Authors

  • Victoria Yewande Soyobi
    MBBS, Oni Memorial Children Hospital, Ibadan, Nigeria ;Riverside Nursing Home, Aberdeen, United Kingdom
  • Kennedy Oberhiri Obohwemu
    PhD, Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham, United Kingdom; PENKUP Research Institute, Birmingham, United Kingdom
  • Peter Omeiza Suberu
    MPH, Cardiorespiratory Unit, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
  • Jesse Omoregie
    PhD, Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham, United Kingdom
  • Gabriel Abayomi
    PhD, Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham, United Kingdom
  • Oluwatoyin Bewaji
    PhD, Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham, United Kingdom.
  • Temitayo Oluwakemi Fynecontry
    MSPH, Flexible Support Options, Newcastle, United Kingdom

DOI:

https://doi.org/10.37547/tajiir/Volume06Issue10-05

Keywords:

Behavioural patterns orphans Kaduna Nigeria

Abstract

Background

The plight of orphans, exacerbated by conflict, disease, and socioeconomic factors, remains a pressing global issue, particularly in sub-Saharan Africa. Nigeria, notably impacted by the HIV/AIDS epidemic, terrorism, and natural disasters, has witnessed a substantial increase in orphan populations. These children face severe challenges, including child abuse, malnutrition, limited access to education, stigmatization, and a range of psychological and behavioural disorders. Despite some interventions, orphanages primarily address material needs, often neglecting comprehensive medical, social, and psychosocial support. This study explores the behavioural patterns of orphans in Kaduna, Nigeria, and examines how their medical and social challenges compare across various orphanages.

Methodology
A cross-sectional, comparative analysis was conducted among 100 orphans from selected orphanages in Kaduna. Data were collected through interviewer-administered questionnaires assessing socio-demographics, medical conditions, behavioural patterns, stigma, psychosocial status, and coping strategies.

Results
The mean age of respondents was 10 years, with 68% being male. Nutritional issues were prevalent, with 53.7% classified as underweight despite 54.9% reportedly consuming balanced diets. Medical concerns were significant, with 33.7% showing clinical signs of illness and 46.7% not fully immunized. Behavioural issues were prominent, including hyperactivity symptoms (27.0%), enuresis (22.3%), and depressive symptoms (1.8%). Socially, most respondents (83.3%) reported positive peer relationships, though bullying (11.4%) and stigmatization (9%) were also observed. Educational access was generally high, with only 2.2% not attending school. However, social support systems varied, with 35.2% reporting strong support and 46.8% adapting their goals as a coping mechanism.

Conclusion
The findings highlight the complex medical and behavioural challenges faced by orphans in Kaduna's orphanages, underscoring the need for integrated interventions that provide medical, psychosocial, and educational support. A holistic approach is crucial to improving their overall well-being and future prospects.

ZENODO DOI:- https://doi.org/10.5281/zenodo.13955072


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PUBLISHED DATE: - 18-10-2024
DOI: -

https://doi.org/10.37547/tajiir/Volume06Issue10-05

PAGE NO.: - 36-54

BEHAVIOURAL PATTERNS OF CHILDREN IN
KADUNA STATE ORPHANAGES: A
COMPARATIVE ANALYSIS


SOYOBI Victoria Yewande

MBBS, Oni Memorial Children Hospital, Ibadan, Nigeria
Riverside Nursing Home, Aberdeen, United Kingdom

Kennedy Oberhiri OBOHWEMU

PhD, Department of Health, Wellbeing & Social Care, Global Banking
School/Oxford Brookes University, Birmingham, United Kingdom.

PENKUP Research Institute, Birmingham, United Kingdom

SUBERU Peter Omeiza

MPH, Cardiorespiratory Unit, Leeds Teaching Hospitals NHS Trust, Leeds,
United Kingdom

OMOREGIE Jesse

PhD, Department of Health, Wellbeing & Social Care, Global Banking

School/Oxford Brookes University, Birmingham, United Kingdom

ABAYOMI Gabriel

PhD, Department of Health, Wellbeing & Social Care, Global Banking

School/Oxford Brookes University, Birmingham, United Kingdom

BEWAJI Oluwatoyin

PhD, Department of Health, Wellbeing & Social Care, Global Banking

School/Oxford Brookes University, Birmingham, United Kingdom

FYNECONTRY Temitayo Oluwakemi

MSPH Flexible Support Options, Newcastle, United Kingdom

CORRESPONDING AUTHOR: - Obohwemu Kennedy Oberhiri

RESEARCH ARTICLE

Open Access


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INTRODUCTION

Life presents a series of opportunities and
challenges, and for children in orphanages, these
challenges are often magnified by the absence of
parental care and the constraints of institutional
settings. Orphanages are institutions that provide
support for children who have lost one or both
parents, or whose families are unable to care for
them due to socio-economic hardships, conflicts,
or other forms of dysfunction (Mahmood, Ullah
and Sha, 2020; Frimpong-Manso, 2021; Yuka and
Omorogiuwa, 2024). While the purpose of these
institutions is to offer shelter, education, medical
care, and emotional support, the reality for many

