Parent–child Communication about Sexual and Reproductive Health in Rural Tanzania: Implications for Young People's Sexual Health Interventions

This 18-page paper explores parent–child communication about sexual and reproductive health (SRH), the content of these discussions, and parents' timing and reasons for their communication with their children ages 14–24 years in rural Tanzania. Data collection involved eight weeks of participant observation, 17 focus group discussions, and 46 in-depth interviews conducted with young people ages 14–24 years and parents of young people in this age group. The research found that due to the consequences of the HIV pandemic, parents are making attempts to communicate with their children about SRH. They are however limited by cultural barriers and lack of appropriate knowledge. According to this paper, with some skills training on communication and SRH, parents may be a natural avenue for channeling and reinforcing HIV/AIDS prevention messages to their children.

The research showed that parent–child communication about SRH occurred in most families. The communication was mainly between mothers and daughters and rarely between father and son or father and daughter. Parent–child communication took the form of warnings, threats, and physical discipline. Discussions were triggered by seeing or hearing something a parent perceived to be negative (such as a death attributable to HIV and an unmarried young person's pregnancy). Although most young people were more relaxed with their mothers than their fathers, there is lack of trust about what they can tell their parents for fear of punishment. Parents were limited to what they could communicate about SRH because they lack appropriate knowledge and adhere to cultural norms that restrict interactions between opposite sexes.

The research found that while parent-child communication was characterised by threats and warnings, communication with grandparents was usually humorous. Most of the young people who lived with grandparents reported that they were closer to them than to their fathers. Their conversations were usually delivered as jokes and rarely as straight forward warnings as was the case with parents. Some grandparents reported that they were comfortable talking about sex with their grandchildren and not their own children because they were not their children and hence there was nothing for them to fear.

The study also found that parents' communication about sex further reinforced the societal expectations about masculinity and femininity. They linked femininity with abstinence until marriage but associated masculinity with sexual prowess. Although fathers were not close to their daughters, they expected their wives to be. Among some of the SRH issues they expected mothers to talk to their daughters about were avoiding unplanned pregnancy and focusing on their education. On the part of mothers, very few communicated about pregnancy prevention explicitly prior to pregnancy happening. Condoms were among some of the issues that parents found difficult to talk about with their children. The biggest dilemma for most parents seemed to be when to talk about different issues relating to SRH with their children.

The report notes that triggers from radio programmes and other sources emerged as good starters for SRH communication within the family. This implies that mass media programmes should be encouraged more and if possible include specific tips on how parents should have meaningful discussions on sexuality with their children. There is also a need to develop programmes to support parents to stay involved in the lives of their young people, and to change their perspectives about their children's sexuality. The report recommends that programmes should teach both parents and young people to communicate explicitly and clearly. Sexual health prevention programmes that are designed for both parents and young people may be of greatest value in promoting safe sex behaviours.

Improving parental knowledge of SRH is also important, so that they are able to communicate with their children in an informed and convincing way. Parents need to be aware that scare tactics and warnings are not necessarily effective. Equally important is the timing for communication. Most parents waited for clues that a child was sexually active before they warned and threatened them about the consequences of engaging in sex. Communicating only after parents realised that their children were sexually active, is likely to have had little impact on the sexual behaviour of their children.

The study also found that parents’ attitudes about SRH are changing, possibly due to parents' desire to protect their children from HIV/AIDS. The report states that this willingness to change may provide a good avenue for interventions to focus on parents as one of the channels for SRH information delivery to young people and to solicit their support on issues related to young people's risk.