Survival, family conditions and nutritional status of motherless orphans in the West Bank, Palestine.
OBJECTIVE
This study describes survival, family care and growth of the orphans of women dying at reproductive age (15-49 years) in the West Bank, Palestine, in 2000 and 2001.


METHODS
One hundred and sixty-seven children who were below 5 years of age at the time of the mother's death were identified. Three had died soon after birth. The family situation for the remaining 164 children was recorded. A planned baseline study could not be done at that time, due to the escalating political violence in the study area. In 2004, an average of 3 years after the mother's death, all orphan families were contacted. Of the 164 orphans, six had left the country with their fathers, and six could not be reached, due to restricted mobility. Home interviews were conducted with the 148 orphans' custodians/care-takers. Family situation and orphans' health status as judged by the interviewees were investigated, and are presented in descriptive statistics. Orphan weight and height were measured, and rates of wasting and stunting were calculated and analysed by gender.


RESULTS
The most striking finding is the high survival rate among the orphans. With the exception of the three neonatal deaths, all orphans who could be reached were alive. Almost all lived with their fathers, most of whom had remarried shortly after the death of their wives, and a stepmother had joined the family in 85% of the cases. Of the orphans under 5 years of age at the time of the interview, 8.8% and 17.6%, respectively, suffered from wasting and stunting, all of whom were girls. These rates were higher than those in the national data from 2003 for Palestinian children.


CONCLUSIONS
Early family reconstruction is suggested to be a contributing factor to the high survival rate. Close monitoring of motherless orphans' health and nutritional status, with a special emphasis on orphan girls, should be ensured.
Division of International Health, Karolinska Institute, Stockholm, Sweden. aladili@p-ol.com
Nadim
N
Al-Adili
Mohammad
M
Shaheen
Staffan
S
Bergstrom
Annika
A
Johansson
D000293:Adolescent; D000328:Adult; D002648:Child; D002655:Child Custody; D046688:Child Mortality; D002669:Child Welfare; D054540:Child, Orphaned / Q000706:statistics & numerical data; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D009752:Nutritional Status; D012737:Sex Factors; D012959:Socioeconomic Factors