The association between contraceptive use transition and fertility dynamics in Zambia

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 reduction in fertility and teenage pregnancy rates. About 69% of the reduction in total fertility rate and 64% of the decline in teenage pregnancy rate were due to shifts in women’s sociodemographic characteristics. Specifically, the increase in contraceptive use rates from 14.2% to 45.0% accounted for 17.7% of the reduction in total fertility rate. Furthermore, 54.8% of teenage pregnancies were averted due to increased contraceptive use among teenagers in Zambia. The study establishes that contraceptive use significantly reduced fertility and teenage pregnancy rates. These trends can be predominantly attributed to an escalation in the proportion of females achieving secondary education, along with delays in age at first marriage and sexual initiation. This necessitates the enhancement of current sexual and reproductive health, and FP approaches to uphold the escalating levels of contraceptive utilization to further increase the impact on fertility dynamics in the country.

Keywords

Women’s health / Contraceptive behavior / Fertility / Reproductive health / Zambia

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