title: FACTORS ASSOCIATED WITH INTERNALISING PROBLEMS IN ORPHANS AND THEIR CAREGIVERS IN RURAL MOZAMBIQUE.
abstract: OBJECTIVE
  To compare internalising problems reported by orphans and their caregivers with that of non-orphans and their caregivers.
  
  
  METHODS
  Case control study.
  
  
  METHODS
  Cahora-Bassa District of Tete, Mozambique
  
  
  METHODS
  Seventy-six maternal or double orphans (aged 10-14 years) and their caregivers were compared with seventy-four non-orphans and their caregivers living in the same neighbourhood.
  
  
  METHODS
  children were interviewed with a semi-structured questionnaire concerning their internalising problems, family structure, school attendance, daily experiences and perceived problems. The children's primary caregivers were also interviewed concerning their depressive symptoms, available social support, socio-economic conditions and perceived problems.
  
  
  RESULTS
  Orphans lived in poorer households than non-orphans and reported more internalising symptoms and more economic and psychosocial disadvantages. Orphan caregivers were more depressed and had less social support than non-orphan caregivers. Child internalising symptoms were independently associated with bullying (B = 8.04, 95% CI: 0.24,15.85), perceived undeserved punishment (B = 11.98, 95% CI: S.98,17.98) and orphan status (B = 33.36, 95% CI: 26.67, 40.05). The effect of punishment was stronger for orphans than non-orphans. Frequency of hunger affected internalising symptoms only in orphans. Caregiver depression was independently associated with low social support (B = -0.35, 95% CI: -0.51, -0.18), few possessions (B = -2.10, 95% CI: -3.42, -0.79) an orphan status (B = 4.54, 95% CI: 3.30, 5.78) and possessions had a stronger effect in orphan caregivers. Quality of housing caused depression only in caregivers of orphans.
  
  
  CONCLUSIONS
  Both orphans and their caregivers were more depressed than the non-orphans and their caregivers. They were exposed to more economic and psychosocial disadvantages and were more vulnerable to risks.
authors: P
authors: P
authors: Libombo
authors: H
authors: H
authors: Baker-Henningham
authors: S
authors: S
authors: Grantham-McGregor
mesh_terms: D000293:Adolescent; D058445:Bullying / Q000706:statistics & numerical data; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D002648:Child; D054540:Child, Orphaned / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D006815:Hunger; D008297:Male; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D011203:Poverty / Q000706:statistics & numerical data*; D011678:Punishment / Q000523:psychology; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012944:Social Support; D011795:Surveys and Questionnaires