Collins Lisa, Ellis Matthew, Pritchard Edward W J, Jenkins Christopher, Hoeritzauer Ingrid, Farquhar Adam, Laverty Orla, Murray Vincent, Nelson Brett D
School of Medicine, University of Bristol , UK.
Paediatr Int Child Health. 2016 Feb;36(1):58-63. doi: 10.1179/2046905514Y.0000000152. Epub 2014 Nov 2.
An important but neglected consequence of the AIDS pandemic that continues across sub-Saharan Africa is the phenomenon of child-headed households (CHH). This study aims to describe the challenges to health and well-being for young people living in child-headed households.
A mixed-methods research approach linked common themes using qualitative and quantitative instruments to provide a broad picture of the location and challenges of CHH in Kabira, Kyotera and Kamuganja in the Rakai District of southern Uganda. Local knowledge was used to locate CHH.
163 children living in 40 CHH were traced: 42·5% of the household heads were double orphans caring for younger siblings, and 43% were also caring for chronically ill or disabled grandparents who were economically unproductive and largely dependent on the eldest child for survival. It was found that those heading households were more likely not to attend school than children living at home with a parent. Their immediate needs ranged from food and shelter to health-care and education. Fear was a major theme: 38% of those interviewed reported fear of 'violence'. Children as young as 13 were responsible for navigating through complex decision-making processes from everyday basic necessities to decisions on the health care of younger siblings and grandparents.
Children and young people living in CHH are a largely invisible and highly vulnerable population. Clear, officially accepted definitions of CHH are a first step in recognising this vulnerable group for whom safeguards will be necessary as social work develops in lower- and middle-income countries (LMICs). The precise numbers of CHH are unknown and further examination of this undocumented group is needed.
在撒哈拉以南非洲持续蔓延的艾滋病疫情产生了一个重要但被忽视的后果，即出现了儿童当家的家庭（CHH）现象。本研究旨在描述生活在儿童当家家庭中的年轻人在健康和福祉方面面临的挑战。
采用混合研究方法，运用定性和定量工具将共同主题联系起来，以全面了解乌干达南部拉凯区卡比拉、基奥泰拉和卡穆甘贾的儿童当家家庭的分布情况及面临的挑战。利用当地知识来确定儿童当家家庭的位置。
追踪到了生活在40个儿童当家家庭中的163名儿童：42.5%的户主是照顾弟弟妹妹的双亲孤儿，43%的户主还照顾身患慢性病或残疾且没有经济生产能力、主要依靠最大的孩子生存的祖父母。研究发现，与和父母同住的孩子相比，当家的孩子更有可能不上学。他们的迫切需求从食物、住所到医疗保健和教育不等。恐惧是一个主要问题：38%的受访者表示害怕“暴力”。年仅13岁的儿童就要负责应对从日常基本必需品到弟弟妹妹和祖父母医疗保健决策等复杂的决策过程。
生活在儿童当家家庭中的儿童和年轻人基本上是一个不为人所见且极易受伤害的群体。明确、官方认可的儿童当家家庭定义是认识这一弱势群体的第一步，随着中低收入国家（LMICs）社会工作的发展，有必要为他们提供保障。儿童当家家庭的确切数量尚不清楚，需要对这一未被记录的群体进行进一步研究。
