A total of 603 mothers completed the questionnaire with response rate of about 98.05%.
Out of the total mothers 443 (73.5%) were lived in rural residence. Five hundred thirty three (88.4%) of mothers were married. The mean age of the mothers was 42.01 ± 7.16 SD years and with the range of 27-58 years. Out of the total mothers 343 (56.1%) of mothers were educated. Three hundred two (50.1%) of mothers were Orthodox by religion and 7 (1.1%) of mothers were Protestant religion followers. Four hundred twenty two (70.3%) of mothers were housewife and 69 (11.4%) of mothers were government employed. Three hundred twelve (51.7%) of mothers were had family size of 1-3 members.
Table 1:- Socio-demographic characteristics of mothers in Wogdie district, 2020 (N=603)
Variable
|
Frequency
|
Percent
|
Maternal age
|
|
|
<35
|
99
|
16.4
|
35-45
|
267
|
44.3
|
>45
|
237
|
39.3
|
Residence
|
|
|
Urban
|
160
|
26.5
|
Rural
|
443
|
73.5
|
Maternal education status
|
|
|
Not educated
|
260
|
43.1
|
Educated
|
343
|
56.1
|
Maternal occupation status
|
|
|
Housewife
|
424
|
70.3
|
Self employed
|
110
|
18.3
|
Government employed
|
69
|
11.4
|
Family size
|
|
|
1-3
|
312
|
51.7
|
4-6
|
185
|
30.7
|
>6
|
106
|
17.6
|
Sex of adolescent they have
|
|
|
Male only
|
189
|
31.3
|
Female only
|
203
|
33.7
|
Both male and female
|
211
|
35.0
|
Age of adolescent they have
|
|
|
10-15
|
175
|
29.0
|
16-19
|
284
|
47.1
|
Both 10-15 and 16-19
|
144
|
23.9
|
Wealth index
|
|
|
Low
|
201
|
33.3
|
Medium
|
188
|
31.2
|
High
|
214
|
35.5
|
Mass media exposure and source of information about sexual and reproductive health issues
HEWs were served as a primary source of SRH issues for 241 (60.1%) of mothers followed by mass-media 135 (33.7%). About 397 (65.8%) of mothers were listen or watch TV at least once per a week
Knowledge of mother about sexual and reproductive health issues
Three hundred five (50.6%) of mothers had a good knowledge about SRH issues. Among 9 selected SRH issues which were included in this study physical and behavioral change during adolescence was the most known which is 372 (61.7%) followed by family planning 352 (58.4%).
Attitude of mothers towards sexual and reproductive health issues communication
Four hundred eleven (68.2%) of mothers had positive attitude towards SRH communication with adolescent. From the selected SRH issues in this study 579 (96.0%) of mother had positive attitude towards family planning communication and 293 (48.6%) of mother had positive attitude towards unwanted pregnancy communication.
Table 2:- Attitude of mothers on selected sexual and reproductive health issues communication in Wogdie district, 2020
Topics
|
Strongly disagree
|
Disagree
|
Agree
|
Strongly agree
|
Family planning
|
7 (1.2)
|
17 (2.8)
|
396 (65.7)
|
183 (30.3)
|
STI
|
2 (0.3)
|
106 (17.6)
|
322 (53.4)
|
173 (28.7)
|
HIV
|
2 (0.3)
|
85 (14.1)
|
321 (53.2)
|
195 (32.3)
|
Early marriage
|
4 (0.4)
|
182 (30.2)
|
256 (42.5)
|
161 (26.7)
|
Unsafe sexual practice
|
1 (0.2)
|
144 (23.9)
|
306 (50.7)
|
152 (25.2)
|
Abortion
|
1 (0.1)
|
174 (28.9)
|
264 (43.8)
|
164 (27.2)
|
Physical and behavioural change of adolescent
|
2 (0.3)
|
105 (17.4)
|
353 (58.5)
|
143 (23.7)
|
Unwanted pregnancy
|
46 (7.6)
|
264 (43.8)
|
183 (30.3)
|
110 (18.3)
|
Sexual violence
|
68 (11.3)
|
182 (30.2)
|
161 (26.7)
|
182 (30.2)
|
Parent are primary source of SRH information
|
2 (0.3)
|
71 (11.8)
|
373 (61.9)
|
157 (26.0)
|
Parent-adolescent sexual and reproductive health communication
The magnitude of parent-adolescent communication was 198 (32.8%) with 95% CI (29.1%, 36.7%). From those mothers who were communicated with their adolescent 101 (51.0%) mothers were communicated with their female adolescence and 44 (22.0%) mothers were communicated with their male and female adolescent. A 48 years old mother said that:- “I prefer my female adolescent to communicate about SRH because I think they (female) are more vulnerable for SRH problems.”
