Larson Bruce A, Wambua Nancy, Masila Juliana, Wangai Susan, Rohr Julia, Brooks Mohamad, Bryant Malcolm
Center for Global Health and Development and Department of International Health, Boston University, Boston, MA, USA.
AIDS Care. 2013;25 Suppl 1(Suppl 1):S40-5. doi: 10.1080/09540121.2012.729807.
The Community-Based Care for Orphans and Vulnerable Children (CBCO) program operated in Kenya during 2006-2010. In Eastern Province, the program provided support to approximately 3000 orphans and vulnerable children (OVC) living in 1500 households. A primary focus of the program was to support savings and loan associations composed of OVC caregivers (typically elderly women) to improve household and OVC welfare. Cross-sectional data were collected in 2011 from 1500 randomly selected households from 3 populations: program participants (CBCO group, n=500), households in the same villages as program participants but not in the program (the local-community-group = Group L, n=300), and households living in nearby villages where the program did not operate (the adjacent-community-group, Group A, n=700). Primary welfare outcomes evaluated are household food security, as measured by the Household Food Insecurity Access instrument, and OVC educational attainment. We compared outcomes between the CBCO and the subset of Group L not meeting program eligibility criteria (L-N) to investigate disparities within local communities. We compared outcomes between the CBCO group and the subset of Group A meeting eligibility criteria (A-E) to consider program impact. We compared outcomes between households not eligible for the program in the local and adjacent community groups (L-N and A-N) to consider if the adjacent communities are similar to the local communities. In May-June 2011, at the end of the OVC program, the majority of CBCO households continued to be severely food insecure, with rates similar to other households living in nearby communities. Participation rates in primary school are high, reflecting free primary education. Among the 18-22 year olds who were "children" during the program years, relatively few children completed secondary school across all study groups. Although the CBCO program likely provided useful services and benefits to program participants, disparities continued to exist in food security and educational outcomes between program participants and their non-OVC peers in the local community. Outcomes for CBCO households were similar to those observed for OVC households in adjacent communities.
基于社区的孤儿和弱势儿童关爱项目（CBCO）于2006年至2010年在肯尼亚开展。在东部省，该项目为居住在1500个家庭中的约3000名孤儿和弱势儿童（OVC）提供支持。该项目的一个主要重点是支持由OVC照料者（通常是老年妇女）组成的储蓄和贷款协会，以改善家庭和OVC的福利。2011年，从3类人群中随机选取1500户家庭收集了横断面数据：项目参与者（CBCO组，n = 500）、与项目参与者同村但未参与项目的家庭（当地社区组 = L组，n = 300）以及居住在项目未开展的附近村庄的家庭（相邻社区组，A组，n = 700）。评估的主要福利成果是家庭粮食安全（通过家庭粮食无保障获取工具衡量）和OVC的教育程度。我们比较了CBCO组与L组中不符合项目资格标准的子集（L-N）之间的成果，以调查当地社区内部的差异。我们比较了CBCO组与A组中符合资格标准的子集（A-E）之间的成果，以考虑项目影响。我们比较了当地和相邻社区组中不符合项目资格的家庭（L-N和A-N）之间的成果，以考虑相邻社区是否与当地社区相似。在2011年5月至6月，即OVC项目结束时，大多数CBCO家庭仍然严重粮食不安全，其比率与附近社区的其他家庭相似。小学入学率很高，这反映了免费小学教育。在项目开展期间为“儿童”的18至22岁人群中，所有研究组中完成中学学业的儿童相对较少。尽管CBCO项目可能为项目参与者提供了有用的服务和福利，但项目参与者与其当地社区中的非OVC同龄人在粮食安全和教育成果方面仍然存在差异。CBCO家庭的成果与相邻社区中OVC家庭的成果相似。
