Positive Outcomes for Orphans and R21 Supplement in 2012

Positive Outcomes for Orphans (POFO) is a longitudinal, multi-country study tracking the experiences of 3,000 orphans and abandoned children (OAC) and their caregivers in five low and middle-income countries. This study began following the POFO cohort in 2006, and in 2010 the grant for “POFO II” was awarded which allowed the study to continue interviewing the POFO participants as they transition through adolescence and early adulthood.

In 2012, the POFO team completed Round 8 data collection at four of the six POFO study sites (the two Indian sites were awaiting official approval from the Indian Council of Medical Research, which was granted in May 2012, delaying the data collection).

In April 2012, an NIH grant was awarded to Dr. Lynne Messer called “Pathways to Health and Wellbeing”; this grant will conduct additional interviews with the child POFO participants to assess their social and sexual networks.

In June 2012 the sixth paper utilizing POFO data was published by Dr. Thielman (DGHI faculty) in PLoS ONE, called “Correlates of Poor Health among Orphans and Abandoned Children in Less Wealthy Countries: the Importance of Caregiver Health.” As of November 2012, all six study-sites began administering the Round 9 surveys.


  • O’Donnell K, Murphy R, Ostermann J, Masnick M, Whetten RA, Madden E, Thielman NM, Whetten K, The Positive Outcomes for Orphans (POFO) Research Team. A brief assessment of learning for orphaned and abandoned Children in low and middle-income countries. AIDS Behav 16(2): 480-90, 2012.
    • ABSTRACT: Assessment of children’s learning and performance in low and middle income countries has been critiqued as lacking a gold standard, an appropriate norm reference group, and demonstrated applicability of assessment tasks to the context. This study was designed to examine the performance of three nonverbal and one adapted verbal measure of children’s problem solving, memory, motivation, and attention across five culturally diverse sites. The goal was to evaluate the tests as indicators of individual differences affected by life events and care circumstances for vulnerable children. We conclude that the measures can be successfully employed with fidelity in non-standard settings in LMICs, and are associated with child age and educational experience across the settings. The tests can be useful in evaluating variability in vulnerable child outcomes.
  • Thielman N, Ostermann J, Whetten K, Whetten R, O’Donnell K (2012) Correlates of Poor Health among Orphans and Abandoned Children in Less Wealthy Countries: The Importance of Caregiver Health. PLoS ONE 7(6): e38109. doi:10.1371/journal.pone.0038109
    • ABSTRACT: Poor caregiver health is a strong signal for poor health of Orphans and Abandoned Children. Strategies to support OAC should target the caregiver-child dyad. Steps to ensure food security, foster gender equality, and prevent and treat traumatic events are needed.

In 2012, CHPIR obtained a R21 grant supplement, Pathways to Health and Wellbeing: social networks of orphans and abandoned youth, which further analyzes the cohort from the POFO study in relation to various social networks. The primary goal of this study is to determine key factors that may put youth at a disadvantage as they transition from structured care settings into their adult lives and those that support positive transitions. In order to accomplish this task, researchers will study existing education and employment support networks as well as sexual communities. Researchers will then be able to determine how certain characteristics of these networks are associated with OAC health outcomes, including poor education, ability to generate income, and HIV risk-taking behaviors. Based on prior OAC-related research, this study expects to find that OAC networks are small and lack variability, leading to reduced access to education, fewer positive employment opportunities, and increased sexual-risk behavior. Findings will be used to construct potential interventions to promote OAC health and well-being.

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