orphaned children is often far from ideal. The
behavioural patterns of children residing in
orphanages are shaped by multiple factors,
including the trauma of losing their parents, the
often-harsh institutional environment, and the
lack of consistent, individualized care. In many
cases, these experiences contribute to significant
behavioural challenges that distinguish these
children from their peers living in family settings.

The phenomenon of orphanages has a long history,
but the situation of orphans in sub-Saharan Africa
has become increasingly dire in recent decades. In
Nigeria, the orphan crisis has been exacerbated by

Abstract


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regional conflicts, poverty, and the HIV/AIDS
pandemic. According to UNICEF, as of 2020, over
17 million orphans were recorded in Nigeria, many
of them concentrated in states such as Kaduna,
where the effects of poverty and conflict have
worsened their plight (UNICEF, 2020). These
children face not only the physical challenges of
poor health and malnutrition (Soyobi, Obohwemu,
and Suberu, 2024) but also deep emotional and
psychological scars that manifest in a range of
behavioural issues. Orphaned and vulnerable
children (OVCs) are particularly susceptible to
mental health problems, including anxiety,
depression, aggression, and attachment disorders,
which significantly influence their behavioural
patterns (Mugisha et al., 2018; Kibachio and Mutie,
2020).

Children in orphanages often exhibit behavioural
patterns that reflect the complex interplay
between their past trauma and their current
environment. Studies have shown that children
who lose one or both parents are at a higher risk of
developing behavioural issues, as they grapple
with the emotional impact of their loss, alongside
the challenges posed by institutional living. For
instance, many children in orphanages have
trouble forming healthy attachments with
caregivers, which can lead to behavioural issues
such as withdrawal, aggression, or hyperactivity
(Aliyu et al., 2018). The lack of consistent
emotional support and the high caregiver-to-child
ratio in many orphanages make it difficult for
children to develop secure attachments, which are
essential for healthy emotional and social
development (Pryce et al., 2020).

The institutional environment of orphanages can
further exacerbate these behavioural issues. In
many orphanages, resources are limited, and
caregivers are often overburdened, leading to a
lack of individualized attention for each child
(Soyobi, Obohwemu, and Suberu, 2024). This

environment can foster feelings of neglect and
abandonment, which may manifest as behavioural
problems. Children may act out in an attempt to
gain attention or may become withdrawn and
emotionally detached. Studies have indicated that
children in orphanages are more likely to exhibit
behavioural problems such as aggression,
defiance, and oppositional behavior than their
peers in family settings (Bakermans-Kranenburg
et al., 2011). These behavioural patterns are often
a coping mechanism in response to the trauma and
stress associated with their environment.

In addition to the emotional and psychological
challenges, children in orphanages often struggle
with developmental delays that can further
influence their behavior. Many children in
institutional care lack access to early childhood
education and developmental support, which can
result in cognitive and behavioural deficits.
Research has shown that children in orphanages
are at higher risk of developmental delays,
including

language

and

social-emotional

development, which can contribute to difficulties
in communication and social interactions (Nelson
et al., 2014). These delays often lead to frustration
and behavioural outbursts, as children struggle to
navigate social situations and express their needs
effectively.

The social dynamics within orphanages also play a

significant role in shaping children’s behavior. In

many orphanages, children are raised in group
settings, where competition for resources,
attention, and affection is common. This
competitive environment can lead to behavioural
issues such as bullying, aggression, and social
isolation. Studies have shown that children in
institutional settings are more likely to engage in
aggressive behaviors, as they attempt to assert
dominance or cope with feelings of insecurity
(Sonderman, 2023; Ozanne et al., 2024). The lack
of stable, nurturing relationships with caregivers


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can also hinder children’s ability to develop

healthy social skills, leading to difficulties in
forming friendships and navigating social
interactions outside the orphanage setting.

