Donatien BEGUY - Academia.edu (original) (raw)

Papers by Donatien BEGUY

Research paper thumbnail of Adolescent Problem Behavior in Nairobi's Informal Settlements: Applying Problem Behavior Theory in Sub-Saharan Africa

Journal of Urban Health, May 1, 2010

Research paper thumbnail of Influence of parental factors on adolescents’ transition to first sexual intercourse in Nairobi, Kenya: a longitudinal study

Reproductive Health, 2015

Background: Several studies have demonstrated a link between young people's sexual behavior and l... more Background: Several studies have demonstrated a link between young people's sexual behavior and levels of parental monitoring, parent-child communication, and parental discipline in Western countries. However, little is known about this association in African settings, especially among young people living in high poverty settings such as urban slums. The objective of the study was to assess the influence of parental factors (monitoring, communication, and discipline) on the transition to first sexual intercourse among unmarried adolescents living in urban slums in Kenya. Methods: Longitudinal data collected from young people living in two slums in Nairobi, Kenya were used. The sample was restricted to unmarried adolescents aged 12-19 years at Wave 1 (weighted n = 1927). Parental factors at Wave 1 were used to predict adolescents' transition to first sexual intercourse by Wave 2. Relevant covariates including the adolescents' age, sex, residence, school enrollment, religiosity, delinquency, and peer models for risk behavior were controlled for. Multivariate logistic regression models were used to assess the associations of interest. All analyses were conducted using Stata version 13. Results: Approximately 6 % of our sample transitioned to first sexual intercourse within the one-year study period; there was no sex difference in the transition rate. In the multivariate analyses, male adolescents who reported communication with their mothers were less likely to transition to first sexual intercourse compared to those who did not (p < 0.05). This association persisted even after controlling for relevant covariates (OR: ≤0.33; p < 0.05). However, parental monitoring, discipline, and communication with their fathers did not predict transition to first sexual intercourse for male adolescents. For female adolescents, parental monitoring, discipline, and communication with fathers predicted transition to first sexual intercourse; however, only communication with fathers remained statistically significant after controlling for relevant covariates (OR: 0.30; 95 % C.I.: 0.13-0.68). Conclusion: This study provides evidence that cross-gender communication with parents is associated with a delay in the onset of sexual intercourse among slum-dwelling adolescents. Targeted adolescent sexual and reproductive health programmatic interventions that include parents may have significant impacts on delaying sexual debut, and possibly reducing sexual risk behaviors, among young people in high-risk settings such as slums.

Research paper thumbnail of Transitions to Adulthood in a High Fertility Context: the Case of Sub- Saharan Africa

This paper describes the challenges and opportunities of transitions to adulthood in high fertili... more This paper describes the challenges and opportunities of transitions to adulthood in high fertility settings, focusing on the case of sub-Saharan Africa, which has the most youthful population in the world. Current challenges in the region are high levels of youth unemployment and under-employment and low levels of education in terms of quality of education and access to education. Early marriage among girls is high in many sub-Saharan African countries, which limits their employment and education prospects. Youth in sub-Saharan Africa are also uniquely vulnerable to poor sexual and reproductive health outcomes, illustrated by early childbearing and the HIV epidemic among youth. The paper concludes with the policy prospects to address these challenges, including increased allocation of resources to support primary and secondary education, vocational training, and access to health services, particularly among the most vulnerable groups of youth.

Research paper thumbnail of Adverse life events and delinquent behavior among Kenyan adolescents: a cross-sectional study on the protective role of parental monitoring, religiosity, and self-esteem

Child and adolescent psychiatry and mental health, 2014

Past research provides strong evidence that adverse life events heighten the risk of delinquent b... more Past research provides strong evidence that adverse life events heighten the risk of delinquent behavior among adolescents. Urban informal (slum) settlements in sub-Saharan Africa are marked by extreme adversity. However, the prevalence and consequences of adverse life events as well as protective factors that can mitigate the effects of exposure to these events in slum settlements is largely understudied. We examine two research questions. First, are adverse life events experienced at the individual and household level associated with a higher likelihood of delinquent behavior among adolescents living in two slums in Nairobi, Kenya? Second, are parental monitoring, religiosity, and self-esteem protective against delinquency in a context of high adversity? We used cross-sectional data from 3,064 males and females aged 12-19 years who participated in the Transitions to Adulthood Study. We examined the extent to which a composite index of adverse life events was associated with delinq...

