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
  • Joyce Eberechukwu Idomeh
    PhD, Department of Social Works (DSW), College of Education, Psychology and Social Work, Flinders University, Bedford Park Campus, Sturt Road, Bedford Park 5042, South Australia
  • Gordon Mabengban Yakpir
    PhD, Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham, United Kingdom
  • Bewaji Aderinsola Oluwatoyin
    PhD Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Manchester, United Kingdom
  • Jesse Omoregie
    PhD, Department of Psychology, University of Bolton, Bolton, United Kingdom
  • Maame Ama Owusuaa
    PhD, Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham, United Kingdom
  • Ibiangake Friday Ndioho
    PhD, Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
  • Reginald Ugochukwu Amanze
    PhD, Department of Psychology, University of Bolton, Bolton, United Kingdom

DOI:

https://doi.org/10.37547/tajssei/Volume06Issue11-07

Keywords:

Orphans Stigma Well-being Kaduna Nigeria

Abstract

Background: Orphans in sub-Saharan Africa, particularly Nigeria, face increasing challenges due to the HIV/AIDS epidemic, terrorism, and natural disasters, leading to a growing orphan population. In addition to the material hardships experienced by orphans, stigmatization remains a profound issue, exacerbating their medical, social, and psychological well-being. Stigma affects children’s self-esteem, mental health, social relationships, and access to opportunities, making it a critical area of concern for orphaned children in institutional care. This study investigates the impact of stigma on the well-being of children in orphanages in Kaduna, Nigeria, focusing on medical, social, and psychosocial aspects of their lives.

Methodology: This cross-sectional descriptive study was conducted among 100 children living in orphanages across Kaduna. Data were collected through interviewer-administered questionnaires designed to capture socio-demographic data, medical conditions, behavioural patterns, stigma levels, and psychosocial status. The study also explored how these children cope with the stigma associated with being orphans.

Results: The findings revealed a significant presence of stigma among the orphan population, with 9% of children reporting being stigmatized by peers. Although 83.3% of respondents indicated positive peer relationships, bullying affected 11.4% of the children. Medical issues were prevalent, with 53.7% of the children underweight and 46.7% not fully immunized. Behavioural disorders such as hyperactivity (27%) and enuresis (22.3%) were also common. Despite these challenges, 89.2% reported good self-esteem, although many employed maladaptive coping mechanisms, with 46.8% adjusting their goals to cope with their circumstances.

Conclusion: The study highlights the pervasive impact of stigma on the well-being of orphans in Kaduna, contributing to psychological distress and health challenges. Addressing the stigma and its effects requires comprehensive intervention strategies that integrate medical, psychosocial, and educational support.


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PUBLISHED DATE: - 15-11-2024
DOI: -

https://doi.org/10.37547/tajssei/Volume06Issue11-07

PAGE NO.: - 77-96

THE IMPACT OF STIGMA ON THE
WELLBEING OF CHILDREN IN KADUNA
ORPHANAGES


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

Joyce Eberechukwu Idomeh

PhD, Department of Social Works (DSW), College of Education, Psychology and Social Work,
Flinders University, Bedford Park Campus, Sturt Road, Bedford Park 5042, South Australia

Gordon Mabengban Yakpir

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

Bewaji Aderinsola Oluwatoyin

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

Jesse Omoregie

PhD, Department of Psychology, University of Bolton, Bolton, United Kingdom

Maame Ama Owusuaa

PhD, Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes

University, Birmingham, United Kingdom

Ibiangake Friday Ndioho

PhD, Department of Health Professions, Manchester Metropolitan University, Manchester,

United Kingdom

RESEARCH ARTICLE

Open Access


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Reginald Ugochukwu Amanze

PhD, Department of Psychology, University of Bolton, Bolton, United Kingdom

Corresponding Author: Obohwemu Kennedy Oberhiri, PhD

INTRODUCTION

Children in orphanages face a myriad of challenges,
many of which stem from the absence of parental
care and the limitations inherent in institutional
living. Orphanages provide essential services such
as shelter, education, and healthcare for children
who have lost one or both parents or whose
families are unable to care for them due to socio-
economic struggles, conflict, or other forms of
dysfunction. However, while these institutions are
designed to provide a supportive environment, the
reality for many children living in orphanages is
often far from ideal. Among the numerous
adversities faced by orphans, social stigma stands
out as a critical factor that profoundly affects their
overall well-being. This stigma

rooted in

negative societal attitudes towards orphans

permeates every aspect of their lives, from how
they are perceived and treated by their
communities to the self-esteem and mental health
challenges they face.

