Falling between the cracks: Health challenges faced by peri-urban schoolchildren in Lusaka, Zambia

Background: School-age children living in peri-urban compounds surrounding Lusaka, Zambia contend with a unique set of health challenges. These compounds have HIV rates and population densities similar to those of urban centers, while lacking most of the sanitation, transportation, and education infrastructure available in cities. The combination of risk factors faced by relatively understudied peri-urban populations warrants attention. Methods: We conducted child health surveys investigating health seeking behavior and disease burden on a convenience sample of 331 children (54.2% female, ages 5 to 17) and caretakers in Ng'ombe Compound, Lusaka. The survey was administered in conjunction with in-school health screening by a local NGO. Results: 16% of children are orphans. 24% of children missed at least one day of school in the last two weeks due to illness (average days missed =1.6). 58.6% of caretakers stated that the household owned a bed net; only 27.8% of children had slept under a bed net the night prior to survey administration. Despite high prevalence of HIV infection in the community, only 30.9% of caretakers stated that they had spoken to their child about HIV/AIDS. Moreover, 71.1% of children did not have any form of health insurance. Conclusion: Schoolchildren living in peri-urban areas face a barrage of risk factors with few available resources to prevent or treat disease. School-based screenings with referral capability are one way to address the health needs of this neglected population.