Regional and national estimates of children affected by all-cause and COVID-19-associated orphanhood and caregiver death in Brazil, by age and family circumstance: a modeling study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Orphanhood and caregiver death can have severe consequences for children. Timely and accurate data can guide policy, particularly during health crises like COVID-19. The aim of our study is to present national and subnational analysis of both all-cause and COVID-19-associated orphanhood and caregiver death in Brazil and compare our model outputs with bespoke administrative datasets.
Methods
We use publicly available national datasets to estimate the number of Brazilian children experiencing parent and caregiver loss due to all causes and COVID-19 in 2020–2021.
Findings
An estimated 1,300,000 (95% uncertainty interval, 1,190,000, 1,430,000) children in Brazil experienced loss of one or multiple parents and/or co-residing caregivers. 673,000 (652,000, 690,000) were estimated to have lost one or both parents, of which 149,000 (144,000, 154,000) were COVID-19 associated; 635,000 (534,000, 758,000) children were estimated to have lost a co-residing grandparent or other kin, of which 135,000 (85,900, 199,000) were COVID-19 associated. Orphanhood varied substantially across states, with the rate of all cause parental orphanhood highest in Roraima at 17.5 (15.6, 20.6) per 1000 children and the lowest in Santa Catarina at 9.5 (8.7, 10.4) per 1000 children. COVID-19-associated orphanhood was also unevenly distributed, with Mato Grosso experiencing the greatest rate, at 4.4 (3.9, 5.3) per 1000 children, while Pará experienced the lowest rate of 1.4 (1.2, 1.8) per 1000 children. Comparisons with limited data from Brazil’s civil registry offices and (manually reviewed death certificates in Campinas found a similar demographic distribution of orphanhood. However, our estimates suggested that administrative sources undercount orphanhood.
Interpretation
Our findings highlight the extent of orphanhood in Brazil and large inequalities between states. Comparisons between administrative data and model estimates show similar temporal patterns and proportions of maternal and paternal orphanhood but different magnitudes. This suggests that strengthening vital registration systems can put children at the center of public health responses globally.
Funding
This study was funded by “Building Global Public Health Capacity to Link Real-Time Modelling Data on COVID-19-associated Orphanhood and Caregiver Deaths to Inform Prevention, Preparedness and Protection from COVID-19 consequences” (2023 CDC/WHO grant) and the Moderna Charitable Foundation.
Orphanhood and caregiver death can have severe consequences for children. Timely and accurate data can guide policy, particularly during health crises like COVID-19. The aim of our study is to present national and subnational analysis of both all-cause and COVID-19-associated orphanhood and caregiver death in Brazil and compare our model outputs with bespoke administrative datasets.
Methods
We use publicly available national datasets to estimate the number of Brazilian children experiencing parent and caregiver loss due to all causes and COVID-19 in 2020–2021.
Findings
An estimated 1,300,000 (95% uncertainty interval, 1,190,000, 1,430,000) children in Brazil experienced loss of one or multiple parents and/or co-residing caregivers. 673,000 (652,000, 690,000) were estimated to have lost one or both parents, of which 149,000 (144,000, 154,000) were COVID-19 associated; 635,000 (534,000, 758,000) children were estimated to have lost a co-residing grandparent or other kin, of which 135,000 (85,900, 199,000) were COVID-19 associated. Orphanhood varied substantially across states, with the rate of all cause parental orphanhood highest in Roraima at 17.5 (15.6, 20.6) per 1000 children and the lowest in Santa Catarina at 9.5 (8.7, 10.4) per 1000 children. COVID-19-associated orphanhood was also unevenly distributed, with Mato Grosso experiencing the greatest rate, at 4.4 (3.9, 5.3) per 1000 children, while Pará experienced the lowest rate of 1.4 (1.2, 1.8) per 1000 children. Comparisons with limited data from Brazil’s civil registry offices and (manually reviewed death certificates in Campinas found a similar demographic distribution of orphanhood. However, our estimates suggested that administrative sources undercount orphanhood.
Interpretation
Our findings highlight the extent of orphanhood in Brazil and large inequalities between states. Comparisons between administrative data and model estimates show similar temporal patterns and proportions of maternal and paternal orphanhood but different magnitudes. This suggests that strengthening vital registration systems can put children at the center of public health responses globally.
Funding
This study was funded by “Building Global Public Health Capacity to Link Real-Time Modelling Data on COVID-19-associated Orphanhood and Caregiver Deaths to Inform Prevention, Preparedness and Protection from COVID-19 consequences” (2023 CDC/WHO grant) and the Moderna Charitable Foundation.
Date Issued
2025-11-01
Date Acceptance
2025-09-10
Citation
The Lancet Regional Health - Americas, 2025, 51
ISSN
2667-193X
Publisher
Elsevier BV
Journal / Book Title
The Lancet Regional Health - Americas
Volume
51
Copyright Statement
© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41080610
PII: S2667-193X(25)00262-5
Subjects
Brazil
COVID-19
Caregiver death
Excess mortality
Orphanhood
Publication Status
Published
Coverage Spatial
England
Article Number
101252
Date Publish Online
2025-09-29