Background Teenage pregnancy remains a major social and public health challenge in developing countries especially sub-Saharan Africa (SSA) where prevalence rates are still increasing. Even if considerable effort has been made over the years to study determining factors of teenage pregnancy in SSA, few studies have looked at the trends and associated factors over a longer period. Furthermore, no known study has focussed on both individual and contextual factors influencing teenage pregnancy in Zambia. This study, thus sought to fill this gap in knowledge by simultaneously investigating trends of teenage pregnancy as well as its individual and contextual determining factors. Methods A total pooled weighted sample of 10,010 teenagers (in the age group 15–19) from four waves of the Zambia Demographic and Health Surveys were extracted. Using bivariate analysis, we investigated the trends of teenage pregnancy between 2001 and 2018. Separate multilevel logistic regression models were fitted on pooled teenage pregnancy data in relation to several individual and contextual level factors. Both fixed and random effects were produced. Bayesian parameter estimates were produced using lme4 package in R statistical programming environment. Results Results of the trends of teenage pregnancy in Zambia have shown an overall decrease of 2% between 2001 and 2018. Almost all the socioeconomic and demographic variables were consistently associated with teenage pregnancy (p < 0.001) in a bivariate analysis across the four survey. In multilevel analysis, the odds of being pregnant were higher for teenagers who were employed (aOR = 1.21, 95% CI: 1.02–1.42), married (aOR = 7.71, 95% CI: 6.31–9.52) and those with knowledge of ovulation period (aOR = 1.58, 95% CI: 1.34–1.90). On the other hand, belonging to households in high wealth quintiles, being literate, exposure to mass-media family planning messages and delayed sexual debut were associated with decreased odds of teenage pregnancy. Conclusion The study shows that teenage pregnancy remains a social and public health challenge in Zambia as the country has seen little decrease in the prevalence over the years under consideration. Factors associated with teenage pregnancy include marital status, and employment, knowledge of ovulation period, wealth quintile, sexual debut and exposure to mass-media family planning messaging. Concerted effort must be made to improve literacy levels, reduce poverty and enhance sexual health promotion through the mass media in view of cultural norms, which may prevent parents and children from discussion sexual education topics thus exacerbate the vice.

Background: Contraceptive use has been used as one of the methods not only to space but also to limit the number of children that a couple/individuals have. Since their introduction, most of the efforts have concentrated on females than males even though males tend to have huge say on the ideal number of children a couple/individuals have. In our study, we sought to determine linkages between contraceptive use and fertility preferences as well as associated demographic and socio-economic characteristics among sexually active males in Zambia regardless of their marital status. Methods: The study had two outcome variables, namely contraceptive use and fertility preference (measured by desire for more children as a count variable). Data for this paper was the male recode dataset from the 2018 Zambia Demographic and Health Survey. Binary logistic regression was performed to determine odds ratios of contraceptive use by selected characteristics of males. Poisson regression model was used to establish factors associated with fertility preferences. Results: Age of men (20-29, 30-39 and 40-49, respectively), residence in rural areas, wealth quintile, religious affiliation of Protestant or Muslim, media exposure, and having discussed Family Planning with a health worker in the last few months were associated with contraceptive use. Males who reported using any contraception method reported 3% less ideal number of children desired compared with those who were not using any method. Older males (age group 30-49), resident in rural areas, with primary education, married, employed, Protestant by religion, and opinionated to the extent of labeling women who use contraceptives “as promiscuous”, had more ideal number of children comparatively. Conclusions: There were minimal differences in the ideal number of children among males who reported using and not using any contraceptive method. Strategies aimed at encouraging contraception use should cover all categories of males so as to achieve universal involvement of men in family planning in Zambia. A study combining both qualitative and quantitative methods would be ideal to look holistically at the demographic, socio-economic and cultural factors associated with non-contraception use and ideal number of children among males.

IntroductionTeenage pregnancy remains a major social and public health challenge in developing countries especially sub-Saharan Africa (SSA) where prevalence rates are still increasing. Even if considerable effort has been made over the years to study determining factors of teenage pregnancy in SSA, few studies have looked at the trends and associated factors over a longer period. Furthermore, no known study has focussed on both individual and contextual factors influencing teenage pregnancy in Zambia. This study, thus sought to fill this gap in knowledge by simultaneously investigating trends of teenage pregnancy and early motherhood as well as its individual and contextual determining factors. MethodsA total pooled weighted sample of 10,010 teenagers (in the age group 15 to 19) from four waves of the Zambia Demographic and Health Surveys (ZDHS) were extracted. Using bivariate analysis, we investigated the trends of teenage pregnancy between 2001 and 2018. Separate multilevel logistic regression models were fitted on pooled teenage pregnancy data in relation to several individual and contextual level factors. Both fixed and random effects were produced. Parameter estimates were produced using Bayesian Markov chain Monte Carlo (MCMC) Methods in BRMS.ResultsResults show that the trends of teenage pregnancy in Zambia have shown an overall decrease of 2% between 2001 and 2018. Almost all the socioeconomic and demographic variables were consistently associated with teenage pregnancy (p < 0.001) in a bivariate analysis across the four ZDHS waves. In multilevel analysis, the odds of being pregnant were higher for teenagers who were aged between 18 and 19 years (AOR = 2.57, 95% CI: 2.20-2.98), employed (AOR= 1.24, 95% CI: 1.06-1.46) married (AOR =8.33, 95% CI: 6.84-10.26) and those with knowledge of fertile period (AOR=1.69, 95% CI: 1.43-2.00). On the other hand, being in higher wealth quintile, 15-17 years of age, exposure to family planning messages and delayed sexual debut were associated with decreased odds of early teenage pregnancy. ConclusionThe study shows that early pregnancy remains a social and public health challenge in Zambia as the country has seen little decrease in the prevalence over the years under consideration. Factors associated with teenage pregnancy and early motherhood include age, marital status, and employment, knowledge of fertility period, wealth quintile, sexual debut and exposure to mass-media family planning messaging. Concerted effort must be made to improve literacy levels, reduce poverty and enhance sexual health promotion through the mass media in view of cultural norms, which may prevent parents and children from discussion sexual education topics thus exacerbate the vice.