The impact of trauma on the behavioural patterns
of children in orphanages cannot be overstated.
Many children in orphanages have experienced
multiple forms of trauma, including the loss of
parents, exposure to violence, and neglect. This
trauma can have lasting effects on their emotional
and behavioural development, contributing to
issues such as post-traumatic stress disorder
(PTSD), anxiety, and depression. These mental
health challenges often manifest in behavioural
problems, including aggression, withdrawal, and
difficulty regulating emotions (Alem, 2020; Thulin
et al., 2022; Wambui, Njeru and Menacha, 2023).
Children who have experienced trauma may also
exhibit hypervigilance, a heightened state of
awareness that can lead to difficulty concentrating,
restlessness, and impulsivity (Cicchetti, 2013).

The behavioural challenges faced by children in
orphanages are further compounded by the lack of
access to mental health services. In many
orphanages, there are no trained mental health
professionals

available

to

address

the

psychological needs of the children. This lack of
support can result in untreated mental health
issues, which may worsen over time and lead to
more severe behavioural problems. Research has
shown that children in institutional care who do
not

receive

appropriate

mental

health

interventions are more likely to experience long-
term emotional and behavioural difficulties,
including increased risk of substance abuse,
criminal behavior, and poor educational outcomes
(Zeanah et al., 2011).

Despite these challenges, there is growing
recognition of the need to address the behavioural
and emotional needs of children in orphanages.
International organizations such as UNICEF and

the World Health Organization (WHO) have
emphasized the importance of providing
comprehensive care that includes not only physical
health but also emotional and psychological
support for children in institutional settings
(UNICEF, 2020; WHO, 2024). Interventions such as
trauma-informed

care,

attachment-based

therapies, and social-emotional learning programs
have been shown to be effective in improving the
behavioural outcomes of children in orphanages.
These interventions focus on helping children
develop healthy attachments, cope with trauma,
and improve their emotional regulation skills
(Zhang et al., 2021; Miller, 2022; Dennis, 2024).

The behavioural patterns of children in
orphanages are shaped by a complex interplay of
factors,

including

trauma,

institutional

environment, and social dynamics. These children
face significant emotional and psychological
challenges, which often manifest in behavioural
problems such as aggression, withdrawal, and
difficulty forming healthy attachments. The lack of
individualized care, developmental support, and
mental health services in orphanages exacerbates
these issues, leading to long-term difficulties in
social and emotional development. Addressing the
behavioural needs of children in orphanages
requires a comprehensive approach that includes
trauma-informed

care,

attachment-based

therapies,

and

social-emotional

learning

programs.

In Nigeria, the behavioural patterns of children in
orphanages have received relatively little attention
in research, despite the significant number of OVCs
in the country. Kaduna State, in particular, has seen
a dramatic increase in the number of orphaned
children due to regional conflicts, poverty, and
disease (Aliyu et al., 2018). Understanding the
behavioural challenges faced by these children is
critical for developing effective interventions that
can improve their well-being and help them reach


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their full potential. This study seeks to fill this gap
by conducting a comparative analysis of the
behavioural patterns of children in orphanages in
Kaduna State. By examining the factors that
contribute to these behavioural patterns, including
trauma, institutional environment, and social
dynamics, this research aims to provide valuable
insights into the unique challenges faced by
children in orphanages and to identify strategies
for improving their behavioural outcomes. By
understanding the behavioural patterns of
children in orphanages, policymakers, caregivers,
and mental health professionals can develop
targeted interventions that improve the well-being
of some of the most vulnerable members of society.

METHODOLOGY

Information on Study Area

Kaduna State, located in Nigeria's northwestern

geopolitical zone, plays a key role in the nation’s

economy. The capital city, Kaduna, is a major urban
center

alongside

Zaria

and

Kafanchan.

Geographically, Kaduna lies on the Kaduna River
and spans an area of 3,080 square kilometers
(1,190 square miles) with coordinates of
10°31'23"N and 7°26'25"E. Over 60 ethnic groups,
including the Gbayi, Hausa, Fulani, Gwong, Atuku,
Bajju, Atyab, Gure, and Ninkyop, populate the state,
making it ethnically diverse (Yakubu, 2006;
Nigeria Demographic Profile, 2021). As a key
economic hub in northern Nigeria, Kaduna is a
trade and transportation center that connects
agricultural regions to other states (Udo, 2023).

Research Sites

Adonai Orphanage Home: Established on
April 10, 2010, by Reverend Mrs. Elizabeth
Afuape, Adonai Orphanage is a faith-based,
non-profit, non-governmental organization
located at 1B Chalawa Crescent, Banawa,
opposite Dambo International School,
Kaduna South (Nigerian NGO Directory,

2012).

