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Zambia: Difference between revisions
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Zambia has a high fertility rate (nearly 6 children per woman), making it the country with the eighth highest fertility rate in the world.<ref>[https://www.cia.gov/library/publications/the-world-factbook/geos/za.html CIA World Factbook7]</ref> According to a 2015 United Nations report, it was found that about 52% of Zambian women (who were of reproductive age and married/in unions) used any form of contraception, including traditional methods. The most common contraceptive methods for Zambian women were found to be contraceptive injectables (20%), birth control pills (12%), and contraceptive implants (6%). Male condoms were used by some couples (about 4%). While some couples opted for sterilization, the rates were rather low (2% for women and 0% for men). There were especially low rates of usage for IUDs (1%) and practically no users of the vaginal barrier method (0%). Traditional methods were also used at a very low rate, such as the rhythm method (less than 1%) and withdrawal (less than 1%).<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]</ref> | Zambia has a high fertility rate (nearly 6 children per woman), making it the country with the eighth highest fertility rate in the world.<ref>[https://www.cia.gov/library/publications/the-world-factbook/geos/za.html CIA World Factbook7]</ref> According to a 2015 United Nations report, it was found that about 52% of Zambian women (who were of reproductive age and married/in unions) used any form of contraception, including traditional methods. The most common contraceptive methods for Zambian women were found to be contraceptive injectables (20%), birth control pills (12%), and contraceptive implants (6%). Male condoms were used by some couples (about 4%). While some couples opted for sterilization, the rates were rather low (2% for women and 0% for men). There were especially low rates of usage for IUDs (1%) and practically no users of the vaginal barrier method (0%). Traditional methods were also used at a very low rate, such as the rhythm method (less than 1%) and withdrawal (less than 1%).<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]</ref> | ||
Generally speaking, Zambian women experience vastly different lives, depending on their economic and social status, whether they live in rural or urban areas, and the agency that they are granted in their families and communities. Women who are more wealthy, educated, urbanized, and independent tend to have greater access to family planning options, particularly if they live in bigger cities like Lusaka or Kitwe, and may be able afford higher quality care at private clinics and hospitals.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363807/ Why don’t urban youth in Zambia use condoms? The influence of gender and marriage on non-use of male condoms among young adults]</ref> However, this is not the case for most women in Zambia, where 64% of people live in poverty (and, in rural areas, 80% of people live in poverty).<ref>[https://www.unicef.org/zambia/children_5157.html UNICEF Zambia - Poverty]</ref> The lack of educational, economic, and social opportunities hit women particularly hard. In 2015, it was estimated that women had a 56% literacy rate (compared to 70.9% literacy rate for men).<ref>[https://www.cia.gov/library/publications/the-world-factbook/geos/za.html CIA World Factbook 2017]</ref> Patriarchal social structures and norms also grant many women limited agency over their property, land, sex lives, and contraceptive decisions. As a result, women may not seek out contraception because their husbands or communities do not approve.<ref>[https://www.genderindex.org/country/zambia/ Gender Index - Zambia]</ref> <ref>[https://www.daily-mail.co.zm/family-planning-the-grim-reality-in-rural-areas/ Family planning: The grim reality in rural areas]</ref> This issue is compounded by the fact that there are widespread stigmas around contraceptives. For example, surveys in 2009 showed that two-thirds of young adults in Zambia believed that condoms promoted promiscuity.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363807/ Why don’t urban youth in Zambia use condoms? The influence of gender and marriage on non-use of male condoms among young adults]</ref> You can read an article from the Lusaka Times, which tried to dispel many of the myths surrounding condoms, [https://www.lusakatimes.com/2016/12/05/facts-about-condoms/ here]. | Generally speaking, Zambian women experience vastly different lives, depending on their economic and social status, whether they live in rural or urban areas, and the agency that they are granted in their families and communities. Women who are more wealthy, educated, urbanized, and independent tend to have greater access to family planning options, particularly if they live in bigger cities like Lusaka or Kitwe, and may be able afford higher quality care at private clinics and hospitals.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363807/ Why don’t urban youth in Zambia use condoms? The influence of gender and marriage on non-use of male condoms among young adults]</ref> However, this is not the case for most women in Zambia, where 64% of people live in poverty (and, in rural areas, 80% of people live in poverty).<ref>[https://www.unicef.org/zambia/children_5157.html UNICEF Zambia - Poverty]</ref> The lack of educational, economic, and social opportunities hit women particularly hard. In 2015, it was estimated that women had a 56% literacy rate (compared to 70.9% literacy rate for men).<ref>[https://www.cia.gov/library/publications/the-world-factbook/geos/za.html CIA World Factbook 2017]</ref> Patriarchal social structures and norms also grant many women limited agency over their property, land, sex lives, and contraceptive decisions. As a result, women may not seek out contraception because their husbands or communities do not approve.