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The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned of Orphaned Children in Uganda Children in Uganda Fred Ssewamala, PhD, Columbia University Senior Research Fellow, New America Foundation

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Page 1: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

The Impact of Children’s Development Accounts on Health and Educational

Outcomes of Orphaned Children in Ugandaof Orphaned Children in Uganda

Fred Ssewamala, PhD, Columbia University

Senior Research Fellow, New America Foundation

Page 2: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Orphaned Children

Sub-Saharan Africa 12.3

Asia 7.3

Latin America (including6.2

the Caribbean)

Region (%)

Source: UNAIDS, et al. (2004).

Page 4: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Study Objective

• This study explores a new intervention in caring for the orphaned children: the family asset-based intervention.

• The family asset-based intervention combines usual reactive care with an economic empowerment component through the use of children development accounts (CDAs).

• Specifically, the study tests the proposition that assets (in this case, savings accounts representing educational opportunity) have psychological and socio-economic benefits for individuals and families.

Page 5: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Child Development Account (CDA) constitutes a tangible asset that can provide poor orphaned children with a means to expand their life options if they are provided with the training and skills to use it effectively on their own behalf.

Page 6: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

CDA: Illustration

Page 7: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Providing scholastic materialsPilot SEED Project:

• Random selection of schools

• Rakai District• 7 schools• 97 children• E & C groups

SUUBI/NIMH funded project:

• 14 Schools• 289 children

Page 8: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

SAMPLE

Table 1 Sample characteristics (N=97)

Girls 70%

Mean child age 13.8 years (SD=1.1)

Average # people in household 6.4 (SD=2.4)

Average # children in household 3.3 (SD=1.9)

Report father not living 72%

Report mother not living 46%

Report relative with HIV/AIDS 17%

Report knowing a person in community/village with HIV/AIDS

51%

Page 9: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Female raised child (N=97)

Education level of female raised child

Primary Sch or

less (US 8th

grade)

49%

Some Lower

Secondary

School (US

High Sch)

19%

Beyond Lower

Secondary

23%

Never attended

school

9%

Other

12%Aunt

13%

Grandmother

23%

Biological

Mother

52%

Page 10: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Male raised child (N=97)

Education level of male raised childNever

attended

school

4%

Beyond Lower

Secondary Sch

28%

Some Lower

Secondary Sch

or less (US

High Sch)

39%

Primary Sch or

less (US 8th

grade)

29%

Other

8%

Grand Father

13%

Uncle

18%

Biological

Father

23%

No male

present

38%

Page 11: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Savings

Average Monthly Net Deposit (AMND) =

Net Deposit per month of participation for a Participant

Mean (without match)= $8.42/mo

Mean (with a match: participants own savings in the CDA plus match from intervention)=

$25.26/mo

ionparticipat of months of #

sWithdrawal le Unmatchab-Interest Deposit nCalculatio

Page 12: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Savings: Participants in the CDA (E) group do save.

First 6 months, participants saved a total of 4,168,000 (four million one hundred and sixty eight thousand) UGSHS. Translates into 83,400 UG SHS. In average savings/participant in a 6-month period.

Translated in USD: US$50.52 saved per participant in a 6-month period or US$8.42 per family in average monthly net deposits.

With a match rate of 2:1, the average participant in the CDA group (E) accumulated an average of $25.26 per month.

RESULTS

Page 13: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

80%

85%

90%

95%

100%

Pretest Follow-up

% r

epo

rtin

g h

avin

g a

n

edu

cati

on

al p

lan

Experimental Control

Child having an educational plan: a statistically significant difference between E (shift 88% to 96%) x C (shift 93% to 83%).

Group= F (1, 81)= 5.6, p<.05Wilks’ Lambada= F = 3.3, p<.05

Page 14: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Child having an educational plan by gender: a trend in having an educational plan among boys

70%

75%

80%

85%

90%

95%

100%

Pretest Follow-up

% r

ep

ort

ing

havin

g a

n

ed

ucati

on

al

pla

n

Experimental (male) Experimental (female)

Control (male) Control (female)

Group*Gender= NS

Page 15: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Level of child-caregiver communication: A statistically significant difference between E (shift

M=2.2 to M=2.5) x C (shift M=2.4 to M=2.2).

