Hierarchical modelling of the effects of orphan status on child nutrition in sub-Saharan Africa

Laura Robertson, Imperial College London

In some countries in sub-Saharan Africa orphanhood is associated with poor nutritional outcomes but in other countries it is not. Specific hypotheses regarding the interaction between orphanhood and country HIV prevalence, GDP and household wealth index, with respect to nutritional outcomes, have been developed using an ecosocial theoretical framework. These hypotheses have been investigated using Demographic and Health Survey data from several countries in sub-Saharan Africa. Multi-level modeling has been used to adjust for differences in variance at the sampling unit and country level. Results suggest there is no association between orphanhood and poor nutritional outcomes in this dataset. There is also no evidence of an interaction between orphan status and country HIV prevalence, GDP or household wealth index. More detailed investigations into possible causal pathways between country, household and individual-level variables and nutritional status have also been conducted, with reference to the theoretical framework.