Framework to enhance the implementation of the school pregnancy re-entry policy in Zambia

Zambia has witnessed a surge in teenage pregnancies at the primary school level since the introduction of the school pregnancy re-entry policy (REP) in 1997, which replaced the expulsion policy, resulting in some stakeholders questioning its worth. A multilevel stakeholder study was conducted in Chongwe, which also included national-level stakeholders through a qualitative study that used in-depth interviews and document analysis. Interviews with 100 participants selected using convenience and purposive sampling methods plus 13 document reviews were conducted. The data were thematically analysed for interviews, and content analysis was used for document analysis. The findings were that pregnancy REP buy-in by stakeholders is compromised by a resource-constrained implementation environment. Therefore, the Kakanda–Sinkala framework proposes political will, public awareness, stakeholder engagement, monitoring through an interlinked management information system and periodic reviews to enhance efficiency and effectiveness in its implementation.