Stigma against orphans manifests in various ways,
and its impact on their psychosocial well-being is
profound. Children in orphanages are often
marginalized by society and may be seen as
"different" or "inferior" because they lack parental
support. This societal bias is deeply ingrained in
many cultures, where family is considered the
foundation of social stability and worth. In Nigeria,
this stigma is exacerbated by cultural and religious
beliefs that frame orphans as unfortunate or
cursed (Nguyen et al., 2016). As a result, children
in orphanages are not only coping with the trauma

Abstract


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of losing their parents but also with the emotional
and psychological burdens of societal rejection.

In sub-Saharan Africa, the orphan crisis has
reached alarming proportions due to the combined
effects of HIV/AIDS, conflict, and economic
instability. Nigeria, as the most populous country
in the region, bears a significant portion of this
burden (Soyobi, Obohwemu & Suberu, 2024;
Soyobi et al., 2024a; Soyobi et al., 2024b).
According to UNICEF (2020), over 17 million
children in Nigeria have lost one or both parents,
and many of these children are concentrated in
states such as Kaduna, where conflict, poverty, and
inadequate healthcare have exacerbated their
plight. Orphaned children in these regions are
often

stigmatized

due

to

widespread

misconceptions and fear surrounding diseases like
HIV/AIDS, which is a leading cause of orphanhood.
Community members may ostracize these
children, assuming that they are carriers of the
disease or that they are responsible for their
parents' deaths, further intensifying the stigma
(Skinner et al., 2006).

This pervasive stigma has a detrimental impact on
the psychological and emotional well-being of
children in orphanages. Research has consistently
shown that social stigma can lead to feelings of
shame, low self-esteem, and a sense of
worthlessness among stigmatized individuals
(Roelen, 2020; Bharti, 2023; Inglis et al., 2023). For
orphaned children, who are already vulnerable
due to the loss of their parents, stigma compounds
their emotional distress and creates additional
barriers to their development. Children in
orphanages often internalize the negative
perceptions of them held by society, which can lead
to a deep sense of self-stigmatization. This
internalized stigma has been linked to higher rates
of depression, anxiety, and other mental health
disorders among orphaned and vulnerable
children (Penner et al., 2020; Wilkerson, 2022;

Cherewick et al., 2023).

Moreover, the social exclusion experienced by
orphaned children due to stigma significantly
impacts their ability to form healthy social
relationships. Orphans in Kaduna are frequently
isolated from their peers and may be bullied or
discriminated against in school or community
settings. This isolation deprives them of the social
support networks that are crucial for emotional
and psychological resilience (Kalomo, Jun and Lee,
2022). Social connectedness has been identified as
a key protective factor for children facing
adversity, but when orphans are stigmatized and
excluded, they are denied this vital source of
support (Sherr et al., 2014). Without meaningful
social connections, these children are at greater
risk of developing long-term psychological issues
and experiencing difficulties in their personal and
professional lives as they grow older.

Institutional care settings, such as orphanages, also
play a role in reinforcing stigma. Children living in
orphanages are often viewed as "institutionalized,"
a term that carries negative connotations of being
dependent, maladjusted, or even dangerous. These
perceptions can persist long after the children
have left the orphanage, influencing how they are
treated in adulthood and limiting their
opportunities for education, employment, and
social integration (Whetten et al., 2014). In many
cases, orphaned children are not only stigmatized
by society but also by the caregivers within the
institutions themselves. Caregivers, who may be
overworked and undertrained, sometimes
reinforce negative stereotypes about orphans,
either consciously or unconsciously, which can
further damage the children's self-esteem and
mental health (Liu, 2021; Mlambo, 2021; Likoko et
al., 2023).

The impact of stigma on the physical health of
orphans is also significant. Stigmatized individuals
are more likely to experience barriers to accessing


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healthcare, either due to direct discrimination or
due to the fear of being judged by healthcare
providers (Meyerson et al., 2021; Dolezal, 2022;
Reilly and Williamson, 2022). For children in
orphanages, this can mean delayed treatment for
medical conditions or a reluctance to seek care
altogether, particularly in cases where the stigma
is linked to diseases like HIV/AIDS. In Nigeria,
where healthcare systems are often under-
resourced, the additional burden of stigma can
further limit access to essential health services for
orphaned children (Aliyu et al., 2018). This lack of
access to healthcare exacerbates existing health
problems and contributes to higher morbidity and
mortality rates among orphaned children
compared to their peers living in family settings
(UNICEF, 2019).

