Zambia Demographic Health Survey Research Articles

Factors Associated with Agreeing to Early Childbearing Among School Girls of Selected Rural Districts in Zambia

Background: The Zambia Demographic Health survey conducted in 2014 reported a notable number of adolescent girls 3627(11.7%) who had their first sexual intercourse by age 15 and the Zambia National Health Strategic Plan 2017-2021 highlighted the high adolescent birth rate which stood at 141 per 1000 live births between the years 2013 and 2014. In this paper, we adopted the WHO definition of an Adolescent as any person between the ages of 10 to 19 years. This study aimed at investigating baseline factors that leads to agreeing into early childbearing practices among adolescent girls in selected rural districts of Zambia nested in the RISE cluster randomized trial. In this study early childbearing was taken to mean any pregnancy before the age of 16. Methods: This study is a nested quantitative cross-sectional design. Participants were girls attending grade seven at various schools in 2016. Information on factors that could influence the participants’ view on childbearing were collected at baseline. A complete enumeration of approximately 5000 girls recruited in 12 rural districts of Central and Southern provinces were analysed. Descriptive statistics were presented as frequencies and percentages in tables. To check for association with categorical variables, either Chi-squared or Fisher’s exact test was done depending on whether the assumptions for Chi-squared test were satisfied or not. Univariate and Multiple Logistic regression analysis was used to test the association between independent factors and early childbearing. Clustering in the study was accounted for using robust standard errors. Results: The findings showed that more than two-thirds 3189 (73.7%) of the participants had little or no knowledge regarding adolescent sexual and reproductive health services while less than one-third 1137 (26%) had knowledge regarding Adolescent Sexual and Reproductive Health services. Adolescents with mobile phones were 2.5 times more likely to have children early compared to adolescents without mobile phones. Majority 227 (69%) who agreed to early childbearing were aged 10 to 15 years, whilst the least 99(30.3%) were in the age range of 16 to 20 years. In addition, results revealed that one-year increase in age of an adolescent girl increases agreeing to early childbearing by 30% (OR=1.30, 95% CI (1.01, 1.67), p- value=0.03). Overall, very few factors (mobile phone and age) at baseline were found to be associated with agreeing to early childbearing. Conclusions: Only mobile phone use and age were associated with agreeing to early childbearing.

Too young to be a wife! analysis of the factors influencing child marriages and its influence on the preferred number of children among women in Zambia.

Context/Background: Zambia has one of the highest rates of child marriages in the world. This study sought to establish the determinants of child marriage in rural and urban areas of Zambia, and to determine the influence of child marriage on fertility preferences of women in Zambia. Data source and methods : The study utilized data from the 2013-2014 Zambia Demographic Health Survey. Data was analysed using the Binary Logistic and Poisson regression models. Results: Timing of conception, age at first sex, region of residence, education level of respondent and their partners, and family size were significant predictors of child marriages in urban areas. In rural areas, region of residence, age at fist sex, education level of respondent and their partners, and family size had significant influence on child marriages. The study further found that women who got married below the age of 18 preferred a higher number of children. Conclusion: The study established that various factors influence child marriages in urban and rural Zambia and in turn child marriages influence the preferred number of children. The findings suggest a multipronged approach to addressing the root cause of the problem.

Gender differentials in sexual initiation among adolescents in Zambia

The purpose of the present study was to assess gender differentials in factors influencing sexual initiation among adolescents in Zambia. Data employed in this study was derived from the 2013 Zambia Demographic Health Survey. Logistic regression analysis was used to identify gender differentials in sexual initiation by considering socio-economic variables. The data revealed that about 22 per cent of the female and 32.6 per cent of males reported having had sex by the age of 15 years old. About 49.5 per cent of the female and 54.9 per cent of the males reported having had sex by the age of 18 years old. Logistic regression analysis identified age, religion, residence, wealth status, working status, educational level, watching television and drinking alcohol as strong predictors of respondent’s likelihood of sexual initiation by the age of 15 years old. The study found that male youths who drank alcohol were 1.4 times more likely to be sexually active by the age of 15 years old compared to those who did not drink alcohol. Female youths who were working were 1.4 times more likely to report having had sex by the age of 15 years old and those who drank alcohol were 1.3 times more likely to report been sexually active by the age of 15 years old. This study is in agreement with other African and western based studies which have shown that socioeconomic and demographic variables have a significant influence on early sexual initiation among adolescents in Zambia. Interventions that seek to prevent HIV and AIDS and unwanted pregnancies among adolescents through regulation of sexual behaviour would need to seriously account for socio-demographic and economic influences. Keywords: Gender differentials, sexual initiation, youth, Zambia

Professional care delivery or traditional birth attendants? The impact of the type of care utilized by mothers on under-five mortality of their children

