Youth In Rwanda That Head Households Commonly Depressed

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Main Category: Mental Health
Also Included In: Depression;  Public Health
Article Date: 06 Sep 2008 - 0:00 PDT

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Of the orphaned youth who are heading households in rural Rwanda can be classified as depressed, according to a report released on September 1, 2008 in Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Rwanda has one of the largest groups of orphans in the world, a result of the 1994 genocide and the epidemic of HIV infection. According to background information in the article, an estimated 290,000 orphans lived in the country in 2005. The authors note that these children are often placed in adverse conditions as a result: "Most African orphans have been absorbed into informal fostering systems," they say. "Such systems, however, are increasingly overwhelmed, and many orphans either head households or live on the street."

To investigate the effects of this change on the group, Neil W. Boris, M.D., of the Tulane University School of Medicine, New Orleans, and colleagues examined 539 Rwandan youths who were serving as the head of their households. A total 539 young people were evaluated, all younger than 24, with an average age of 20. The youth met with trained interviewers who administered scales that measured symptoms of grief, depression, adult support, and community marginalization, as well as surveys regarding demographics, health, vulnerable conditions, and risky behaviors.

In examining the data, the scientists found:

• 77% of the youth population were performing subsistence farming.
• 7% of the youth population had six or more years of schooling. 
• In the status of their parents, 71.4% reported both parents dead, 26.2% reported one parent dead, and of these, almost 25% indicated that the genocide led to at least one of their deaths. s
• 44% reported only eating one meal per day in the last week. 
• 80% gave a health rating as poor or fair. 
• The average depression scale score was higher than the standard cutoff score for adolescents. 53% of the subjects were positive in screening for depression. 
• 76% agreed with a statement indicating that there is community rejection or orphans. 
• 26% strongly agreed that they had at least one friend. 
• 64% said they had lost their confidence in people. 
• 40% agreed that life was meaningless or had lost faith in God since their parents' deaths.

The authors note some additional trends trends in this data. "Hunger, grief, few assets, poor health status and indices of social marginalization were associated with more depressive symptoms in this sample," they say. "Ten years after the Rwandan genocide and in the midst of the HIV/AIDS epidemic, the effects of poverty and social disruption on the most vulnerable youth in Rwanda are evident."

They state that further research is needed, examining the families that are supported by these youths. "The effect of caregiver depression on younger children living in youth-headed households is not yet known," they say. "Further study of orphans and vulnerable children in countries such as Rwanda, in particular, studies that inform large-scale interventions, are necessary if the next generation of youth is to thrive."

Depressive Symptoms in Youth Heads of Household in Rwanda: Correlates and Implications for Intervention
Neil W. Boris, MD; Lisanne A. Brown, PhD; Tonya R. Thurman, PhD; Janet C. Rice, PhD; Leslie M. Snider, MD, MPH; Joseph Ntaganira, PhD; Laetitia N. Nyirazinyoye, MPH
Arch Pediatr Adolesc Med. 2008;162(9):836-843.
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Written by Anna Sophia McKenney
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