Title: Orphanhood among children under age 18 in Democratic Republic of the Congo: A regional perspective Running head: Orphanhood in Democratic Republic of the Congo Zacharie Tsala Dimbuene, PhD1,2,3 Email: [email protected] or [email protected] Raphael Muanza Nzuzi1 Email: [email protected] Hardie Banza Ngoie1 Email: [email protected] Ornan Ipashi Ipashi1 Email: [email protected] Patrick Ntwali Matabaro1 Email: [email protected] 1 Department of Population Sciences and Development, Faculty of Economics and Management, University of Kinshasa, Democratic Republic of the Congo 2 Statistics Canada, Ottawa, Ontario, Canada 3 Corresponding author. Email: [email protected] 1 Abstract There is an abundant literature on orphanhood in sub-Saharan Africa inspired by the rising HIV prevalence in many countries of the region. Most studies have been conducted at national levels, ignoring therefore the heterogeneity within countries. Yet this has programmatic policy implications. This study fills the gap in the context of Democratic Republic of the Congo and attempts to address the effects of two independent but important factors, namely HIV prevalence, and wars and violence in the Eastern part of the country using two Demographic and Health Surveys. Findings did not show any indication of a strong and significant relationship between HIV prevalence and orphan rates at provincial level. Based on these findings, there is a possible effect of wars and violence on orphan rates. Also, gender differences were observed at both national and provincial levels. 2 Introduction The number of orphans in sub-Saharan Africa (SSA) has steadily increased over the past years. Recent estimates indicate that SSA is the most affected region worldwide with over 12 million of orphaned children by AIDS (UNAIDS, 2008). With this alarming figure, orphanhood has become a serious social problem in SSA; and scholars have justifiably named it a “crisis” (Beegle et al., 2010; Evans, 2005; Evans & Miguel, 2007). First, there are only a few social support systems in SSA outside of families. Therefore, orphan children are more vulnerable and are more likely to be homeless and/or head of household, living in extreme poverty (Case et al., 2004). Additionally, orphans are at greater risks of malnutrition (Kimani-Murage et al., 2011; Cluver et al., 2012; Crampin et al., 2003; Rayond et al., 2018), poor school outcomes (Evans & Miguel, 2007; Oleke et al., 2007; Ainsworth & Filmer, 2006), and sexual behaviour (Mkandawire, 2013; Tsala Dimbuene & Kuate Defo, 2013; Tsala Dimbuene & Kuate Defo, 2012). Second, children who lost one or both parents have gone through a series of traumatic events. The consequences of these latter may have adverse outcomes such as depression, stress and anxiety (Raymond et al., 2018; O’Donnell et al., 2014). Third, even though the knowledge about AIDS regarding the modes of transmission and prevention strategies has increased over time (Tsala Dimbuene & Kuate Defo, 2011), there still is lot of stigma attached to the pandemic. Therefore, orphan children of AIDS can be stigmatized and may be denied education or health care (UNAIDS & UNICEF, 2003; Hill et al., 2008). As a consequence, subsequent living arrangements for orphaned children do not help either. In fact, my own work has shown that adolescents and youth living in neither- or one-parent families are more likely to initiate first at an earlier age compared with those who resided in two-parent families (Tsala Dimbuene & Kuate Defo, 2012; Kuate Defo and Tsala Dimbuene, 2012; Tsala Dimbuene & Kuate Defo, 2013). Previous research has done much progress portraying the orphan crisis in SSA as a region and at country level. However, there are some other dimensions of the phenomenon, which are understudied. For example, it is absurd to assume that orphanhood is evenly distributed within a country because AIDS prevalence varies within a country and therefore its effects may differ from a region to another. In the context of Democratic Republic of the Congo (DRC) which has been devastated by wars and armed groups in the Eastern DRC for over 20 years, conflicts which resulted in population displacement, rape, and deaths may generate unexpected effects on orphanhood in the country (Beegle et al., 2010). Yet furthering our understanding of the distribution of orphanhood within a country is critical and has programmatic implications to better focus efforts targeted at social protection of orphans. Within this background, this paper contributes to the existing literature in SSA in describing orphanhood in DRC through a regional perspective and whenever possible looking into differences between girls and boys under age 18. There are justifiable reasons for a continuous focus on youth under 18 years, which forms in many SSA countries over 3 52% of the total population. In DRC, people less than 15 years represent 46% out of an estimated population of 84 million (PRB, 2018). As aforementioned, it is important to have a clear understanding of orphanhood because, along with subsequent living arrangements, they have implications on the well-being of this segment of the population. More specifically, the paper attempts to disentangle the effects of two independents phenomena, namely HIV and successive wars. Data and Methodology To achieve this goal, this paper uses data from two consecutive Demographic and Health Surveys (DHS) conducted in 2007 and 2013-14. 