Intra-household differences in health seeking behaviour for orphans and non-orphans in an NGO-supported and non-supported sub-county of Luwero, Uganda.
OBJECTIVE
Comparing healthcare dynamics among orphans and non-orphans in an NGO supported and a non-supported sub-county so as to identify the level of equity.


METHODS
This was a cross-sectional unmatched case-control research. A sample of 98 orphans and 98 non-orphans in an NGO supported sub-county and a similar number in a control sub-county participated. For each child, a corresponding caregiver participated. Each respondent was interviewed. Analysis was comparative. Relationships between variables were ascertained using a X(2).


RESULTS
Fevers were the most common health problem. However, 14.3% of children reported an experience of diarrhoea in an NGO-supported sub-county as opposed to 85.7% in the control sub-county (p = 0.014). Twenty percent of children in the NGO supported sub-county reported skin infections compared to 80% in the control sub-county [p= 0.008]. When orphans fell sick, more caregivers in the supported sub-county consulted village clinics compared to self herbal-medication (p = 0.009). Majority of orphan caregivers compared to those for non-orphans in the control sub-county took their children to village clinics as opposed to health centres (p = 0.002). In the control sub-county, fewer caregivers responded to children's illness by buying medicines from drug-shops as opposed to taking them to village clinics [(p = 0.040).


CONCLUSIONS
There were some differences between orphans and non-orphans within each sub-county and between orphans in the two sub-counties. NGO support is critical in cultivating equity, compassion and non-discrimination. The extended family system in Africa was managing orphan care although it displayed cracks in support systems.
Muhwezi
Wilson Winstons
WW
Department of Psychiatry, Makerere University College of Health Sciences, School of Medicine, P.O. Box 7072, Kampala. wmuhwezi@med.mak.ac.ug
Muhangi
Denis
D
Mugumya
Firminus
F
D000293:Adolescent; D000328:Adult; D017028:Caregivers; D016022:Case-Control Studies; D002648:Child; D002669:Child Welfare; D054540:Child, Orphaned / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005581:Foster Home Care / Q000706:statistics & numerical data*; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019372:Orphanages; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014454:Uganda; D014837:Voluntary Health Agencies; D055815:Young Adult