The process of institutionalization-deinstitutionalization and children’s psychological adjustment in Rwanda:: Parents matter

Negative effects of institutionalization and positive effects of deinstitutionalization on children’s wellbeing have been well documented. However, the majority of reports on institutional care rely on adult interviews and there is a wide disparity of results and methodologies in few result-oriented studies of deinstitutionalization outcome. In addition, though all over the world, especially in developed countries, many children in orphanage have parents; little is known about on the effect of having or not living biological parents and be institutionalized. The present thesis aims generally to investigate whether institutionalization negatively impacts the psychological adjustment of children. Specifically, this thesis aims at (1) exploring children’s perceptions on institutionalization process; (2) investigating the influence of biological parental living status on institutionalized children’s psychological adjustment; and (3) evaluating the effectiveness of deinstitutionalization as well as conditions for better psychological adjustment once children are deinstitutionalized. With a prospective longitudinal comparative design, focus group discussions and self-report questionnaires were used by the present thesis to collect respectively qualitative and quantitative data from 177 children aged 9 to 16 and their parents/primary caregivers divided in 6 registered orphanages and 5 primary schools in Rwanda. Grounded theory was used to analyze qualitative data whilst analysis of variance and multiple regression were used to analyze quantitative data. Outcome variables included externalizing and internalizing behavior, attachment and self-esteem. Taken together, our results show that institutionalization has a negative impact on children’s psychological adjustment. The most remarkable and unexpected finding is that Rwandan children living in institution have more impairment in psychopathological symptoms when they have living parents. They considered institutionalization as an orphanization process. Another remarkable finding is that the present thesis failed to prove the improvement of psychological adjustment due to de-institutionalization in all domains as expected. The improvement was reported in attachment while no change was observed in externalizing behavior or self-esteem after deinstitutionalization and worse, internalizing behavior worsened among de-institutionalized children. Family relationships and parenting involvement were reported to be the strongest predictors of children’s psychological adjustment in most of measured outcome variables. Unexpectedly, socioeconomic status, didn’t gain as much importance in that prediction. Contrariwise, adult’s perceived quality of life was a significant mediated predictor in children’s externalizing behavior and had a moderating effect in children’s internalizing behavior. This should be considered to develop and improve supportive specific interventions for children and considered when making the decision of placing or not a child with parents in an institution. Results suggest the intensification of identifying and addressing the behavioral problems as part of deinstitutionalization process focusing also on family characteristics to improve children’s psychological adjustment. Moreover, understanding the development of psychopathological problems during the process of institutionalization and de-institutionalization may be key to preventing high costs associated with these disorders across the life course

Parenting practices and family relationships during the COVID-19 lockdown in Ghana

The effects of the COVID-19 pandemic have been far reaching across almost every sphere of life. Families, which are the basic units of society, have not been spared the ravages of the pandemic. Changes in family daily routines as a result of COVID-19 can affect spousal relationships, parenting and childcare practices. However, the extent to which the pandemic has affected parenting practices and family relationships in Ghana is not known. The goal of this study was to assess how parenting practices and family relationships have been influenced during the COVID-19 pandemic in Ghana. Data for this paper was drawn from an online questionnaire response from 463 participants in Ghana as a subset analysis from a multi-country study on personal and family coping system with COVID-19 pandemic in the global south. The mean score for pre-COVID-19 relationship with partner (36.86) was higher (p<0.0001) than the mean score for during COVID-19 relationship with partner (35.32) indicating that COVID-19 has had negative influence on relationships. The mean score for pre-COVID-19 parenting (32.78) was higher (p<0.0001) compared to the mean score for during COVID-19 parenting (31.40) indicating negative influence on parenting. We have predicted that participants whose coping levels were “Well” on the average, are likely to be doing well in relationship with partners and parenting practices during the COVID-19 period The challenging public health containment measures of the COVID-19 pandemic have negatively influenced the relationship between partners and parenting practices in Ghana

Prevalence and correlates of depression among rural and urban Rwandan mothers and their daughters 26 years after the 1994 genocide against the Tutsi

Background: In the past 26 years since the genocide against the Tutsi, mental illness continues to be the greatest challenges facing the Rwandan population. In the context of the 1994 genocide against Tutsi, there are three different survival status within Rwandan women. Those who were targeted by the genocide referred to as ‘survivors’, those who were in the country during the genocide but were not targeted referred to as ‘non-targeted’, and those who were outside the country referred to as ‘1959 returnees’. All these groups experienced the traumatic events differently. The literature shows that traumatic stress exposure is associated with depression. Objectives: To demonstrate differences in trauma exposure in a sample of mothers and daughters according to their genocide survival status. To examine differences in depression prevalence between these three groups of mothers and daughters as a function of their genocide survival status and place of residence. To examine the relationship between major depression, survival status, place of residence, and trauma exposure in sample of mothers and daughters, including the relationship between mothers’ depression and daughters’ depression. Methods: A sample of 309 dyads of mothers and daughters was recruited. Data were collected using the Mini International Neuropsychiatric Interview, Life Events Questionnaire and the Social Demographics Questionnaire. Data were analysed using descriptive statistics, chi-square test, logistic regression, and one-way ANOVA. Results: There is a significant difference in trauma exposure in three survival categories of mothers and daughters. A 23% of mothers and 18.4% of daughters met criteria for major depression, with urban participants twice as likely to meet criteria as participants from rural areas. Depression was associated with trauma exposure and place of residence in mothers’ and daughters’ samples. Maternal depression was associated with depression in daughters. Conclusions: Family support counselling services and research to identify factors of intergenerational depression are needed