A comparison of male and female headed house holding of orphans and vulnerable children in Nigeria

1 Association for Reproductive and Family Health,-Lopin 1 Project, Plot 815A, Ibadan Army Officers Mess Road, Ibadan, Oyo State, Nigeria. 2 United States Agency for International Development (USAID), Plot 1075, Diplomatic drive, Central Business District, Garki, Abuja, Federal Capital Territory, Nigeria. 3 Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.


INTRODUCTION
A household is one or more individual(s) occupying the same room(s) in a house or building such that all members eat from the same source. It could also be made up of one or more families, extended in their relationship (Lawson, 2014). However, the household is regarded as the fundamental social and economic unit of society. The head of household is defined as "the one who manages the income earned and expenses incurred *Corresponding author. E-mail: bamelijah@gmail.com. Tel: +234-803-395-1181.
Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution License 4.0 International License by the household, and is recognized by other members of the household as the head (UNHS, 09/10). This household head could either be a male or a female.
Historically, household headship in many African countries including Nigeria is synonymous with the primary provider of economic needs of the household members and males are culturally and socially enjoined to hold this position right from the day of marriage, when a family starts. It is a major responsibility of the household head to provide direction and access to social and basic services such as food, health, education, potable water, protection, psychosocial support, good hygiene and sanitation for members of his or her households (Appleton, 1996). This is more so in many societies in Nigeria where patriarchy is the cultural norm, and so headship of the household is usually related with men (Bammeke, 2010). Although in recent times, it is being encapsulated that women are recognized as potential household heads but in reality men are most often ascribed the headship position because of the patriarchal view that men should provide for the family while women nurture it (Illo, 1989).
However, it appears there is indeed a paradigm shift in headship of households in many regions of the world where household heads were known to be typically men have witnessed a rising proportion of households headed by females. For example, 13% of households in the Near East/North Africa, 16% in Asia, 22% in sub-Saharan Africa, and 24% in Latin America have females as head of households. In fact the proportion of female headed households (FHH) was more than one-third in countries such as Ghana, Haiti and Zimbabwe (Bongaarts, 2001) and between 15 and 27% in Nigeria, Kenya, Uganda and Chad (World Bank, 2015;ICRW, 1988). Studies have shown that the nature of poverty in sub-Saharan countries in Africa could be responsible for the observed situations that female headed households tend to be poorer and less equipped to cater for children in their households. But, it has been perceived that with the nature of poverty experienced in the sub-Saharan countries, female headed households tend to be poorer and less prepared to care for children in their households (Milazzo and van de Walle, 2015). But this observation is not limited to developing countries as globally femaleheaded households are well known as poorer of the poor (Kennedy and Haddad, 1994).
In spite of the inadequacies of females to cater for a household as the head, there has been a continual upsurge in the number of female headed households. A key population of interest in this study is the households of orphans and vulnerable children (OVC). In most cases these children are made orphans by HIV/AIDS or other events that make the female the surviving parent and so forced to assume the burden of headship of their households. And so, the welfare of the surviving children becomes that of the surviving wives who unfortunately might not have been prepared for their sudden headship role of their households. It is therefore not surprising to find these female households to perform poorly on the living standard indicators such as per capita expenditures (purchasing power), poverty incidence and caloric intake. Also, when assets, capacity to borrow and labor resources are considered, FHHs are more vulnerable to the shocks that lead to declines in living standards in the long term (Ha, 2002).
Regrettably, the incidence of OVC has been on the increase globally and Nigeria shares a high burden of this special population. The Federal Ministry of Women Affairs and Social Development puts the number of OVC in Nigeria as 17.5 million (FMWASD, 2014). Studies have shown that female-headed households are naturally more mature households with older adults and less young children, hence, they have smaller household size. A global report showed that the OVC population has been fuelled by the epidemic of HIV/AIDS contributing about 16.6 million of the OVC who lost either one or both parents (majority of whom are in the African continent) (Asia, 2011). In fact, the death of prime-age-adults due to HIV/AIDS has orphaned millions of children, jeopardizing their well-being and compromising their opportunities (Guarcello et al., 2004. Thus, households with orphans and vulnerable children often suffer from inadequate care with a sizeable majority being cared for by not too well prepared mothers and end up with extended family members (UNICEF, 2006). A study in Malawi showed that OVC prefer to live in households headed by their grandparents. In some countries in sub-Saharan Africa, 40-60% of orphans live in grandmother-headed households (UNICEF, 2006).
Unfortunately, there is a dearth of strategic information on the caregivers of households of OVC with respect to the heads of these households in Nigeria. The Federal Ministry of Women and Social Development in Nigeria in partnership with foreign partners like the United State Government through PEPFAR and the USAID have been in the vanguard of care for the OVC. Recently, a project entitled Local Partners for Orphans and Vulnerable Children in Nigeria (LOPIN) was sponsored by USAID to mitigate the impact of HIV/AIDS on families infected and affected in selected states and LGAs with high burden of HIV/AIDS in Nigeria. The strategy adopted is to link the families of OVC to appropriate educational, nutritional, protective and health services while empowering the households to enable them provide for their households on a sustainable manner. The Association for Reproductive and Family Health (ARFH), an indigenous local non-governmental organization (NGO) with headquarters located in Ibadan, South West Nigeria, started the implementation of this project in 13 LGAs located in Akwa Ibom, Lagos and Rivers states of Nigeria in 2015. In a baseline survey, the heads or caregivers of the OVC households were identified and their personal social demographic characteristics and other health characteristics of the households and OVC were documented.

