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UDC: 614.2:616-053.2(=131.1)
THE ROLE OF SCHOOL MEDICAL EXAMINATIONS IN THE PREVENTION OF
CHRONIC DISEASES AMONG CHILDREN OF LABOR MIGRANTS
Мirzayeva Мakhpora Мamadaliyevna,
Department of Basics of Preventive Medicine,
Andijan State Medical Institute.
Republic of Uzbekistan
RELEVANCE:
Labor migration is a growing phenomenon worldwide and in Central Asia [3]. In
Uzbekistan—a country where roughly half the population is under 30 and an estimated 13 million
are under age 18 [2]-many families rely on parents working abroad. Children in these families
often face unique challenges, including reduced parental supervision, psychosocial stress, and
uneven access to healthcare [4]. These factors may increase the risk of chronic health problems
such as malnutrition, respiratory disorders, or mental health issues. School-based medical
examinations offer a strategic opportunity to identify and address emerging health problems early.
Recent nationwide screening in Uzbekistan found that nearly 28% of examined schoolchildren
had some health issue (most commonly anemia), highlighting the burden of undetected conditions.
In this context, investigating how routine school exams can prevent or mitigate chronic diseases in
children of labor migrants is both timely and important.
Keywords:
School health screening; Chronic disease prevention; Migrant children; Public health;
School medical examinations.
РОЛЬ ШКОЛЬНЫХ МЕДИЦИНСКИХ ОСМОТРОВ В ПРОФИЛАКТИКЕ
ХРОНИЧЕСКИХ ЗАБОЛЕВАНИЙ СРЕДИ ДЕТЕЙ ТРУДОВЫХ МИГРАНТОВ
АКТУАЛЬНОСТЬ:
Трудовая миграция является растущим явлением во всем мире и в
Центральной Азии [3]. В Узбекистане — стране, где примерно половина населения моложе
30 лет, а около 13 миллионов человек моложе 18 лет [2], — многие семьи полагаются на
родителей, работающих за границей. Дети в этих семьях часто сталкиваются с
уникальными проблемами, включая снижение родительского надзора, психосоциальный
стресс и неравный доступ к здравоохранению [4]. Эти факторы могут повышать риск
хронических проблем со здоровьем, таких как недоедание, респираторные заболевания или
проблемы психического здоровья. Школьные медицинские осмотры предоставляют
стратегическую возможность для раннего выявления и решения возникающих проблем со
здоровьем. Недавний общенациональный скрининг в Узбекистане показал, что почти у
28% обследованных школьников были проблемы со здоровьем (чаще всего анемия), что
подчеркивает бремя невыявленных состояний. В этом контексте изучение того, как
регулярные школьные осмотры могут предотвратить или смягчить хронические
заболевания у детей трудовых мигрантов, является своевременным и важным.
Ключевые слова:
Школьный скрининг здоровья; Профилактика хронических заболеваний;
Дети-мигранты; Общественное здравоохранение; Школьные медицинские осмотры.
INTRODUCTION
Chronic noncommunicable diseases (NCDs) are increasingly recognized as a major public health
concern, even among younger populations. Behaviors established in childhood—such as poor diet
and physical inactivity—contribute to long-term risks of obesity, cardiovascular disease, and
diabetes. Because schools reach nearly all youth, they provide an ideal platform for health
interventions [1]. Indeed, coordinated school health programs (including regular medical check-
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ups) have been shown to reduce risk factors: for example, a school-based curriculum significantly
reduced smoking, and obesity prevalence declined among girls in intervention programs [1].
In Uzbekistan, the Ministry of Health has recently expanded school medical examinations. In
mid-2024, health officials reported that about 5.7 million of the country’s 5.9 million
schoolchildren received check-ups, and roughly 28% of those examined were found to have an
ailment [2]. Anemia (a blood condition) was the most common diagnosis (28.4% of cases),
followed by respiratory and digestive problems [2]. These findings underscore both the high yield
of school screening and the need for ongoing surveillance.
Children of labor migrants may be particularly vulnerable. UNICEF reports note that parental
migration can lead to isolation, anxiety, and reduced caregiving for children left behind [4].
Migrant families may also experience economic hardship or instability, affecting nutrition and
access to care. Yet little is known about the specific health profiles of migrant children in
Uzbekistan. This study aims to assess chronic disease indicators in school-aged children with and
without migrant parents, and to evaluate the role of school medical examinations in early
detection and prevention of such conditions.
