'Ring' your future, without changing diaper - Can preventing teenage pregnancy address child marriage in Zambia?

Teenage pregnancy and child marriage are prevalent in Zambia and are complexly interrelated issues with common causes and effects. The aim of this study was to explore factors in the social and cultural environment shaping young people's sexual behaviour, with specific attention to teenage pregnancy and child marriage in Eastern Zambia. The study was conducted in selected wards in Petauke, Chadiza and Katete districts, using an exploratory mixed-method design including a household survey, focus group discussions and in-depth interviews. The participants included 1,434 young females and males aged 15 to 24, female and male parents and caregivers; grandmothers; traditional leaders; teachers; health and social workers; representatives from youth associations, community-based and non-governmental organizations; and district level policy makers. Qualitative data were analysed using thematic content analysis and NVivo was used to manage the data, while survey data were analysed using Stata. The study revealed a high prevalence rate of teenage pregnancy (48%) and child marriage (13%) among young women. The mean age at first pregnancy or fatherhood was lower among female (17) than male respondents (20). A clear interlinkage between teenage pregnancy and child marriage was found, the two issues were mutually reinforcing. While teenage pregnancy appeared both as a cause and consequence of child marriage, marriage was mostly a common response to pregnancy. Early sexual debut, limited knowledge and use of contraception, poverty and limited future perspectives as well as sexual and gender norms were identified as the main causative factors of teenage pregnancy and therefore, child marriage. Based on the findings, a conceptual model to explain the interrelationships between young people's sexual behaviour, teenage pregnancy and child marriage is discussed. To address teenage pregnancy and child marriage in Eastern Zambia, there is a need to look into the realities and needs of young people regarding sex and relationships