Stigma also has far-reaching consequences for the
educational outcomes of orphaned children. In
Kaduna, as in many other parts of Nigeria,
education is often seen as the primary route out of
poverty and a key determinant of future success.
However, orphaned children face numerous
barriers to accessing quality education, not least of
which is the stigma attached to their orphan status.
Teachers,

classmates,

and

even

school

administrators may hold prejudiced views
towards

orphaned

children,

leading

to

discriminatory practices such as exclusion from
school activities, lower expectations, and even
verbal or physical abuse (Mugisha et al., 2018).
This stigmatization within the educational system
not only hinders the academic achievement of
orphaned children but also discourages them from
fully participating in school life, further isolating
them from their peers and reducing their chances
of success in later life.

Despite these challenges, there is growing
recognition of the need to address the stigma faced
by orphans and its impact on their well-being.
International organizations such as UNICEF and

the World Health Organization (WHO) have
emphasized the importance of tackling stigma as
part of a broader strategy to improve the lives of
orphaned and vulnerable children (WHO, 2019;
UNICEF, 2020). Efforts to reduce stigma include
public awareness campaigns aimed at challenging
harmful stereotypes and promoting the rights and
dignity of orphans. These initiatives have been
shown to be effective in reducing stigma in some
contexts, particularly when they involve the
participation of community leaders, religious
institutions, and local government agencies
(Chidakwa and Khanare, 2024). Additionally,
interventions that provide psychosocial support to
orphaned children, such as counseling, peer
support groups, and social-emotional learning
programs, can help mitigate the harmful effects of
stigma and improve their overall well-being
(Cluver et al., 2013).

This paper highlights the profound impact of social
stigma on the psychological and emotional well-
being of orphaned children in Kaduna, Nigeria.
Additionally, it provides insights into how cultural
and religious beliefs in Nigeria exacerbate the
stigma faced by orphans. The paper offers a
detailed examination of the orphan crisis in sub-
Saharan Africa, with a specific focus on Nigeria and
the state of Kaduna. Furthermore, it links social
stigma to higher rates of depression, anxiety, and
other mental health disorders among orphaned
children.

Addressing the impact of stigma on the well-being
of children in orphanages requires a multi-faceted
approach that involves not only changing societal
attitudes but also improving the conditions within
orphanages and ensuring that children have access
to the resources they need to thrive. Policymakers,
caregivers, educators, and community leaders all
have a role to play in reducing stigma and
promoting the well-being of orphaned children. By
fostering a more inclusive and supportive


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environment, it is possible to mitigate the negative
effects of stigma and help these children realize
their full potential.

METHODOLOGY

The study area for this research is Kaduna, a key
city in the northwestern region of Nigeria, serving
as the capital of Kaduna State. Kaduna is not only
an important economic hub but also a center of
culture and education. It is located on the Kaduna
River, occupying a total area of approximately
3,080

square

kilometers

(Kaduna

State

Government, 2021). With coordinates of

10°31’23"N and 7°26’25"E, Kaduna enjoys a

strategic position, linking northern Nigeria to
other regions. The state hosts over 60 ethnic
groups, including the Gbayi, Hausa, Fulani, Gwong,
Atuku, Bajju, Atyab, Gure, and Ninkyop, reflecting
its rich ethnic diversity (Nigeria Population
Commission, 2019). Economically, Kaduna plays a
vital role in the surrounding agricultural and
industrial sectors, making it an important trade
and transport hub (Adeyemi & Oluwatosin, 2018).

The three orphanages selected as research sites for
this study represent various facets of institutional
care in Kaduna. First, the Adonai Orphanage Home,
founded on April 10, 2010, by Reverend Mrs.
Elizabeth Afuape, is a faith-based, non-profit
organization located in Banawa, Kaduna South. Its
mission is rooted in providing care, shelter, and
emotional support to orphaned children,
particularly those who have lost their families due
to poverty or conflict (Oluwatoyin, 2019). Second,
the Mercy Orphanage Home, established by
Reverend Dr. Tunde Balanta on November 24,
2001, is another non-governmental organization
(NGO) focusing on the care of orphans. Located in
Ungwan Romi, Kaduna South, Mercy Orphanage
also follows a faith-based approach, offering not
only shelter but also educational support and
healthcare services to its residents (Balanta,
2020). Finally, the Jamiyyar Matan Arewa

Orphanage, created by the Social Organization of
Northern Women on May 27, 1963, is one of the
oldest

orphanages

in

Northern

Nigeria,

emphasizing the welfare of both women and
children. The orphanage fosters communal
support and unification of women in the region,
reflecting the traditional values of Northern
Nigerian societies (Adeyemi et al., 2017).

