Abstract
BackgroundDespite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia.MethodsA qualitative case study design was adopted, involving 33 individual interviews and 9 focus group discussions with adolescents and other key-informants such as parents, teachers and policymakers. Thematic and critical discourse analysis were used to analyze the data.ResultsAdolescents’ age significantly reduced their access to Sexual and Reproductive Health, SRH services. Also, adolescent fertility discussions were influenced by marital norms and Christian beliefs, as well as health and rights values. While early marriage or child-bearing was discouraged, married adolescents and adolescents who had given birth before faced fewer challenges when accessing SRH information and services compared to their unmarried or nulliparous counterparts. Besides, the major influencers such as parents, teachers and health workers were also conflicted about how to package SRH information to young people, due to their varying roles in the community.ConclusionThe pluralistic view of adolescent fertility is fueled by “multiple consciousnesses”. This is evidenced by the divergent discourses that shape adolescent fertility control in Zambia, compounded by the disempowered position of adolescents in their communities. We assert that the competing moral worlds, correct in their own right, viewed within the historical and social context unearth significant barriers to the success of interventions targeted towards adolescents’ fertility control in Zambia, thereby propagating the growing problem of high adolescent fertility. This suggests proactive consideration of these discourses when designing and implementing adolescent fertility interventions.
Highlights
Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries
Since the International Conference on Population and Development (ICPD) at Cairo in 1994, adolescent sexual and reproductive health (SRH) has risen to the development agenda, with adolescent fertility noted as a major priority [5]
To understand further the circumstances that reinforce high adolescent fertility in Zambia, this paper explores the multiple discourses or “multiple consciousnesses” that concurrently shape adolescent fertility in Zambia, drawing on a perspective that highlights the inseparable nature of dissonant views within the same people; keeping in mind the reduced access to SRH services among young people [25] and their pursuit for more power over their SRH decisions
Summary
Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. Adolescent fertility, defined as ‘any pregnancy-related experience among those 10–19 years of age, including live birth, abortion, stillbirth, or miscarriage’ [6] thrives in low resource settings, usually driven by low educational attainment and early-marriages [7]. Despite a global and regional push towards ending child marriage and early childbearing [12], a key intervention in the Sustainable Development Agenda, and with steady progress made towards increasing access to adolescentfriendly health services[13], most low-resource settings, including Zambia, regard the majority of the teenage pregnancies within marriage, but share negative attitudes towards pregnancies out of wedlock [14]. Disproportionate access to contraception and safe abortion services among adolescents has been tied to marital status and other factors related to low socio-economic status [7, 13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