1 DHSs usually focus on women of reproductive ages (15-49 years); however they collect information about household living environments and assets, and household composition as well. In this paper, we used the household datasets, which include information about household members and selected characteristics. The household sample sizes in 2007 and 2014 were different in the sense that sample size in 2014 was almost twice that of 2007.2 Regarding the samples used in the analyses, readers should note that information about living arrangements were collected only for individuals under age 18. As such, our analyses restricted to those sub-samples. We noted that samples of the surveys in the two years were a bit different, Figures 1.a and 1.b are an attempt to check the comparability of the two samples for individuals under age 18. Figure 1.a shows that the two distributions in 2007 and 2014 are quite comparable. -------------------------------------- Figures 1.a and 1.b about here --------------------------------- Figure 1.b indicates that prevalence rates of orphanhood increased with age; however the prevalence rates did not vary very much except at certain ages (5, 10, 15). This may be due to a known effect in demography, the “attraction at rounded ages such as 5, 10, and 15”. However, it is worthy to recognize that ignoring the effects of age and gender can be misleading. In this paper, orphan was defined as an individual aged under 18 whom one or both parents were reported to be deceased. In fact, DHS collected information about parental survival. More specifically, the respondent of the household questionnaire in each household was asked whether the [mother], or [father] of each household member was alive. Responses ranged from yes, no or don’t know. Based on this definition, it was possible to categorize orphans as single (when only one parent was deceased) or double orphan (when both 1 Data collection for this last survey spanned from 2013 to 2014. However, most data were collected in 2013. For the sake of presentation in the paper, we refer to this last survey as DHS-2014. 2 In 2007, 8,886 households were selected while 18,171 were selected in 2014. 4 parents were deceased). Further, single orphans can be either paternal orphans (if the father was deceased) or maternal orphans (if the mother was deceased). In both surveys, there were only small percentages of missing values; they were excluded because they do not affect the final results. In order to define living arrangements for the population of interest, DHS collected information on whether the mother/father of the specific person under age 18 lived in the household. Responses ranged from 0 to a maximum. When the father or mother did not live in the household, responses were coded 0. Otherwise they were coded 1 or plus. Another information, that we used in the current study which is however insufficient to fully capture the living arrangements, is the relationship with the head of the household. As I mentioned in my previous work (Tsala Dimbuene, 2010), it is not possible to determine whether or not a child lives with the two parents just by knowing he/she is the son or daughter of the head of the household. Combining the information on parental survival and co-residence, it was possible to identify four mutually exclusive categories including neither parent, father only, mother only, and two parents. Finally, because orphans are particularly vulnerable, we used the information on the relationship with the head of the household because this can exacerbate or buffer their vulnerability. Finally, there are also some data limitations because we wanted to get a thorough picture of both orphanhood and living arrangements by age and province. However due to small cases when disaggregating the numbers, it was not possible to pursue this goal. Main findings 1. Variation of orphan rates between 2007 and 2014 This section briefly examines the evolution of orphan rates between the two consecutive DHS in DRC. Similar studies were undertaken at national level.3 As mentioned before, figures at national level are important, however they mask within-country variation. It is therefore important to unravel the distribution of the phenomenon at provincial level.4 Most studies on orphanhood in SSA seek the effects of HIV/AIDS on orphanhood and living arrangements of children. -------------------------------------- Table 1 about here --------------------------------- 3 See for details, Bicego et al. (2003); Monaschand Boerma (2004); Beegle et al.