Family planning

Unmet need for family planning among married women in Zambia: lessons from the 2018 Demographic and Health Survey | BMC Women’s Health

The promotion of contraception is important in reducing fertility and affects maternal morbidity and mortality in most developing countries [1]. Globally, 12% of women who are married or in union were estimated to have unmet need for family planning in 2017; this meant that twelve out of 100 married women who wanted to stop or delay childbirth could not do so because they were not using any method of contraception [1, 2]. Among the regions of the world, sub-Saharan Africa has the highest unmet need for family planning, at 24% [2,3,4]. In 2018, the unmet need for family planning was 20% among married women in Zambia. The prevalence of unmet need for family planning in Zambia is higher than global and continental averages. This can be attributed to the slow increase in contraceptive use. The modern contraceptive prevalence rate among women aged 15-49 in Zambia was 48%, falling from 33% in 2013-14 to 23% in 2001. [5, 6]. Unmet family planning needs can affect maternal and child health. Therefore, the potential health benefits of reducing unmet need for family planning are vast, as it would lead to a decline in unintended pregnancies leading to a reduction in maternal, infant and child mortality. [7, 8]. It is estimated that meeting unmet need for family planning alone could reduce maternal deaths by almost a third [2, 9].

From a reproductive health and human rights perspective, all women of childbearing age should have access to family planning methods to prevent unwanted pregnancies and to space or limit the number of births. The realization of this right is an important intervention to improve maternal health, child health and the general well-being of women and families. Following the 2012 London Summit on Family Planning, Zambia committed to increase its budgetary allocation to family planning commodities to eliminate unmet need for family planning and achieve universal coverage of family planning. family planning by expanding the range of contraceptive techniques and expanding access to underserved people. [10, 11].

An exploratory study conducted in Ghana in 2019 to determine factors associated with unmet need for family planning among women of reproductive age in low- and middle-income countries, found that a woman’s age and level of education were negatively associated with unmet need for family planning while the number of living children a woman had was positively associated with unmet need for family planning [12, 13]. Reported reasons for not using contraceptives included husband’s opposition or fear of husband’s infidelity, and a wife’s fear of side effects or other health problems related to contraceptive methods. [12, 13]. The literature on unmet need for family planning is abundant worldwide, but little research has been documented on its association with other individual-level variables, such as women’s recent visits to a health facility. , household wealth and exposure to mass media. family planning messages in the sub-Saharan region and in Zambia in particular.

The prevalence of unmet need for family planning provides information on the size of an important subgroup of the population for family planning (FP) program management, i.e. women at risk pregnancy with a clear need for FP services based on their stated desire to space or limit births but not use any family planning method [1, 2, 9, 14]. Successful implementation of the Family Planning 2020 (FP2020) initiative calls for focused planning and investment of resources in reproductive health interventions, with expected production of positive health outcomes [1, 2, 9, 15, 16].

In Zambia, there are studies on the determinants of unmet need for family planning among married women using Demographic and Health Survey data. A study based on data from the 2007 Demographic and Health Survey in Zambia focused on variations in unmet need for contraception among married women. The study found that the unmet need for limitation was associated with age at first marriage and a partner’s desire for more children, while the unmet need for spacing was associated with the number of children. children a woman has had and place of residence. [13, 17,18,19]. A woman’s age and number of children were strongly associated with an unmet need for family planning.

Research has shown that unmet need for family planning can be associated with several factors including; demographic, socio-economic, cultural and religious variables, as well as the availability and accessibility of contraceptive methods. This study was conducted to examine factors associated with unmet need for family planning among married women in Zambia, based on data from the recent Demographic and Health Survey. The results of this study will be useful in informing the direction and programming of health policies that seek to address the challenges of meeting the family planning needs of married women in Zambia.