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The Challenge

Over the past two decades, global health interventions have focused on the health of children under five, often ignoring the needs of school-aged children. However, kids still get sick after they turn 6. School-aged children remain highly exposed to a number of preventable and treatable illnesses, which negatively affect physical, cognitive, and emotional development and contribute to school absenteeism and poor academic performance and high drop-out rates. This all undermines the success of the future adult populations, as higher educational attainment, improved adult health outcomes, and higher economic attainment are strongly interdependent.

The health of school-aged children often

goes overlooked 

While many ailments afflicting school-aged children are preventable and curable, many low-income school-aged children rarely access available healthcare, and most do not receive quality health education. A recent study found that as many as a third of Lusaka's low-income school children regularly suffer from preventable and treatable illnesses and 36% show signs of stunting that hinder their development. 

Adolescent girls are particularly vulnerable and face additional challenges of gender-based violence, menstrual hygiene management and rising numbers of adolescent pregnancy. Our integrated school health model targets this vulnerable population with essential, high impact interventions in a convenient location - the school.

Factors impacting the health of

school-aged children

In Zambia, although primary healthcare services are free-of-charge at government health facilities, poor school-age children rarely access such services, for a number of reasons:

Limited public awareness of the health needs of children over 5 years old

Most child health programs focus on the survival and development of children under 5. The consequences of poor health in older children are less immediate and may not be fully apparent until later in adolescence. As a result, governments, community members and parents often overlook the importance of the health of school-aged children between the ages of 5 and 14. 

Less parental support for older children

Two-thirds of Zambians live on less than PPP $3.00 per day. Few parents and guardians in low-income urban communities are salaried, with most working in the informal economy, often in small shops. For these parents, missing a day of work, and therefore a day of income, can result in significant economic hardship. The illness of a child usually forces difficult decisions, and simple denial can often be the line of least resistance.

 

Guardians are responsive to the health needs of their youngest children, as they recognize that conditions can quickly become life threatening. On the other hand, many school-aged children are expected to take care of themselves. Guardians hope that the illness will resolve itself and so they delay seeking formal treatment for their children for days, weeks, or even months, frequently causing the children to experience more complications and worse outcomes.

Limited to no specialized care at government facilities for children over 5 years of age

Specialized pediatric care at nearly all Zambian government health facilities is reserved exclusive for children under 5, with children 6 and older joining the adult stream at health facilities.This situation can be both intimidating and medically inappropriate.

Limited funding and targeted health programs for middle-age children

Nearly all children’s health funding is targeted at children under 5. In Zambia, community outreach programs such as vaccinations campaigns and mass drug administration for worm infestations often miss school-aged children.