Mercy Orphanage Home: Founded by
Reverend Dr. Tunde Balanta on November
24, 2001, Mercy Orphanage Home is
another faith-based, non-governmental,
non-profit organization located at 12-14
Kagoro Close, Ungwan Romi, Chikun,
Kaduna South (Kareem, 2015).

Jammiyyr Matan Arewa Orphanage Home:
This organization, established on May 27,
1963, serves as a social organization for
Northern women, providing a platform for

women’s welfare and supporting orphans

(Jammiyyr Matan Arewa, 2017).

Study Design

The research adopted a cross-sectional descriptive
study design, which is commonly used to evaluate
the prevalence of certain characteristics in a
population at a specific point in time (Wang and
Cheng, 2020).

Study Population

The study population comprised orphanages
located in Kaduna State.

Inclusion Criteria

Children under 19 years of age residing in
any of the orphanages in Kaduna were
included in the study (WHO, 2016).

Exclusion Criteria

Children above 18 years of age or those
unwilling or unable to participate due to
mental or emotional states were excluded
from the research (Field, 2005).

Sample Size Determination

The sample size was determined using the
formula:

n = z

2

pq/d

2


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Where n=minimum sample size required,
p=0.207

27

, q=1-p (=0.793), z=the value of standard

normal deviation taken to be 1.96(at 95%
confidence interval), d=sampling error tolerance
at 95% confidence interval taken to be 0.05 (5%).

n=1.96

2

x0.207x0.793/0.05

2

n=0.631/0.0025=252.2

Therefore, minimum sample size required
N=252.2

However, the final sample size for a population
less than 10,000 (n

f

=n/(1+(n/N))

n=Initial sample size

N=Estimated population of the study area

n

f

=Final sample size

n=252.2

N=120

n

f=

252.2/ (1+ (252.2/120)

n

f=

81.3

This resulted in a final sample size of 90, after
factoring in a 10% non-response rate (Bartlett et
al., 2001).

Sampling Technique

The study used a two-stage sampling technique:

1.

In the first stage, three orphanages were

randomly selected from the seven total
orphanages in Kaduna.

2.

In the second stage, all children meeting the

inclusion criteria were sampled from the selected
orphanages.

For instance, Mercy Orphanage had 46 children, of
whom 40 met the criteria. In Adonai Orphanage, all
46 children were eligible, and in Jammiyyr Matan
Arewa, all 14 children were sampled (Umar &
Adegboye, 2018).

Tools of Data Collection

A questionnaire was administered to assess the
socio-medical issues faced by children in
orphanages. Some responses were provided by
caregivers. Additional tools included:

Mid Upper Arm Circumference (MUAC)

MUAC, first proposed by Shakir (1975), is a method
used to assess malnutrition in children. A
measurement of less than 11 cm indicates severe
acute malnutrition, while measurements between
11 and 12.5 cm suggest moderate acute
malnutrition. Measurements between 12.5 and
13.5 cm indicate risk, and values above 13.5 cm
suggest adequate nourishment (WHO, 2017).

Weighing Scale for BMI

Body Mass Index (BMI) is calculated by dividing an

individual’s weight in kilograms by the square of

their height in meters. It helps to assess nutritional
status:

Underweight: BMI <18.5 kg/m²,

Normal: 18.5 to 24.99 kg/m²,

Overweight: 25 to 29.99 kg/m²,

Obese: ≥30 kg/m².

Rosenberg Self-Esteem Scale (RSES)

The RSES, developed by Morris Rosenberg in 1965,
is a widely used tool for measuring self-esteem. It
uses a 10-item Likert scale, where higher scores
indicate higher self-esteem (Rosenberg, 1965).
Scores between 15 and 25 are within the normal
range, while scores below 15 indicate low self-
esteem (Mann et al., 2004).

Duke-UNC

Functional

Social

Support

Questionnaire (FSSQ)


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The FSSQ, developed by Broadhead et al. (1988),
measures perceived social support. Responses are
scored on a scale of 1 to 5, with higher average
scores indicating greater perceived support
(Broadhead et al., 1988).

Hyperactivity/Impulsivity

Symptoms

and

Major Depressive Disorder

Both conditions were assessed using the DSM-IV
criteria. A score of 60% or higher on the respective
scales indicated a diagnosis of either condition
(American Psychiatric Association, 2000).

Method of Data Collection

Six trained research assistants (five 500-level
medical students and one 600-level medical
student) administered the questionnaires. Data
collection was conducted over three Saturdays,
with an average of 30 respondents interviewed
each day (Akanbi et al., 2019).