BackgroundBecause of the high under-five mortality rate, the government in Zambia has adopted the World Health Organization (WHO) policy on child delivery which insists on professional maternal care. However, there are scholars who criticize this policy by arguing that although built on good intentions, the policy to ban traditional birth attendants (TBAs) is out of touch with local reality in Zambia. There is lack of evidence to legitimize either of the two positions, nor how the outcome differs between women with HIV and those without HIV. Thus, the aim of this paper is to investigate the effect of using professional maternal care or TBA care by mothers (during antenatal, delivery, and postnatal) on under-five mortality of their children. We also compare these outcomes between HIV-positive and HIV-negative women.MethodsBy relying on data from the 2013–2014 Zambia Demographic Health Survey (ZDHS), we carried out propensity score matching (PSM) to investigate the effect of utilization of professional care or TBA during antenatal, childbirth, and postnatal on under-five mortality. This method allows us to estimate the average treatment effect on the treated (ATT).ResultsOur results show that the use of professional care as opposed to TBAs in all three stages of maternal care increases the probability of children surviving beyond 5 years old. Specifically for women with HIV, professional care usage during antenatal, at birth, and during postnatal periods increases probability of survival by 0.07 percentage points (p.p), 0.71 p.p, and 0.87 p.p respectively. Similarly, for HIV-negative women, professional care usage during antenatal, at birth, and during postnatal periods increases probability of survival by 0.71 p.p, 0.52 p.p, and 0.37 p.p respectively. However, although there is a positive impact when mothers choose professional care over TBAs, the differences at all three points of maternal care are small.ConclusionGiven our findings, showing small differences in under-five child’s mortality between utilizers of professional care and utilizers of TBAs, it may be questioned whether the government’s intention of completely excluding TBAs (who despite being outlawed are still being used) without replacement by good quality professional care is the right decision.

Determinants of HIV Testing Among Sexually Active Young People in Zambia

This study used data from the 2013 Zambia Demographic Health Survey (ZDHS) based on a nationally representative sample carried out by Central Statistical Office of Zambia. This paper analyzed a special module designed to collect information on the extent of the uptake of HIV testing by sexually active young people in Zambia. The analysis of this paper is based on 1879 young women aged 15-19 and 2747 aged 20-24 years respectively. Their male counterparts were 1675 aged 15-19 and 2005 aged 20-24 years. Overall 84% of females and 57% of males reported having tested for HIV. Regression analysis further showed that age, place of residence, work status, educational level, consistency of condom use and number of sex partners were significantly related to the uptake of HIV testing for both female and male participants. Young sexually active people should be availed affordable educational opportunities which in turn will hopefully accord them to viable economic opportunities. The media exposure to the young men and women should preach consistent condom use as well as a reduction in their sexual partners.Key Words: HIV testing; Sexually active; Condom use; Prevalence

Determinants of condom use among currently married men in Zambia

HIV is one of the leading health threats and cause of morbidity and mortality in Zambia. Among many preventive measures, condom use is the most effective methods of preventing HIV. The aim of this study was to investigate factors associated with condom use among currently married men in Zambia. Secondary data from the 2013 Zambia Demographic Health Survey was used. Results from binary logistic regression analysis showed that condom use is associated with being young (β = -0.71, p < 0.001), being rich (β = 0.25, p < 0.05), paying for sex (β = 0.42, p < 0.001), perceiving risk of contracting HIV (β = 0.38, p < 0.001), and believing in the efficacy of condom use as a protective measure against HIV (β = 0.24, p < 0.01). Condom use in Zambia is associated with socio-demographic characteristics and habits of adult males. Therefore, prevention measures aimed at increased the use of male condoms should integrate social demographic characteristics and habits of adult males to be effective.Keywords: Condom use, married men, determinants, Zambia

Contextual Factors Associated with Domestic Violence among Currently Married Women in Zambia: Findings from Zambia Demographic Health Survey

Contextual Factors Associated with Domestic Violence among Currently Married Women in Zambia: Findings from Zambia Demographic Health Survey

Domestic Violence and Sexual Health among Young Women in Zambia

This paper aims at describing the prevalence and correlates of domestic violence, and evaluating their associations with key health outcomes among Zambian young females aged 15–24 years.Data from the 2007 Zambia Demographic Health Survey was utilized. The survey was carried out by Central Statistical Office with the technical assistance from Macro International through MEASURE DHS programme. The 2007 ZDHS is based on a nationally representative sample of 7146 ever married women of 15-49 age group covering 320 Standard Enumeration Areas (clusters). In this paper, the data analysis was only restricted to young women aged 15-24.The results show that among the various forms of violence against women, 22% of the women faced sexual violence, followed by emotional violence (21%) and physical violence (16%). The results further revealed that age, religion, educational level, working status, condom use during last sex and had any STDs in the last 12 months, had genital sores/ulcers in the last 12 months were the most prominent factors significantly explaining variation in the prevalence of physical, emotional and sexual violence. Domestic violence is a complex societal scourge which is unlikely to be attributed to one single determinant.Keywords: Domestic Violence

