Health and livelihood outcomes associated with participation in a community-based empowerment program for orphan families in semirural Kenya: a cross-sectional study

Over 40 million African children have lost one or both parents to death or desertion for various causes. Recent unconditional cash-transfer programs in sub-Saharan countries have been found effective at mitigating financial, health, and educational challenges concomitant with parental loss. Due to constraints on governmental resources useful for oversight, however, these gains have been less pronounced than in other contexts where governmental oversight allows cash transfers to be conditioned on preset social and health goods.

The present study presents cross-sectional survey data from a community-based intervention combining elements of conditional cash transfer, empowerment- and income-generating programs in rural Kenya. Orphan and vulnerable children (OVC)-headed households in the catchment area are eligible for inclusion in the 3-year program.

Survey questions addressed monthly income, yearly financial status, food and medical access, malaria net usage, water source and purification practices, years of completed school, literacy, and sexual practices. Significant differences were found in each of these areas between the three different cohorts, categorized by year of program entry, though sexual practices only varied among females across the three cohorts.

Findings suggest an overall protective effect as a function of exposure to the program. Households with longer program exposure report statistically significant improvements in weekly income, savings rates, food security, medical security, food independence, insecticide-treated net usage, water purification practices, completing 8 years of schooling, literacy and sexual practices among females compared to households in their first year.

This study supports the use of a community-based intervention hybridizing other standard interventions to reduce health risks among OVC in Kenya.