Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia

Joseph Lasong; Yuan Zhang; Simon Afewerki Gebremedhin; Sampson Opoku; Chrissie Stansie Abaidoo; Tamara Mkandawire; Kai Zhao; Huiping Zhang

doi:10.1136/bmjopen-2019-030980

Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia

BMJ Open. 2020 Mar 31;10(3):e030980. doi: 10.1136/bmjopen-2019-030980.

Authors

Joseph Lasong¹, Yuan Zhang¹, Simon Afewerki Gebremedhin², Sampson Opoku³, Chrissie Stansie Abaidoo⁴, Tamara Mkandawire², Kai Zhao¹, Huiping Zhang⁵

Affiliations

¹ Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
² Public Health School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
³ Department of Social Health Management, School of Public Health, Huazhong University of Science and Technology, Tongji Medical College, Wuhan, Hubei, China.
⁴ Department of Anatomy, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana.
⁵ Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China zhpmed@126.com.

Abstract

Objective: Zambia is among the world's top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women.

Design: Cross-sectional study.

Setting: Rural Zambia.

Participants: Secondary data of 4903 married or cohabiting rural women (15-49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson's χ² and descriptive statistics were performed to examine factors associated with modern contraceptive use.

Results: Factors that were positively associated with contraceptive use were respondent's education (secondary adjusted ORs (AOR = 1.61, p≤0.002); higher (AOR = 2.39, p≤0.050)), wealth index (middle class, (AOR = 1.35, p≤0.005); rich (AOR = 2.04, p≤0.001) and richest (AOR = 1.95, p≤0.034)), high parity (1-2 (AOR = 5.31, p≤0.001); 3-4 (AOR = 7.06, p≤0.001); 5+ (AOR = 8.02, p≤0.001)), men older than women by <10 years (AOR = 1.50, p≤0.026) and women sensitised about family planning at health facility (AOR = 1.73, p≤0.001). However, old age (40-49 years (AOR = 0.49, p≤0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR = 0.77, p≤0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR = 0.78, p≤0.026) and women without knowledge of number of children husband desires (AOR = 0.71, p≤0.001) were negatively associated with contraceptive use.

Conclusion: Modern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.

Keywords: Africa; Zambia; modern contraceptive use; rural; women of reproductive age.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Contraception / statistics & numerical data*
Contraception Behavior*
Contraceptive Agents*
Cross-Sectional Studies
Family Planning Services
Female
Humans
Male
Marriage*
Middle Aged
Pregnancy
Young Adult
Zambia

Substances

Contraceptive Agents