Pregnancy loss: spontaneous and induced abortions among young women in Lusaka, Zambia.

An estimated 60% of all adolescent pregnancies in low-income countries are unintended. The present study was carried out at the university hospital in Lusaka, Zambia over a four-month period in 2005. The aim was to explore experiences of pregnancy loss and to ascertain the girl's contraceptive knowledge and use and their partner's involvement in the pregnancy/abortion. Eighty-seven girls aged 13-19 years admitted to hospital for incomplete abortions were interviewed. Of these girls, 53 (61%) had had a spontaneous abortion and 34 (39%) had undergone an unsafe induced abortion. Significantly more girls with an unsafe induced abortion were single, students, had completed more years in school and were in less stable relationships. Girls' overall contraceptive knowledge and use was low and most pregnancies were unplanned. Partners played a decisive role in terminating pregnancy through unsafe induced abortion. Traditional healers, girls themselves and health professionals were the main abortion providers. Young women's health risks due to unprotected sex and lack of contraceptive services should urgently be addressed. The existence of the abortion law and access to emergency contraception should be better publicized in Zambia.

Zambian male adolescents' perceptions about premarital sexual relationships.

The role adolescent boys play in premarital sexual activities, gender power relations, and the reproductive health risks they are exposed to, has received little attention in research. This qualitative study has aimed to explore Zambian male adolescents' perceptions and expectations about premarital sexual relationships. Seven focus group discussions were conducted between November 2000 and May 2001, in George and Chimwemwe compounds, with 53 boys aged 15 to 19. The findings reveal that adolescent premarital sexual relationships are common and considered by many boys as a prerequisite to achieving an adult male's autonomy and status. The boys viewed themselves as the privileged gender, with greater freedom than girls, and were the major decision-makers on sexual matters in relationships. The results indicate that traditional values and stereotypical gender roles continue to influence Zambian boys' male identity. However, a sense of ambiguity among the boys on issues of gender imbalance in premarital relationships indicates a potential and preparedness to break with traditional trends - a true challenge for public health priorities and interventions.

Loveness and her brothers: trajectories of life for children orphaned by HIV/AIDS in Zambia.

A central theme in the contemporary rhetoric of those charged with managing HIV/AIDS interventions is how to handle and alleviate the plight of orphans and other vulnerable children (OVCs). The many glossy documents describing the policy and action plans of funders and organisations involved in AIDS work often highlight these children. Unfortunately, this does not necessarily result in increased support for research about children affected by HIV/AIDS, or even the increased allocation of resources to improve their life-situation. Discourse surrounding OVCs appears, in effect, to be barely more than a politically correct strategy for attracting resources while conveying the impression that concern for OVCs is a humane and central aspect of HIV/AIDS prevention and mitigation. In many rural African villages, however, the plight of orphans continues unmitigated and unaffected by the larger structures of purported interventions. These bold charges are supported by the following narrative account of a group of siblings in Zambia for one decade, as derived from a longitudinal micro study. It follows the children from the onset of parental death, through successive transfers to the homes of various relatives, ending with a sad form of closure: return to the ruins of their natal home as a child-headed household trying to make ends meet. The plight of these children epitomises an experience common to many children orphaned by AIDS, who are suffering without mitigation from the surrounding structures that exist to help vulnerable children.