Data Management and Analysis

Data were manually verified for accuracy before
being entered into SPSS version 20.0 for analysis.
Descriptive statistics were used to summarize
demographic data, and cross-tabulation was
performed to assess relationships between
variables. Results were presented in tables and
charts, and compared with findings from similar
studies (Pallant, 2020).

Ethical Considerations

1.

A letter of introduction was obtained from
the Department of Community Medicine,
Faculty of Medicine, ABU Zaria, and
presented to the directors of the
orphanages, who granted permission to
conduct the study.

2.

Informed consent was obtained from

eligible participants or their caregivers
(Council for International Organizations of
Medical Sciences, 2016).

Limitations of the Study

1.

The study only included three orphanages
due to time and resource constraints.

2.

Additional variables like Mantoux tests and
vitamin A levels could not be included due
to logistical challenges (Akanbi et al., 2019).

3.

The study's cross-sectional design presents
a limitation, as it captures knowledge and
skills at a single point in time (December
2016), potentially missing changes that may
have occurred since then. Consequently,
caution is needed when interpreting these
findings in the current context, as shifts in
healthcare policies, ongoing training
programs, or variations in resource
availability may have impacted healthcare
workers' knowledge and skills over the
years. Moreover, the reliance on self-
reported data to assess knowledge, rather
than direct observation of clinical practice,
introduces potential bias. Respondents may
either overestimate their competencies or
fail to fully disclose their limitations, which
could skew the results.

RESULTS

A total of 110 questionnaire was administered to
assess the medico-social problems of children
living in orphanages in Kaduna. A total of 100
questionnaires were retrieved with a response
rate of 91%.

Socio-demographic information of orphans living
in orphanages in Kaduna


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Table 1: Socio-demographic characteristics of respondents

Socio-demographic characteristics

of respondents

Frequency (n=100)

Percentage (%)

Age (in years)

0-4

8

18.0

5-9

26

16.0

10-14

41

41.0

15-19

25

25.0

Total

100

100.0

Sex

Male

68

68.0

Female

32

32.0

Total

100

100.0

Ethnicity

Hausa

41

41.0

Yoruba

30

30.0

Igbo

10

10.0

Birom

8

8.0

Others

11

11.0

Total

100

100.0

Religion

Islam

14

14.0

Christianity

86

86.0

Total

100

100.0

The table 1 above showed that the age group of respondents 10-14years have the highest percentage
(41%) while age group 0-4years has the least percentage of respondents (8%). There are more males
(68%) than female (32%) respondents. The predominant tribe is Hausa (41%), followed by Yoruba
(30%). Others include Baju, Ebira, Idoma, etc. There are more Christian (86%) than Muslim (14%)
respondents.

Prevalence of Common Medical Problems among Orphans in Orphanages in Kaduna


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Table 2: Physical well-being of respondents

Variables

All the
time [n
(%)]

Most of
the time
[n (%)]

More than
half of the
time [n
(%)]

Less than
half of the
time [n
(%)]

Some of
the time
[n (%)]

At no time
[n (%)]

Total [n
(%)]

I feel well and
energetic

34(39.1)

35(40.2)

8(9.2)

8(9.2)

2(2.3)

-

100(100)

I feel physically fit
to do anything I
want

31(35.6)

35(40.2)

10(11.5)

10(11.5)

1(1.1)

-

100(100)

I am comfortable
about my weight,
shape and physical
condition

41(48.8)

29(34.5)

11(13.1)

1(1.2)

1(1.2)

1(1.2)

100(100)

I do get all the
sleep I need

37(44.0)

20(23.8)

20(23.8)

4(4.8)

3(3.6)

-

100(100)

I am free from
unexplained
physical health
symptoms

29(35.8)

14(17.3)

11(13.6)

2(2.5)

23(28.4)

2(2.5)

100(100)

I woke up feeling
fresh and rested

41(50.0)

18(22.0)

12(14.6)

3(3.7)

6(7.3)

2(2.4)

100(100)

My daily life has
been filled with
things that interest
me

23(28.4)

29(35.8)

23(28.4)

5(6.2)

1(1.2)

-

100(100)

I eat good
balanced diet daily

45(54.9)

20(24.4)

7(8.5)

2(2.4)

8(9.8)

-

100(100)

I feel calm and
relax

30(36.6)

30(36.6)

14(17.1)

2(2.4)

6(7.3)

-

100(100)

