Family Instability and Pathways to Adulthood in Urban South Africa

Intergenerational Clustering of Under-Five Mortality: A Cohort Perspective in Low- and Middle-Income Countries

A burgeoning demographic literature documents the exceedingly high rates at which contemporary cohorts of women across the Global South experience the death of their children-even amid historic declines in child mortality. Yet, the patterning of maternal bereavement remains underinvestigated, as does the extent to which it replicates across generations of the same family. To that end, we ask: Are the surviving daughters of bereaved mothers more likely to eventually experience maternal bereavement? How does the intergenerational clustering of maternal bereavement vary across countries and cohorts? To answer these questions, we make use of Demographic and Health Survey Program data from 50 low- and middle-income countries, encompassing data on 1.05 million women and their mothers spanning three decadal birth cohorts. Descriptive results demonstrate that maternal bereavement is increasingly patterned intergenerationally across cohorts, with most women experiencing the same fate as their mothers. Multivariable hazard models further show that, on average, women whose mothers were maternally bereaved have significantly increased odds of losing a child themselves. In most countries, the association is stable across cohorts; however, in select countries, the risk associated with having a bereaved mother is shrinking among more recent birth cohorts.

The Role of Families in Adolescent and Young Adults' PrEP Use

While pre-exposure prophylaxis (PrEP) is a key HIV prevention tool for adolescents and young adults (AYAs), its initiation and sustained use is shaped by AYAs' unique social contexts, including family. We explored the role of families in AYAs' PrEP use through qualitative in-depth interview (IDI) data from iPrevent, an end-user study designed to identify factors that could optimize PrEP adherence among South African youth (18-24 years old). These data were collected using a semi structured guide and were analysed using an inductive approach. Several themes describing family influence on AYAs' PrEP use emerged including family support; family attitude towards PrEP; and the family's ability to obviate PrEP disclosure challenges. In addition, dimensions of family closeness, categorized as 'close', 'in-between' and 'loose-knit,' appeared important in contextualizing family influence on AYAs' PrEP use. We found that family remains a proximal and fundamental social system in which AYA are socialized and greater family engagement could aid PrEP implementation in this priority population.

"I Don't Know Where I Have to Knock for Support": A Mixed-Methods Study on Perceptions and Experiences of Single Mothers Raising Children in the Democratic Republic of Congo

Introduction and Objectives: It is well-documented that single mothers in sub-Saharan Africa face unique psychosocial challenges which can lead to child health and developmental disadvantages, often impacting life trajectories for both the mother and child. Years of instability, conflict, and widespread poor governance within the Democratic Republic of Congo (DRC) have resulted in magnified challenges for parents, making it more difficult to provide supportive and effective parenting. To address gaps in knowledge regarding the specific challenges experienced and adaptations made among single mothers raising children in contexts of adversity, the present study aimed to investigate the phenomenon of single mother parenting in the DRC. Methods: Cognitive Edge SenseMaker, a mixed-method data collection tool, was used to collect self-interpreted narratives among parents in eastern DRC. Quantitative SenseMaker data were uploaded into Tableau, a data organization and analysis tool, to visualize differences in response patterns between single mother (n = 263) and two-parent family study participants (n = 182). Single mother micronarratives (n = 251) were then coded line-by-line and analyzed thematically. Qualitative themes identified in the single mother micronarratives were used to facilitate a deeper and more nuanced understanding of key quantitative SenseMaker findings. Findings and Conclusions: Our study found that single mothers experienced immense challenges raising children in the DRC, including financial-, health- and parenting-related hardships. Single mothers described negative emotions and higher levels of household adversity while providing for their children in situations of extreme poverty compared to two-parent family respondents. Self-reliance was exhibited among most single mothers in an attempt to overcome challenges, primarily financial barriers, and to prioritize the health and well-being of their children. However, many children still lacked access to sufficient food, education, and healthcare. Limited governmental and social security support for single mothers was identified as contributing to heightened challenges and the self-reliance observed among single mothers. Findings emphasize that additional research and attention should be directed towards identifying the specific needs of, and available resources for, single mothers in different localities in an effort to inform policies and programs that best support families.

