Abstract
BackgroundAfrica 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.MethodsDemographic 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.)ResultsThe 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).ConclusionsAfrican 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.
Highlights
Africa is facing a nutritional transition where underweight and overweight coexist
Primary caregiving of children is challenging in Africa, where the Acquired Immune Deficiency Syndrome and the Human Immunodeficiency Virus (HIV/AIDS) pandemic has increased the number of orphan and vulnerable children (OVC) in need of care
When we compared OVC primary caregivers to the other three caregiving groups by country, we found that OVC primary caregivers had lower mean Body mass index (BMI) than non-OVC primary caregivers in Namibia, and the inverse situation was found in Zambia (Fig. 1)
Summary
Africa is facing a nutritional transition where underweight and overweight coexist. 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. Primary caregiving of children is challenging in Africa, where the Acquired Immune Deficiency Syndrome and the Human Immunodeficiency Virus (HIV/AIDS) pandemic has increased the number of orphan and vulnerable children (OVC) in need of care. Rates of overweight and obesity are high and rising in Africa, among women, and are a cause for concern [3]. It has been suggested that the presence of under-nutrition and overweight and obesity among adolescent girls is due Kanamori et al BMC Public Health (2015) 15:757 to changes in traditional diets, dependence on processed foods and insufficient local food production [4]. Overweight is traditionally desirable among African women, and thought to reflect success and not having HIV/AIDS
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