Aims
This paper focuses on the characteristics of the gender of the heads of the OVC households and the wellbeing of their OVC. It also compares the advantages and disadvantages of female and male headed households as it affects the welfare of the OVC households.

METHODOLOGY
This is a descriptive cross sectional survey of OVC households conducted in 13 Local Government Areas (LGAs) in Nigeria; 5 each in Akwa Ibom and Lagos States and 3 others in Rivers State. The LGAs in Akwa Ibom State were: Ikot Ekpene, Okobo, Oron, Uruan and Uyo; Lagos State: Agege, Ajeromi, Badagry, Ojo and Kosofe while those in Rivers State were: Port Harcourt, Eleme, and Obio/Akpor. The LGAs were purposively selected as they were part of the 32 PEPFAR/USAID priority LGAs with high burdens of HIV and OVC in Nigeria (PEPFAR, 2012). The National Vulnerable Assessment Questionnaire was used to identify the vulnerable households (Federal Ministry of Women Affairs and Social Development, Nigeria, 2009;Bamgboye et al., 2017).The survey was carried out between May and July 2016, by the Association of Reproductive and Family Health (ARFH), the implementing partner of LOPIN Region 1 project.

Data collection
A structured questionnaire adapted from MEASURE Evaluation OVC tool kit was used to obtain information on the demographic characteristics of the caregivers or heads of the enrolled vulnerable households, their household socio economic characteristics, including household income, membership of savings groups and access to obtaining loans by personal interview (MEASURE Evaluation, 2014). There was also an enquiry about their income generating activities and potential interests of the OVC caregivers hitherto limited by funds. These caregivers were also asked about the constraints or obstacles to doing business as well as their general perceptions of their economic situations. Ethical consideration was adhered to by obtaining an informed consent from each respondent.

