How can we improve healthcare access and general self-rated health among orphans and vulnerable children? Findings from a Kenyan cross-sectional study.
OBJECTIVE
This study analyzes healthcare access and general self-rated health (GSRH) among orphan and vulnerable child (OVC) households enrolled in an empowerment program in Eastern Province, Kenya. Analyses investigate whether reported monthly income mediates the association between program participation and medical security. Predictors of GSRH are also investigated.


METHODS
Cross-sectional survey data on families (n = 707) participating in a multisectoral empowerment program were collected in June 2012. Regression methods were used to investigate study aims.


RESULTS
Monthly income mediated 14.3 % of the total effect of program participation on healthcare accessibility. Program participation was not significantly associated with higher GSRH.


CONCLUSIONS
Increased reported monthly income predicted improved healthcare access, but only explained a portion of improved healthcare access in the study population. Partnerships between community-based empowerment programs and clinical providers might successfully target multiple outcomes among OVC, including improved healthcare access, though further research on potential synergies is required. GSRH was associated with increased access to food, medical care, literacy, safe drinking water and household income. Further research on GSRH among OVC should target measurement validity, potential sources of disparity in GSRH between OVC and non-OVC, and targets for improving GSRH among OVC.
Sodzo International, Houston, USA, mlgoodman15@gmail.com.
Michael L
ML
Goodman
Sarah E
SE
Seidel
Reegan
R
Kaberia
Philip H
PH
Keiser
D000293:Adolescent; D002648:Child; D002669:Child Welfare; D054540:Child, Orphaned; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D005523:Food Supply; D006297:Health Services Accessibility / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D007182:Income; D007630:Kenya; D000067010:Literacy; D008297:Male; D057566:Self Report; D035862:Vulnerable Populations; D014881:Water Supply; D055815:Young Adult