1. Does religious affiliation moderate adolescent premarital sexual behavior in marginalized slum settlements in Nairobi City? 9 th INDEPTH AGM Pune, 26 th – 27 th October 2009 Jacques B.O. Emina Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center Nairobi Viwandani Korogocho

2. Outline 1. Rationale of the study 2. Theoretical considerations 3. Methodology 4. Findings 5. Discussion and conclusion Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

3. 1. The rationale of the study - Background - Objectives Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

4. Religion influences individual knowledge, attitudes and behavior; Pervasiveness of religious institutions in sub-Saharan Africa (SSA) Prevalence of reproductive health issues and challenges to achieve the Millennium Development Goals in SSA: -high risk of out-of-wedlock pregnancy, prevalence of adolescent fertility and school dropout -risk of unsafe abortion, high risk of HIV/AIDS transmission -Infant and maternal mortality Potential conflict: -most religious groups (Christian and Muslim), advocate abstinence among single people whereas some ethnic traditions tolerate premarital sex; -religious commitment and premarital sex abstinence in the context of poverty and social disorganization; Mixed results depending on the context Methodological Problems: Definition of religion affiliation and availability of appropriate data. 1.1. Religious affiliation and premarital sexual behavior Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

5. Population: 59,688 persons-year (2007) 1.Females aged 15-22 represent about 5 percents; 2.95 percents believers 3.Total fertility rate: 3.1 Premarital sexual behavior: 1.15 years in slum compared to 18 in non-slum areas 2.32 percent of contraceptive use during the first sex 3.Adolescent fertility: 11.5% Human Development and population wellbeing (2007) 1.High Infant mortality : 72.5 ‰ 2.50 percent of female (15-49) are without any income generating activity 3.28 percent of women of reproductive age have attained at least secondary school. 1.2. Nairobi Urban Health DSS: Context Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

6. 1.3. Objectives 1.1. Assess the association between religious affiliation and premarital sexual behavior 2.Identify the causes of differences if any Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

7. 2. Theoretical considerations: - Characteristics model - Particularized theology model - Social interaction model -Religiosity model Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

8. Analytical models for religious affiliation and premarital sexual activity Characteristics model (De Jong, 1965; Agadjanian, 2001; Emina, 2005). Cultural inheritance model (Romaniuk, 1967 ; Retel-Laurentin, 1974). Social disorganization and demographic model (Cherlin &Riley, 1986). Financial capital and rational adaptation (Cherlin &Riley, 1986). Analytical models for premarital sexual activity in sub-Saharan Africa Particularized theology model (DeJong, 1965; Addai, 2000; Smith, 2004; Agha et al., 2006). Social interaction model (Chamie, 1981; Agadjanian, 2001). 2.1. Theoretical considerations Religiosity and religious commitment Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

9. Religious affiliation - Religion denomination Congregation characteristics - Doctrine - Belong to a federation - size; - Frequency of meeting Social interaction & network - Belong to a religious club Socio-economic Characteristics - Age; Ethnicity - Education – Living arrangement - Occupation -Household Wealth Index Premarital sex Sexual activity/ has boyfriend Religiosity - Self perception - Services attendance - Religious scriptures influence decisions, - Spiritual leaders influence decisions Outcome Covariate Predictor 2.1. Conceptual framework Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

10. 3. Methodology: -Data -Measurements -Methods and strategy of analysis Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

11. 3.1. Data and measurements Sample: 1,030 females aged 15-22 from the 2007-UPHD-Transition project Measurement VariablesIndicators Premarital sexual behavior Abstinence from premarital sex (never has sex intercourse and does not have boy friend) Religious affiliationReligion denomination Demographic characteristics Age, Living arrangement Cultural characteristicsEthnicity, Education Socioeconomic characteristics occupation, Household Wealth Index, slum area Social interactionBelonging to religious club ReligiosityComposite index (No and low; high) Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

12. 3.2. Sample characteristics Proportion of females (15-22) by religious affiliation & selected characteristics Cathol.Protest.Pentecot.Oth. Chr.MuslimNo relig.Total Age 15-19 72.9 74.474.774.169.066.065.2 Ethnicity Kikuyu 33.647.139.625.92.366.035.3 Education <secondary 13.919.414.312.47.89.414.2 Slum area Korogocho 45.950.655.927.283.050.952.8 Living arr. -Parent 57.164.570.274.169.066.065.2 Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

13. 3.3. Methods: statistical tools in three steps Descriptive analysis: frequencies and cross-tabulations Probit models and three stages simultaneous Probit model Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

14. 4. Results: -Bivariate - Stratification -Multivariate probit models Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

15. 4.1. Non religion more likely to be engaged in premarital sex whereas Muslim more likely to premarital sexual abstinence: bivariate analysis % AbstinenceOdds ratio abstinence Catholic 51.1 Reference Protestant 54.1 1.13 Pentecostals 54.7 1.16 Other Christian 67.9 2.03*** Muslim 86.8 6.31*** Non religion 30.2 0.41*** Total 57.4 Chi-square 71.74*** Note : * p<0.10; ** p<0.05; *** p<0.01 Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

16. 4.2. None of the model explain totally the observed difference Model 1Model 2Model 3Model 4Model 5 CatholicRef. Protestant 1.13 1.211.101.190.26 Pentecostal 1.16 1.231.091.161.19 Other Christian 2.03*** 1.73*1.77**2.00***1.63 Muslim6.31*** 4.40***6.90***6.58***4.78*** Non religion 0.41*** 0.550.53*0.620.93 Model 1: bivariate (crude effect) Model 2: control for socioeconomic characteristics Model 3: control for social interaction Model 4: control for religiosity Model 5: control for all variables Note : * p<0.10; ** p<0.05; *** p<0.01 Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

17. 4.3. Simultaneous three stages equations confirms high premarital abstinence among Muslim Premarital abstinence CatholicRef. Protestant 1.03 Pentecostal 1.05 Other Christian 1.09 Muslim 1.29*** Non religion 0.99 Not in religious club 0.90*** In religious clubRef. Low religiosity 0.90*** High religiosityRef. Belong to religious club CatholicRef. Protestant1.04 Pentecostal1.07 Other Christian1.16** Muslim0.98 Non religion0.89 Low religiosity0.76*** High religiosityRef. Religiosity CatholicRef. Protestant0.91** Pentecostal0.98 Other Christian0.98 Muslim0.97 Non religion0.55*** Not in religious club0.78** In religious clubRef. Note : * p<0.10; ** p<0.05; *** p<0.01 Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

18. Religious affiliation reduce the likelihood of premarital sexual activity in NUHDSS Muslims are more likely to observe abstinence than other believers Characteristic model explains differences among Christian as well as between Catholics and non religious Use of Heckman models to take into account selection problem and use of Conditional (recursive) mixed process estimator Information on social control, religious discourses on premarital sexual behavior as well as longitudinal data will allow to improve knowledge in this area Religious leaders could play an important role to improve adolescent and young adults reproductive health in NUHDSS. 5. Discussion and conclusion Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

19. Acknowledgments Wellcome Trust Rockefeller Foundation Flora and William Hewlett Foundation Government of Kenya Korogocho and Viwandani communities Indepht Network Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center

20. Thanks!!! Improving the wellbeing of Africans through policy relevant research on population and health African Population and Health Research Center