From 9 selected sexual and reproductive health issues HIV was the most communicated topic which is 197 (98.0%) mothers but abortion was the least communicated topic which is about 44 (21.9%). A 59 years old mother explained that:- “The most common topics of parent-adolescent communication were: HIV, abstinence and pregnancy.”
A 19 years old female adolescent also explained that
“Most of our (adolescent) parent tells about…value of virginity, HIV, avoiding any sexual activity and warn them (adolescent) again and again.”
6.6 Major reasons for not communicated about sexual and reproductive health issue
In this study 144 (72.73%) of mothers reported that the major reason for not communicate with their adolescent was lack of knowledge and lack of attention accounts 18 (9.09%). A qualitative finding explored about reason for not communication about SRH as follows.
A 19 years old male adolescent explained as:-
“Parents do not want to communicate sexual and reproductive issues with adolescents because such issues are culturally considered as taboo, they (parent) think that communicating those (SRH) things is the role of schools but schools are not doing that.”
A 18 years old female adolescent also explained that:-
“Parents do not communicate about sexual and reproductive health issues with adolescent. The problem is our social norm that defines SRH as taboo and we also feel fear.”
A 49 years old male parent said that:-
“Such communication was taking place when something happens to adolescent. Like when premarital pregnancy, HIV related problems, abortion, and related complications occur or heard from Mass Media otherwise we (parent) have no attention to communicate.”
A 18 years old female adolescence also explained that:-
“Parent always talks about virginity and their (parent) dignity….They warn us do not involve in any sexuality practice if we participate in sexuality they punish and remove form home so in this situation how we communicate with them (parent).”
A 37 yrs mother told that:-
“Ehhh really speaking I am very fear to communicate this (SRH) and I have not enough knowledge about SRH. I prefer my husband to do this.”
A 45 years priest said that:-
“BIBLE does no hinder communication about sexual and reproductive health but most people do not think that. Our church is not educate the followers to not to communicate about SRH. Parent should educate adolescent about all health aspect and they (parent) have an obligation to keep the health of life next to spiritual life”
A 54 years old Sheik explained that:-
“QUARAN is very complete book in the world. If parents read it (QUARAN) they (parent) know about SRH and educate everything including sexual and reproductive health but people do not read.”
Table 3:- Major reason for not communication about sexual and reproductive health among mothers in Wogdie district, 2020 (multiple response is possible)
Reasons for not communication
|
Frequency (percentage)
|
Lack of knowledge
|
144 (35.4)
|
Fear
|
78 (19.1)
|
Religious taboos
|
65 (16.0)
|
Cultural taboos
|
44 (10.8)
|
Communication on RH makes child rude
|
42 (10.3)
|
Child not listen
|
24 (5.1)
|
Lack of attention
|
19 (4.1)
|
6.7 Associated factors of communication about sexual and reproductive health issues
In bi-variable analysis residence, maternal age, family size, maternal educational status, maternal occupational status, sex of adolescent, age of adolescent, wealth status, mass media exposure status of mother, maternal SRH knowledge and maternal attitude towards SRH communication have P-values <0.25 and included in multiple binary logistic regressions.
On multiple binary logistic regressions rural residence, family size of 4-6 and >6, maternal educational status of uneducated, maternal occupational status of house-wife, wealth status of low, poor maternal knowledge and negative maternal attitude towards SRH communication had significant negative association with SRH communication at p value of less than 0.05.
The odds of parent-adolescent communication about SRH among mothers who were lived in rural residence was 94.4% times less likely as compared with mothers who were lived in urban residence [AOR=0.056, 95% CI (0.010, 0.331)].
The odds of parent-adolescent communication about SRH among mothers who had family size of 4-6 and >6 was 80.1% and 66.2% times less likely as compared with mothers mothers who had family size of 1-3 [(AOR=0.199, 95% CI (0.070, 0.564) and AOR= 0.338, 95% CI (0.130, 0.874))] respectively.
The odds of parent-adolescent communication about SRH among mothers who were not educated were 57.9% times less likely as compared with educated mothers [AOR=0.421, 95% CI (0.186, 0.951)].
