Horizons Report | June 2005

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June 2005

On Their Own
Strengthening youth-headed households in Rwanda

Young man standing in front of shelves of items.

A 21-year old head of household in Rwanda in the store he rents to provide income for his three siblings.

Photo credit: Neil Boris

All over the world AIDS-affected children face innumerable challenges with respect to their physical, economic, and emotional well-being. But in Rwanda, the 1994 genocide has compounded the effects of the ongoing AIDS epidemic, resulting in one of the world’s highest percentages of orphans among children 17 years or younger (17 percent) and large numbers of youth-headed households¹. Many of these young people are essentially on their own, left behind by parents and other caregivers, stigmatized by war or disease, and neglected by extended families, communities, and formal structures.

Traditionally, programs for orphans and vulnerable children in Rwanda and elsewhere have focused on providing material assistance, such as school fees, food, and health care. But program managers are increasingly recognizing the importance of social and psychological services to foster the healthy emotional and physical development of these young people.

In Rwanda, a World Vision program has provided support since 2000 to youth-headed households, a distinct subset of orphaned children, to meet their nutritional, shelter, educational, and health care needs. However, information gathered from children and youth in these households revealed their ongoing sense of isolation, loneliness, and exposure to maltreatment. World Vision Rwanda (WVR) realized that the project’s beneficiaries had other needs that could not be met by material support alone. They also recognized the importance of research to help design an intervention to better meet the needs of their beneficiaries and to assess its impact.

In response, WVR teamed up with Tulane University School of Public Health, the Rwanda School of Public Health, and the Horizons Program to improve the psychosocial well-being of youth-headed households in four districts in Gikongoro province through a community mentorship program.

As part of the operations research process to design and evaluate the mentorship program, the researchers conducted focus groups with youth and adults in late 2003. In March 2004, they administered a baseline survey to 692 youth heads of households who were WVR program beneficiaries.

The survey sample included an almost equal number of males and females and most were between the ages of 19 and 24 (range: 12 to 24 years). For 70 percent of respondents, both parents are deceased. The remainder have been abandoned or do not know their parent’s whereabouts. Nearly a third care for three or more children, with females more likely than males to care for several children.

Multiple Needs

Findings from the baseline research show that the needs of respondents are vast and complex. Although most of the sample have been receiving services from WVR for several years, indicating a considerable length of time as head of their household, they continue to face significant challenges to meeting their basic needs and safeguarding their health and emotional well-being.

Only about a fourth of the school-age respondents are in school. Barriers to attendance include school expenses and responsibilities at home. More than half of respondents do not possess a pair of shoes and 31 percent of households do not have a latrine. Nearly a fourth of respondents consider themselves to be in poor health and nearly half of these youth report having a serious illness at the time of the survey.

To provide for themselves and their families, the vast majority depend on farming and selling produce. Very few depend on parents’ savings or assistance from friends or relatives. Because of limited resources, many consistently face a shortage of food, with 44 percent indicating that they eat only once a day. Among respondents with younger youth at home, more than half had gone without food sometime within the week preceding the survey so that the others in the household would have enough to eat. Only 54 percent feel they are sufficiently providing for the needs of their family.

Psychological and Social Impacts

Taking on the role as head of household has had significant psychological and social impacts on these young people. Researchers found that more than 80 percent of respondents had felt depressed or desperate since the loss of or abandonment by their parent(s). Moreover, they are still greatly affected by the loss, which, for many, has reduced their confidence in other people (64 percent) and contributed to their feeling that life is meaningless (44 percent).

Female counselor sitting on a wooden couch with three children.

Gaudiose Niyirema, a WVR facilitator, visits a youth-headed household to arrange for their basic needs package and mentor visits.

Photo credit: Neil Boris

Many youth feel unsupported by members of their extended family. Although 82 percent report contact with their relatives and a majority say that they see them at least once a week, only 36 percent trust their relatives to look out for their best interests. In fact, more than twice as many have confidence in the willingness of their neighbors to help them (57 percent) than their extended family (25 percent). The vast majority (85 percent) feel that only World Vision staff care about them.

