Transitions to adulthood in men and women in rural Malawi in the 21st century using sequence analysis: Some evidence of delay

Background: Many sub-Saharan African countries have large populations of young people, and these cohorts have the potential to bring significant change. Understanding the changing lives of young people is important for ensuring individuals experience healthy and successful transitions to adulthood and for understanding how best to ensure they realise their full potential, for themselves and their communities. Methods: This analysis used detailed, prospectively collected data on men and women from the Karonga Health and Demographic Surveillance Site in rural Malawi between 2004–2017. Multi-channel sequence analysis was conducted for the domains of leaving school, getting married, and having children. Sequences were grouped into clusters and descriptive and multinomial logistic regression carried out to assess differences in the transition to adulthood by sex, calendar time, and sociodemographic factors. Conclusions: Many participants followed a fairly early and rapid transition to adulthood; however, a sizable proportion experienced later marriage. These participants were split into those (mostly men) who received little education and had a long delay between school-leaving and marrying, and those who spent longer in education. Access to secondary school increased over time for both men and women, while only women experienced delays in age at marriage. Where associations between sociodemographic factors and transitions to adulthood were found, they suggested that greater access to resources was associated with a later transition out of education, and therefore to marriage. Contribution: Sequence analysis applied to longitudinal HDSS data proved a useful tool to identify different trajectories to adulthood in this rural Malawian context.