The odds of parent-adolescent communication about SRH among house-wife mothers was 91.5% times less likely as compared with government employed mothers [AOR=0.085, 95% CI (0.024, 0.298)].
The odds of parent-adolescent communication about SRH among mothers who had low wealth status was 68.4% times less likely as compared with mothers who had high wealth status [(AOR= 0.316, 65% CI (0.129, 0.777)].
The odds of parent-adolescent communication about SRH among mothers who had poor knowledge was 93.7% times less likely as compared with mothers who had good knowledge about SRH [AOR=0.063, 95% CI (0.024, 0.164)].
The odds of parent-adolescent about SRH among mothers who had negative attitude towards SRH communication was 96.3% times less likely as compared with mothers who had positive attitude [AOR=0.037, 95% CI (0.0080, 0.169)].
Table 4 Bi-variable and Multi-variable analysis of factors associated with parent-adolescent communication about sexual and reproductive health communication among mother in Wogdie district, 2020
Variables
|
Communication
|
COR (95% CI)
|
AOR (95% CI)
|
Yes
|
No
|
|
|
|
|
Residence
|
|
|
|
|
Urban
|
88
|
72
|
1.00
|
1.00
|
Rural
|
110
|
333
|
0.270 (0.185, 0.395)
|
0.056 (0.010, 0.331)*
|
Maternal age
|
|
|
|
|
<35
|
9
|
90
|
0.270(0.129, 0.568)
|
0.660 (0.191, 2.296)
|
35-45
|
125
|
142
|
2.38 (1.637, 3.459)
|
2.519 (0.899, 4.988)
|
>45
|
64
|
173
|
1.00
|
1.00
|
Family size
|
|
|
|
|
1-3
|
82
|
230
|
1.00
|
1.00
|
4-6
|
72
|
113
|
1.787 (1.212, 2.636)
|
0.199 (0.070, 0.564)*
|
>6
|
44
|
62
|
1.991 (1.255, 3.157)
|
0.338 (0.130, 0.874)*
|
Maternal education
|
|
|
|
|
Uneducated
|
18
|
242
|
0.067 (0.040, 0.114)
|
0.421 (0.186, 0.951)*
|
Educated
|
180
|
163
|
1.00
|
1.00
|
Maternal occupational status
|
|
|
|
|
House wife
|
60
|
364
|
0.025 (0.012, 0.052)
|
0.085 (0.024, 0.298)*
|
Private employee
|
78
|
32
|
0.366 (0.162, 0.824)
|
1.076 (0.272, 4.257)
|
Government employee
|
60
|
9
|
1.00
|
1.00
|
Sex of adolescent they have
|
|
|
|
|
Male only
|
56
|
133
|
1.469 (0.937, 2.305)
|
0.652 (0.177, 2.398)
|
Female only
|
95
|
108
|
3.069 (2.005, 4.698)
|
1.430 (0.482, 4.241)
|
Both male and female
|
47
|
164
|
1.00
|
1.00
|
Age of adolescent they have
|
|
|
|
|
10-15
|
13
|
162
|
1.00
|
1.00
|
16-19
|
141
|
143
|
12.287 (6.670, 22.636)
|
1.891 (0.725, 4.932)
|
Both
|
44
|
100
|
5.483 (2.814, 10.683)
|
2.507 (0.686, 9.153)
|
Wealth index
|
|
|
|
|
Low
|
95
|
106
|
1.283 (0.87, 1.892)
|
0.316 (0.129, 0.777)*
|
Medium
|
15
|
173
|
0.124 (0.069, 0.225)
|
0.244 (0.098, 1.611)
|
High
|
88
|
126
|
1.00
|
1.00
|
Mass media exposure
|
|
|
|
|
Not exposed
|
79
|
318
|
0.182 (0.125, 0.263)
|
0.609 (0.178, 2.080)
|
Exposed
|
119
|
87
|
1.00
|
1.00
|
Maternal knowledge
|
|
|
|
|
Poor
|
38
|
267
|
0.123 (0.082, 0.185)
|
0.063 (0.024, 0.164)*
|
Good
|
160
|
138
|
1.00
|
1.00
|
Maternal attitude
|
|
|
|
|
Negative
|
40
|
152
|
0.421 (0.282, 0.629)
|
0.037 (0.0080, 0.169)*
|
Positive
|
158
|
253
|
1.00
|
1.00
|
* Significance at P<0.05, Hosmer, Leme show test 0.121, they indicates mothers,