I usually visit
hospital for
treatment

41(50.0)

15(18.3)

11(13.4)

7(8.5)

8(9.8)

-

100(100)

I do get all I need
anytime the need
arise

15(18.3)

15(18.3)

26(31.7)

10(12.2)

11(13.4)

5(6.1)

100(100)

I eat what I want
and not what I see

14(17.1)

13(15.9)

11(13.4)

8(7.3)

14(17.1)

24(29.3)

100(100)

From the above table, result shows that a high percentage of respondent felt well and energetic all the
time (39.1), most of the time (40.2) and none (0%) none of the time. This implies that about 80% feel well
and energetic and approximately 90% feel physically fit and comfortable with their weight, shape and
physical condition. About 46.4% of them eat what they want while majority (55.6%) eat what they see
rather than what they want, majority (83.3%) eat balanced diet likewise 81.7% visit the hospital
whenever they are ill.


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Table 3: Body mass index and mid upper arm circumference of respondents

Body mass index and MUAC of

respondents

Frequency (n=95)

Percentage (%)

BMI

Underweight

51

53.7

Normal weight

35

36.8

Overweight

4

4.2

Obese

5

5.3

Total

95

100.0

MUAC (cm)

<11.0

2

28.6

11.0-12.5

2

28.6

12.5-13.5

1

14.3

>13.5

2

28.6

Total

7

100.0

From the table above, more than half (53.7%) of the children are underweight while 36.8% weigh within
normal and 5.3% are obese. Less than half (28.6%) of respondents have severe acute malnutrition, 28.8%
also have moderate acute malnutrition, 14.3% is at risk of malnutrition and 28.6% of the respondents are
well nourished.

Table 4: Clinical examination result of respondents

Signs and symptoms/Age
group

0-4(n=8)

5-9(n=26)

10-
14(n=40)

15-
18(n=25)

Total(n=95)

De-pigmentation of hair

-

-

2

1

3

Muscle wasting

-

-

-

-

-

Moon face

-

-

-

1

1

Flaky paint dermatitis

-

-

-

-

-

Oedema

-

-

Bitot spot

-

-

-

2

2

Conjuctival xerosis

-

-

-

1

1

Xerosis of the skin

-

-

-

-

-

Cheilosis

1

1

1

-

3

Magenta tongue

-

-

1

1

2

Loss of ankle and knee jerk

-

-

-

-

-

Atrophic lingual papillae

-

1

-

-

1

Spongy bleeding tongue

-

-

-

1

1

Open fontanella

-

-

-

-

-


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Bow leg

1

-

-

1

2

Knock knee

3

1

2

6

Pale conjunctival

1

1

2

1

5

Enlarged thyroid gland

-

-

-

-

-

Mottled dental enamel

1

1

1

2

5

Total [n (%)]

4

7

8

13

32 (33.7)

66.3% of the respondents had no physical signs on clinical examination while 33.7% of the respondent
do.

Figure 1: Immunization status of respondents

The number of respondents that are fully immunized (53.3) were slightly higher than those that were not
fully immunized (46.7%).

Table 5: Frequency distribution of respondents with BCG scar and the immunization card seen

Table 5 above showed that 87.5% of the under-

five’s immunization card were seen and 62.5% of them

have BCG scar.

53.3

46.7

immunisation status

n=15

fully immunized

not fully immunized

Number of immunization card seen
and presence of BCG scar on

respondents among under-fives

Frequency (n=8)

Percentage (%)

Number of immunization card seen

7

87.5

Presence of BCG scar

5

62.5


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Figure 2: Frequency distribution of children that sleep under ITN

Figure 2 above showed that 87% of the respondents sleep under insecticide treated net.

4.3 Behavioural patterns of orphans living in orphanages in Kaduna

Table 6: Behavioural patterns of orphans in orphanages in Kaduna

Behavioural patterns of
respondents

Frequency

(n=85)

Percentage

(%)

Hyperactivity/impulsivity
symptoms

Present

23

27

Absent

62

73

Total

85

100.0

Major depressive disorder

Present

1

1.8

Absent

84

98.2

Total

85

100.0

Enuresis

5-9years

2

12.5

87%

13%

Percentage of children that use ITN

use ITN

does not use ITN


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10-14years

4

9.8

Total

6

22.3

Tic disorders

Present

-

Absent

85

100

Total

85

100

Table 6 above showed that 27% of respondents have hypersensitivity/impulsivity disorder, 1.8% are
suffering from major depressive disorder, 22.3% have enuresis with age group 5-9years being majority
(12.5%) and none of the respondents has tic disorders.