This research follows a cross-sectional descriptive
design, a widely used approach in social sciences
for capturing the status of a population at a specific
point in time (Levin, 2006). A cross-sectional
design is particularly effective in understanding
the prevalence of medical and social issues faced
by children in institutional care, offering insights
into their immediate health and social support
needs (Kreuter, 2016).

The study population consists of children living in
orphanage homes in Kaduna. The inclusion criteria
for participants are children under the age of 19
living in the selected orphanages, while the
exclusion criteria are those above 18 years old or
those unwilling or unable to participate
(Oluwatoyin, 2019).

The sample size (n) drawn from the selected
subjects was determined using the formula below:

n = z2pq/d2

Where n=minimum sample size required,
p=0.20727, 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%). Based on these calculations, a sample
size of 90 participants was deemed necessary,
considering a 10% non-response rate (Mugisha et
al., 2018; National Population Commission, 2018).

A two-stage sampling technique was employed. In
the first stage, three out of seven orphanages in
Kaduna were randomly selected. The second stage
involved total sampling of all eligible children in


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these orphanages. For instance, in the Mercy
Orphanage, 46 children were residing, but 40 met
the inclusion criteria. In Adonai Orphanage, all 46
children were included in the sample, while the
Jamiyyar Matan Arewa Orphanage had 14 children,
all of whom participated (Kareem, 2015).

The tools used for data collection included a
structured,

interviewer-administered

questionnaire designed to capture information on
the medical and social challenges of the children.
The questionnaire was supplemented by
anthropometric measures, such as the Mid-Upper
Arm Circumference (MUAC) and Body Mass Index
(BMI), as well as psychosocial assessment tools
like the Rosenberg Self-Esteem Scale and the Duke-
UNC Functional Social Support Questionnaire
(Broadhead et al., 1988). These instruments have
been widely validated for assessing nutritional and
psychological well-being in vulnerable populations
(Shakir, 1975; Rosenberg, 1965).

MUAC measurements provide a quick assessment
of malnutrition, a common health issue in
orphanages due to limited resources and
overcrowded living conditions (Aliyu et al., 2018).
According to Shakir (1975), a MUAC of less than 11
cm indicates severe malnutrition, while values
between 11 cm and 12.5 cm signify moderate
malnutrition. The BMI was calculated using a
standard formula, allowing the researchers to
assess whether the children fell within healthy
weight categories (Balanta, 2020).

To assess the psychological well-being of the
children, the Rosenberg Self-Esteem Scale (RSES)
was employed. The RSES is a widely recognized
tool in social science research for measuring an
individual's self-esteem through a ten-item Likert
scale (Rosenberg, 1965). Additionally, the Duke-
UNC Functional Social Support Questionnaire
(FSSQ) was used to assess the strength of social
support networks available to the children
(Broadhead et al., 1988). Social support is critical

for the well-being of orphaned children, as
previous studies have shown that children with
stronger social networks tend to have better
mental health outcomes (Broadhead et al., 1988).

Data on hyperactivity/impulsivity disorder and
major depressive disorder were collected using
diagnostic criteria from the Diagnostic and
Statistical Manual of Mental Disorders, Fourth
Edition (DSM-IV). The DSM-IV is a well-established
tool in psychiatry for diagnosing mental health
conditions, and its criteria are used globally in both
clinical and research settings (American
Psychiatric Association, 2000). Any child who met
six or more of the ten diagnostic criteria for
attention deficit hyperactivity disorder (ADHD)
was considered to have hyperactivity/impulsivity
disorder, while the same threshold was applied for
diagnosing major depressive disorder (American
Psychiatric Association, 2000).

The data collection process involved the assistance
of six trained research assistants, all of whom were
medical students at Ahmadu Bello University
(ABU), Zaria. These assistants conducted
interviews under the supervision of the lead
researcher, ensuring consistency in data collection.
The process took place over three consecutive
Saturdays, with an average of 30 children
interviewed each day (Adeyemi et al., 2017).