Background One of the outcomes of sexual violence is unintended pregnancy. In Zambia, 15% of married women age 15—49 years had experienced sexual violence from their husband or partner. The prevalence of unintended pregnancies among women age 15—49 years has risen from 33% in 1992 to 38% in 2018. The link between sexual violence and unintended pregnancy in Zambia was investigated in this study. Methods This study used the women's dataset from the 2018 Zambia Demographic and Health Survey, a cross-sectional survey. The study looked at a weighted sample size of 4,465 women age 15 – 49 years. Unintended pregnancy was measured by combining response categories of mistimed and unwanted pregnancy. Multivariate binary logistic regression was performed to establish the net effects of sexual violence and each explanatory variable on unintended pregnancy. Results The findings suggest that sexual violence does have a role in unintended pregnancies (AOR 1.74; CI 1.38—2.19). Ever use of contraception is also a significant predictor of unintended pregnancy (AOR 1.48; CI 1.16—1.88), even when other characteristics are taken into account. Results have shown that a woman who had ever used contraception and had experienced sexual violence was more likely to have an unintended pregnancy. Conclusion Spousal sexual violence is highly associated with unintended pregnancies in Zambia. Addressing intimate partner sexual violence is among the ways to prevent unintended pregnancies. It is also important to sensitize women on reporting acts of sexual violence to relevant authorities as this will not only prevent reoccurrence of sexual violence but also reduce unintended pregnancies and associated long-term effects.

Background: Intimate partner violence against women is acknowledged as a worldwide public health issue. One of the outcomes of sexual violence is unintended pregnancy. In Zambia, 15% of married women age 15 to 49 had experienced sexual violence from their husband or partner. Since 1992, the prevalence of unintended pregnancies among women age 15 to 49 has risen to 38%. The link between sexual violence and unintended pregnancy in Zambia was investigated in this study.Methods: The women's dataset from the 2018 Zambia Demographic and Health Survey was used in this study. The study looked at a weighted sample size of 5,132 women age 15 to 49. Descriptive, chi-square, bivariate, and multivariate binary logistic regressions were used in the data analysis. Multivariate binary logistic regression was performed to establish the net effects of sexual violence and each explanatory variable on unintended pregnancy.Results: The findings suggest that sexual violence does have a role in unintended pregnancies (AOR 1.74; 1.38 - 2.19). Contraception use is also a significant predictor of unintended pregnancy (AOR 1.48; 1.16 - 1.88), even when other characteristics are taken into account. Results have shown that if a woman had ever used contraception and had experienced sexual violence, she was more likely to have an unintended pregnancy.Conclusion: Spousal sexual violence is highly associated with unintended pregnancies in Zambia. Addressing intimate partner sexual violence is among the ways to prevent unintended pregnancies. It is also important to sensitize on women reporting acts of sexual violence to relevant authorities as this will not only prevent reoccurrence of sexual violence but also reduce unintended pregnancies and associated long-term effects.

Background Intimate partner violence against women is acknowledged as a worldwide public health issue. One of the outcomes of sexual violence is unintended pregnancy. In Zambia, 15% of married women age 15 to 49 had experienced sexual violence from their husband or partner. Since 1992, the prevalence of unintended pregnancies among women age 15 to 49 has risen to 38%. The link between sexual violence and unintended pregnancy in Zambia was investigated in this study. Methods The women's dataset from the 2018 Zambia Demographic and Health Survey was used in this study. The study looked at a weighted sample size of 5,132 women age 15 to 49. Descriptive, chi-square, bivariate, and multivariate binary logistic regressions were used in the data analysis. Multivariate binary logistic regression was performed to establish the net effects of sexual violence and each explanatory variable on unintended pregnancy. Results The findings suggest that sexual violence does have a role in unintended pregnancies (AOR 1.74; 1.38–2.19). Contraception use is also a significant predictor of unintended pregnancy (AOR 1.48; 1.16–1.88), even when other characteristics are taken into account. Results have shown that if a woman had ever used contraception and had experienced sexual violence, she was more likely to have an unintended pregnancy. Conclusion Spousal sexual violence is highly associated with unintended pregnancies in Zambia. Addressing intimate partner sexual violence is among the ways to prevent unintended pregnancies. It is also important to sensitize on women reporting acts of sexual violence to relevant authorities as this will not only prevent reoccurrence of sexual violence but also reduce unintended pregnancies and associated long-term effects.