DISCUSSION

The behavioural patterns observed in orphaned
children in Kaduna State orphanages reflect both
the shared and distinctive influences of their socio-
cultural environment, educational access, and
health status, as well as the psychological effects of
orphanhood. These findings are crucial in
understanding

how

these

children's

developmental trajectories align with and differ
from those reported in other studies on orphan
populations globally.

The age distribution, with the majority of
respondents between the ages of 10-14 years, is
consistent with previous research in orphanages
across Nigeria and other parts of the world. A study
conducted in Ogun State found that most orphans
were within a similar age bracket, though the
gender distribution in the Kaduna study revealed a
significantly

higher

proportion

of

male

respondents (68%) compared to female
respondents (32%) (Folarin & Bello, 2016). The
underrepresentation of females may reflect
cultural norms around gender roles in northern
Nigeria, where male children may be more likely to
be enrolled in institutional care due to the
preference for males to receive formal education
or social services (Adejumo et al., 2017). This is
also consistent with findings from rural China,
where there is a slight predominance of males in
orphanage populations (Zhang et al., 2019).

One notable finding from the study is the
predominance of the Hausa ethnic group (41.0%)
among the respondents, which reflects the ethnic
composition of Kaduna State. The education levels
of the respondents, with most children having
attained primary education (57%) followed by
junior secondary school (26.7%), are comparable
to findings in western Nigeria, where a majority of
orphaned children also had primary-level
education (Adejumo et al., 2017). However, despite
these similarities, the low percentage of children
with education beyond junior secondary school
highlights the challenges that orphanages face in
providing continuous education, which has

implications for the children’s future opportunities

and socioeconomic mobility. This aligns with the
conclusions of research in South Africa, where
institutionalized children often experience
disruptions in their educational progression due to
systemic inadequacies in orphanage facilities
(Cluver et al., 2012).

Physical health was another key area of interest in
this study. The reported high levels of physical
well-being, where 40.2% of the children felt
energetic most of the time, closely mirror findings
from studies conducted in other Nigerian states
(Folarin & Bello, 2016). However, slight variations
exist when compared to the Ogun State study,
where a higher percentage of children reported
feeling well and energetic all the time (60.9%).


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These differences may reflect variations in the
quality of care and resources available to children
in different orphanage systems. For instance,
orphanages in urban areas such as those in Ogun
State may have better access to healthcare
services, nutrition, and recreational activities
compared to those in more rural or less affluent
regions like Kaduna (Oladokun et al., 2016a).

Malnutrition, a common issue among orphans in
low-resource settings, remains a concern in
Kaduna

orphanages.

The

prevalence

of

underweight children (53.7%) in this study is
significantly higher than what has been reported in
orphanages in other parts of Nigeria, such as Imo
State, where only 19% of the children were
underweight (Nwafor et al., 2018). This disparity
may be attributed to differences in the economic
capacity of orphanages and the availability of
government or NGO support for nutritional
programs. The findings in Kaduna are more
comparable to those in rural Ethiopia, where
orphaned children are similarly vulnerable to poor
nutritional outcomes due to limited access to
adequate food supplies (Belay & Deribew, 2019).

Mental health concerns, particularly behavioural
disorders, are a significant aspect of the study. The
prevalence of hyperactivity/impulsivity symptoms
(27%) aligns with findings from orphanages in
Cairo, where 19.62% of children were diagnosed
with similar conditions (Mohamed et al., 2017).
This suggests that children in institutional care
settings are particularly susceptible to such
disorders, possibly due to the absence of stable
familial environments, inadequate emotional
support, or trauma related to parental loss (Patel
et al., 2019). The lower incidence of major
depressive disorder (1.8%) compared to studies in
Cairo and India, where rates were 7.17% and 25%,
respectively, raises questions about the variability
of depressive symptoms across different cultural
and environmental contexts (Mohamed et al.,

2017). It is possible that the supportive peer
relationships reported by a majority of the
respondents (83.3%) serve as a buffer against
severe depressive symptoms, as positive social
interactions have been shown to mitigate the
negative psychological effects of orphanhood
(Cluver et al., 2012).

Peer relationships and social integration are
pivotal to the emotional and social development of
orphaned children. The study reports that 83.1%
of respondents relate well with their peers, and
83.3% stated that their peers relate well with
them. This finding is consistent with a study
conducted in South Africa, where 70% of children
in orphanages reported positive peer relationships
(Cluver et al., 2012). However, the fact that 11.4%
of respondents experienced bullying and 9% felt
ostracized highlights the ongoing challenges of
social integration within orphanages. These social
stressors, although less pronounced than in some
studies, such as the South African study where
30% of children reported feeling ostracized,
nonetheless emphasize the need for interventions
aimed at fostering inclusive and supportive peer
environments (Cluver et al., 2012).