Derived variables
Some of the variables analyzed were derived from questions asked during the survey. These variables were Paid Employment, Food security, Household economy, Psycho social support, Adequacy of Shelter.
Paid employment: This variable was derived from: "Are you paid in cash or kind for this work or are you not paid at all?" If payment was in cash only or cash and kind, it is recoded as 1 (Having a source of income); but if the response was either "in kind only or not paid at all", it was re-coded as 0 (No source of income).
Household economy was derived by generating a new variable from the question: "Was your household able to pay for food-related expenses, school-related expenses?" If response was Yes, it was re-coded as 1 interpreted as "good economy" and recoded as "poor economy" if response was No or 2.
Food security was derived from three questions: "In the past 4 weeks, was there ever no food of any kind to eat in your household? ""In the past 4 weeks, did you or any household member go to sleep at night hungry because there was not enough food?" "In the past 4 weeks, did you or any member of your household go a whole day and night without eating anything because there was not enough food?" If each of the 3 responses was "Yes" coded as"1", it gave a maximum score of 3. Everyone with a score ≥1 was coded as "food insecure" otherwise as "food secure" with a score of 0.
Psychosocial support: This variable was generated from responses to the following questions: "Is child happy and content with a generally positive mood and hopeful outlook and "Is child cooperative?" coded as 1 if "Yes" and "0" if No and "Does child enjoy participating in activities with adults and other children?" also coded as 1 if "Yes" and 0 if "No". The maximum score from these two questions was 2 and so scores <2 were re-coded as "Need psychosocial support" and 2 recoded as "Do not need psychosocial support".
Adequacy of shelter was derived from responses to the following question "Do you think child has stable shelter that is adequate, safe, dry and secure?" There are four options to this question and options 1 and 2 are recoded as "1" that is Adequate shelter while options 3 and 4 are recoded as "0" interpreted and categorized as "Inadequate shelter".
Descriptive statistics such as means, medians and standard deviations were used to summarize quantitative variables while categorical variables were summarized with proportions and percentages. The wealth index was calculated using standard methods as described in our previous publications (Fagbamigbe et al., 2015). The Student-T-test and X 2 -test were used to determine statistical significant differences between two mean values and associations between any two categorical variables respectively. The logistic regression model was used to obtain the odds of females as OVC Household Heads (HH) given a particular variable, after adjusting for some important social and demographic variables. The results were presented in appropriate tables. The statistical analysis was carried out using SPSS version 21 (IBM SPSS, 2017).

RESULTS
We examined a total of 3,706 households from the three states in which ARFH-LOPIN 1 PROJECT was implemented. The distributions of the number of households by state are Lagos State-1,299, Rivers State-912 and Akwa Ibom State-1,495. Table 1 shows the socio-demographic characteristics of the heads of these households categorized by their sex. There was a female preponderance of the households" heads as males constituted only 44%. The mean age of all the household heads was 45.1 years with a standard deviation of 14.7 years, higher among males (46.8 years, SD=14.5) than females (43.7 years, SD=14.6 years), p<0.01. The age distribution of these households" heads is also shown in panel 1 of Table 1.The average age of the household heads was different for different states, being statistically significantly higher in Akwa Ibom (48.0years, SD= 15.7) than in Lagos (43.0 years) and Rivers (43.1 years) States.  Table 3 shows the distribution of OVC by demographic and access variables to basic social services in each state. Table 4 shows the odds of a household head are 14 times more likely to be male if age 25-34 years relative to being less than 25 years. However, these likelihoods decreased with increase in age to about 2 times in older age groups. The result in Table 4 also shows that relative to those who are married female HHs are more likely to be unmarried. In fact they are either never married, widowed, divorced or separated.
The male HHs are more than 3 times not likely to have access to health care than female HHs. Children under male HHs are 25% more likely to need psychosocial support than their female headed households counterparts. In comparison with Akwa Ibom State, males are about 80% less likely to be HHs heads in Lagos and Rivers States. There was indeed an almost 4 times likelihood of a HH to undergo quranic education than female HH. Male HHs are almost 2 times more likely to complete secondary school than female HHs.

