Constantly evolving heterogeneous definitions

An “AIDS orphan” is most commonly defined as a child who has lost one or both parents to HIV/AIDS. However, it is understandable that various definitions will emerge when taking into account whether one or both parents have died and at what age childhood ends.
Thus, since the beginning of the orphan crisis in sub-Saharan Africa in the early 90s, the definition of an AIDS orphan raises problems of homogeneity.

Maternal, paternal, or double orphan

The first studies on AIDS orphans only concerned maternal orphans and defined orphans as “children under 15 years of age who had lost their mothers to AIDS”. They assumed that it was more difficult for a child to loose his or her mother than father from an emotional standpoint and that is was easier to collect demographic data on motherhood Preble, 1990, Gregson, Garnett et al., 1994.

Most of the estimates and models were based on this definition and considered an orphan as a child who had lost his or her mother Foster and Williamson, 2000; children whose fathers had died were not classified as orphans.
Thus, we could not estimate paternal orphans at a national level using African censuses, even recent ones, which are supposed to count orphans Foster and Williamson, 2000. Today, Demographic and Health Surveys (DHS), conducted more or less regularly in many developing countries, contribute to measuring this phenomenon by taking into account paternal, maternal, and double orphans.

Nevertheless, recent studies have shown that the death of the father could have as much if not more disastrous effects on a child than the loss of the mother because in developing countries the death of the father has greater socio-economic impact due to the frequent loss of the child’s inheritance rights World Bank, 1997, Sengendo and Nambi, 1997. Consequently, it is important de take into account each parent’s death insofar as the death of the mother or the father have different effects on orphans Saoke, Mutemi et al., 1996.Studies which exclude paternal orphans under-estimate the total number of orphans by 45% to 70%Foster and Williamson, 2000.

Double orphans (whose both parents have died) must also be considered. Most of the studies show a high prevalence of double orphans because of the heterosexual transmission of HIV/AIDS inducing a high probability that both parents are infected and eventually die one after the other Preble, 1990, Gregson, Garnett et al., 1994.
Today, AIDS-orphans estimates include paternal, maternal, and double orphans Grassly and Timaeus, 2003, UNICEF, UNAIDS et al., 2002.

Age of orphans

Statistics on AIDS orphans generally include children under 15 years of age Hunter and Williamson, 1997, Nampanya-Serpell, 2001, Bicego, Rutstein et al., 2003, UNICEF, UNAIDS et al., 2002, Monasch and Boerma, 2004; the 15-17 age category is usually included in the 15-49 adult  age category.

Few studies concern orphans under 18 years of age, but some define an orphan as “a child under 18 who has lost either or both parents” Hunter, 1990, Barnett and Blaikie, 1992, Foster, Makufa et al., 1997, Nyambedha, Wandibba et al., 2001, Nyambedha, Wandibba et al., 2003.

There is a problem in defining an orphan as a child under 15 years because it excludes older adolescents who face specific risks, in particular young girls who are victims of economic and sexual exploitation Tarantola and Gruskin, 1998. Moreover, in accordance with the Declaration of the Rights of Children, an orphan is considered as a child under 18 years United Nations and Assembly, 1989.

The methods based on this first definition led to an under-estimation of the total number of orphans. The definitions that exclude the 15-17 years age category under-estimate the total number of orphans by 25% to 35% Foster and Williamson, 2000.

Thus the inclusion of the 15-17 years age group in statistics may considerably increase the estimated number of orphans.

It is only since 2004 that UNAIDS has included the 15-17 years age category in the definition of an orphan. This recent definition is in agreement with the international definition of childhood and acknowledges that orphans are not always young children, insofar as adolescents make up the majority of orphans in all the countries of sub-Saharan Africaand that the problems which adolescents face persist beyond 15 years of age. UNICEF, UNAIDS et al., 2004

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