Unmet need for family planning among married women in Zambia: lessons from the 2018 Demographic and Health Survey

Namukoko, Harriet; Likwa, Rosemary Ndonyo; Hamoonga, Twaambo Euphemia; Phiri, Million

doi:10.1186/s12905-022-01709-x

Cited by 16 publications

(14 citation statements)

References 20 publications

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“…Similar to our findings, studies in Tigray [ 36 ] and Dire Dawa [ 38 ] in Ethiopia, Nigeria [ 34 ] and India [ 41 ] found that women living with HIV residing in rural areas were more likely to have unmet need for family planning than their counterparts from the urban areas. The probable explanation for this phenomenon is that women in rural areas have lower exposure to information and limited access to sexual and reproductive health services than their urban counterparts, as reported in surveys in Zambia and elsewhere [ 30 , 34 ].…”

Section: Discussionsupporting

confidence: 91%

“…Our analysis revealed that geographical residence (rural versus urban), age of a woman, socioeconomic status, number of children ever born to a woman (parity), employment status and partner’s age constituted factors significantly associated with unmet need for family planning. These findings are largely consistent with other studies [ 34 – 38 ] including a Zambian study which analysed unmet need for family planning using the 2018 DHS data [ 34 ]. From a review of literature, predictors of contraceptive uptake and unmet need for family planning are similar for HIV positive and HIV negative women.…”

Section: Discussionsupporting

confidence: 91%

“…Our study findings suggest that the more children a woman has the higher the chances they have an unmet need for family planning. This is in line with study findings from Zambia [ 34 ] Ethiopia [ 36 – 38 ] and Nigeria [ 39 ] including a multi-country study that analysed nineteen DHS survey data from Sub-Sahara Africa [ 40 ]. It is probable that with higher parity, women will have attained the desired number of children hence a greater need for limiting and in the context of limited access to contraceptive services, the unmet need is potentially high.…”

Section: Discussionsupporting

confidence: 89%

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Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of vertical transmission of HIV

Lungu,

Chewe

2024

BMC Public Health

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Background Prevention of vertical (mother to child) transmission of HIV is one of the key strategies towards HIV epidemic control. Despite considerable progress over the past decade in Zambia, the country is yet to reach global and national target for elimination of vertical transmission of HIV. Avoidance of unintended pregnancy among women living with HIV is one of the cost-effective interventions in a comprehensive approach to prevent vertical transmission of HIV. Therefore, this study aimed at ascertaining trends in and predictors of unmet need for family planning among women living with HIV in Zambia. Methods The study employed a repeated cross sectional (RCS) study design, using data from the three (3) most recent consecutive rounds of the Zambia Demographic and Health Survey (ZDHS) conducted in 2007, 2013/2014 and 2018. The study used data from a total of 27,153 women aged 15–49 years over the three survey periods among whom 4,113 had an HIV positive result following a rigorous HIV testing algorithm of the demographic and health surveys, and these constituted our sample size of women living with HIV. We used descriptive statistics and logistic regression analyses to respectively ascertain trends in and predictors of unmet need for family planning among women living with HIV. Results Over the three survey points, unmet need for family planning among women living with HIV has largely remained unchanged from 20.8% in 2007 to 20.5% in 2013/14 and 21.1% in 2018 DHS. Residence, age of women, household wealth, woman’s parity, employment, and age of spouse emerged as significant predictors of unmet need for family planning among women living with HIV in Zambia. Conclusion Preventing HIV infection in a child preserves life, contributes to improving quality of life from its early stages and averts lifetime costs of HIV treatment and associated healthcare costs. There is need to consider optimization of interventions to prevent vertical transmission of HIV including shaping programming regarding preventing unintended pregnancies among women living with HIV. Among other aspects, policy and practice need to strengthen SRH/HIV integration and better target rural residents, younger women, those with high parity and consider positive male engagement to reduce unmet need for family planning among women living with HIV.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of vertical transmission of HIV

Lungu,

Chewe

2024

BMC Public Health

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“…The result was partially consistent with a study in Zambia, where women with 0 or 1 child were less likely to have an unmet need compared to women with ≥ 4 children, while there were no differences between women with 0 or 1 child and women with 2 or 3 children. (25) This might be because of the difference in variable categorization between our study and that of Zambia. The study in Zambia divided the categories into four subgroups (0-1 child, 2-3 children, 4-5 children and ≥ 6 children), (25) whereas in our study, four subgroups were divided differently (0 child, 1 child, 2 children, and ≥ 3 children).…”

