Zambia

Zambia (formerly Northern Rhodesia), a landlocked country in southern Africa, became an independent country in 1964. A worldwide decline in the price of copper, Zambia's chief export, threw the country into poverty in the 1970s, and civil war in surrounding countries also caused an influx of refugees and further strained the national budget. The population in 2009 was estimated at 11.9 million; the median age is 17 years, and 45.1 percent of the country is aged 14 years or younger. The population is 99.5 percent African, with 50–75 percent Christian and the remainder primarily Muslim or Hindu. The population growth rate is 1.6 percent, despite a net migration rate of minus 2.6 per 1,000; the high growth rate is due to a high birth rate of 40.5 births per 1,000 population and an extremely high fertility rate (an estimate of the number of children per woman) of 5.2.

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a serious problem; 15.2 percent of the adult population are estimated to be infected, and 1.1 people were estimated to be living with HIV/AIDS by 2007. For these reasons, prophylactic measures to prevent mother-to-infant transmission of HIV are a high priority. Life expectancy at birth is extremely low for both men (38.5 years) and women (38.7 years). Literacy rates are substantially higher (86.8 percent) for men than for women (74.8 percent), and children are only expected to attend school for seven years. Per capita Gross Domestic Product (GDP) was estimated at $1,500 in 2008, and was quite unevenly distributed with a Gini index of 50.8. The per-capita expenditure on health in 2002 was $20, with just over half of that provided by the government.

Childhood immunization rates for major diseases ranged from 76 percent to 94 percent in 2003, and 94 percent of pregnant women received at least one prenatal care visit. However, only 43 percent of births were attended by trained personnel, and the same percentage took place in health facilities, while maternal and infant death rates remain high. In 2000, the maternal mortality rate was 750 per 100,000 live births, the stillbirth rate was 31 per 1,000 total births, the early neonatal mortality rate was 26 per 1,000 live births, and the neonatal mortality rate 40 per 1,000 live births.

Save the Children, an international organization devoted to improving maternal and child health, places Zambia in its Tier III or least developed countries, where it ranks 19th out of 33 countries on the Women's Index (taking into account factors such [Page 1292]as life expectancy, maternal mortality, availability of modern contraception, and maternity leave benefits) and 20th out of 33 countries on the Mothers' Index (taking into account additional factors related to children's health and well-being, such as the under-5 mortality rate and gender parity in primary school enrollment).