DISCUSSION
The preponderance of households of orphans and vulnerable children headed by females found in these selected LGAs is not surprising. In fact it is in consonance with the Nigerian demographic data that suggest a higher survival rate among females than males (National Bureau of Statistics, 2016). Headship of households normally reverts to females as a result of either the death of the husband or divorce which is not uncommon in the Nigerian society. Besides this, traditionally, in most marital relationships, wives are generally younger than their husbands in Nigeria. Therefore this phenomenon can explain why the females heading households in this study were younger than their male counterparts.
Another finding is the similarity in the age distribution of the house hold heads in Lagos and Rivers States and this can be attributed to the high level of urban settlements in both states characterized with a high level of commercial life. However, Akwa Ibom State is more of a traditional settlement experiencing less pollution and exposure to hazards thereby providing a good explanation for the higher survival of people living in these communities. This study also observed that about 2 in every 3 female household heads were either widowed or divorced, a finding which corroborates the report that female household heads are more of the divorced and widowed population (Oginni et al., 2013;Milkalitsa, 2015). The high mortality rate among males has been identified as a factor attributed to the continual rise in females becoming household heads in developing countries of the world (Motts, 1994;Banerjee and Roy, 2015;Kousar et al., 2017). According to some reported studies, singlehood, separation/divorce and widowhood have been attributed to the shift in responsibilities to care for children which opens women and the wards to  vulnerability (Chant, 2003;Opara, 2016). The fact that the husbands in most traditional Nigerian society are the primary bread winners could also be attributed to high poverty levels among widows and single mothers who were definitely not prepared for such responsibilities as heading households and whose productive resources could be under the control of male relatives due to the patriarchal systems in Nigeria. However, our finding that the females heading households are more likely to be unmarried corroborated findings from other studies  (Habib, 2010). The finding in this study that female headed households were more likely to be food secured than their male counterparts seems to support the general notion that when women have active role in decision making in the household (either as heads of households or as co-decision-makers with their husbands), the nutritional status of their children improves. But it contradicts the report of a study by Ponle that femaleheaded households were mostly affected by food poverty with a higher incidence of malnutrition (Lawson, 2014;Milkalitsa, 2015;Tibesigwa and Visser, 2015;Mengesha GS 2017 ). Anecdotal reports also observed that women in Nigeria and indeed other African countries would always do things within their powers to ensure there is always food on the table for the family. In fact a recent study reported that the proportion with food poverty was higher in female headed households than male-headed households (Lawson, 2014;Anyanwu, 2010;Tibesigwa and Visser, 2015). A similar study reported females are not known to fully and properly support their families and ensure the wellbeing of their children (Jackson, 1996;Liu et al., 2017)). This same study concluded that female headed household is a proxy for women"s poverty. And the hypothesis that female headed households are always associated with poverty that ranks among the poorest of the poor in the world cannot be easily controverted (Zarhan, 2011;Chant, 1997).
This notion of poverty about women may not be out of place if one considers the basic culture of Nigerians and indeed most African countries that places the responsibility of household finances in the hands of husbands. Therefore, the head of household is generally regarded as the key economic provider of a household. It has been reported that in the African perspective a man is usually recognized as the breadwinner of the household and as such its head (Hedman et al., 1996;Liu et al., 2017;Montoya and Teixeira 2017)). And no matter the economic status of the spouse, the man is the recognized head of the household Dar , 2018). In the recent past, traditional Nigerian society considers the woman as part of the household property to be protected and provided for by the man-the husband, who is the head of the household (Eboiyehi, 2013).Therefore the concept of females heading households could be new in Nigeria. But recent studies have documented that females now head households in the absence of males in a patriarchal culture such as the case in Nigeria (Habib, 2010;Hamid, 1992;Opara, 2016;Morakinyo et al., 2015). However, National Bureau of Statistics had reported as high as 16.5% of the households in Nigeria, are headed by women -(NBS, 2009). The impact of HIV/AIDs might have reduced the number of males and this must have increased the number of female headed households.
The observed lower proportions of OVC currently enrolled in school and also attending school regularly in female headed households compared with those in male headed households is a phenomenon generally associated with womanhood. In the Nigerian culture, there is a general tendency for females to be more lenient with children who choose not to go to school than males. And in this peculiar case of OVC, the female head of households might also send the children on hawking some goods items thereby making them another source of income generation (Guarcello et al., 2004;Shahbazi et al., 2015). And as reportedly previously, this may partly explain why OVC is generally limited in the pursuant of formal education (Bammeke, 2010). Another major finding in this survey is that a higher proportion of OVC in male headed households had access to health care and needed psychosocial support than female headed households. This has been reported in a previous study that found a higher mortality among members living in female headed households than males" (Doctor, 2011;Gupta et al., 2015;Khalid and Martin 2017).

Conclusion
Households headed by females appear to be on the increase in Nigeria. The education of the girl child is strongly recommended to prepare them for responsibilities other than house wives. The condition of orphans make them vulnerable with female caregivers who themselves are symbols of poverty. The high poverty level in Nigeria demands that a special attention should be paid to the care of orphans and vulnerable children (OVC) if they are to live a meaningful life. The OVC households deserve such services as health, education, nutrition and economic strengthening. This study also found that households headed by males are more likely to withstand the shocks attributed to vulnerable households. The program should hence focus more on gender norm to improve the potential leadership roles of females in any household.