Section: Resultsmentioning

confidence: 81%

“…(25) This might be because of the difference in variable categorization between our study and that of Zambia. The study in Zambia divided the categories into four subgroups (0-1 child, 2-3 children, 4-5 children and ≥ 6 children), (25) whereas in our study, four subgroups were divided differently (0 child, 1 child, 2 children, and ≥ 3 children). In this study, the higher the number of children, the higher the likelihood that women had an unmet need for contraception.…”

Section: Resultsmentioning

confidence: 81%

Unmet need for contraception among married women in the Kyrgyz Republic from the 2006, 2014 and 2018 Multiple Indicator Cluster Survey: A cross- sectional study

Dolonbaeva,

Inthaphatha,

Dzhangaziev

et al. 2023

Preprint

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Background This study aims to investigate the prevalence of an unmet need for contraception from 2006 to 2018, and examine the factors associated with an unmet need for contraception among married women over the course of 12 years in the Kyrgyz Republic. Methods This study employed three datasets from the Multiple Indicator Cluster Survey 2006, 2014, and 2018. There were 9,229 women aged 15–49 who were married and fecund included in this study. Logistic regression was employed to estimate the relationship of an unmet need for contraception with other factors. A P value < 0.05 was set as statistically significant. Results The prevalence of an unmet need for contraception was 19.9% in 2006, 20.4% in 2014, and 22.5% in 2018. Intrauterine devices were the prominent contraceptive method of usage among Kyrgyz women, but the trend of usage drastically declined over time. From 2006 to 2018, factors associated with unmet need for contraception included women’s age, area of residence, mother tongue of household head, age of husband, and number of children ever born. Conclusion The unmet need for contraception among married Kyrgyz women slightly increased, and the trend of contraception usage declined from 2006 to 2018. Sexual health education for young people and youth-friendly services should be promoted. An effective and reliable supply chain, including financing, forecasting, and procurement for contraception commodities, should be prioritized and strengthened. Regular supportive supervision visits are essential to improve the knowledge and skills of healthcare providers, and to sustain intrauterine device service as a contraceptive choice for Kyrgyz women.

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Choice of desired family size among young women in Zambia: what matters?

et al. 2023

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In many developing countries, population expansion and high fertility rates have been of concern to individuals, society, and governments. Zambia is one of the countries in sub-Saharan Africa, which has been experiencing high fertility for more than four decades since it attained independence. Understanding of factors associated with desired family size, especially amongst young women, is important because their future reproductive behaviour has the potential to influence the country’s course of fertility. Therefore, this study was conducted to examine the determinants of family size choice among young women in Zambia. The study analysed data extracted from repeated cross-sectional surveys conducted in 2007, 2013 and 2018. The analysis was done on a pooled weighted sample of 15,528 young women aged 15–24 years. Multivariate logistic regression was used to examine factors associated with the desired family size of young women. All analyses were conducted using Stata software version 17 and considered complex survey design. The prevalence of young women who had the desire of at least 4 children has been considerably high in Zambia, at 63.2%. Young women in the age group 20–24 were found to have higher odds (AOR = 1.31; 95% CI: 1.03, 1.66) of desiring at least 4 children compared to those aged 15–19. Women living in the rural areas were (AOR = 1.41; 95% CI: 1.10, 1.79) more likely to desire at least 4 children compared to their counterparts living in urban areas. Age of a young woman, place of residence, level of education, household wealth status, number of living children, and exposure to mass-media family planning messages were significantly associated with desire of at least 4 children. The desire for a large family size remains a social concern for reducing fertility in Zambia. This is because the proportion of young women who desire a large family size has been consistently high. Increasing access to education and sexual reproductive health information to young women especially to those in rural areas is key to changing their reproductive behaviour.

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Unmet need for family planning among married women in Zambia: lessons from the 2018 Demographic and Health Survey

Cited by 16 publications

References 20 publications

Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of vertical transmission of HIV

Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of vertical transmission of HIV

Unmet need for contraception among married women in the Kyrgyz Republic from the 2006, 2014 and 2018 Multiple Indicator Cluster Survey: A cross- sectional study

Choice of desired family size among young women in Zambia: what matters?

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