Examining the correlates of gender equality and the empowerment of married women in Zambia

This paper is an analysis of the factors that predict the involvement of women in decision-making within households in Zambia. It is a study at the micro-level of some of the indicators used in calculating the Gender Status Index, which reflects women empowerment and gender equality. Using the 2007 Zambia Demographic Health Survey and complementary log–log models, the study investigates the determinants of women empowerment and gender equality. At the multivariate level, wealth, education, and employment significantly influence women’s involvement in household decision-making. Older women were however, more likely to be involved in decision-making concerning daily household purchases. Interestingly, married women from the Northwestern and Western parts of the country were more likely to engage in a patriarchal bargain and negotiate spaces of power and decision-making than those from the Lusaka province – the capital. These findings will be beneficial for programme and policy formulation with regard to women empowerment and gender equality in Zambia. Women’s involvement in decision-making with their partners and within the household will spill over into their integration and representation on civil–political platforms, with a potential to increase productivity and improve development outcomes in context.

Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: Analysis of demographic and health survey data

Data from the 2005 Ethiopia Demographic and Health Survey (EDHS) and the 2007 Zambia Demographic Health Survey (ZDHS) were analyzed to examine the association between World Health Organization (WHO) recommended IYCF indicators and nutritional status among children 0- 23 months of age in Ethiopia and Zambia. A total of 1810 and 2512 children within this age group from Ethiopia and Zambia , respectively , were included in the analysis. Exclusive breast -feeding among children 0- 5.9 months of age is low in both Ethiopia (43 % ) and Zambia (51 % ). Timely introduction of complementary food is lower in Ethiopia (61 %) compared to Zambia (90 %). Only 7 percent of children between 6- 23 months of age consumed diets that met the minimum dietary diversity requirement of four or more food groups consumed per day compared to 37 % in Zambia. Multiple linear and logistic regression analyses using appropriate measures to account for the complex survey design were applied to examine the associations between IYCF practices and child anthropometry. Linear regression results show that exclusive breast -feeding (EBF) is positively associated with weight -for -height z -score (WHZ) (effect size (ES) 0.65; p<0.001) and weight -for- age z -score (W AZ) (ES 0.28; p<0.01) in Zambia. In Ethiopia, EBF under 6 months of age is negatively associated with height -for- age z - score (HAZ) (ES 0.81; p<0.01). Timely introduction of complementary food between 6- 8 months of age was positively associated with HAZ (ES 1.19; p<0.01) in Zambia. Higher dietary diversity score was associated with higher HAZ (ES 0.23, p<0.001 in Ethiopia; ES 0.12, p<0.01 in Zambia) and WAZ (ES 0.17, p<0.001 in Ethiopia; ES 0.04, p<0.10 in Zambia) in both countries. The findings demonstrate the need to reinforce age - appropriate IYCF practices to address child undernutrition. Special attention is needed to improve the complementary feeding practices, particularly diet diversity for children 6 -23 months of age , while sustaining a focus on EBF among children under 6 months of age, in order to improve overall nutrition al status of young children in Ethiopia and Zambia.

Students' perceptions of Zambian women: choosing where to deliver

In Zambia 57% of births occur at home under the supervision of unskilled attendants. This situation poses a danger to the lives of both delivering mothers and their newborns. The 2001–2002 Zambia Demographic Health Survey revealed that nearly two thirds of mothers who died in childbirth had delivered at home and most of the maternal deaths reported at health facilities were as a result of late referrals from home. The purpose of the study, therefore, was to explore Zambian midwifery students' perceptions of Zambian women's choice of place of delivery, either home or health facility. Four focus group discussions were held with 40 students from Lusaka School of Midwifery. The study deduced that in order to make childbirth safer midwives need to see themselves as change agents not as victims of external factors over which they have no influence.

AIDS Prevention in Zambia: Implications for Social Services

The incidence of AIDS continues to be higher in the African continent than elsewhere in the world. In Zambia, given the current pace of infection, projections suggest that approximately two million Zambians are likely to die toward the end of this decade. In this paper, we argue that current AIDS educational programs can be substantially reinforced by incorporating the services of family planning agencies in Zambia. Data used for the study come from the Zambia Demographic Health Survey (ZDHS), 1996. We suggest that the social work profession has crucial responsibility for designing AIDS prevention programs. A number of roles that social workers can play based on the values and philosophy of the profession is outlined. Limitations of the study are also discussed.