A Sequence-Analysis Approach to the Study of the Transition to Adulthood in Low- and Middle-Income Countries

This study investigates whether young people in low- and middle-income countries (LMICs) have experienced processes of destandardization of the life course similar to those observed in high-income societies. We provide two contributions to the relevant literature. First, we use data from 263 Demographic and Health Surveys (DHS) across 69 LMICs, offering the richest comparative account to date of women's transition to adulthood (TTA) patterns in the developing world. In so doing, we adopt sequence analysis and shift the focus from individual life-course events-namely first sexual intercourse, first union, and first birth-to a visually appealing approach that allows us to describe interrelations among events. By focusing on the analysis of trajectories rather than the occurrence of single events, the study provides an in-depth focus on the timing of events, time intervals between events, and how experiencing (or not) one event might have consequences for subsequent markers in the TTA in cross-national comparative perspective. Second, we identify clusters of TTA and explore their changes across cohorts by region and household location of residence (rural vs. urban). We document significant differences by macro-regions, yet relative stability across cohorts. We interpret the latter as suggestive of cultural specificities that make the TTA resistant to change and slow to converge across regions, if converging at all. Also, we find that much of the difference across cluster typologies ensues from variation related to when the transition begins (early vs. late), rather than from the duration between events, which tends to be uniformly quick across three out of four clusters.

Premarital Fertility and Marital Timing in Malawi

In Malawi, Africa, the median age at first marriage is among the lowest on the continent and adolescent fertility rates are among the highest. Using high-frequency panel data from the country designed to follow single women and men into marriage, we examine the extent to which premarital fertility is associated with the timing of marriage. Two notable findings emerge. First, premarital fertility typically leads to a more rapid transition into marriage, compared to not having had a premarital conception or birth, and this effect is as strong for men as it is for women. Second, among women with premarital fertility, those who are wealthier, and those who have two parents alive, have lower odds of not marrying. Among men with premarital fertility, however, no patterns predict their subsequent marital outcomes. This study contributes to the literature on fertility and marriage in sub-Saharan Africa by including men in the analysis.

Determinants and Consequences of Adolescent Fatherhood: A Longitudinal Study in Ethiopia, India, Peru, and Vietnam

PURPOSE

Adolescent parenthood is a major challenge in low- and middle-income countries (LMICs). However, the vast majority of the evidence has focused on adolescent motherhood. Little is known about adolescent fatherhood in LMICs. The aim of this study was to examine the determinants of early fatherhood and its consequences on a range of outcomes among adolescent males.

METHODS

This study used three waves of longitudinal data from the multicountry Young Lives cohort study, specifically following a sample of 1,779 adolescent boys at ages 15, 19, and 22 years in Ethiopia, India, Peru, and Vietnam. Individual fixed effects models were conducted to investigate the sociodemographic determinants of adolescent fatherhood and the consequences of adolescent fatherhood on males' education, health, psychosocial well-being, and time use outcomes.

RESULTS

The results indicated that lower educational attainment, absence of the adolescent's mother and father from the home, larger household size, and poverty increased the likelihood of becoming an adolescent father by age 22 years. The results revealed that becoming an adolescent father was associated with a higher likelihood of school dropout, being overweight, smoking, greater internalizing problems, and less time spent on leisure activities and more time spent on caregiving responsibilities.

CONCLUSIONS

Highlighting the experiences of young men as adolescent parents in LMICs, findings underscore the importance of prevention strategies to delay early parenthood for adolescent boys and multicomponent interventions to support young fathers and their unique health, socioeconomic, psychosocial, and behavioral needs.

