The New York Times Magazine has a story, "America Is Stealing the World's Doctors," that focuses on an Indian who grew up in Zambia, went home to India to study medicine, then tried for a few years to be a surgeon in Zambia. He gave up and is now becoming a doctor here. The pay is 10 times better and the working conditions are too. But what about the huddled masses of Zambians needing doctor's care? Zambia has 1 doctor for every 23,000 people. 

Since everybody else in the New York Times is talking about contraception, I looked through this article to see if there was any mention of the concept that maybe what Zambia needs is relatively fewer but healthier Zambians. 

Of course not. 

So, what is the Total Fertility Rate in Zambia? 

It's 6.28 babies per woman per lifetime. That appears to have gone up slightly over the last decade, assuming that these kind of statistics out of Zambia can detect small trends. In any case, that's a huge TFR.

The mortality rate in Zambia is very high, but the population has still grown by 50% over the last 20 years. 

It would seem hard to think about health care in Zambia without at least considering issues of contraception, yet the whole topic is routinely ignored when thinking about Africa.