Emergence of overweight problems among orphan and vulnerable child caregivers in southern africa

Background. Africa is facing a nutritional transition where underweight and overweight coexist.The association between being an orphan and vulnerable child (OVC) caregiver in Africa on the caregivers' overweight status is inadequately understood. OVC caregivers should be in the spotlight due to the crisis that 12 million OVC represents in Africa. This cross-sectional study investigated the association between African OVC caregiving and women's overweight status, and the modifying role of socio-demographic characteristics on this relationship. Methods. Demographic Health Surveys data collected during 2006-2007 from 20-49 year old women in Namibia (n=6,638), Swaziland (n=3,285), and Zambia (n=4,497) were analyzed using weighted marginal means and logistic regressions. Results. The overweight prevalence for 20-49 year old women was 34.2% in Namibia, 59.5% in Swaziland and 22.1% in Zambia.In Namibia, non-OVC caregivers (OR=1.70; 95% CI=1.08-2.68) and non-primary caregivers not living with an OVC (OR=2.59; 95% CI=1.57-4.27) were more likely to be overweight than OVC primary caregivers. In Zambia, non-OVC caregivers were less likely to be overweight than OVC caregivers (OR=0.54; 95% CI=0.41-0.71). In Swaziland and Zambia, OVC caregivers were more likely to be overweight than non-child caregivers. Women's age (Namibia) and parity (Zambia) were effect modifiers. Conclusions. Overweight problems among African OVC caregivers have emerged and should be addressed. Given the chronic nature of most diseases associated with overweight and by extension the huge cost of treatment, African public health systems and programs targeting OVC families should be prepared to face a new overweight epidemic alongside existing ones such as HIV/AIDS, tuberculosis, and malaria.