Self-esteem is another crucial behavioural
indicator of psychological well-being. The majority
of respondents (89.2%) reported having good self-
esteem, with males showing a significantly higher
percentage (60.5%) than females (27.7%). This
finding diverges from research conducted in Ogun
State, where females exhibited higher self-esteem
levels than males (Olaniyi et al., 2016). This gender
difference in self-esteem may be culturally rooted,
as northern Nigerian society tends to place greater
emphasis on male achievement and autonomy,
which could boost self-esteem in male children. On
the other hand, females may experience more
restricted roles and opportunities, contributing to
lower self-esteem. These patterns mirror findings
from studies in other patriarchal societies, such as


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in India, where girls in institutional care often
report lower self-esteem due to societal norms that
devalue their roles (Patel et al., 2019).

Coping mechanisms are a vital aspect of
behavioural patterns, especially in orphan
populations. The study revealed that more than
half (64.6%) of the respondents employed coping
strategies to manage their situations, although a
significant proportion exhibited negative coping
methods, such as distancing themselves from their
problems (53.8%) or making efforts to forget their
situations (50.6%). This is similar to findings from
Ethiopia, where orphaned children demonstrated
lower resilience scores and often resorted to
maladaptive coping strategies (Belay & Deribew,
2019). The prevalence of negative coping
mechanisms underscores the importance of
providing psychosocial support within orphanage
settings to foster healthier coping strategies. The
provision of counseling services and resilience
training could help mitigate the long-term
psychological impact of orphanhood.

The educational outcomes of the respondents were
generally positive, with 97.8% attending school
and 87.7% receiving formal Western education.
This is consistent with studies from other parts of
Nigeria, such as Abuja and Ogun State, where near-
universal school attendance among orphans has
been reported (Oladokun et al., 2016b). The strong
emphasis on education in these settings reflects
the understanding that education is a crucial tool
for breaking the cycle of poverty and ensuring
better future prospects for orphaned children.
However, the relatively lower percentage of
children attending junior secondary school
suggests that there may be barriers to continued
education beyond the primary level, possibly due
to financial constraints or limited capacity within
orphanage systems to support higher education.

In essence, the behavioural patterns of children in
Kaduna State orphanages reveal a complex

interplay of factors influencing their development.
While there are positive aspects, such as strong
peer relationships and good educational access,
challenges remain in areas such as mental health,
nutrition, and coping strategies. The findings align
with broader research on orphan populations, but
also highlight specific contextual factors unique to
the socio-cultural environment of northern
Nigeria. Addressing these challenges through
targeted interventions, including mental health
support, improved nutritional programs, and
resilience training, is crucial for fostering the long-
term well-being of these vulnerable children.

CONCLUSION

This study underscores the significant prevalence
of behavioural disorders among children in
orphanages in Kaduna State, Nigeria. High rates of
hyperactivity and enuresis reflect underlying
psychological and emotional issues that require
urgent attention. Poor self-esteem is also
prevalent,

highlighting

the

need

for

comprehensive psychosocial support. Despite
these challenges, most children have access to
formal education and perform well academically,
suggesting resilience and potential for positive
outcomes. Contrary to common assumptions, the
majority report low levels of stigmatization,
indicating good social integration, which may aid
their emotional resilience and overall well-being.
Addressing behavioural issues through targeted
interventions is crucial for improving the quality of
life for orphans in Kaduna. Ensuring psychological
support, along with maintaining access to
education and fostering social support systems, is
essential for their long-term development and
integration into society. Collaborative efforts
between government agencies, non-governmental
organizations, and the community are necessary to
address these multidimensional issues and
enhance the well-being of orphans in Kaduna.

ACKNOWLEDGEMENTS


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The authors would like to acknowledge the
management and technical staff of PENKUP
Research Institute, Birmingham, United Kingdom
for their excellent assistance and for providing
manuscript

writing/editorial

support

in

accordance with Good Publication Practice (GPP3)
guidelines.

FUNDING

This research did not receive any grant from
funding agencies in the public, commercial, or not-
for-profit sectors.

Authors’ Contributions

The entire study procedure was conducted with
the involvement of all writers.

Conflict of Interest

The authors declare no conflicts of interest.

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