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The 2024 Zambia Demographic and Health Survey (ZDHS) has revealed a significant decline in fertility rates across the country, marking a major demographic shift since 1992.
The Total Fertility Rate (TFR) has dropped from 6.5 children per woman in 1992 to 4.0 children per woman in 2024, highlighting progress in family planning and public health efforts.
The decline has been more pronounced in urban areas, where fertility rates decreased from 5.8 in the three years preceding the 1992 survey to 3.2 in the three years preceding the 2024 survey.
In rural areas, fertility declined from 7.1 to 4.9 over the same period. Between the 2018 and 2024 surveys, rural areas recorded a sharper drop in TFR, falling from 5.8 to 4.9 children per woman, compared to a decline from 3.4 to 3.2 in urban areas.
The survey also examined HIV prevention awareness and sexual behavior among Zambians aged 15 to 24, revealing notable disparities based on geographic location and gender.
Among individuals in this age group, 43.1 percent of men demonstrated knowledge about HIV prevalence, compared to 41.9 percent of women.
In urban areas, more women (51.0 percent) than men (50.2 percent) had knowledge of HIV prevention methods, while in rural areas, 38.0 percent of men and 33.4 percent of women demonstrated knowledge.
Disparities were also evident in HIV testing rates among men and women aged 15 to 49.
The data showed that 83.0 percent of women reported having ever been tested for HIV and receiving results, compared to 72.0 percent of men.
In the past 12 months, 50.0 percent of women and 40.0 percent of men reported being tested and receiving results.
The ZDHS collected data from a sample of 13,625 households, with 12,808 households successfully interviewed, achieving a response rate of nearly 100 percent.
Among eligible participants, 14,362 women aged 15 to 49 were identified, with 13,951 completing interviews, yielding a response rate of 97 percent.
For men aged 15 to 59, 13,424 were identified, and 12,585 were successfully interviewed, achieving a response rate of 94 percent.
The findings highlighted a transformative decline in fertility rates and provide critical insights into HIV awareness and testing behaviors.
Public health officials and policymakers are expected to use the data to tailor programmes aimed at further reducing disparities and promoting equitable access to health services across Zambia.
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