Research paper thumbnail of Pregnancy-related mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites

Global health action, 2014

Women continue to die in unacceptably large numbers around the world as a result of pregnancy, pa... more Women continue to die in unacceptably large numbers around the world as a result of pregnancy, particularly in sub-Saharan Africa and Asia. Part of the problem is a lack of accurate, population-based information characterising the issues and informing solutions. Population surveillance sites, such as those operated within the INDEPTH Network, have the potential to contribute to bridging the information gaps. To describe patterns of pregnancy-related mortality at INDEPTH Network Health and Demographic Surveillance System sites in sub-Saharan Africa and southeast Asia in terms of maternal mortality ratio (MMR) and cause-specific mortality rates. Data on individual deaths among women of reproductive age (WRA) (15-49) resident in INDEPTH sites were collated into a standardised database using the INDEPTH 2013 population standard, the WHO 2012 verbal autopsy (VA) standard, and the InterVA model for assigning cause of death. These analyses are based on reports from 14 INDEPTH sites, coveri...

Research paper thumbnail of Cause-specific childhood mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

Global Health Action, 2014

Research paper thumbnail of Cause-specific mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

Global Health Action, 2014

Research paper thumbnail of The INDEPTH standard population for low- and middle-income countries, 2013

Global Health Action, 2014

Research paper thumbnail of Health and demographic surveillance systems: contributing to an understanding of the dynamics in migration and health

Global Health Action, 2013

Background: Migration is difficult to measure because it is highly repeatable. Health and Demogra... more Background: Migration is difficult to measure because it is highly repeatable. Health and Demographic Surveillance Systems (HDSSs) provide a unique opportunity to study migration as multiple episodes of migration are captured over time. A conceptual framework is needed to show the public health implications of migration. Objective/design: Research conducted in seven HDSS centres [International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network], published in a peer-reviewed volume in 2009, is summarised focussing on the ageÁsex profile of migrants, the relation between migration and livelihoods, and the impact of migration on health. This illustrates the conceptual structure of the implications of migration. The next phase is described, the Multi-centre Analysis of the Dynamics In Migration And Health (MADIMAH) project, consisting of workshops focussed on preparing data and conducting the analyses for comparative studies amongst HDSS centres in Africa and Asia. The focus here is on the (standardisation of) determinants of migration and the impact of migration on adult mortality. Results: The findings in the volume showed a relatively regular age structure for migration among all HDSS centres. Furthermore, migration generally contributes to improved living conditions at the place of origin. However, there are potential negative consequences of migration on health. It was concluded that there is a need to compare results from multiple centres using uniform covariate definitions as well as longitudinal analysis techniques. This was the starting point for the on-going MADIMAH initiative, which has increased capacity at the participating HDSS centres to produce the required datasets and conduct the analyses. Conclusions: HDSS centres brought together within INDEPTH Network have already provided strong evidence of the potential negative consequences of migration on health, which contrast with the beneficial impacts of migration on livelihoods. Future comparative evidence using standardised tools will help design policies for mitigating the negative effects, and enhancing the positive effects, of migration on health.

Research paper thumbnail of Health & Demographic Surveillance System Profile: The Kombewa Health and Demographic Surveillance System (Kombewa HDSS)

International Journal of Epidemiology, 2014

The Kombewa Health and Demographic Surveillance System (HDSS) grew out of the Kombewa Clinical Re... more The Kombewa Health and Demographic Surveillance System (HDSS) grew out of the Kombewa Clinical Research Centre in 2007 and has since established itself as a platform for the conduct of regulated clinical trials, nested studies and local disease surveillance. The HDSS is located in a rural part of Kisumu County, Western Kenya, and covers an area of about 369 km 2 along the northeastern shores of Lake Victoria. A dynamic cohort of 141 956 individuals drawn from 34 718 households forms the HDSS surveillance population. Following a baseline survey in 2011, the HDSS continues to monitor key population changes through routine biannual household surveys. The intervening period between setup and baseline census was used for preparatory work, in particular Global Positioning System (GPS) mapping. Routine surveys capture information on individual and households including residency, household relationships, births, deaths, migrations (in and out) and causes of morbidity (syndromic incidence and prevalence) as well as causes of death (verbal autopsy). The Kombewa HDSS platform is used to support health research activities, that is clinical trials and epidemiological studies evaluating diseases of public health importance including malaria, HIV and global emerging infectious diseases such as dengue fever. Formal data request and proposed collaborations can be submitted at

Research paper thumbnail of Family Ties and Urban-Rural Linkages among Older Migrants in Nairobi Informal Settlements

Population, Space and Place, 2012

Research paper thumbnail of Transition into first sex among adolescents in slum and non-slum communities in Nairobi, Kenya

