title: Family economic strengthening and mental health functioning of caregivers for AIDS-affected children in rural Uganda.
abstract: In sub-Saharan Africa, many extended families assume the role of caregivers for children orphaned by AIDS (AIDS-affected children). The economic and psychological stress ensued from caregiving duties often predispose caregivers to poor mental health outcomes. Yet, very few studies exist on effective interventions to support these caregivers. Using data from a randomized controlled trial called Suubi-Maka (N= 346), this paper examines whether a family economic strengthening intervention among families caring for AIDS-affected children (ages 12-14) in Uganda would improve the primary caregivers' mental health functioning. The Suubi-Maka study comprised of a control condition (n= 167) receiving usual care for AIDS-affected children, and a treatment condition (n= 179) receiving a family economic strengthening intervention, including matched savings accounts, and financial planning and management training to incentivize families to save money for education and/or family-level income generating projects. This paper uses data from baseline/pre-intervention (wave 1) interviews with caregivers and 12-month post-intervention initiation (wave 2). The caregiver's mental health measure adapted from previous studies in sub- Saharan Africa had an internal consistency of .88 at wave 1 and .90 at wave 2. At baseline, the two study groups did not significantly differ on caregiver's mental health functioning. However, at 12-month follow-up, multiple regression analysis located significant differences between the two study groups on mental health functioning. Specifically, following the intervention, caregivers in the treatment condition reported positive improvements on their mental health functioning, especially in the symptom areas of obsession-compulsion, interpersonal sensitivity, hostility, and psychoticism. Findings point to a need for programs and policies aimed at supporting caregivers of AIDS-affected children to begin to consider incorporating family-level economic strengthening components in their usual care protocols, especially in low-resource countries of sub-Saharan Africa. Economic empowerment programming may help enhance the well-being of caregivers and their families.
authors.affiliation: School of Social Work, Columbia University, New York, NY, USA.
authors.forename: Julia Shu-Huah
authors.initials: JS
authors.lastname: Wang
authors.affiliation: School of Social Work, Columbia University, New York, NY, USA ; School of Social Work and School of International and Public Affairs, Columbia University, New York, NY, USA.
authors.forename: Fred M
authors.initials: FM
authors.lastname: Ssewamala
authors.affiliation: Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea.
authors.forename: Chang-Keun
authors.initials: CK
authors.lastname: Han
keywords: Uganda; children savings accounts; mental health; orphaned children caregivers; sub-Saharan Africa