Page 154 - IJPS-11-5

International Journal of

Population Studies

RESEARCH ARTICLE
The association between contraceptive use

transition and fertility dynamics in Zambia

Million Phiri * , Clifford Odimegwu 1 , and Tobias Chirwa 3
1,2
1 Department of Demography and Population Studies, School of Social Sciences, University of the
Witwatersrand, Johannesburg, Gauteng, South Africa
2 Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities
and Social Sciences, University of Zambia, Lusaka, Zambia
3 Department of Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg,
Gauteng, South Africa

Abstract
The Zambian government has recognized family planning (FP) as a key strategy to
reduce high fertility and teenage pregnancy rates. Over the years, contraceptive
use has been increasing steadily in the country; however, the effects of increased
contraceptive use on fertility dynamics have rarely been explored in Zambia. In this
study, we examined the relationship between contraceptive transition and fertility
dynamics using the Zambia Demographic and Health Surveys conducted from
1992 to 2018. We applied a Blinder–Oaxaca multivariable decomposition analysis
technique to quantify the contribution of contraceptive transition to the observed
*Corresponding author: reduction in fertility and teenage pregnancy rates. About 69% of the reduction in
Million Phiri total fertility rate and 64% of the decline in teenage pregnancy rate were due to
(million.phiri@unza.ac.zm) shifts in women’s sociodemographic characteristics. Specifically, the increase in
Citation: Phiri, M., contraceptive use rates from 14.2% to 45.0% accounted for 17.7% of the reduction in
Odimegwu, C., and Chirwa, T. total fertility rate. Furthermore, 54.8% of teenage pregnancies were averted due to
(2025). The association between increased contraceptive use among teenagers in Zambia. The study establishes that
contraceptive use transition and
fertility dynamics in Zambia. contraceptive use significantly reduced fertility and teenage pregnancy rates. These
International Journal of Population trends can be predominantly attributed to an escalation in the proportion of females
Studies, 11(5): 148-163. achieving secondary education, along with delays in age at first marriage and sexual
https://doi.org/10.36922/ijps.4866
initiation. This necessitates the enhancement of current sexual and reproductive
Received: September 17, 2024 health, and FP approaches to uphold the escalating levels of contraceptive utilization
Revised: May 4, 2025 to further increase the impact on fertility dynamics in the country.
Accepted: June 12, 2025
Published online: June 30, 2025 Keywords: Women’s health; Contraceptive behavior; Fertility; Reproductive health; Zambia
Copyright: © 2025 Author(s).
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution 1. Introduction
License, permitting distribution,
and reproduction in any medium, The average total fertility rate in Sub-Saharan Africa (SSA) continues to exceed the
provided the original work is average total fertility rate observed across all developing nations (Bongaarts, 2017;
properly cited. Mback, 2017; Zulu et al., 2025). This may suggest the need for better integrated sexual
Publisher’s Note: AccScience and reproductive health (SRH) policies and programs to strengthen family planning
Publishing remains neutral with (FP) access and utilization. Governments in SSA countries recognize that promoting
regard to jurisdictional claims in
published maps and institutional FP is crucial for accelerating the reduction of fertility rates, as well as teenage pregnancy
affiliations. and maternal deaths. Many governments are making significant efforts to promote

Volume 11 Issue 5 (2025) 148 https://doi.org/10.36922/ijps.4866