Journal of Youth Studies, 2010

Research paper thumbnail of Adolescent Problem Behavior in Nairobi's Informal Settlements: Applying Problem Behavior Theory in Sub-Saharan Africa

Journal of Urban Health, 2010

Research paper thumbnail of Monitoring of Health and Demographic Outcomes in Poor Urban Settlements: Evidence from the Nairobi Urban Health and Demographic Surveillance System

Journal of Urban Health, 2011

Research paper thumbnail of Overview of migration, poverty and health dynamics in Nairobi City's slum settlements

Journal of Urban Health, 2011

Research paper thumbnail of Do Migrant Children Face Greater Health Hazards in Slum Settlements? Evidence from Nairobi, Kenya

Journal of Urban Health, 2010

Research paper thumbnail of Timing and Sequencing of Events Marking the Transition to Adulthood in Two Informal Settlements in Nairobi, Kenya

Journal of Urban Health, 2011

Research paper thumbnail of Growing Up at the “Margins”: Concerns, Aspirations, and Expectations of Young People Living in Nairobi's Slums

Journal of Research on Adolescence, 2013

Research paper thumbnail of Entry Into Motherhood Among Adolescent Girls in Two Informal Settlements in Nairobi, Kenya

Journal of Biosocial Science, 2013

SummaryThe contribution of adolescents' childbearing to total fertility rates in many sub-Sah... more SummaryThe contribution of adolescents' childbearing to total fertility rates in many sub-Saharan African countries is higher than in other parts of the world. In this paper, data collected from 897 female adolescents aged 15–19 years are analysed to investigate patterns and determinants of entry into motherhood in two informal settlements in Nairobi, Kenya, using Kaplan–Meier estimates and Cox regression models. About 15% of these adolescents have had a child. The findings show that marriage, being out of school and having negative models in peer, family and school contexts are associated with early childbearing among females aged 15–17 years. For adolescents aged 18–19 years, school attendance considerably delays entry into motherhood while marriage hastens its timing. Furthermore, older adolescents with high levels of social controls (parental monitoring or perceived peer orientation to or approval of prosocial behaviours) and individual controls (high religiosity and positiv...

Research paper thumbnail of Inconsistencies in Self-Reporting of Sexual Activity Among Young People in Nairobi, Kenya

Journal of Adolescent Health, 2009

Research paper thumbnail of Adolescent Problem Behavior in Nairobi's Informal Settlements: Applying Problem Behavior Theory in Sub-Saharan Africa

Journal of Urban Health, May 1, 2010

Research paper thumbnail of Influence of parental factors on adolescents’ transition to first sexual intercourse in Nairobi, Kenya: a longitudinal study

Reproductive Health, 2015

Background: Several studies have demonstrated a link between young people's sexual behavior and l... more Background: Several studies have demonstrated a link between young people's sexual behavior and levels of parental monitoring, parent-child communication, and parental discipline in Western countries. However, little is known about this association in African settings, especially among young people living in high poverty settings such as urban slums. The objective of the study was to assess the influence of parental factors (monitoring, communication, and discipline) on the transition to first sexual intercourse among unmarried adolescents living in urban slums in Kenya. Methods: Longitudinal data collected from young people living in two slums in Nairobi, Kenya were used. The sample was restricted to unmarried adolescents aged 12-19 years at Wave 1 (weighted n = 1927). Parental factors at Wave 1 were used to predict adolescents' transition to first sexual intercourse by Wave 2. Relevant covariates including the adolescents' age, sex, residence, school enrollment, religiosity, delinquency, and peer models for risk behavior were controlled for. Multivariate logistic regression models were used to assess the associations of interest. All analyses were conducted using Stata version 13. Results: Approximately 6 % of our sample transitioned to first sexual intercourse within the one-year study period; there was no sex difference in the transition rate. In the multivariate analyses, male adolescents who reported communication with their mothers were less likely to transition to first sexual intercourse compared to those who did not (p < 0.05). This association persisted even after controlling for relevant covariates (OR: ≤0.33; p < 0.05). However, parental monitoring, discipline, and communication with their fathers did not predict transition to first sexual intercourse for male adolescents. For female adolescents, parental monitoring, discipline, and communication with fathers predicted transition to first sexual intercourse; however, only communication with fathers remained statistically significant after controlling for relevant covariates (OR: 0.30; 95 % C.I.: 0.13-0.68). Conclusion: This study provides evidence that cross-gender communication with parents is associated with a delay in the onset of sexual intercourse among slum-dwelling adolescents. Targeted adolescent sexual and reproductive health programmatic interventions that include parents may have significant impacts on delaying sexual debut, and possibly reducing sexual risk behaviors, among young people in high-risk settings such as slums.

