Abstract
Institutionalized children in low-income countries often face maltreatment and inadequate caregiving. In addition to prior traumatization and other childhood adversities in the family of origin, abuse and neglect in institutional care are linked to various mental health problems. By providing a manualized training workshop for caregivers, we aimed at improving care quality and preventing maltreatment in institutional care. In Study 1, 29 participating caregivers rated feasibility and efficacy of the training immediately before, directly after, and 3 months following the training workshop. The results showed high demand, good feasibility, high motivation, and acceptance of caregivers. They reported improvements in caregiver–child relationships, as well as in the children’s behavior. Study 2 assessed exposure to maltreatment and the mental health of 28 orphans living in one institution in which all caregivers had been trained. The children were interviewed 20 months before, 1 month before, and 3 months after the training. Children reported a decrease in physical maltreatment and assessments showed a decrease in mental health problems. Our approach seems feasible under challenging circumstances and provides first hints for its efficacy. These promising findings call for further studies testing the efficacy and sustainability of this maltreatment prevention approach.
Highlights
In many low-income countries, in Sub-Saharan Africa and South Asia, the number of orphans has been constantly rising over the last decades with estimated numbers of 56,000,000 and 40,800,000 respectively, for example as a consequence of poverty, the HIV/AIDS epidemic or political conflicts (Maundeni and Malinga-Musamba, 2013; United Nations Children’s Fund, 2014)
Maltreatment prevention in institutional care in low-income countries is an aspect that has predominantly been neglected in research so far, despite the high rates of maltreatment and its repeatedly reported detrimental effects on the children’s well-being (Gershoff, 2002, 2013; Hermenau et al, 2014)
The present study closes this gap and provides an attachment theorybased and practice-oriented training workshop that is feasible in challenging circumstances
Summary
In many low-income countries, in Sub-Saharan Africa and South Asia, the number of orphans has been constantly rising over the last decades with estimated numbers of 56,000,000 and 40,800,000 respectively, for example as a consequence of poverty, the HIV/AIDS epidemic or political conflicts (Maundeni and Malinga-Musamba, 2013; United Nations Children’s Fund, 2014). These countries are often overburdened with the high number of orphans; and family or community-based care cannot be provided for all children in need (Li et al, 2008). Similar results with maltreatment experienced by most of the children were found in studies in orphanages in Tanzania (Hermenau et al, 2011, 2014)
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