Alfred Agwanda

Determinants of transitions to first sexual intercourse, marriage and pregnancy among female adolescents: evidence from South Nyanza, Kenya.

The timing of transitions to sexual activity, marriage and childbearing in sub-Saharan Africa is undergoing profound changes. This study investigates the determinants of adolescent transitions in South Nyanza, a socioeconomically deprived setting in Kenya where adolescent reproductive health is a particular concern. The analysis is based on Cox regression of timing of first sexual intercourse, first marriage and first pregnancy, using data from a survey of 1247 females aged 12-19 years. The results show that higher household socioeconomic status and educational attainment are associated with delayed onset of all three transition events. Furthermore, mothers higher educational attainment is protective for initiation of sexual intercourse while rural residence is protective for pregnancy experience. Other protective factors include communication with parents or with fellow girlfriends. However, discussing sexual matters with boyfriends, high internal locus of control, and gender bias are associated with early onset of the three transition events.

Size of newborn and caesarean section deliveries among teenagers in sub-Saharan Africa : Evidence from DHS

This paper uses DHS data from 20 countries in sub-Saharan Africa, collected in the late 1990s and early 2000s, to examine perceived size of newborn and Caesarean section deliveries among teenagers in the region. A comparison between teenagers and older women, based on logistic regression analyses for individual countries, as well as multilevel logistic analyses applied to pooled data across countries, and controlling for the effects of important socioeconomic and demographic factors, shows that in general, births to teenagers are more likely to be small in size but are less likely to be delivered by Caesarean section compared with births among older women. An examination of the country-level variations shows significant differences in perceived size of newborn and Caesarean section deliveries between countries. However, the observed pattern by maternal age does not vary significantly between countries, suggesting that these patterns are generalizable for the region. For teenagers with characteristics associated with higher odds of Caesarean section, being in a country with an overall higher rate particularly amplifies their individual probability.

Gender-role attitudes and reproductive health communication among female adolescents in South Nyanza Kenya.

In this paper, we use data from three districts of Nyanza Province in Kenya to examine gender-role attitudes and reproductive health communication among adolescent females aged 12-19 years. We test for differences in gender-role attitudes between younger (12-15) and older (16-19) adolescents. We explore the possible association between educational attainment and gender-role attitudes by estimating a random effects model. We also examine the association between gender-role attitudes and reproductive health communication via an unordered multinomial logit model. The results show that adolescent females in this setting hold conservative views on decision making within the home and at the same time portray less conservative views concerning marriage and reproductive behaviour. We also find some differences by age regarding gender-role attitudes and reproductive health communication. Our findings further indicate that educational attainment is significantly associated with gender-role attitudes, which in turn are significantly associated with reproductive health communication.