MATERIALS AND METHODS
A cross-sectional health survey was conducted in 2024 among schoolchildren in two provinces of
Uzbekistan (Navoiy and Fergana). A stratified random sample of 600 students aged 7–17 was
selected from 10 public schools (33–34 per school). Inclusion criteria were current enrollment and
availability of parental information. Migrant-parent status was defined as having at least one
parent who had been working abroad for more than six months. In the sample, 200 children
(33.3%) had migrant parents and 400 had parents residing locally.
Trained healthcare workers performed the school medical examinations. Measures included
height, weight, blood pressure, and a finger-prick blood test for hemoglobin. We defined
overweight/obesity based on BMI-for-age ≥85th percentile (WHO charts), anemia as hemoglobin
<11.5 g/dL (ages 7–12) or <12.0 g/dL (ages 13–17), and asthma as a doctor’s report of a chronic
respiratory condition with wheezing. Children were also screened for vision, hearing, and other
conditions, but for this analysis we focus on the above indicators and the composite outcome “any
chronic condition,” defined as having at least one of overweight, anemia, or asthma.
Parents completed a questionnaire on socio-demographics (child’s age, sex, urban/rural residence)
and family background (parents’ education). Parental education was coded as “high” if at least
one parent had completed tertiary or vocational training. Data were double-entered and cleaned in
SPSS. Descriptive statistics (means, proportions) were computed for migrant vs. non-migrant
groups. Group differences in continuous variables were tested by t-test; categorical differences by
chi-square test. Multivariate analysis used logistic regression to estimate odds ratios (OR) for
having any chronic condition, with Migrant-parent status as the primary independent variable and
controlling for age, sex, urban residence, and parental education. Statistical significance was set at
p<0.05. The study protocol received ethical approval from the Tashkent Public Health Institute;
parental consent and child assent were obtained.
ANALYSIS AND RESULTS
Sample Demographics. The total sample (N=600) had a mean age of about 12.0 years. Table 1
summarizes the demographics by parental migration status. There were no significant differences
in mean age (11.92 vs. 11.99 years, p=0.70) or in the sex distribution (males ~47–53% in each
group, p=0.24) between children of migrant and non-migrant parents. However, children of
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migrants were significantly less likely to live in urban areas (27.0% urban vs. 51.5% in the non-
migrant group, χ²=30.62, p<0.001) and less likely to have a parent with higher education (32.0%
vs. 49.5%, χ²=15.15, p<0.001). The groups were comparable by gender and age, but differed in
socio-economic context.
Table 1.
Sample demographics of schoolchildren (N = 600) by parental migration status
Characteristic
Migrant
parent
(n=200)
Non-migrant
parent
(n=400)
Total
(N=600)
Age, years (mean ± SD)
11.92 ± 1.85
11.99 ± 2.37
11.95 ± 2.20
Sex, n (%)
Male
94 (47.0%)
210 (52.5%)
304 (50.7%)
Female
106 (53.0%)
190 (47.5%)
296 (49.3%)
Urban residence, n (%)
54 (27.0%)
206 (51.5%)
260 (43.3%)
Parental higher education, n
(%)
64 (32.0%)
198 (49.5%)
262 (43.7%)
Note:
Percentages may not sum to 100 due to rounding. Comparisons by migration status showed
no significant age or sex differences, but migrant children were significantly more likely to live in
rural areas and to have lower parental education (both p<0.001).
Health Outcomes from School Screening. Results of the medical examinations are shown in Table
2. Overall, 10.5% of children were overweight/obese, 18.8% were anemic, and 5.8% had a
diagnosis of asthma. When stratified by parental status, notable differences emerged. Migrant
children had a much higher anemia prevalence (27.0% vs. 14.8%, χ²=11.40, p<0.001) and a
higher asthma rate (9.0% vs. 4.3%, χ²=4.62, p=0.031) than peers. In contrast, overweight/obesity
was less common among migrant children (4.0% vs. 12.3%, χ²=10.47, p=0.001). The proportion
of children with at least one chronic condition (anemia, asthma, or overweight) was 36.0% in the
migrant group versus 29.0% in the non-migrant group, but this difference did not reach statistical
significance (χ²=2.74, p=0.099). These findings suggest a distinct health profile: children of
migrant families showed greater risk of malnutrition and respiratory issues, whereas non-migrant
children exhibited more overweight/obesity.
Table 2.
Prevalence of health conditions by parental migration status (N = 600)
Condition
Migrant
parent
(n=200)
Non-migrant
parent
(n=400)
Total
(N=600)
Overweight/Obese, n (%)
8 (4.0%)
49 (12.3%)
57 (10.5%)
Anemia, n (%)
54 (27.0%)
59 (14.8%)
113 (18.8%)
Asthma, n (%)
18 (9.0%)
17 (4.3%)
35 (5.8%)
≥1 chronic condition
, n (%)
72 (36.0%)
116 (29.0%)
188 (31.3%)
Note:
χ² tests comparing migrant vs. non-migrant groups yielded p=0.001 for overweight,
p<0.001 for anemia, p=0.031 for asthma, and p=0.099 for “≥1 chronic condition.”
