Orphans and Vulnerable Youth in Bulawayo, Zimbabwe: An Exploratory Study of Psychosocial Well-Being and Psychosocial Support Programs

This 58-page report presents findings from an exploratory study by the Regional Psychosocial Support Initiative (REPSSI) and Catholic Relief Services' Support to Replicable, Innovative Village/Community-level Efforts (STRIVE) Programme of vulnerable youth living in and around Bulawayo, Zimbabwe. It describes their demographic characteristics, exposure to stress and trauma, and psychosocial well-being. The report also highlights the relationships between psychosocial well-being outcomes and exposure to stress and trauma, and the differences in psychosocial well-being between males and females, orphaned and non-orphaned youth, and younger and older adolescents. In addition, the report explores the relationships between exposure to different psychosocial support (PSS) programmes and measures of psychosocial well-being and distress.

The study's objectives were to:

• Develop a better understanding of psychosocial well-being among vulnerable adolescents and how to measure it.
• Explore the effects of participation in psychosocial support programmes on adolescents’ psychosocial well-being.

The study focuses on adolescents because of the presence of PSS programmes for this age group in the study area. The process involved, first, formative qualitative research with youth and adults working with youth to determine local concepts, manifestations, and domains of well-being among youth. Findings were used to inform development of a quantitative survey which was administered to a cross-sectional sample of 1,258 orphans and vulnerable youth aged 14-20.

Excerpts from the Conclusions and Recommendations section of the report follow:

"Most respondents had experienced multiple traumatic events, including the death of loved ones, illness in the family, stigma, and rejection in times of need. Respondents also identified numerous causes of stress in their daily lives, such as lack of money, job opportunities, and health care. The difficult political and economic context in modern-day Zimbabwe likely added to this. Another source of stress identified by youth was not having adults to talk to about relationships, problems, and other issues. This highlights the importance of adult guidance for youth.

Not surprisingly, indications of psychosocial distress were widespread. More than half of youth reported feelings of worry or stress, irritability, sadness, difficulty concentrating, being overwhelmed, and hopelessness. These are outcomes that, in a Western context, would be suggestive of depression and anxiety.

Social connectedness, such as having supportive relationships with primary caregivers and members of one’s cultural or faith groups, is widely recognised as a protective factor that "buffers the consequences of negative experiences on children" (Duncan and Arnston 2003). Unfortunately, social support for vulnerable youth in this study was inconsistent. Answers to social support questions revealed a mixed picture, with about half of youth reporting feeling very well supported by adults in their lives and people in their religious community. However, a significant vulnerable group also emerged, who never felt supported by their community, peers, or people in their religious community. Of note were reports of abandonment by family and friends in times of need and of youth living with guardians who were made to feel unwelcome.

Despite cumulative stresses and trauma, responses also suggest resilience in the youth studied. Resilience is an individual’s capacity to adapt, cope, and remain strong in the face of adversity, including stressful and traumatic events (Boyden et al. 2000). The majority of all youth in the sample reported confidence, capacity to help themselves, and hopefulness for the future. However, a very vulnerable group unable to cope with difficulties, lacking self-confidence, and pessimistic about the future also emerged.

In terms of vulnerability, the findings suggest that females, orphans, and older youth may be particularly disadvantaged. Females in this sample were more likely than males to have experienced the death of a loved one and other traumatic events and reported more sources of stress in their daily lives. They also showed higher levels of psychosocial distress, such as less hopefulness, trust in others, and self-confidence, and were more likely to manifest this distress through somatic (physical) symptoms such as poor appetite and fatigue. The experience of orphanhood was associated with greater exposure to trauma and stress, less social support, and lower levels of psychosocial well-being. Compared to their peers, orphaned youth had poorer access to supportive adults in whom they can confide.

Older youth had higher trauma scores and reported more signs of psychosocial distress. At the same time, older respondents, many of whom were peer leaders, tended to report more self-confidence and self esteem than younger respondents.

When comparing the intervention groups to the comparison group, all three interventions were associated with greater self-confidence, especially among males. However, positive associations with the other three psychosocial well-being outcomes - hopefulness, self-efficacy, and ability to cope - were much more limited...

Program Implications:

• It is necessary to find creative ways of sensitizing parents and caregivers to children’s needs to talk to someone about their feelings, relationships, and healthy life decisions...
• PSS programs need to be aware of the potential added vulnerability of females to trauma, daily stress, and psychosocial distress...
• Older youth may benefit from tailored PSS programs that help them cope with increasing responsibilities...
• PSS programs need to be responsive to the unique needs of orphaned adolescents without causing further stigmatization...
• PSS programs should explore better ways to address psychosocial distress on the one hand, while cultivating resilience on the other...
• PSS programs should be adapted to reflect children's grieving processes and attitudes toward illness, loss, and death in this specific cultural context...
• A comprehensive response to the psychosocial needs of vulnerable youth must go beyond discrete PSS programs to address underlying contextual causes of trauma and stress..."