Cross-cultural evidence does not support universal acceleration of puberty in father-absent households

Father absence in early life has been shown to be associated with accelerated reproductive development in girls. Evolutionary social scientists have proposed several adaptive hypotheses for this finding. Though there is variation in the detail of these hypotheses, they all assume that family environment in early life influences the development of life-history strategy, and, broadly, that early reproductive development is an adaptive response to father absence. Empirical evidence to support these hypotheses, however, has been derived from WEIRD (Western, Educated, Industrialized, Rich and Democratic) populations. Data from a much broader range of human societies are necessary in order to properly test adaptive hypotheses. Here, we review the empirical literature on father absence and puberty in both sexes, focusing on recent studies that have tested this association beyond the WEIRD world. We find that relationships between father absence and age at puberty are more varied in contexts beyond WEIRD societies, and when relationships beyond the father-daughter dyad are considered. This has implications for our understanding of how early-life environment is linked to life-history strategies, and for our understanding of pathways to adult health outcomes, given that early reproductive development may be linked to negative health outcomes in later life This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.

Divorce, living arrangements, and material well-being during the transition to adulthood in rural Malawi

In this paper, we use longitudinal data to investigate how parental death and divorce influence young women's own experience of divorce in Malawi, a setting where women marry relatively early and unions are fragile. We find that maternal death and parental divorce are positively associated with divorce for young women but, after controlling for socio-demographic and marital characteristics, only the association with maternal death remains statistically significant. Maternal and paternal death are both strongly associated with women's post-divorce living arrangements, which in turn affects their material well-being. This finding suggests that divorcing at a young age shapes the subsequent life chances of women; although some women return to their parental home and may have the opportunity to reset the transition to adulthood, other women begin their 20s as head of their own household and with considerable material disadvantage.

Measuring extended families over time in informal settlements in Nairobi, Kenya: Retention and data consistency in a two-round survey

BACKGROUND

Researchers have increasingly turned to longitudinal data to understand how the family environment of children changes over time and how this change affects their well-being. While the value of such efforts is clear, the inherent challenges of collecting robust data over time may limit or bias our understanding of family complexity.

OBJECTIVE

Drawing on data from an exploratory study on kinship structure and support for low income single mothers and their young children in Nairobi, Kenya, this paper aims to (1) assess the strengths and weaknesses of our approach in reflecting the complexities of kinship dynamics and (2) analyze how methodological issues such as selection and reporting inconsistency can influence our understanding of the role of kin in children's lives.

METHODS

The analysis used data from two waves of the Kinship Support Tree (KST) project. The starting sample consisted of 462 single mothers with at least one child under the age of 7, with data collected on approximately 5,000 resident and nonresident kin. Descriptive statistics and conventional tests of significance were used to analyze selection factors and inconsistencies in reporting across waves.

RESULTS

The study yielded a 91% retention rate after six months and the analysis provides some assurance that selectivity from attrition and reporting inconsistency are not entirely driven by shifts in support provision by kin. However, the selectivity of the sample underscores caution in generalizing the results.

CONCLUSIONS

While the challenges of conducting follow-up surveys such as the KST are serious, these findings suggest that it is possible to collect consistent data on kinship structure and support from the perspective of children in a mobile population. Tracking kinship structure over time using the KST is not only feasible but more importantly is unlikely to lead to incomplete or biased understanding of kinship.

CONTRIBUTION

After further testing with a wider range of women, we hope to disseminate our results for use in a wide range of contexts both in and out of Africa. We believe this data is vital to designing appropriate interventions to improve the well-being of children growing up in these communities.

Work and family transitions and the self-rated health of young women in South Africa

Understanding the transition to adulthood has important implications for supporting young adults and understanding the roots of diversity in wellbeing later in life. In South Africa, the end of Apartheid means today's youth are experiencing their transition to adulthood in a changed social and political context which offers opportunities compared to the past but also threats. This paper presents the first national level analysis of the patterning of key transitions (completion of education, entry into the labour force, motherhood and marriage or cohabitation), and the association between the different pathways and health amongst young women. With the use of longitudinal data from the South African National Income Dynamics Study (2008-2015), this paper employs sequence analysis to identify common pathways to adulthood amongst women aged 15-17 years at baseline (n = 429) and logistic regression modelling to examine the association between these pathways and self-rated health. The sequence analysis identified five pathways: 1. 'Non-activity commonly followed by motherhood', 2. 'Pathway from school, motherhood then work', 3. 'Motherhood combined with schooling', 4. 'Motherhood after schooling', and 5. 'Schooling to non-activity'. After controlling for baseline socio-economic and demographic characteristics and health, the regression results show young women who followed pathways characterised by early motherhood and economic inactivity (1, 3 and 4) had poorer self-rated health compared to women whose pathways were characterised by combining motherhood and economic activity (2) and young women who were yet to become economically active or mothers (5). Therefore, policies should seek to prevent adolescent childbearing, support young mothers to continue their educational careers and enable mothers in work and seeking work to balance their work and care responsibilities. Further, the findings highlight the value of taking a holistic approach to health and provide further evidence for the need to consider work-family balance in the development agenda.