1.5

2

2.5

3

Pretest Follow-up

Co

mm

un

icati

on

wit

h c

are

giv

er

(ran

ge:

0-3

)

Experimental Control

Wilks’ Lambada= F = 3.0, p<.05 Group= F (1, 69)= 3.6, p<.05

Page 16: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Level of child-caregiver communication by gender: a trend toward increased communication evident among boys

1.5

2

2.5

3

Pretest Follow-up

Co

mm

un

icati

on

wit

h

care

giv

er

(ran

ge:

0-3

)

Experimental (male) Experimental (female)

Control (male) Control (female)

Group*Gender= NS

Page 17: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Child HIV/AIDS prevention attitudes: a statistically significant difference between E (shift M=17.3 to M=18.5 ) x C (shift M=18.4 to M=17.6).

16

17

18

19

20

Pretest Follow-up

Mean

sco

re o

n p

reven

tio

n

att

itu

de s

cale

(ra

ng

e:

6-2

4)

Experimental Control

Group= F (1, 82)= 5.1, p<.05Wilks’ Lambada= F = 4.6, p<.01

Page 18: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Child HIV/AIDS prevention attitudes by gender: a trend in having a more dramatic positive change in E boys.

16

17

18

19

20

Pretest Follow-up

Mean

sco

re o

n p

reven

tio

n

att

itu

de s

cale

(ra

ng

e:

6-2

4)

Experimental (male) Experimental (female)

Control (male) Control (female)

Group*Gender= NS

Page 19: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Educational Plan

“ I keep telling them [the relatives] that I don’t want to get married after P7. I don’t… I don’t… I told Mubiiru the same thing… I want to continue on to Senior and be a nurse….”

(15 year-old participant).

Selected quotes from in-depth Interviews

Page 20: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Child-Caregiver Communication

“ For the first time…my jaaja (grandma) seems at peace…. She knows if I work hard I will … (silence)…will go to senior one…. I know I can… I will use the money in our bank [the CDA]”

(a 14 year-old participant in the CDA group)

Selected quotes from in-depth Interviews

Page 21: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Policy Implications & the Way Forward

• CDAs are in line with the Ugandan government policy of “Bonabaggawala”/Wealth for all. Problem, politically motivated.

• CDAs may facilitate the universal primary education being piloted: Uganda, Kenya, Malawi, Tanzania.

• Financial institutions have been very receptive to the idea of introducing OVC and other children to using banks at an early age. For example, the “Younger Savers’ Accounts” program of DFCU bank, and the CSA of Centenary Rural Development Bank.

Page 22: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Policy Implications & the Way Forward

• The Principal Investigator is in the process of working with Parliamentarians and other Policy makers to put the CDAs on the Ugandan government agenda, especially in regards to funding USE. This is very feasible. A Columbia University Policy Student is doing her internship in Uganda, specifically to do this.

• We needed to start somewhere. If it works in Uganda, other countries will follow. UPE was the same way.

• We need to interest Donor institutions/multinationals: World Bank, IMF, USAID, UNDP, etc, to move this to the next level.

Page 23: Of Orphaned Children in Uganda The Impact of Children’s Development Accounts on Health and Educational Outcomes of Orphaned Children in Uganda Fred Ssewamala,

Acknowledgements

Financial Support for SEED Pilot Study1. Social Intervention Group, Columbia University:

2. Center for Social Development, Washington University in St. Louis: (Michael Sherraden, PhD).

3. The Friedman Family Foundation

Financial Support for SUUBI Project:National Institute of Mental Health (NIMH-1 R21 MH076475-01)

Other support:New America Foundation—Fellowship

-Mary Mckay PhD, Jane Waldfogel PhD, Elwin Wu PhD, William Bannon PhD, Stacey Alicea MPH, Leyla Ismayilova MSW,