Unmet Need for Family Planning Among Married Women in Zambia: Lessons from the 2018 Demographic and Health Survey

Abstract Introduction: Unmet need for family planning among married women is still high in Africa. In the year 2018, one in every five married women in Zambia had an unmet need for family planning. Unmet need for family planning can increase the number of unintended pregnancies and abortions, both of which have the potential to increase the proportion of women of child bearing age who are at high risk of birth complications. Studies have shown that factors explaining unmet need for family planning vary significantly from country to country, depending on access and availability of family planning services for women. We conducted this study to understand the determinants of unmet need for family planning in Zambia. Knowledge of factors associated with unmet need for family planning can help governments and stakeholders to identify health strategies to reduce unwanted fertility and prevent maternal and child mortality.Methods: The study used datasets from the Zambia Demographic and Health Survey which was a representative cross-sectional survey conducted in 2018. Zambia conducted a Demographic and Health to capture health indicators which are used to measure progress of implementation of health sector interventions. We did analysis on a sample of 7, 597 married women aged 15-49 years. Chi-square test and multivariate logistic regression were used to analyse determinants of unmet need for family planning. Stata version 14.2 was used to analyse weighted data and survey commands were applied to account for the complex sample design. Results: Study findings have revealed that half of the married women were still not using contraception by 2018. Unmet need for family planning among married women is still a public health issue in Zambia. In multivariate regression analysis; age, parity, household wealth and exposure to media-based family planning messages were found to be significantly associated with unmet need for family planning among married women.Conclusion: There is need to enhance family planning policy and programming in the country in order to achieve desired health outcomes. Mass media campaigns and community-based outreach activities with special focus on the young women can achieve significant results in reducing unmet need for family planning. Further, there should be some deliberate interventions to conduct family planning talks during in health facilities targeting women who visit maternal and children care clinics.