Discrepancies between UN models and DHS survey estimates of maternal orphan prevalence: insights from analyses of survey data from Zimbabwe
Identifieur interne : 000590 ( Ncbi/Checkpoint ); précédent : 000589; suivant : 000591Discrepancies between UN models and DHS survey estimates of maternal orphan prevalence: insights from analyses of survey data from Zimbabwe
Auteurs : L. Robertson [Royaume-Uni] ; S. Gregson [Royaume-Uni, Zimbabwe] ; C. Madanhire [Zimbabwe] ; N. Walker [États-Unis] ; P. Mushati [Zimbabwe] ; G. Garnett [Royaume-Uni] ; C. Nyamukapa [Zimbabwe]Source :
- Sexually Transmitted Infections [ 1368-4973 ] ; 2008.
Abstract
Model-based estimates of maternal (but not paternal) orphanhood are higher than those based on data from demographic and health surveys (DHS). We investigate the consistency of reporting of parental survival status in data from Manicaland, Zimbabwe.
We compared estimates of paternal and maternal orphan prevalence in three rounds of a prospective household census in Manicaland (1998–2005) with estimates from DHS surveys and UNAIDS model projections. We investigated the consistency of reporting of parental survival status across the three rounds and compared estimates of adult mortality from the orphan data with direct estimates from concurrent follow-up of a general population cohort. Qualitative data were collected on possible reasons for misreporting.
Paternal and maternal orphan prevalence is increasing in Zimbabwe. Mothers reported as deceased in round 1 of the Manicaland survey were more likely than fathers to be reported as alive in rounds 2 or 3 (33.3% vs 13.4%). This pattern was most apparent among younger children. The qualitative findings suggest that foster parents sometimes claim adopted children as their natural children.
These results are consistent with misreporting of foster parents as natural parents. This appears to be particularly common among foster mothers and could partly explain the discrepancy between mathematical model and DHS estimates of maternal orphanhood.
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DOI: 10.1136/sti.2008.029926
PubMed: 18647868
PubMed Central: 2569835
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Gregson</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Infectious Disease Epidemiology, Imperial College, London, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Disease Epidemiology, Imperial College, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Biomedical Research and Training Institute, Harare, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Biomedical Research and Training Institute, Harare</wicri:regionArea><wicri:noRegion>Harare</wicri:noRegion></affiliation></author><author><name sortKey="Madanhire, C" sort="Madanhire, C" uniqKey="Madanhire C" first="C" last="Madanhire">C. 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Robertson</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Infectious Disease Epidemiology, Imperial College, London, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Disease Epidemiology, Imperial College, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Gregson, S" sort="Gregson, S" uniqKey="Gregson S" first="S" last="Gregson">S. Gregson</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Infectious Disease Epidemiology, Imperial College, London, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Disease Epidemiology, Imperial College, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Biomedical Research and Training Institute, Harare, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Biomedical Research and Training Institute, Harare</wicri:regionArea><wicri:noRegion>Harare</wicri:noRegion></affiliation></author><author><name sortKey="Madanhire, C" sort="Madanhire, C" uniqKey="Madanhire C" first="C" last="Madanhire">C. Madanhire</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Biomedical Research and Training Institute, Harare, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Biomedical Research and Training Institute, Harare</wicri:regionArea><wicri:noRegion>Harare</wicri:noRegion></affiliation></author><author><name sortKey="Walker, N" sort="Walker, N" uniqKey="Walker N" first="N" last="Walker">N. Walker</name><affiliation wicri:level="2"><nlm:aff id="aff3"><addr-line>Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Mushati, P" sort="Mushati, P" uniqKey="Mushati P" first="P" last="Mushati">P. Mushati</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Biomedical Research and Training Institute, Harare, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Biomedical Research and Training Institute, Harare</wicri:regionArea><wicri:noRegion>Harare</wicri:noRegion></affiliation></author><author><name sortKey="Garnett, G" sort="Garnett, G" uniqKey="Garnett G" first="G" last="Garnett">G. Garnett</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Infectious Disease Epidemiology, Imperial College, London, UK</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Disease Epidemiology, Imperial College, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Nyamukapa, C" sort="Nyamukapa, C" uniqKey="Nyamukapa C" first="C" last="Nyamukapa">C. Nyamukapa</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Biomedical Research and Training Institute, Harare, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Biomedical Research and Training Institute, Harare</wicri:regionArea><wicri:noRegion>Harare</wicri:noRegion></affiliation></author></analytic><series><title level="j">Sexually Transmitted Infections</title><idno type="ISSN">1368-4973</idno><idno type="eISSN">1472-3263</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives:</title><p>Model-based estimates of maternal (but not paternal) orphanhood are higher than those based on data from demographic and health surveys (DHS). We investigate the consistency of reporting of parental survival status in data from Manicaland, Zimbabwe.