Determinants of unmet need for contraception in Zambia

Abstract

This study attempts to identify some of the socio-economic, socio-cutural and demographic factors influencing unmet need for contraception based on data drawn from the Zambia Demographic and Health Survey (ZDHS) conducted in 1996. The objective of the study stemmed from the fact that determinants of unmet need for contraception in Zambia have not been identified and are hence, poorly understood. Therefore, the specific objectives of the study were to estimate the magnitude of unmet need by selected background characteristics of the women and to identify factors that have significant effects on unmet need for contraception. The study adopted the definition of unmet need used in the ZDHS of 1996 which captures the currently married women only. According to this survey, 27 per cent of currently married women are classified-as having unmet need for contraception - 19 per cent for spacing their next birth and 8 per cent for limiting births. The study made use of simple percentages to show the distribution of the respondents by the selected background variables and cross tabulations to show the association between the dependent variable (unmet need) and selected independent variables. Logistic regression analysis was used to determine factors that have significant effects on unmet need for contraception in Zambia. The results of the analysis showed that significant differentials in unmet need for contraception among currently married Zambian women exists. Unmet need for contraception varies according to the socio-economic, socio-cultural and demographic background characteristics of the women. Factors affecting unmet need for contraception were found to be age of the respondent, region of residence, religion, number of living children, spousal communication, type of place of residence, and respondent's approval of family planning. The study recommends that efforts to eliminate unmet need for contraception should give priority to women who have been identified to have a higher likelihood of experiencing unmet need. For example, older women, those with more than 7 living children, those who reside in urban areas, those who belong to Muslim and "Other" religious group and those who reside in Southern, Eastern, and Luapula provinces. This entails increasing the number of health facilities providing family planning, and that existing ones to function better and to be more sensitive to women's culture and socio-economic circumstances. There is also need to increase the number of health personnel. Furthermore, there is need to increase the availability and accessibility of temporary contraceptive methods in the country, particularly in rural areas. Adequate Information, Education and Communication (IEC) activities should support community-based programmes in educating individuals and couples about the various family planning methods available for spacing and limiting. Family planning programmes should also continue to encourage dialogue between spouses. The study recommends that more work should be undertaken to improve the measurement of unmet need with a view to including all women regardless of their marital status and restricting to women who are currently exposed to the risk of pregnancy.