Zambia was reclassified by the World Bank as a lower middle income country in 2011 but still ranks 163 out of 186 countries on the 2012 Human Development Index. Despite improved economic performance, issues such as income inequality and poor access to services have not been addressed as expected. Numerous challenges burden the country, including high rates of malnutrition, poverty, food insecurity, HIV and AIDS and malaria. While Zambia has reduced the rate of extreme poverty from 58 percent (1991) to 42.7 percent (2010), extreme poverty continues to be much higher in rural areas (57 percent) compared to urban areas (13 percent ). Zambia's food security challenges are worsened by a high dependence on rain-fed agriculture and the absence of market incentives to encourage a fundamental shift from subsistence farming. Consequently, access to food is a challenge for many. According to the Zambia Vulnerability Assessment Committee, the number of people at risk of food insecurity is up from about 63,000 in 2012 to about 209,000 in 2013. This is attributed to localized poor crop production due to poor weather conditions in some parts of the country.
Zambia is currently host to 34,000 refugees and people of concern. Some 28,000, of which half are Angolans, reside in settlements in Mayukwayukwa Refugee Settlement in the Western province and Meheba Refugee Settlement in the North-Western province. The rest of the refugees reside outside the camps and do not receive material assistance. A cessation clause for Angolan refugees was effected in June 2012 and since then the Zambian government has been processing applications for local integration of the Angolans who are now people of concern. Additionally, another cessation clause, affecting 4,000 former Rwandans, took effect in June 2013. The Zambian Government expects that most of the 4,000 Rwandan refugees in the country will return home. UNHCR will support the repatriation of refugees willing to return home, while resettlement will be used for refugees who lack foreseeable alternative solutions or who have specific protection needs.
High food prices and high unemployment rates combine to place considerable stresses on the most vulnerable sectors of the population. The national HIV prevalence rate is ranked 7th globally at 12.7 percent, and chronic malnutrition stands at 45.4 percent. Some 53 percent and 46 percent of Zambian children have Vitamin A and iron deficiency respectively, compromising their long term development. Zambia is part of the Scaling Up Nutrition (SUN) initiative and is focusing growing interest on nutritional issues.
According to national statistics, there have been significant improvements in school enrolment rates since the mid-1990s but educational attainment in Zambia remains low and inequitable. The median years of completed schooling for the adult population are only six, meaning many Zambians have not achieved the required seven years of primary education. While gender disparities have narrowed, gaps between rural and urban areas remain large.