</p></sec><sec><title>Methods:</title><p>We compared estimates of paternal and maternal orphan prevalence in three rounds of a prospective household census in Manicaland (1998–2005) with estimates from DHS surveys and UNAIDS model projections. We investigated the consistency of reporting of parental survival status across the three rounds and compared estimates of adult mortality from the orphan data with direct estimates from concurrent follow-up of a general population cohort. Qualitative data were collected on possible reasons for misreporting.</p></sec><sec><title>Results:</title><p>Paternal and maternal orphan prevalence is increasing in Zimbabwe. Mothers reported as deceased in round 1 of the Manicaland survey were more likely than fathers to be reported as alive in rounds 2 or 3 (33.3% vs 13.4%). This pattern was most apparent among younger children. The qualitative findings suggest that foster parents sometimes claim adopted children as their natural children.</p></sec><sec><title>Conclusions:</title><p>These results are consistent with misreporting of foster parents as natural parents. This appears to be particularly common among foster mothers and could partly explain the discrepancy between mathematical model and DHS estimates of maternal orphanhood.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Stover, J" uniqKey="Stover J">J Stover</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ghys, Pd" uniqKey="Ghys P">PD Ghys</name></author><author><name sortKey="Brown, T" uniqKey="Brown T">T Brown</name></author><author><name sortKey="Grassly, Nc" uniqKey="Grassly N">NC Grassly</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Grassly, Nc" uniqKey="Grassly N">NC Grassly</name></author><author><name sortKey="Timaeus, Im" uniqKey="Timaeus I">IM Timaeus</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Grassly, Nc" uniqKey="Grassly N">NC Grassly</name></author><author><name sortKey="Lewis, Jjc" uniqKey="Lewis J">JJC Lewis</name></author><author><name sortKey="Mahy, M" uniqKey="Mahy M">M Mahy</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Brass, W" uniqKey="Brass W">W Brass</name></author><author><name sortKey="Hill, K" uniqKey="Hill K">K Hill</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blacker, Jgc" uniqKey="Blacker J">JGC Blacker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Timaeus, I" uniqKey="Timaeus I">I Timaeus</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Timaeus, I" uniqKey="Timaeus I">I Timaeus</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Gregson, S" uniqKey="Gregson S">S Gregson</name></author><author><name sortKey="Garnett, Gp" uniqKey="Garnett G">GP Garnett</name></author><author><name sortKey="Nyamukapa, Ca" uniqKey="Nyamukapa C">CA Nyamukapa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Timaeus, Im" uniqKey="Timaeus I">IM Timaeus</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Timaeus, Im" uniqKey="Timaeus I">IM Timaeus</name></author><author><name sortKey="Nunn, Aj" uniqKey="Nunn A">AJ Nunn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brass, W" uniqKey="Brass W">W Brass</name></author><author><name sortKey="Bamgboye, Ea" uniqKey="Bamgboye E">EA Bamgboye</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Timaeus, Im" uniqKey="Timaeus I">IM Timaeus</name></author><author><name sortKey="Jasseh, M" uniqKey="Jasseh M">M Jasseh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Somoza, J" uniqKey="Somoza J">J Somoza</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Timaeus, Im" uniqKey="Timaeus I">IM Timaeus</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blacker, Jgc" uniqKey="Blacker J">JGC Blacker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blacker, Jgc" uniqKey="Blacker J">JGC Blacker</name></author><author><name sortKey="Mukiza Gapare, J" uniqKey="Mukiza Gapare J">J Mukiza-Gapare</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hill, K" uniqKey="Hill K">K Hill</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zlotnik, H" uniqKey="Zlotnik H">H Zlotnik</name></author><author><name sortKey="Hill, K" uniqKey="Hill K">K 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Nyamukapa</name></author><author><name sortKey="Gregson, S" uniqKey="Gregson S">S Gregson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gregson, S" uniqKey="Gregson S">S Gregson</name></author><author><name sortKey="Mushati, P" uniqKey="Mushati P">P Mushati</name></author><author><name sortKey="Nyamukapa, C" uniqKey="Nyamukapa C">C Nyamukapa</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Royaume-Uni</li><li>Zimbabwe</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Maryland</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Robertson, L" sort="Robertson, L" uniqKey="Robertson L" first="L" last="Robertson">L. Robertson</name></region><name sortKey="Garnett, G" sort="Garnett, G" uniqKey="Garnett G" first="G" last="Garnett">G. Garnett</name><name sortKey="Gregson, S" sort="Gregson, S" uniqKey="Gregson S" first="S" last="Gregson">S. Gregson</name></country><country name="Zimbabwe"><noRegion><name sortKey="Gregson, S" sort="Gregson, S" uniqKey="Gregson S" first="S" last="Gregson">S. Gregson</name></noRegion><name sortKey="Madanhire, C" sort="Madanhire, C" uniqKey="Madanhire C" first="C" last="Madanhire">C. Madanhire</name><name sortKey="Mushati, P" sort="Mushati, P" uniqKey="Mushati P" first="P" last="Mushati">P. Mushati</name><name sortKey="Nyamukapa, C" sort="Nyamukapa, C" uniqKey="Nyamukapa C" first="C" last="Nyamukapa">C. Nyamukapa</name></country><country name="États-Unis"><region name="Maryland"><name sortKey="Walker, N" sort="Walker, N" uniqKey="Walker N" first="N" last="Walker">N. 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