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Zimbabwe's falling birth rate a burden
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Two seemingly ordinary moments tell a deeper story of Zimbabwe's shifting reproductive landscape. In Harare, a woman welcomes her second child five years after her first - exactly as planned. In rural Murewa, a young mother secretly takes oral contraceptives, fearing her husband's disapproval. Though separated by geography and circumstance, both women are quietly exercising control over their reproductive choices - a reflection of broader demographic shifts reshaping Zimbabwe.
According to a comparative analysis of the 2015 and 2023/2024 Zimbabwe Demographic and Health Surveys (ZDHS), the country is experiencing subtle but significant social changes. Fertility is declining. Contraceptive use is rising. Education levels are improving. And while inequalities persist, the data reveals an evolving society where reproductive intentions are increasingly aligning with outcomes.
Zimbabwe's fertility rate has dropped by 30 percent over the last four decades, from 5.6 children per woman in 1982 to 3.9 in 2024. Although the pace of decline over the past decade has slowed - from 4.0 in 2015 to 3.9 today - other indicators suggest progress. For example, the average birth interval has increased from 43.7 months to 47.4 months, signaling greater reproductive control. Teenage pregnancies have also slightly declined, with 21 percent of girls aged 15 to 19 now reporting early childbearing, down from 22 percent in 2015 - a shift likely tied to laws banning child marriages.
Yet regional and socio-economic divides remain stark. Rural women still average 1.5 more children than their urban counterparts. But among more educated and wealthier women, the gap between desired and actual fertility is narrowing, hinting at growing autonomy over reproductive decisions. The United Nations' World Fertility 2024 report projects that Zimbabwe will not complete its fertility transition - the shift from high to low fertility - until after 2054, placing it behind global averages but ahead of many Sub-Saharan peers.
While Zimbabwe's fertility rate of 3.9 sits below the Sub-Saharan average of 4.3, it remains well above the global average of 2.2. High fertility continues to correlate with low income, poor education and limited access to contraception, highlighting the challenges Zimbabwe must overcome to reap the benefits of demographic transition.
On the health front, mortality outcomes paint a mixed picture. The under-5 mortality rate has stagnated at 69 deaths per 1,000 live births since 2015. More concerning is the rise in infant mortality, up from 50 to 56 per 1,000 live births, and an increase in neonatal mortality - deaths within the first month of life - which rose to 37 per 1,000, the highest ever recorded in the ZDHS. These figures threaten the country's chances of meeting the Sustainable Development Goal (SDG) targets of reducing under-5 mortality to 25 and neonatal deaths to 12 by 2030.
Nonetheless, maternal healthcare is improving. The percentage of women delivering in health facilities has climbed from 78 percent in 2015 to 88 percent in 2024. More women are also receiving postnatal care, with 68 percent now being checked within two days of delivery, up from 57 percent in 2015. Yet gaps remain, especially in rural areas. The under-5 mortality rate is still higher in rural Zimbabwe - 71 deaths per 1,000 live births compared to 66 in urban zones - though the disparity has narrowed over time.
One of Zimbabwe's most promising successes has been in family planning. Modern contraceptive use among married women rose modestly from 67 percent in 2015 to 69 percent in 2024. Unmet need - women who want to delay or stop childbearing but are not using contraception - fell slightly from 10 percent to 9 percent. Disparities remain, however: urban women are more likely to have their contraceptive needs met than rural women, and those with higher education are significantly better served than those with only primary schooling.
Crucially, education plays a defining role in shaping reproductive choices. Women with secondary or higher education consistently report lower fertility rates and greater access to contraception. In 2024, highly educated women had a total fertility rate of 3.8, compared to 5.1 among those with only primary education. The ZDHS reveals that 90 percent of urban women and 82 percent of rural women actively participate in contraceptive decision-making. Still, 4 percent of married women aged 15 to 49 report pressure from partners or families to bear children against their wishes - underscoring persistent cultural barriers to full autonomy.
The United Nations Population Fund (UNFPA), which has supported Zimbabwe's reproductive health system, notes that domestic funding has played a growing role in sustaining family planning services. UNFPA Zimbabwe country representative Miranda Tabifor said the government has invested US$4.5 million over the past three years, while UNFPA contributed US$9 million more.
HIV, too, remains a defining issue in Zimbabwe's demographic profile. A decade ago, adult HIV prevalence stood at 13.8 percent. By 2024, new infections had dropped by 75 percent, placing Zimbabwe on track to meet its 2030 goal of a 90 percent reduction. However, awareness appears to be slipping. Knowledge about preventing mother-to-child transmission of HIV has declined among both men and women, and young women remain disproportionately affected by the epidemic, with HIV prevalence among women aged 20 to 24 almost three times higher than among men.
The epidemic is also ageing. More people over 50 are living with HIV, thanks largely to the success of antiretroviral therapy. While this is a positive sign of longevity, it places new demands on the healthcare system.
Education emerges as a consistent catalyst for change. The latest ZDHS reports that women's median years of schooling have risen from 6.5 to 7.5 since 2010/2011, and men's from 6.7 to 7.7. Higher levels of education are strongly associated with lower fertility, better child health outcomes, and higher contraceptive use. Yet, urban and wealth disparities remain pronounced. Only 17 percent of rural women and 21 percent of rural men have completed secondary school, compared to 38 percent and 41 percent in urban areas.
These shifts - in fertility, health, education and autonomy - point to the slow emergence of a demographic dividend. According to a 2017 UNFPA study, Zimbabwe's opportunity to harness this dividend - when a declining birth rate leads to a proportionally larger working-age population - opened before 1990 and will remain open until 2060. But capitalising on it will require urgent investment in adolescent health, women's education and job creation.
