Résumé : Zambia is among the countries in sub-Saharan Africa most seriously affected by the HIV/AIDS pandemic. An estimated 40,000-90,000 AIDS-related deaths would have occurred by the end of 2000. At the beginning of the epidemic in the mid-80s and early 90s, the majority of AIDS-related deaths in the adult population occurred among men in the age group 20- 45 years. A period when they were at their most productive. Loss of the breadwinners had an immense economic and financial impact on widows, their children and other dependants from the extended family. This study of the economic impact of the AIDS pandemic at household level in Zambia investigated risk and protective factors in rural and urban communities associated with the impact of premature death of the breadwinner on the livelihood of their surviving spouses, dependent children, as well as wider circle of their extended family. Retrospective data were collected from households in which one or both parents died from AIDS between 1991 and 1995. Structured interviews were conducted with 223 urban and 101 rural families in low-income neighborhoods. In the urban sample, family displacement from original home which had been provided through the job of the breadwinner, was highly predictive of a shift for the surviving family to poorer housing with most families losing electricity or piped water supply and experiencing food shortages. In the rural sample, the loss of adult labor forced families to withdraw older children from school to help maintain current levels of food production. Educational continuity was most severely jeopardized in the urban sample for children of lowincome families and girls. In both urban and rural zones, age was the principal factor predictive of nutritional and health status in AIDS-affected families, with younger children the most vulnerable. Implications are discussed for the design of services to reach children and families with the greatest needs. Intervention strategies should be carefully adjusted to respond to the rural and urban differences and to the ecological, social and economic conditions of each community.
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