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Indicators

14.4.1 Prevalence of orphanhood among children under 15- mother and father both dead
Program Area: Social impact 
Definition: The percent of children under 15 in a household survey whose mother and father have died. 
Numerator: Total number of children who are currently under 15 and whose mother and father are both dead. 
Denominator: Total number of children currently under 15 listed by respondents in the survey. 
Measurement Tools: Household schedule in UNAIDS general population survey; MICS (UNICEF); Census data. 
What It Measures: HIV is changing the face of adult mortality in many communities, killing men and women at just the ages when they are normally forming families and bringing up children. Their deaths leave behind orphans who must be cared for, generally by other members of the community. The social and economic impact of rising orphanhood can be considerable; national AIDS programmes tracking orphanhood will be better equipped to plan for impact mitigation efforts. This indicator tracks levels of orphanhood in a country. 
How to Measure It: In a household survey or a national census, respondents are asked the ages of all children in the household and whether the mothers and fathers of those children are alive. Those children who are currently under the age of 15 and whose mother or father or both are dead form the numerator for this indicator. The denominator is all children currently under 15 listed by respondents in the survey.

It is useful to break the results down into maternal orphanhood, paternal orphanhood, and double orphanhood. 

Strengths and Limitations: Data on an increase in orphanhood can be a very powerful indicator of the impact of an AIDS epidemic. Besides tracking the impact of AIDS deaths on communities, this indicator also has multiple advocacy uses.

One limitation of this measure is that it is not able to distinguish AIDS-related orphanhood from orphanhood due to other causes. However since young adult death was stable or falling in most countries for some years before the arrival of HIV, it is not unreasonable to assume that the bulk of any rise in orphanhood over baseline levels is attributable to HIV.

Orphans may be more mobile than other children. Those most in need of care may be in child-headed households that do not qualify for inclusion in a household survey. Street children living in orphanages will also be missed. Households with AIDS-related deaths often completely disintegrate following the death of heads, and children are sent to live with relatives in the same or another area. Using a household survey and asking about whether the parents are still alive will help alleviate the primary household disintegration issue.

Definitions of orphanhood differ among countries. In some countries, the legal definition includes all children under 18 who have lost either or both parents, for example, while in others it includes all children under 15 who have lost their mother. It is suggested that the standard definition given in this indicator is used to allow for comparison across populations. However, countries may also wish to compile an indicator based on their own national definition of orphanhood. The methodology for constructing the indicator remains unchanged. 

Use of Indicator: Core indicator in generalised epidemics 
Tools: Surveys (UNAIDS, DHS, UNICEF)  
SSO Code:  
UNGASS: No 
The President's
Emergency Plan:
No 
OVC: No 
MDG: No 

USAID | UNAIDS | UNICEF | WHO | CDC | US Census Bureau
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