Household structure vs. composition: Understanding gendered effects on educational progress in rural South Africa

BACKGROUND

Demographers have long been interested in the relationship between living arrangements and gendered outcomes for children in sub-Saharan Africa. Most extant research conflates household structure with composition and has revealed little about the pathways that link these components to gendered outcomes.

OBJECTIVES

First, we offer a conceptual approach that differentiates structure from composition with a focus on gendered processes that operate in the household; and second, we demonstrate the value of this approach through an analysis of educational progress for boys and girls in rural South Africa.

METHODS

We use data from the 2002 round of the Agincourt Health and Demographic Surveillance System. Our analytical sample includes 22,997 children aged 6-18 who were neither parents themselves nor lived with a partner or partner's family. We employ ordinary least squares regression models to examine the effects of structure and composition on educational progress of girls and boys.

RESULTS

The results suggest that non-nuclear structures are associated with similar negative effects for both boys and girls compared to children growing up in nuclear households. However, the presence of other kin in the absence of one or both parents results in gendered effects favouring boys.

CONCLUSION

The absence of any gendered effects when using a household structure typology suggests that secular changes to attitudes about gender equity trump any specific gendered processes stemming from particular configurations. On the other hand, gendered effects that appear when one or both parents are absent show that traditional gender norms and/or resource constraints continue to favour boys.

CONTRIBUTION

Despite the wealth of literature on household structure and children's educational outcomes in sub-Saharan Africa, the conceptual basis of these effects has not been well articulated. We have shown the value of unpacking household structure to better understand how gender norms and gendered resource allocations impact education.

A Longitudinal Analysis of Well-Being of Ghanaian Children in Transnational Families

This study is the first to employ panel data to examine well-being outcomes-self-rated health, happiness, life satisfaction, and school enjoyment-of children in transnational families in an African context. It analyzes data collected in 2013, 2014, and 2015 from secondary schoolchildren and youth (ages 12-21) in Ghana (N = 741). Results indicate that children with fathers, mothers, or both parents away and those cared for by a parent, a family, or a nonfamily member are equally or more likely to have higher levels of well-being as children in nonmigrant families. Yet, there are certain risk factors-being a female, living in a family affected by divorce or by a change in caregiver while parents migrate-that may decrease child well-being.

Maternal union instability and childhood mortality risk in the Global South, 2010-14

Efforts to improve child survival in lower-income countries typically focus on fundamental factors such as economic resources and infrastructure provision, even though research from post-industrial countries confirms that family instability has important health consequences. We tested the association between maternal union instability and children's mortality risk in Africa, Latin America and the Caribbean, and Asia using children's actual experience of mortality (discrete-time probit hazard models) as well as their experience of untreated morbidity (probit regression). Children of divorced/separated mothers experience compromised survival chances, but children of mothers who have never been in a union generally do not. Among children of partnered women, those whose mothers have experienced prior union transitions have a higher mortality risk. Targeting children of mothers who have experienced union instability-regardless of current union status-may augment ongoing efforts to reduce childhood mortality, especially in Africa and Latin America where union transitions are common.

Age at migration, family instability, and timing of sexual onset

This study builds on and extends previous research on nativity variations in adolescent health and risk behavior by addressing three questions: (1) whether and how generational status and age at migration are associated with timing of sexual onset among U.S. adolescents; (2) whether and how family instability mediates associations between nativity and sexual debut; and (3) whether and how these associations vary by gender. We find that first- and second-generation immigrant youth initiate sexual activity later than native youth. Foreign-born youth who migrate after the start of adolescence exhibit the latest sexual onset; boys' sexual behavior is particularly sensitive to age at migration. Parental union stability is protective for first- and second-generation youth, especially boys; however, instability in co-residence with parents accelerates sexual debut for foreign-born girls, and dilutes protections from parental marital stability. Use of a non-English language at home delays sexual onset for immigrant girls, but not boys.

