Technical information for COVID-19 Orphanhood Calculator

This calculator shows minimum estimates for the number of children affected by COVID-19 and excess deaths through the pandemic. Methods are based on Hillis, Unwin, Chen et al Lancet 2021 with the following changes:

10/3/2022

• We now update our estimates for countries in Africa (see below) starting from the beginning of our analysis..

20/2/2022

• Starting on 1 November 2021, we have updated our estimates for countries in Africa, using a WHO-led assessment of health information system capacities in 133 countries, which showed that death reporting in Africa is only 10% complete. Thus we adjusted all countries in the WHO Africa Region, except for South Africa (one of our study countries, for which excess death data is available), for the actual expected orphanhood rate that was 10 times higher than estimated.

2/2/2022

• We have changed the fit to incorporate newly available data as described here.
• Please note the totals may differ from what is reported in the paper due to backdating in the underlying data. We are also unable to treat England & Wales separate from Scotland & Northern Island so a combined total is give, which impacts the global total.

28/7/2021

• We have added a fixed effect for Europe into our logistic regression to impove the extrapolation for our European non-study countries.
• We now use IHME or World Bank data to fill in missing total fertility rates.

20/7/2021

• Reporting rates for Peru changed in June. We now have removed our excess death/COVID-19 multiplier.
• We report orphanhood for the whole of the United Kingdom combined instead of separately.

Code for reproducing the estimates is contained in our GitHub repository.

Our method uses excess or COVID-19 attributed deaths combined with fertility data from 21 study countries (Argentina, Brazil, Colombia, England & Wales, France, Germany, India, Islamic Republic of Iran, Italy, Kenya, Malawi, Mexico, Nigeria, Peru, the Philippines, Poland, Russian Federation, Spain, South Africa, the USA and Zimbabwe) to produce minimum estimates of orphanhood and children who were affected by the loss of a primary or secondary grandparent caregiver. To extrapolate beyond our study, we relied on the high correlation between total fertility rate (TFR) and the ratio of affect children to deaths and fit a logistic model. TFR data for our extrapolation comes from the UN Population Division World Prospects and COVID-19 attributed deaths from Johns Hopkins University. We use excess death to COVID-19 attributed deaths adjustment factors for Brazil, Colombia, England & Wales, France, Islamic Republic of Iran, India, Italy, Mexico, Russian Federation, South Africa, Spain and the USA (see Hillis, Unwin, Chen et al.)

Our estimates are minimum estimates because we largely rely on COVID-19 death reporting, which could be a significant undercount. We use reliable estimates of excess deaths where possible, but we could still be underestimating orphanhood. Our estimates are also based on simplifying assumptions as we cannot account for important demographic and epidemiological patterns. For example, we do not take into account the association between low income and large family sizes and the fact that a grandparent who lives in a multigenerational household providing care for grandchildren has more exposure than an adult of the same age who lives alone.

Definitions

• Orphanhood: defined by UNICEF as death of one or both parents.
• Loss of primary caregiver: Death of at least one parent or at least one custodial grandparent or kin.
• Loss of primary and / or secondary caregiver: Death of at least one primary caregiver and / or secondary caregiving kin.

Contact

Seth Flaxman (s.flaxman@imperial.ac.uk) or Juliette Unwin (h.unwin@imperial.ac.uk) about queries with the calculator. Susan Hillis (seh0@cdc.gov) about the paper and report.

Warranty

Imperial makes no representation or warranty about the accuracy or completeness of the data nor that the results will not constitute in infringement of third-party rights. Imperial accepts no liability or responsibility for any use which may be made of any results, for the results, nor for any reliance which may be placed on any such work or results.

Licence

This data set is licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0) by Imperial College London on behalf of its COVID-19 Response Team. Copyright Imperial College London 2021.