Across sub-Saharan Africa, there are over 55 million orphans and vulnerable children and youth (OVC). Accompanying the loss of parental support are loss of income and social status among this population. Facing increased risks of poorer psychosocial, physical and economic health, OVC have become a public health concern in the past few decades. Three main mechanisms have been used to support OVCs in their communities: cash-transfers, empowerment programs and income generation. National governments across the sub-continent are currently scaling-up unconditional cash transfers, increasing the number of families who receive a set amount of cash for caring for OVCs without condition on how it is spent. Empowerment programs aim at decreasing stigma by promoting collective identity and efficacy among communities of lower social status. Income generation has been used to increase market participation through mechanisms like micro-lending and job training. The program under study is a community-based program that innovatively combines all three mechanisms. Program participants are identified by community leaders as orphan or vulnerable siblings and enrolled in the program after review by a social worker. The siblings primarily live independently, rather than in the systems of other families. Current program enrollment in Kenya is 1250 families of an average size of 5.1 members. Program inputs last for three years, and include group membership, mentor and peer support, training in a marketable skill, health and hygiene, receipt of a “start-up kit” to begin a business, and community-conditioned cash transfer for expenses related to education, housing, food and business. This study used a cross-sectional survey of 1060 OVC-heads of household to assess self-efficacy, resilience, literacy, educational attainment, income, potentially adverse sexual risk exposure, diarrheal prevalence and treatment, and food consumption and security. The sample was stratified across the three active cohorts in the group, where a cohort is the set of families entering the program in the same year. Descriptive and inferential statistics were used to assess differences. Findings show increased program participation significantly predicts improvements in self-efficacy, resilience, food consumption and security, food independence, household income, probability of successfully completing primary school (8 years), probability of regularly treating water prior to consumption, improved water source and degree of potentially adverse sexual risk among females. These findings hold when adjusted for relevant covariates. In conclusion, the present study meaningfully contributes to the understanding of various threats to OVC well-being, and how these threats can be reduced by participation in a novel family-oriented community-based program.
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