Data analysis was performed using the Statistical
Package for Social Sciences (SPSS) software,
version 20.0. Descriptive statistics were used to
summarize the demographic characteristics of the
respondents,

and

cross-tabulations

were

conducted to explore relationships between
variables. The normality of the data was verified
before further analysis (Levin, 2006). Results were
presented in tables and charts, and comparisons
were drawn with existing research on the medical
and social challenges faced by orphans (National
Population Commission, 2018).

Ethical approval for the study was obtained from


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the Department of Community Medicine at ABU
Zaria, and permission was granted by the directors
of the selected orphanages. Informed consent was
sought from the caregivers and eligible children,
ensuring adherence to ethical guidelines for
research involving vulnerable populations
(Nigeria National Health Research Ethics
Committee, 2017).

Despite these efforts, limitations in the study
included the inability to cover all orphanages in
Kaduna due to time and resource constraints, as
well as the exclusion of variables such as vitamin A
levels that could have provided additional insights
into the children's nutritional status (Oluwatoyin,
2019). The cross-sectional design of this study also
presents a limitation, as it captures only a single
point in time (December 2016) and may not reflect

current realities. Therefore, caution is needed
when interpreting the findings, especially
considering potential changes in healthcare
practices and policies since the data collection.
Developments such as updated healthcare policies,
the implementation of new training programs, or
changes in resource availability could have
influenced the knowledge and skills of healthcare
workers in the subsequent years. Additionally, the
study relies on self-reported data to assess
knowledge, rather than objective observation of
clinical performance. This reliance may introduce
bias, as healthcare workers might overestimate
their competencies or understate their challenges,
potentially affecting the accuracy of the findings.

Socio-demographic information of orphans living
in orphanages in Kaduna

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


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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

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

41(50.0)

15(18.3)

11(13.4)

7(8.5)

8(9.8)

-

100(100)


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hospital for
treatment
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.

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

0-4(n=8)

5-9(n=26)

10-

15-

Total(n=95)


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group

14(n=40)

18(n=25)

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

-

-

-

-

-

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%).

53.3

46.7

immunisation status

n=15

fully immunized

not fully immunized


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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.

Figure 2: Frequency distribution of children that sleep under ITN

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

Level of stigma among orphans living in orphanages in Kaduna

87%

13%

Percentage of children that use ITN

use ITN

does not use ITN

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 3: Level of stigma among orphans living in orphanages in Kaduna.

Figure 3 above showed that 83.3% of the respondents have good relationship with their peers and 9% of
the respondents were ostracized by peers.

Psycho-social status among orphans living in orphanages in Kaduna

Table 7: Psycho-social status of respondents lining in orphanages in kaduna

83.3

83.1

11.4

9

0

10

20

30

40

50

60

70

80

90

do your peers relate well

with you

do you relate well with

your peers

do you get bullied in

school or by friends

do people stay away from

you because you are an

orphan

level of stigma

Series 1

Psycho-social status of respondents

Frequency (n=100)

Percentage (%)

Attends school

Yes

87

97.8

No

2

2.2

Total

89

100.0

Type of education

Western

79

89.7

Quranic

3

3.4

Home

6

6.9

Total

87

100.0

Mathematics and English


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Table 7 above showed that majority (97.8%) of the children attends school, (89.7%) sought western

education and 3.4% school at

home while 6.9% sought qur’anic education. Majority (80.2%) have

Mathematics and English textbooks while 19.8% do not have Mathematics and English textbooks, 18.8%

were absent from school in the last one week and majority (85.7%) of them were absent from school in
the last one week due to sickness.


Figure 4: The frequency distribution of children and their number in class

78.50%

19.00%

2.50%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

20-40

40-60

>60

Number of students in class

Number of students in class

Textbook

Yes

69

80.2

No

17

19.8

Total

87

100.0

Absence from school

Yes

16

18.4

No

71

81.6

Total

87

100.0

Reasons for school absenteeism

Illness

12

85.7

Lack of school fees

2

14.3

Total

14

100.0


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Figure 4 above showed that majority (78.5%) of the children are in a class of 20-40 persons

Figure 5: Shows the last position in school.

The figure above showed that majority (38.7%) of the children had between 11th and 20th position in the
last term.

Table 8: showing self-esteem status of orphans living in orphanages in Kaduna

The above table showed that 89.2% of them have good self-esteem of which majority are males (60%)
and 11.8% have poor self-esteem.

