Page 165 - IJPS-11-5

International Journal of
Population Studies Contraception and fertility in Zambia

This conclusion is supported by the findings of this current nationally representative sample of sexually active women
study, which has shown that an increase in the proportion of reproductive age in Zambia. The availability of multiple
of women who were married at the age of 20 years or later DHS datasets made it possible to investigate the long-term
was one of the major contributors to fertility decline in trends in contraceptive use and fertility dynamics.
Zambia. This trend was accompanied by an increase in the Furthermore, it was possible to examine the effects
proportion of women attaining secondary education or of contraceptive use on fertility dynamics in Zambia.
an increase in those who initiated sexual debut at the age However, causality cannot be inferred in this study due to
of 20 years or later. Furthermore, our study shows that a the cross-sectional study design employed by the DHS.
reduction in the proportion of women who desired six or
more children had a significant effect in reducing the fertility 5. Conclusion
rate in the country. This suggests that SRH interventions This study found that although fertility rates remain high,
aimed at reducing fertility should also target women with contraceptive use significantly contributed to the shift
high fertility preferences to create a greater impact. in fertility dynamics in Zambia. Furthermore, there is
The study has provided evidence that contraceptive evidence that contraceptive transition among adolescent
transition among women of reproductive age has occurred girls has helped avert teenage pregnancies over time. This
in Zambia. Although the observed increase in contraceptive study also revealed that an increase in the proportion of
use has positively contributed to changing fertility dynamics, women who attained secondary or tertiary education,
fertility and teenage pregnancy rates are still high compared delayed initiation of sexual debut, and delayed age at
to other countries in the region (Kalinda et al., 2022; Yussuf first marriage are the main drivers of changes in fertility
et al., 2020). This calls for actions to increase resources dynamics in Zambia. There is a need to enhance access to
to FP programs in the country to enhance the benefits of education and contraceptive methods, especially among
contraceptive use. There is also a need for further research adolescent girls. Additionally, comprehensive sexuality
to critically examine other drivers of fertility dynamics in education that promotes delay in initiating sexual debut
Zambia to design interventions that could help address and discourages early marriage should be promoted and
high fertility. For sustained fertility decline, couples must be prioritized, especially for adolescents and young women.
“ready, willing, and able” to use modern contraception, with Such health interventions have the potential to equip
readiness, willingness, and ability measured by a desire to young women with accurate information about SRH.
limit births, approval of FP, and knowledge of contraceptive Acknowledgments
methods, respectively (Biney et al., 2021; Muhoza et al., 2018).
We appreciate the DHS program, ICF International,
Our study results underscore the need for public health and other partners involved in conducting the DHSs for
and FP policies to prioritize educational opportunities Zambia from 1992 – 2018.
for girls and promote adolescent SRH initiatives such as
comprehensive sexuality education that encourages delayed Funding
marriage and early sexual activity. Such measures can lead
to more sustainable reductions in fertility and teenage None.
pregnancy rates, ultimately improving health outcomes and Conflict of interest
socioeconomic development. Moreover, this research offers
significant findings regarding how contraceptive transition The authors declare that they have no competing interests.
has contributed to significant changes in fertility dynamics in Author contributions
Zambia. By demonstrating that the observed contraceptive
transition accounted for a substantial reduction in the total Conceptualization: Million Phiri, Clifford Odimegwu
fertility rate and prevented over half of teenage pregnancies, Formal analysis: Million Phiri
the findings underscore the need for health policymakers Investigation: Million Phiri
to lobby for increased financial investment in FP programs, Methodology: Million Phiri, Tobias Chirwa
especially adolescent reproductive health programs. This Writing – original draft: Million Phiri
will help address the country’s population growth challenges Writing – review & editing: All authors
and high teenage pregnancies.
Ethics approval and consent to participate
4.1. Strengths and limitations
In the study, secondary data sources were used. Permission to
The results of this analysis can be generalized to the total use DHS datasets was given by the DHS program. The DHS
population of married women in Zambia, as it included a data does not contain any personal identification of survey

Volume 11 Issue 5 (2025) 159 https://doi.org/10.36922/ijps.4866