Fertility and family planning in the 2024 MDHS

Fertility estimates

For the three years preceding the survey, Dzaleka’s estimated total fertility rate was 4.9 children per woman, compared with 3.7 in the rest of Malawi. The report also records a higher general fertility rate and crude birth rate in the camp sample.

That overall result sits alongside later childbearing on two other measures. Median age at first birth among women aged 20 to 49 was 20.5 years in Dzaleka and 19.1 elsewhere. Among women aged 15 to 19, 17 percent in Dzaleka had ever been pregnant, compared with 32 percent in the national comparison.

These indicators describe different dimensions of fertility and are not contradictory: a population can have later first births or fewer teenage pregnancies while still having more births across a woman’s reproductive years.

Wanted and observed fertility

Women aged 15 to 49 in Dzaleka reported wanted fertility of 4.4 children, compared with an observed total fertility rate of 4.9. In the national comparison the figures were 3.1 and 3.7. The report therefore estimated that observed fertility exceeded wanted fertility in both populations.

Contraceptive use

Among currently married women aged 15 to 49 in Dzaleka, 37 percent were using any contraceptive method: 33 percent used a modern method and 4 percent a traditional method. The comparable any-method figure elsewhere in Malawi was 68 percent. Injectables and implants were the most frequently reported methods in both groups.

The report estimates unmet need for family planning at 20 percent among currently married women in Dzaleka, compared with 11 percent elsewhere. Total demand was 57 percent in Dzaleka and 79 percent in the national comparison.

Reading the figures carefully

The contraceptive-use and unmet-need estimates apply to currently married women, not every woman or household in the camp. The table reports 377 women in the Dzaleka denominator. The survey identifies a service and reproductive-health gap, but it does not establish a single cause. Access, preferences, provider availability, information, cost and other factors require additional research.