Premarital Births and Union Formation in Rural South Africa

CONTEXT

In rural South Africa, women often delay union formation until they are in their late 20s, though premarital first births are common.

METHODS

Longitudinal data from the Agincourt Health and Socio-Demographic Surveillance System in rural South Africa were used to examine the relationship between premarital birth and union entry among 55,158 nonmigrant women aged 10-35 who took part in at least one annual census from 1993 to 2012. Discrete-time event history models were used to determine whether the likelihood of union formation differed between women who had had a premarital first birth and those who had not. Associations between single motherhood and union type (marriages or nonmarital partnerships) were identified using logistic regression.

RESULTS

Forty-five percent of women had had a premarital first birth and 25% had entered a first union. Women who had had a premarital first birth were less likely than other women to have entered a first union (odds ratio, 0.6). Women who had had a premarital birth in the past year were more likely than those without a premarital birth to have entered a union (1.5), but women had reduced odds of union formation if they had had a birth 1-2 years earlier (0.9) or at least five years earlier (0.8). Unions formed within two years of a premarital birth had an elevated likelihood of being nonmarital partnerships (1.2-1.4).

CONCLUSIONS

Single motherhood is common in the Agincourt HDSS, and women with a premarital first birth face challenges in establishing committed unions with partners.

Transition to Parenthood and HIV Infection in Rural Zimbabwe

BACKGROUND

The relationship between the risk of acquiring human immunodeficiency virus (HIV) infection and people's choices about life course events describing the transition to parenthood-sexual debut, union (in the form of marriage, cohabitation, or long-term relationship), and parenthood-is still unclear. A crucial role in shaping this relationship may be played by the sequence of these events and by their timing. This suggests the opportunity to focus on the life courses in their entirety rather than on the specific events, thus adopting a holistic approach that regards each individual's life course trajectory as a whole.

METHODS

We summarise the individual life courses describing the transition to parenthood using ordered sequences of the three considered events. We aim to (i) investigate the association between the sequences and HIV infection, and (ii) understand how these sequences interact with known mechanisms for HIV transmission, such as the length of sexual exposure and the experience of non-regular sexual partnerships. For this purpose, we use data from a general population cohort study run in Manicaland (Zimbabwe), a Sub-Saharan African area characterised by high HIV prevalence.

RESULTS

For both genders, individuals who experienced either premarital or delayed childbearing have higher HIV risk compared to individuals following more standard transitions. This can be explained by the interplay of the sequences with known HIV proximate determinants, e.g., a longer exposure to sexual activity and higher rates of premarital sex. Moreover, we found that people in the younger birth cohorts experience more normative and safer sequences.

CONCLUSIONS

The shift of younger generations towards more normative transitions to parenthood is a sign of behaviour change that might have contributed to the observed reduction in HIV prevalence in the area. On the other hand, for people with less normative transitions, targeted strategies are essential for HIV prevention.

Instability in Parent-Child Coresidence and Adolescent Development in Urban South Africa

There is widespread recognition of the importance of family stability for child development. South Africa presents an interesting context in which to study the consequences of family instability because of the traditionally fluid nature of household composition due to labor migration, child fostering, and non-marital fertility. More recently, the HIV pandemic has added another source of instability. Within South Africa, however, patterns of instability differ markedly across racial groups. We use the Cape Area Panel Study (CAPS) data to examine the implications of changes in parent-child coresidence for educational and sexual development of young South Africans. We show that changes in maternal and paternal coresidence have implications for the timing of sexual initiation for both black and coloured adolescents. Maternal and paternal transitions also lead to poorer educational outcomes for coloured adolescents, but parental disruptions are not significantly related to educational outcomes for blacks. These findings suggest that the implications of coresidential instability vary by race, reflecting racial differences with respect to cultural, social, and economic conditions.