Health of school-age children and factors associated with non-enrolment in school in rural areas of Kinondoni district, Dar es Salaam

A population-based cross-sectional study was conducted in rural areas of Kinondoni district from February to March 1998. Kunduchi and Bunju wards were randomly selected from a list of five wards which constitute the peri-urban portion of the district. The two wards were administratively divided into eight villages out of which four were randomly selected for the study. The aim of the study was to determine the health of school-age children and the factors associated with nonenrolment among out-of-school children. The study involved 314 children aged 7-14 years who had their anthropometric measurements taken for assessment of their nutritional status. The children were also examined for Ascaris lumbricoides, hookworm, and Schistosoma haematobium. The study involved a house to house visit of households selected for the study. The visits at household level aimed at taking anthropometric measurements of the children, collection of stool and urine specimen and to conduct interviews on parents. In each household visited mother or guardian was interviewed on the socio-economic status of the household and observations were made concerning the household socio-economic indicators. In summary, the following findings were established: Over half of the examined children had poor health. Out of 314 children examined, 3.5% had trichuriasis, 4.8% had ascariasis, 17.2% had urinary schistosomiasis 24.8 % were malnourished and 25.8% had hookworm. There was no difference in health status between enrolled and non-enrolled children in terms of urinary schistosomiasis, ascariasis and nutritional status. The difference was observed in hookworm infection where the prevalence rate and egg output was higher in non-enrolled children 31.4% than in enrolled children 20.3% (x2 = 5.1, ldf, p = 0.02). Socio-economic and demographic factors were found to be associated with enrolment status of the children in school (x2 = 7.26, 2df, p = 0.03). Reasons for non-enrolment were financial constraints 32%, pregnancy 4.5%, distance to schools 1.2%, taking care of siblings 46.1 %, poor health 7.1 %, poor academic performance 7.5% and attending "madrasa" (Muslims religion nursery school) 1.6%. This study recommends that the existing interventions should be expanded to reach out-of-school children. The government and non-governmental organisations should be approached to provide adequate medicaments for the treatment of geohelminths and urinary schistosomiasis. Because poverty is the major factor underlying non-enrolment there is need for activities to alleviate poverty and empower people economically. There is need for vocational institutions to provide practical training for children and useful skills especially for drop-outs. Government and non-governmental organisations should assist in educating children from poor parents. This will reduce drop-out rates and non-enrolment.