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

Orphaned Children Sub-Saharan Africa 12.3 Asia 7.3 Latin America (including6.2 the Caribbean) Region (%) Source: UNAIDS, et al. (2004).

Rakai

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.

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.

CDA: Illustration

Providing scholastic materials Pilot SEED Project: Random selection of schools Rakai District 7 schools 97 children E & C groups SUUBI/NIMH funded project: 14 Schools 289 children

SAMPLE Table 1Sample characteristics (N=97) Girls 70% Mean child age13.8 years (SD=1.1) Average # people in household6.4 (SD=2.4) Average # children in household3.3 (SD=1.9) Report father not living72% Report mother not living46% Report relative with HIV/AIDS17% Report knowing a person in community/village with HIV/AIDS 51%

Female raised child (N=97) Education level of female raised child

Male raised child (N=97) Education level of male raised child

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

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

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

Child having an educational plan by gender: a trend in having an educational plan among boys Group*Gender= NS

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

Level of child-caregiver communication by gender: a trend toward increased communication evident among boys Group*Gender= NS

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

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

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

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

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.

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.

Acknowledgements Financial Support for SEED Pilot Study 1.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 MH ) Other support: New America Foundation—Fellowship -Mary Mckay PhD, Jane Waldfogel PhD, Elwin Wu PhD, William Bannon PhD, Stacey Alicea MPH, Leyla Ismayilova MSW,