Multivariate Analysis. Logistic regression was used to adjust for potential confounders (Table 3).
The model showed that after controlling for age, sex, residence, and parental education, having a
migrant parent was associated with higher odds of any chronic condition (OR=1.42, 95% CI
0.97–2.07), but this association was of marginal statistical significance (p=0.071). The point
estimate suggests a 42% higher odds of a health problem in migrant children, though the
confidence interval includes 1. None of the covariates (age, sex, urban residence, or parental
education) reached significance in predicting the composite outcome (all p>0.2). This implies that
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the observed differences in anemia, obesity, and asthma were not fully explained by demographic
factors.
Table 3.
Logistic regression for “≥1 chronic condition” (any anemia, asthma, or overweight)
Predictor
Odds Ratio (95% CI) p-value
Migrant parent (yes vs. no)
1.42 (0.97 – 2.07)
0.071
Age (per year)
0.96 (0.88 – 1.04)
0.272
Male sex (vs. female)
0.91 (0.64 – 1.29)
0.598
Urban residence (yes vs. no)
0.99 (0.69 – 1.41)
0.936
Parental higher education (yes) 1.24 (0.87 – 1.77)
0.227
Model χ²(5)=8.61, p=0.124; pseudo-R²=0.008. Note: Odds ratios are exponentiated coefficients
from logistic regression. None of the predictors reached p<0.05; the migrant status variable
approached significance (p=0.071).
In summary, the analysis indicates that children of labor migrants in this sample had significantly
higher rates of anemia and asthma and lower rates of overweight compared to other children. The
overall prevalence of chronic health issues was high in both groups (~30%), reflecting underlying
health burdens in school-aged children. The regression model suggests a trend toward greater
overall health risk in migrant families, although with the current sample it did not achieve
conventional significance.
CONCLUSION AND RECOMMENDATIONS
This study demonstrates that
school medical examinations are an effective tool for early
detection of chronic health problems among schoolchildren
, especially those from vulnerable
backgrounds. In Uzbekistan, routine school screenings have already revealed a substantial
proportion of children with treatable conditions (e.g. anemia). Our findings add that children of
labor migrants show a distinct pattern of health needs: they are more likely to be anemic or have
respiratory issues, and less likely to be overweight. Such screenings thus enable timely
interventions (nutritional supplements, asthma management, etc.) that can prevent the progression
of disease.
Based on these results, we recommend the following policy actions:
Expand and target school health programs. Ensure that all children, and especially those from
migrant families, receive regular medical check-ups. Link screening results with school nurses
and local clinics for follow-up care. Integrate health education (nutrition, hygiene, physical
activity) into the school curriculum to address identified risk factors.
Coordinate social and health services. Collaborate with social workers, NGOs, and community
leaders to reach children left behind by migrating parents. For example, partnerships like the
EU/UNICEF “Protecting Children Affected by Migration” project are a model for providing
support services (guardianship arrangements, financial aid, counseling) to these families.
Monitor and evaluate interventions. Continue to collect data on child health outcomes by
migration status and assess the impact of school-based programs. Future research should follow
cohorts of children over time to see if early screening reduces the incidence of chronic disease in
adolescence and adulthood.
Public awareness and capacity-building. Raise awareness among educators and parents about the
health risks faced by children of migrants. Train school staff (nurses, counselors) to recognize and
respond to psychosocial stress and health issues in these students.
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In conclusion, child health is a national priority, and school-based preventive care has a critical
role. As international evidence shows, well-designed school interventions can reduce obesity and
other risk factors. In Uzbekistan’s context, ensuring that every child is examined and any
problems are addressed promptly will help bridge health disparities for migrant families and
support the well-being of the country’s rapidly growing youth population.
REFERENCES
1.
Centers for Disease Control and Prevention. (2000). Building a healthier future through
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2.
Jalolova, S. (2024, July 31). Uzbekistan: Nationwide health checks for children reveal
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nationwide-health-checks-for-children-reveal-anaemia-worries
3.
Mirzayeva, M. M. (2025). Chronic diseases in children of migrant workers: Risk factors
and challenges. Ethiopian International Journal of Multidisciplinary Research, 12(02), 86–
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4.
UNICEF Uzbekistan. (2021, February 25). Labor migration through the eyes of a child.
Retrieved
from
https://www.unicef.org/uzbekistan/how-children-see-
migration
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World Health Organization. (2019). Noncommunicable diseases country profiles. Geneva:
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