Parental Communication on Sexual and Reproductive Health: An Adolescent Perspective in Kerala, India

Introduction: "Adolescent sexual and reproductive health" describes the mental and physical health of adolescents, as well as their capacity to avoid unintended pregnancy, unsafe abortion, sexually transmitted infections (including HIV/AIDS), and any kind of coercion or sexual assault. Promoting healthy sexual and reproductive activities among adolescents requires open and honest communication between parents and their adolescent children.

Objectives: To estimate the proportion of parental communication with adolescent on sexual and reproductive health (SRH) matters, to determine the relationship of adolescents’ knowledge on SRH matters and attitude towards communication with parents on SRH matters and to determine the factors associated with the parent- adolescent communication on SRH matters.

Methods: A cross-sectional study was conducted among 262 students from 10th and 11th grades studying at schools in Kottayam District and were selected by convenient sampling.

Results: Out of the 262 adolescents, nearly half 115 (43.9%) reported having discussions with their parents about SRH matters. Among those who communicated, 57.4% (66 adolescents) stated that such conversations occurred rarely and the nearly two third 64(55.7%) mentioned that the discussions were based on the situation. Pubertal changes and menarche were the major topics of conversation (87.8%). Among the 262 adolescents, 147(56.1%) did not discuss SRH matters with parents and the most frequently reported reasons for lack of communication between parents and adolescents as perceived by adolescents were shame 68 (26%), followed by fear 19 (7.3) and feeling of knowledgeable than their parents 13(5%). The minimal perceived reasons reported were less knowledge and communication ability of parents, aadolescents' inability to initiate the conversation and discouragement of parents etc. There was significant relation between adolescents’ knowledge on SRH matters and attitude towards communication with parents on SRH matters (p<0.05 level). Majority of adolescents had 222(84.7%) poor knowledge on SRH matters and while only 3 (1.1%) had good knowledge. With respect to attitude towards communication with parents on SRH matters nearly half of the adolescents 48.9% had unfavorable attitude, whereas just over half 51.1% had favorable attitude. Age (p <0.05), gender (p <0.05), class of study (p <0.05), presence of elder siblings at home (p <0.05), previous information on SRH (p <0.05) and attitude towards SRH communication with parents (p <0.05) were significantly associated with the parent- adolescent communication on SRH matters.

Conclusion: The findings showed limited discussion between parents and adolescents on SRH matters and also areas of discussion also limited to pubertal changes and menstruation. Shame was perceived by the adolescents as the most common reason for not discussing SRH matters for those who had no discussion with parents. Strategies need to be developed and implemented by stakeholders in this regard to empower parents and also strengthen the knowledge and attitude of adolescents so that they can take informed decisions and develop positive self-image.