<ref>[https://www.genderindex.org/country/zambia/ Gender Index - Zambia]</ref> <ref>[https://www.daily-mail.co.zm/family-planning-the-grim-reality-in-rural-areas/ Family planning: The grim reality in rural areas]</ref> This issue is compounded by the fact that there are widespread stigmas around contraceptives. For example, it is a common misconception among many women that contraceptives cause permanent infertility.<ref>[https://globalpressjournal.com/africa/zambia/myths-infertility-mean-many-young-zambian-women-dont-use-contraception-already-late/ Fertility Myths – Not Access – Stand Between Zambian Women and Contraception]</ref> Furthermore, surveys in 2009 showed that two-thirds of young adults in Zambia believed that condoms promoted promiscuity.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363807/ Why don’t urban youth in Zambia use condoms? The influence of gender and marriage on non-use of male condoms among young adults]</ref> You can read an article from the Lusaka Times, which tried to dispel many of the myths surrounding condoms, [https://www.lusakatimes.com/2016/12/05/facts-about-condoms/ here]. | ||
While Zambia has a large urban population (43.5% of total population in 2018), there are still many women who live in remote and rural areas. For these women, it is particularly difficult to access family planning services. They may need to travel long distances, often by foot, to access family planning services from Community Based Distributors (CBDs). The CBDs typically have condoms available, but as of 2016, they were not trained or authorized to offer longer-lasting contraceptive methods, such as IUDs or implants.<ref>[https://www.ippf.org/blogs/overcoming-family-planning-challenges-zambia Overcoming family planning challenges in Zambia]</ref> Rural women typically tend to marry young and give birth early, as children are seen as a sign of prestige.<ref>[https://www.cia.gov/library/publications/the-world-factbook/geos/za.html CIA World Factbook7]</ref> | While Zambia has a large urban population (43.5% of total population in 2018), there are still many women who live in remote and rural areas. For these women, it is particularly difficult to access family planning services. They may need to travel long distances, often by foot, to access family planning services from Community Based Distributors (CBDs). The CBDs typically have condoms available, but as of 2016, they were not trained or authorized to offer longer-lasting contraceptive methods, such as IUDs or implants.<ref>[https://www.ippf.org/blogs/overcoming-family-planning-challenges-zambia Overcoming family planning challenges in Zambia]</ref> Rural women typically tend to marry young and give birth early, as children are seen as a sign of prestige.<ref>[https://www.cia.gov/library/publications/the-world-factbook/geos/za.html CIA World Factbook7]</ref> | ||
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* You can find '''female condoms''' sold in pharmacies in Zambia. However, they do not appear to be widely used and there are reports of women rejecting them as an option. You can read a story about rural women rejecting female condoms [https://www.daily-mail.co.zm/why-women-shun-their-condoms/ here]. | * You can find '''female condoms''' sold in pharmacies in Zambia. However, they do not appear to be widely used and there are reports of women rejecting them as an option. You can read a story about rural women rejecting female condoms [https://www.daily-mail.co.zm/why-women-shun-their-condoms/ here]. | ||
* You can find a variety of '''oral contraceptive pills (birth control pills)''' available at pharmacies, clinics, hospitals, and NGOs that provide health services. Some of the birth control pill brands you can expect to see are Diane 35, Safe Plan, Microgynon, and Oraclon. | * You can find a variety of '''oral contraceptive pills (birth control pills)''' available at pharmacies, clinics, hospitals, and NGOs that provide health services. Some of the birth control pill brands you can expect to see are Diane 35, Safe Plan, Microgynon, and Oraclon. | ||
** Note: If you obtain birth control pills with instructions that are only in non-English languages (such as Chinese), they may be in the country illegally, and the Zambian government warns against using them. You can read more about this issue [https://www.daily-mail.co.zm/chinese-contraceptive-pill-worries-state-medical-bodies/ here]. | |||
* If you want an '''intrauterine device (IUD)''', you can get it inserted it at various hospitals and clinics in Zambia. For example, at [http://victoriahospitals.org/ Victoria Hospital], you can get a copper IUD inserted for k1600 (as of June 2018). For women who are low-income, there may be free or low-cost options available at NGOs and public sector facilities, such as Marie Stopes International (see below for more information on MSI). | * If you want an '''intrauterine device (IUD)''', you can get it inserted it at various hospitals and clinics in Zambia. For example, at [http://victoriahospitals.org/ Victoria Hospital], you can get a copper IUD inserted for k1600 (as of June 2018). For women who are low-income, there may be free or low-cost options available at NGOs and public sector facilities, such as Marie Stopes International (see below for more information on MSI). | ||
* If you want an '''contraceptive implant''', you can get it inserted at various hospitals and clinics in Zambia. For example, at [http://victoriahospitals.org/ Victoria Hospital], you can get the Jadelle implant inserted for k1000 (as of June 2018). For women who are low-income, there may be free or low-cost options available at NGOs and public sector facilities, such as Marie Stopes International (see below for more information on MSI). | * If you want an '''contraceptive implant''', you can get it inserted at various hospitals and clinics in Zambia. For example, at [http://victoriahospitals.org/ Victoria Hospital], you can get the Jadelle implant inserted for k1000 (as of June 2018). For women who are low-income, there may be free or low-cost options available at NGOs and public sector facilities, such as Marie Stopes International (see below for more information on MSI). | ||