Research paper thumbnail of Transitions to Adulthood in a High Fertility Context: the Case of Sub- Saharan Africa

This paper describes the challenges and opportunities of transitions to adulthood in high fertili... more This paper describes the challenges and opportunities of transitions to adulthood in high fertility settings, focusing on the case of sub-Saharan Africa, which has the most youthful population in the world. Current challenges in the region are high levels of youth unemployment and under-employment and low levels of education in terms of quality of education and access to education. Early marriage among girls is high in many sub-Saharan African countries, which limits their employment and education prospects. Youth in sub-Saharan Africa are also uniquely vulnerable to poor sexual and reproductive health outcomes, illustrated by early childbearing and the HIV epidemic among youth. The paper concludes with the policy prospects to address these challenges, including increased allocation of resources to support primary and secondary education, vocational training, and access to health services, particularly among the most vulnerable groups of youth.

Research paper thumbnail of Adverse life events and delinquent behavior among Kenyan adolescents: a cross-sectional study on the protective role of parental monitoring, religiosity, and self-esteem

Child and adolescent psychiatry and mental health, 2014

Past research provides strong evidence that adverse life events heighten the risk of delinquent b... more Past research provides strong evidence that adverse life events heighten the risk of delinquent behavior among adolescents. Urban informal (slum) settlements in sub-Saharan Africa are marked by extreme adversity. However, the prevalence and consequences of adverse life events as well as protective factors that can mitigate the effects of exposure to these events in slum settlements is largely understudied. We examine two research questions. First, are adverse life events experienced at the individual and household level associated with a higher likelihood of delinquent behavior among adolescents living in two slums in Nairobi, Kenya? Second, are parental monitoring, religiosity, and self-esteem protective against delinquency in a context of high adversity? We used cross-sectional data from 3,064 males and females aged 12-19 years who participated in the Transitions to Adulthood Study. We examined the extent to which a composite index of adverse life events was associated with delinq...

Research paper thumbnail of Pregnancy-related mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites

Global health action, 2014

Women continue to die in unacceptably large numbers around the world as a result of pregnancy, pa... more Women continue to die in unacceptably large numbers around the world as a result of pregnancy, particularly in sub-Saharan Africa and Asia. Part of the problem is a lack of accurate, population-based information characterising the issues and informing solutions. Population surveillance sites, such as those operated within the INDEPTH Network, have the potential to contribute to bridging the information gaps. To describe patterns of pregnancy-related mortality at INDEPTH Network Health and Demographic Surveillance System sites in sub-Saharan Africa and southeast Asia in terms of maternal mortality ratio (MMR) and cause-specific mortality rates. Data on individual deaths among women of reproductive age (WRA) (15-49) resident in INDEPTH sites were collated into a standardised database using the INDEPTH 2013 population standard, the WHO 2012 verbal autopsy (VA) standard, and the InterVA model for assigning cause of death. These analyses are based on reports from 14 INDEPTH sites, coveri...

Research paper thumbnail of Cause-specific childhood mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

Global Health Action, 2014

Research paper thumbnail of Cause-specific mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

Global Health Action, 2014

Research paper thumbnail of The INDEPTH standard population for low- and middle-income countries, 2013

Global Health Action, 2014

Research paper thumbnail of Health and demographic surveillance systems: contributing to an understanding of the dynamics in migration and health

Global Health Action, 2013

Background: Migration is difficult to measure because it is highly repeatable. Health and Demogra... more Background: Migration is difficult to measure because it is highly repeatable. Health and Demographic Surveillance Systems (HDSSs) provide a unique opportunity to study migration as multiple episodes of migration are captured over time. A conceptual framework is needed to show the public health implications of migration. Objective/design: Research conducted in seven HDSS centres [International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network], published in a peer-reviewed volume in 2009, is summarised focussing on the ageÁsex profile of migrants, the relation between migration and livelihoods, and the impact of migration on health. This illustrates the conceptual structure of the implications of migration. The next phase is described, the Multi-centre Analysis of the Dynamics In Migration And Health (MADIMAH) project, consisting of workshops focussed on preparing data and conducting the analyses for comparative studies amongst HDSS centres in Africa and Asia. The focus here is on the (standardisation of) determinants of migration and the impact of migration on adult mortality. Results: The findings in the volume showed a relatively regular age structure for migration among all HDSS centres. Furthermore, migration generally contributes to improved living conditions at the place of origin. However, there are potential negative consequences of migration on health. It was concluded that there is a need to compare results from multiple centres using uniform covariate definitions as well as longitudinal analysis techniques. This was the starting point for the on-going MADIMAH initiative, which has increased capacity at the participating HDSS centres to produce the required datasets and conduct the analyses. Conclusions: HDSS centres brought together within INDEPTH Network have already provided strong evidence of the potential negative consequences of migration on health, which contrast with the beneficial impacts of migration on livelihoods. Future comparative evidence using standardised tools will help design policies for mitigating the negative effects, and enhancing the positive effects, of migration on health.

