Drivers of adolescent pregnancy in rural Zambia: a qualitative study in Kalabo District, Western Province
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Adolescent pregnancy in rural Kalabo, Zambia, is shaped by intersecting gender norms, cultural expectations, economic pressures, and institutional barriers rather than individual behavior alone. The discussion emphasizes that the sikenge initiation rite reinforces expectations of obedience, domestic responsibility, marriage, and fertility, linking womanhood and family respectability to motherhood and limiting girls’ reproductive agency. Stigma around unmarried girls seeking contraception, pressure to prove fertility, and expectations of marriage following pregnancy further reinforce early childbearing.
Objectives The study explored individual, interpersonal, community, institutional, and legal factors, particularly gendered power relations, that drive adolescent pregnancy in rural Kalabo District, Western Province, Zambia.
Methods This qualitative study conducted 32 in-depth and key informant interviews between October 2016 and September 2017 with 22 pregnant girls and young women aged 10–19 and 10 parents, traditional leaders, marriage counsellors, a teacher, and healthcare providers. Reflexive thematic analysis used a hybrid deductive-inductive approach guided by the social ecological model and theory of gender and power. Social norms inquiry examined gender socialization; expectations around obedience, sexuality, marriage, and fertility; sikenge initiation practices; contraceptive stigma; norms linking womanhood with motherhood; and sanctions for resisting cultural expectations.
Results Four interconnected themes emerged: culture and tradition, early marriage, barriers to sexual and reproductive health information and services, and weak legal enforcement. Sikenge teachings reinforced submissive gender roles and fertility expectations, while family and community pressures prioritized marriage and motherhood over education. Pregnancy could prompt marriage to restore family honor or secure economic support, while married girls faced pressure to conceive quickly. Contraceptive stigma, misinformation, judgmental providers, inadequate sexuality education, limited youth-friendly services, and conflicting consent requirements restricted pregnancy prevention. Informal settlement of sexual abuse cases through marriage or compensation further weakened protections for girls.
Conclusions Preventing adolescent pregnancy requires coordinated action across community, education, health, and legal systems that addresses gender norms, improves adolescent-responsive services and sexuality education, strengthens legal accountability, and supports girls’ autonomy and informed decision-making.
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