Most respondents feel isolated from the community, think that people speak badly about them, and feel that others would rather hurt them than help them. Females had less confidence in their neighbors to help them and less trust in the community than males.

Youth perceive a lack of community support for various reasons. Many cited the war, noting that since then, people no longer help one another. Others suspect that they are not liked because of their poverty or because the community had ill feelings about their parents. Eighty-seven percent of respondents think that the community feels it is World Vision’s responsibility to take care of the children’s needs. Also, over three-quarters believe the community is jealous of the services they are granted as orphans.

Lacking adult protection, study investigators found that the respondents and their households are extremely vulnerable to mistreatment. Youth reported instances of abuse, from sexual and physical abuse to exploitation. Over half said someone intentionally harmed their property, and more than a third reported that someone tried to steal their land or property. More than a fourth of respondents (males especially) reported having been beaten. Females are vulnerable to sexual coercion, with nearly one in 10 reporting being forced to have sex. Given fear or embarrassment around sexual abuse and rape, it is likely that this number is actually higher. In addition, 10 percent of females said they submitted to unwanted sex in hopes of obtaining support for themselves and/or their families. A smaller percentage of males reported being forced to have sex (1 percent) or having unwanted sex in hopes that the person would take care of them and their siblings (6 percent).

Mentorship Model

The findings from the baseline research support the basic premise of the mentorship program—that these young people need someone to talk to, to protect and defend them, and most of all, to let them know that the community cares about them.

“This love, support, and guidance cannot come just from an NGO; it must come from neighbors, family, and friends who comprise the network of social connections in their lives,” said Leslie Snider of Tulane University, one of the study’s principal investigators.

Initial results from the first three months appear promising; averaging three visits a month, the mentors made more than 4,000 visits.

The mentorship program involving 156 adult volunteers began in October 2004 with 442 of the 692 study households. The mentor volunteers have been carefully recruited and trained, and receive ongoing support to develop a stable, caring relationship with children and youth through regular home visits. The volunteers help build their life skills; provide guidance, attention, and encouragement; and help to ensure their health and safety. Importantly, they also build a caring and trusting relationship with youth that, over time, will hopefully yield positive benefits for their health and psychosocial development.

While spending one to two hours with the youth during their visits, the mentors engage them in conversation, help solve problems, and evaluate their physical and emotional needs. The volunteers record their observations on a simple pictorial monitoring form that they discuss at volunteer group meetings and submit to WVR to help them monitor the household needs and prioritize the distribution of WVR resources.

Encouraging Results

Initial results from the first three months appear promising; averaging three visits a month, the mentors made more than 4,000 visits in total. Although some adult volunteers initially encountered resistance from the youth, many of these mentors reported that after a few visits, the youth opened up and now look forward to their visits.

The adult volunteers appear to be an important asset to the children, especially as a mediator within the home and in the community. The adults have helped solve issues between siblings, such as selling resources to buy non-essential items and physical abuse by an older sibling. One mentor helped a youth access legal services to get payment for a goat that had been stolen by someone in the community.

Working with WVR, the mentors also have discussed the baseline research findings at four community meetings in order to increase awareness about the problems faced by the youth and children they are mentoring and to engage community members in their care and support.

After the first year of program implementation, the survey will be repeated with the same youth to assess the impact of the mentorship program on their psychosocial well-being, specifically their social connectedness, role functioning, psychological health, and general well-being. World Vision Rwanda will expand the program to all households after the second survey. Study results should be available mid-2006.

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See Also

For additional information please contact:
Horizons
Population Council
4301 Connecticut Ave. NW, Suite 280
Washington, DC 20008
Telephone: +1 202 237 9400
Facsimile: +1 202 237 8410
E-mail: horizons@popcouncil.org

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This page updated
18 January 2006