Table 9: showing the quality of social support for orphans living in orphanages in Kaduna

34.7

21.3

38.7

5.3

0

5

10

15

20

25

30

35

40

45

1st-5th

6th-10th

11th-20th

0thers

Last position

Series 1

Self-esteem status

Male n (%)

Female n (%)

Total (%)

Good self-esteem

46(60.5)

21(27.7)

67(89.2)

Poor self-esteem

6(7.9)

3(3.9)

9(11.8)


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Table 9 above showed that majority (35.2%) had good (25-29.9) social support score and 15.5% have
an average (16-19.9) social support score

Coping strategies of orphans living in orphanages in Kaduna

Figure 6: Shows how the orphans cope with their various situations

The figure above showed that 64.6% of the children try to deal with their situation, however majority of
them shy away from their challenges.

DISCUSSION

The findings of this study align with existing
literature on the stigma experienced by orphans in

institutional care, with particular emphasis on its
profound effects on their well-being. Stigma can
manifest in different forms, such as social

56.3

53.8

46.8

64.6

50.6

42.3

0

10

20

30

40

50

60

70

modify the way

you think or act

distance yourself

from the problem

change your goals

in order to avoid

the problem

deal with the

problem

try to forget it

just tolerate it

Coping strategies among orphans

Series 1

Social support score
(8-40)

Frequency (n=71)

Percentage (%)

16-19.9

11

15.5

20-24.9

19

26.8

25-29.9

25

35.2

>30

16

22.5


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exclusion,

discrimination,

and

reduced

opportunities, all of which can negatively impact
the physical, emotional, and social well-being of
children in orphanages. While the study in Kaduna
revealed that a significant number of the
respondents reported good health, emotional
stability, and self-esteem, the effects of stigma
were still evident in certain areas such as peer
relationships and social integration.

A key element of the stigma surrounding orphans
is the societal perception that orphanhood is
linked to inferiority or inadequacy, particularly in
societies where familial ties are central to identity.
This social bias often results in the marginalization
of orphans and their subsequent exclusion from
social networks. Studies have consistently shown
that children living in orphanages face a higher
likelihood of being stigmatized compared to their
peers who grow up in familial settings (Beegle et
al., 2020). This stigma can negatively impact their
mental health, leading to feelings of shame,
loneliness, and low self-worth (Nyamukapa et al.,
2019; Soyobi et al., 2024b; Soyobi et al., 2024c). In
Kaduna, while many children reported having
good peer relationships, about 9% of the
respondents

indicated

experiences

of

ostracization, aligning with the broader trend
observed in previous studies.

The majority of the respondents (83.1%) reported
positive peer relationships, which is a promising
indicator of social inclusion within the orphanage
environment. However, the 11.4% of children who
reported being bullied by their peers and the 9%
who were ostracized highlight the ongoing
challenges of peer-based stigma within these
settings. This is consistent with findings from a
study in South Africa, where 70% of orphans had
positive relationships with their peers, but a
significant portion (30%) reported being
ostracized (Foster, 2020). Peer-based stigma in
orphanages often stems from the perception that

orphaned children are different or less fortunate,
which can lead to social exclusion and bullying
(Cluver et al., 2018). This exclusion can further
isolate orphans, perpetuating a cycle of stigma and
emotional distress.

The findings on self-esteem in the current study,
where 89.2% of respondents reported good self-
esteem, particularly among males, contrast with
some previous studies that found lower self-
esteem levels among orphans. For instance,
research conducted in Ogun State revealed that
more females than males exhibited higher self-
esteem (91.3% vs. 88.7%) (Adebayo et al., 2020).
These discrepancies in self-esteem levels may be
influenced by cultural and environmental factors,
including the quality of care and emotional support

provided within orphanages. However, orphans’

self-esteem can still be vulnerable to the effects of
stigma, especially if they are consistently subjected
to negative societal perceptions. Stigma has been
shown to erode self-esteem by reinforcing feelings
of inferiority and unworthiness (Richter et al.,
2018).

Physical well-being, as indicated by the relatively
high percentage of children reporting good health
in the Kaduna study, reflects the provision of
adequate healthcare in these orphanages. More
than half (54.9%) of the respondents reported
consuming a balanced diet daily, while 40.2% felt
physically fit to carry out normal daily activities
most of the time. These findings are somewhat
consistent with studies conducted in other regions,
such as Ogun State, where 60.9% of children
reported feeling well and energetic all the time
(Afolayan & Adekoya, 2021). Access to healthcare
and nutrition in orphanages plays a significant role
in maintaining the physical health of orphaned
children, mitigating some of the effects of stigma
related to neglect or inadequate care.

