Educational disparities among children affected by AIDS

Background: An estimated 15 million children have lost one or both of their parents to AIDS; millions more are living with and frequently caring for chronically ill parents, sharing scarce resources with foster children, and living in poverty exacerbated by the HIV/AIDS epidemic. While there is growing international commitment to mitigate the impact of HIV/AIDS on children, which populations should be targeted for assistance is widely debated in academic and policy circles without consensus. Our study contributes to this debate by investigating the extent to which orphans are educationally disadvantaged relative to children in extreme poverty or otherwise affected by AIDS. Methods: Data are drawn from the nationally-representative 2004-5 Malawi Integrated Household Survey. Linear and logistic multilevel models are used to examine the association between orphanhood and other AIDS-related impacts and a range of educational outcomes (ever and current school enrollment, dropout, and highest grade level achieved). Results: Double and maternal orphans are less likely to be currently enrolled (OR=0.46, 0.41 respectively), more likely to dropout (OR=2.33, 4.73), and more likely to be behind in grade attainment (RD = -0.27, -0.28); these disparities are not explained by poverty status. Neither living with a chronically ill parent nor in a household experiencing a recent adult death was associated with educational disadvantage. Conclusions: While acknowledging that any strategy to mitigate the impact of the epidemic on children's schooling should have poverty alleviation at its core, our results simultaneously emphasize the additional disadvantage experienced by orphans and suggest the need for specialized programming.