Research paper thumbnail of Health & Demographic Surveillance System Profile: The Kombewa Health and Demographic Surveillance System (Kombewa HDSS)

International Journal of Epidemiology, 2014

The Kombewa Health and Demographic Surveillance System (HDSS) grew out of the Kombewa Clinical Re... more The Kombewa Health and Demographic Surveillance System (HDSS) grew out of the Kombewa Clinical Research Centre in 2007 and has since established itself as a platform for the conduct of regulated clinical trials, nested studies and local disease surveillance. The HDSS is located in a rural part of Kisumu County, Western Kenya, and covers an area of about 369 km 2 along the northeastern shores of Lake Victoria. A dynamic cohort of 141 956 individuals drawn from 34 718 households forms the HDSS surveillance population. Following a baseline survey in 2011, the HDSS continues to monitor key population changes through routine biannual household surveys. The intervening period between setup and baseline census was used for preparatory work, in particular Global Positioning System (GPS) mapping. Routine surveys capture information on individual and households including residency, household relationships, births, deaths, migrations (in and out) and causes of morbidity (syndromic incidence and prevalence) as well as causes of death (verbal autopsy). The Kombewa HDSS platform is used to support health research activities, that is clinical trials and epidemiological studies evaluating diseases of public health importance including malaria, HIV and global emerging infectious diseases such as dengue fever. Formal data request and proposed collaborations can be submitted at

Research paper thumbnail of Family Ties and Urban-Rural Linkages among Older Migrants in Nairobi Informal Settlements

Population, Space and Place, 2012

Research paper thumbnail of Transition into first sex among adolescents in slum and non-slum communities in Nairobi, Kenya

Journal of Youth Studies, 2010

Research paper thumbnail of Adolescent Problem Behavior in Nairobi's Informal Settlements: Applying Problem Behavior Theory in Sub-Saharan Africa

Journal of Urban Health, 2010

Research paper thumbnail of Monitoring of Health and Demographic Outcomes in Poor Urban Settlements: Evidence from the Nairobi Urban Health and Demographic Surveillance System

Journal of Urban Health, 2011

Research paper thumbnail of Overview of migration, poverty and health dynamics in Nairobi City's slum settlements

Journal of Urban Health, 2011

Research paper thumbnail of Do Migrant Children Face Greater Health Hazards in Slum Settlements? Evidence from Nairobi, Kenya

Journal of Urban Health, 2010

Research paper thumbnail of Timing and Sequencing of Events Marking the Transition to Adulthood in Two Informal Settlements in Nairobi, Kenya

Journal of Urban Health, 2011

Research paper thumbnail of Growing Up at the “Margins”: Concerns, Aspirations, and Expectations of Young People Living in Nairobi's Slums

Journal of Research on Adolescence, 2013

Research paper thumbnail of Entry Into Motherhood Among Adolescent Girls in Two Informal Settlements in Nairobi, Kenya

Journal of Biosocial Science, 2013

SummaryThe contribution of adolescents' childbearing to total fertility rates in many sub-Sah... more SummaryThe contribution of adolescents' childbearing to total fertility rates in many sub-Saharan African countries is higher than in other parts of the world. In this paper, data collected from 897 female adolescents aged 15–19 years are analysed to investigate patterns and determinants of entry into motherhood in two informal settlements in Nairobi, Kenya, using Kaplan–Meier estimates and Cox regression models. About 15% of these adolescents have had a child. The findings show that marriage, being out of school and having negative models in peer, family and school contexts are associated with early childbearing among females aged 15–17 years. For adolescents aged 18–19 years, school attendance considerably delays entry into motherhood while marriage hastens its timing. Furthermore, older adolescents with high levels of social controls (parental monitoring or perceived peer orientation to or approval of prosocial behaviours) and individual controls (high religiosity and positiv...

Research paper thumbnail of Inconsistencies in Self-Reporting of Sexual Activity Among Young People in Nairobi, Kenya

Journal of Adolescent Health, 2009