TARGETING FAMILIES AFFECTED BY HIV AND AIDS 37
the degree of relatedness of the orphan to the household head. Children liv- ing in households headed by nonparental relatives were systematically worse off than those in households headed by parental relatives, and those living with nonrelatives fared even worse. Where intrahousehold discrimination exists, Case, Paxson, and Ableidinger (2003) recommend targeting orphans, because income support given to families may not benefit them. Data from Kenya, Tanzania, and Zimbabwe show that orphans eleven through
fourteen years of age are significantly more likely to be at a low grade for their age, and in Ghana and Nigeria, young paternal and double orphans are at a lower grade for their age, as are older paternal orphans (Bicego, Rut- stein, and Johnson 2003). School and student surveys in Botswana, Malawi, and Uganda found mixed results, with orphans and nonorphans faring better, worse, or the same with respect to different measures (Bennell 2005). Country- level studies present more insights, with gender implications: using longitu- dinal data from the KwaZulu-Natal, South Africa, Demographic Surveillance Area, Case and Ardington (2006) find that maternal orphans are significantly less likely to be enrolled, have completed fewer years of school, and, if en- rolled, have less money spent on their education than children whose mothers are alive. These results hold for younger and older orphans, but there were no differences between the outcomes of boys and girls. These disadvantages were not found for paternal orphans. Using a five-year panel study of 20,000 children in Kenya, Evans and Miguel (2007) found a substantial and highly significant drop in primary school participation following the death of a par- ent and a smaller drop just before death. The impacts are more than twice as large following maternal deaths as following paternal deaths. The effects are largest for children whose mothers have died, as well as for those with lower baseline educational performance. Panel data on 1,300 households ana- lyzed by Deininger, Garcia, and Subbarao (2003) in Uganda showed that orphans were disadvantaged in primary and secondary education, but this effect was reversed after the introduction of universal primary education. New results from a panel survey conducted in Malawi in 2000 and 2004 found that maternal and double orphans tend to face higher mortality risks and lower schooling outcomes than paternal orphans and nonorphans, especially in the case of boys. As in Uganda, the effect on young orphans who enrolled following the introduction of free primary education in 1994 was less than that on adolescent orphans (Ueyama 2007). These studies show that programs reducing the costs of education can mitigate the effects of parental death. Although many studies focus on orphans, these do not capture the experi-
ences of children before they become orphans, which may be as bad or worse with respect to impacts on education and other areas. In a study in Uganda, Gilborn et al. (2001) found that older children (ages thirteen through seven-
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