However, the relatively high percentage of
children who were classified as underweight


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(53.7%) in the Kaduna study raises concerns about
malnutrition and its potential connection to
stigma. Malnutrition among orphans is often
exacerbated by societal neglect and the perception
that orphans are less deserving of resources
compared to children raised in family settings. In
contrast, a study in Imo State found lower rates of
underweight children (19%) but higher levels of
stunting (34%) (Obialo et al., 2019). The
nutritional disparities between different regions
can be attributed to varying levels of support and
care in orphanages, but they also highlight the
ways in which stigma may manifest in resource
allocation and caregiving practices.

Mental health outcomes, particularly the presence
of hyperactivity/impulsivity disorders (27%) and
enuresis (22.3%) in the current study, align with
findings from similar studies in Cairo, where
19.62% of orphans had hyperactivity disorder and
23.03% suffered from enuresis (Abdelrahman et
al., 2017). The incidence of these disorders in
orphans is often linked to the emotional and
psychological stress that arises from experiences
of stigma, neglect, and separation from their
families. These mental health challenges can be
compounded by the lack of adequate psychosocial
support in some orphanage settings, leaving
children more vulnerable to the effects of stigma
(McLoughlin et al., 2019).

The coping mechanisms employed by the children
in this study, where a significant number (56.3%)
modified their behaviour to deal with their
challenges, reflect the resilience of orphans in the
face of adversity. However, the reliance on
negative coping strategies, such as distancing
themselves from problems or changing their goals
to avoid challenges, underscores the psychological
toll that stigma can take on these children. These
findings are consistent with research in Ethiopia,
where orphans exhibited below-average resilience
scores, reflecting the difficulty they face in coping

with the emotional and social challenges posed by
stigma (Tadesse et al., 2021).

Stigma not only affects orphans' social and
emotional well-being but also has broader
implications for their educational outcomes. The
study found that 97.8% of respondents were
attending school, with the majority (87.7%)
receiving formal Western education. This is a
positive indicator of educational access, which is
crucial for breaking the cycle of poverty and
marginalization that often affects orphaned
children. However, previous studies have shown
that stigma can negatively impact orphans'
academic performance by reducing their
motivation and limiting their opportunities for
social and academic engagement (Vreeman et al.,
2019). While the majority of children in this study
reported having access to quality education, it is
important to consider the potential long-term
effects of stigma on their academic trajectories.

In essence, the findings of this study underscore
the pervasive impact of stigma on the well-being of
children living in orphanages in Kaduna. While
many children reported good physical health,
emotional stability, and social support, the effects
of stigma were still evident in areas such as peer
relationships, mental health, and coping
mechanisms. These findings are consistent with
previous research, which has demonstrated that
stigma can have far-reaching consequences for the
well-being of orphaned children. Addressing the
stigma associated with orphanhood is critical to
improving the social, emotional, and academic
outcomes of children in orphanages. This requires
not only interventions aimed at reducing societal
stigma but also efforts to provide orphaned
children with the psychosocial support they need
to thrive in the face of adversity.

CONCLUSION

This study underscores the significant impact of
stigma on the well-being of children in orphanages


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in Kaduna State, Nigeria. The findings reveal that
while many children suffer from various health
conditions and behavioural disorders, the
presence of stigma exacerbates these challenges.
High rates of hyperactivity and enuresis reflect
underlying psychological and emotional issues
that are intensified by stigmatization, demanding
urgent attention.

The prevalence of poor self-esteem among many
children further highlights the detrimental effects
of

stigma,

underscoring

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. However, the impact of stigma can
undermine these achievements by affecting their
emotional resilience and overall well-being.

Addressing the impact of stigma 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
mitigate the effects of stigma and enhance the well-
being of orphans in Kaduna. By addressing these
multidimensional issues, we can create a more
supportive environment that promotes the holistic
development of these vulnerable children.

Availability of Data and Materials

The authors declare consent for all available data
present in this study.

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.

Competing Interests

The authors declare no conflicts of interest.

Acknowledgements

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
medical writing/editorial support in accordance
with Good Publication Practice (GPP3) guidelines.

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