The data from the 2023/2024 ZDHS suggests that Zimbabwe is inching forward. Births are more widely spaced. Contraceptive use is more common. Women are making more intentional choices about childbearing. Child health is improving in some areas, though neonatal outcomes remain a concern. HIV is being contained, albeit with slipping awareness. And education is steadily reshaping reproductive behaviour.
The demographic dividend window remains open - but only just. If policymakers fail to act boldly and invest in the country's youth and women, the opportunity may quietly close.
According to a comparative analysis of the 2015 and 2023/2024 Zimbabwe Demographic and Health Surveys (ZDHS), the country is experiencing subtle but significant social changes. Fertility is declining. Contraceptive use is rising. Education levels are improving. And while inequalities persist, the data reveals an evolving society where reproductive intentions are increasingly aligning with outcomes.
Zimbabwe's fertility rate has dropped by 30 percent over the last four decades, from 5.6 children per woman in 1982 to 3.9 in 2024. Although the pace of decline over the past decade has slowed - from 4.0 in 2015 to 3.9 today - other indicators suggest progress. For example, the average birth interval has increased from 43.7 months to 47.4 months, signaling greater reproductive control. Teenage pregnancies have also slightly declined, with 21 percent of girls aged 15 to 19 now reporting early childbearing, down from 22 percent in 2015 - a shift likely tied to laws banning child marriages.
Yet regional and socio-economic divides remain stark. Rural women still average 1.5 more children than their urban counterparts. But among more educated and wealthier women, the gap between desired and actual fertility is narrowing, hinting at growing autonomy over reproductive decisions. The United Nations' World Fertility 2024 report projects that Zimbabwe will not complete its fertility transition - the shift from high to low fertility - until after 2054, placing it behind global averages but ahead of many Sub-Saharan peers.
While Zimbabwe's fertility rate of 3.9 sits below the Sub-Saharan average of 4.3, it remains well above the global average of 2.2. High fertility continues to correlate with low income, poor education and limited access to contraception, highlighting the challenges Zimbabwe must overcome to reap the benefits of demographic transition.
On the health front, mortality outcomes paint a mixed picture. The under-5 mortality rate has stagnated at 69 deaths per 1,000 live births since 2015. More concerning is the rise in infant mortality, up from 50 to 56 per 1,000 live births, and an increase in neonatal mortality - deaths within the first month of life - which rose to 37 per 1,000, the highest ever recorded in the ZDHS. These figures threaten the country's chances of meeting the Sustainable Development Goal (SDG) targets of reducing under-5 mortality to 25 and neonatal deaths to 12 by 2030.
Nonetheless, maternal healthcare is improving. The percentage of women delivering in health facilities has climbed from 78 percent in 2015 to 88 percent in 2024. More women are also receiving postnatal care, with 68 percent now being checked within two days of delivery, up from 57 percent in 2015. Yet gaps remain, especially in rural areas. The under-5 mortality rate is still higher in rural Zimbabwe - 71 deaths per 1,000 live births compared to 66 in urban zones - though the disparity has narrowed over time.
One of Zimbabwe's most promising successes has been in family planning. Modern contraceptive use among married women rose modestly from 67 percent in 2015 to 69 percent in 2024. Unmet need - women who want to delay or stop childbearing but are not using contraception - fell slightly from 10 percent to 9 percent. Disparities remain, however: urban women are more likely to have their contraceptive needs met than rural women, and those with higher education are significantly better served than those with only primary schooling.
The United Nations Population Fund (UNFPA), which has supported Zimbabwe's reproductive health system, notes that domestic funding has played a growing role in sustaining family planning services. UNFPA Zimbabwe country representative Miranda Tabifor said the government has invested US$4.5 million over the past three years, while UNFPA contributed US$9 million more.
HIV, too, remains a defining issue in Zimbabwe's demographic profile. A decade ago, adult HIV prevalence stood at 13.8 percent. By 2024, new infections had dropped by 75 percent, placing Zimbabwe on track to meet its 2030 goal of a 90 percent reduction. However, awareness appears to be slipping. Knowledge about preventing mother-to-child transmission of HIV has declined among both men and women, and young women remain disproportionately affected by the epidemic, with HIV prevalence among women aged 20 to 24 almost three times higher than among men.
The epidemic is also ageing. More people over 50 are living with HIV, thanks largely to the success of antiretroviral therapy. While this is a positive sign of longevity, it places new demands on the healthcare system.
Education emerges as a consistent catalyst for change. The latest ZDHS reports that women's median years of schooling have risen from 6.5 to 7.5 since 2010/2011, and men's from 6.7 to 7.7. Higher levels of education are strongly associated with lower fertility, better child health outcomes, and higher contraceptive use. Yet, urban and wealth disparities remain pronounced. Only 17 percent of rural women and 21 percent of rural men have completed secondary school, compared to 38 percent and 41 percent in urban areas.
These shifts - in fertility, health, education and autonomy - point to the slow emergence of a demographic dividend. According to a 2017 UNFPA study, Zimbabwe's opportunity to harness this dividend - when a declining birth rate leads to a proportionally larger working-age population - opened before 1990 and will remain open until 2060. But capitalising on it will require urgent investment in adolescent health, women's education and job creation.
The data from the 2023/2024 ZDHS suggests that Zimbabwe is inching forward. Births are more widely spaced. Contraceptive use is more common. Women are making more intentional choices about childbearing. Child health is improving in some areas, though neonatal outcomes remain a concern. HIV is being contained, albeit with slipping awareness. And education is steadily reshaping reproductive behaviour.
The demographic dividend window remains open - but only just. If policymakers fail to act boldly and invest in the country's youth and women, the opportunity may quietly close.
Source - Sunday Mail
