The authors declare that they have no competing interest.
MK developed the study design and methods, performed statistical analyses and drafted the manuscript. MK and OCP conceptualized the study and interpreted the results. OCP, SM, SL, XH and RF reviewed the study design and methods and edited the manuscript. SM also contributed with her expertise in sub-Saharan Africa’s health, economic and social issues. All authors read and approved the final manuscript.
AB carried out the molecular genetic studies, participated in the sequence alignment and drafted the manuscript. JY carried out the immunoassays. MT participated in the sequence alignment. ES participated in the design of the study and performed the statistical analysis. FG conceived of the study, and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.
MK is an epidemiologist with 21 years of work experience with vulnerable populations in the U.S., Africa and Latin America. He is the Scientific Director for the HIV Risk Reduction in High Risk Latina Migrant Workers Project at Florida International University Center for Research on U.S. Latinos HIV/AIDS and Drug Abuse. OCP is an Associate Professor in the Department of Epidemiology and Biostatistics, University of Maryland School of Public Health. OCP has conducted health disparities research in the Federal government (21+ years) and academia (6+ years). SM is an Associate Professor of Demography and Sociology Department of African-American Studies and the Associate Director of the Maryland Population Research Center. SM research interest includes children’s well-being, household composition and family structure, the social context of HIV/AIDS and population movement all in the context of sub-Saharan Africa. RHF is a Professor in the Department of Behavioral and Community Health, and Affiliate Professor in the Maryland Institute for Applied Environmental Health (MIAEH). XH is an Assistant Professor in the Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park. SL is a social epidemiologist with a main research interest in social determinants of health. SL is an Associate Professor in the Department of Epidemiology and Biostatistics, University of Maryland School of Public Health.
Africa is facing a nutritional transition where underweight and overweight coexist. Although the majority of programs for orphan and vulnerable children (OVC) focus on undernourishment, the association between OVC primary caregiving and the caregivers’ overweight status remains unclear. We investigated the association between OVC primary caregiving status with women’s overweight status in Namibia, Swaziland and Zambia.
Demographic Health Survey (DHS) cross-sectional data collected during 2006–2007 were analyzed using weighted marginal means and logistic regressions. We analyzed data from 20–49 year old women in Namibia (N 6638), Swaziland (N 2875), and Zambia (N 4497.)
The overweight prevalence of the primary caregivers of OVC ranged from 27.0 % (Namibia) to 61.3 % (Swaziland). In Namibia, OVC primary caregivers were just as likely or even less likely to be overweight than other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were just as likely or more likely to be overweight than other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were more likely to be overweight than non-primary caregivers living with OVC (Swaziland AOR = 1.56, Zambia AOR = 2.62) and non-primary caregivers not living with OVC (Swaziland AOR = 1.92, Zambia AOR = 1.94). Namibian OVC caregivers were less likely to be overweight than non-caregivers not living with an OVC only in certain age groups (21–29 and 41–49 years old).
African public health systems/OVC programs may face an overweight epidemic alongside existing HIV/AIDS, tuberculosis and malaria epidemics. Future studies/interventions to curb overweight should consider OVC caregiving status and address country-level differences.