and intervention programs. The findings also underscore the need for policies which support families as a means of supporting vulnerable children. Finally, findings reinforce the wisdom of programs which target vulnerable children based on needs, rather than orphan status. These findings can be useful for informing future program and policy development designed to meet needs of vulnerable children.
本研究旨在探讨脆弱儿童的家庭构成（家庭规模和主要照顾者）与儿童福祉的三个指标（免疫状况、获得食物、教育保障）之间的关系。本横断面研究使用肯尼亚一个非政府援助机构 2006-2009 年的入组数据，评估了内罗毕两个城市贫民窟的 1424 名儿童。采用逻辑回归获得调整后的优势比（OR）和 95%置信区间（CI），以检验家庭构成措施与儿童福祉之间的关系。多变量结果也按孤儿状况进行分层。与居住在 4-6 人家庭的脆弱儿童和与非亲属居住的脆弱儿童相比，免疫接种不足的可能性更大（OR=1.51，95%CI：1.13-2.01，OR=9.02，95%CI：4.62-17.62）。矛盾的是，与非亲属照顾者一起生活的脆弱儿童获得不足食物的风险较低（OR=0.19，95%CI 0.07-0.33）。单亲艾滋病毒阳性儿童的完全免疫接种率低于单亲艾滋病毒阴性儿童。研究结果提供了有关特定群体的信息，这些群体可能需要加强儿童免疫教育和干预方案的关注。这些发现还强调了需要支持家庭的政策，以支持脆弱儿童。最后，研究结果强调了根据需求而不是孤儿状况来确定脆弱儿童目标的方案的合理性。这些发现可为制定旨在满足脆弱儿童需求的未来方案和政策提供参考。
