Adolescent-parent partnership guidelines for improving communication on sexual and reproductive health in Addis Ababa, Ethiopia

Abstract

Background: Globally, adolescents face health risks, especially with respect to sexuality and reproduction. Each year, 7.4 million girls have unintended pregnancies that resulted to 3 million unsafe abortions. There is a paucity of evidence on the level of adolescent-parent communication on sexual and reproductive health issues and guiding framework for the essential sexual and reproductive health programs in Ethiopia. Purpose: The purpose of the study was to assess adolescent-parent partnership and develop guidelines for improving communication on sexual and reproductive health in Addis Ababa, Ethiopia. Methods: A cross-sectional study design was conducted among in-school adolescents paired with their parents. A total of 660 in-school adolescents and their parents and or guardians participated in the study. A multi-stage sampling technique was applied to select the study participants. Data from in-school adolescents was collected using a facilitator guided self-administered questionnaire and face-to-face interviews with parents using structured quantitative survey questionnaire. Descriptive, binary and multiple logistic regressions were carried out to compute the proportions, and odds ratio at 95% confidence interval, respectively. Results: More than one-fourth (28.3%) of in-school adolescents have ever had sexual intercourse. Nearly half (45%) of them had sex with multiple sexual partners and 54.4% did not use condoms. From sexually active in-school adolescent girls, one-in-ten (10.4%) of them had experienced an unwanted pregnancy. Of these, 70% had terminated their pregnancy. The comprehensive level of discussion regarding common sexual and reproductive health issues was found to be very low, 5.7%. In-school adolescents cited feeling ashamed, embarrassed, lack of knowledge, and cultural unacceptability as major barriers to discussing sexual and reproductive health issues with their parents. School grade level of in-school adolescents’, religion and knowledge were significantly associated with adolescent-parents’ communication about their sexual and reproductive health issues. Adolescents’ sex, age, religion, lived with and fathers’ occupation were significantly associated with in-school adolescents’ knowledge and in-school adolescents’ sex, age and knowledge about sexual and reproductive health were significantly associated with in-school adolescents’ behaviour. Parent’s age and educational status were significantly associated with parental communication and parents’ sex, age and educational status were also significantly associated with parents’ knowledge about their adolescents’ sexual and reproductive health. Conclusion: This study showed that in-school adolescents had early sexual initiation, experienced risky sexual behaviours that jeopardized with poor comprehensive sexual and reproductive health communication between in-school adolescents and their parents. Therefore, designing effective parent-adolescent communication intervention is critical in improving knowledge and communication of both parents and adolescents about common sexual and reproductive health issues. Adolescents’ engagement and participation in different clubs, awareness raising sessions and other platforms plays a pivotal role to prevent and avoid those risky adolescent sexual behaviours.