The participants' age ranged from 43 to 60 years with 6 males and 12 females. The participants had children ranging from 4-6 and of those children about 1-3 were pregnant or having a child (See Table 1).
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Results from individual interviews yielded three themes which described the views of parents/guardians related to the discussion of sexual and reproductive health issues with teenagers (See Table 2). The themes incorporated religious beliefs affecting sexual reproductive health discussions with teenagers; communication and Discussion of sexual and reproductive health issues with teenagers; and parent-teenager relationship enhances sexual reproductive health discussions which were substantiated by direct quotations from participants.
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Religious beliefs affecting sexual reproductive health discussions with teenagers.
Some parents, who were interviewed during the current study, disagreed with the introduction of SRH services in schools or parents being involved in discussing SRH with their children, indicating that it was against their religion, while others indicating that it was cultural taboo. In their own words the participants said:
“My religion prohibits such topics; no sex before marriage. We are trying to teach our children good morals, but you want to bring things that will promote immorality.” (P12, Female, 50)
Gender and cultural stereotypes influence SRH communication
Gender and culture influence sexual communication compromising sexual health and the associated with doubts of seeking or providing reproductive health information. Gender-related issues were cited by some parents as factors causing discomfort. Male parents indicated that they could not talk to their daughters about menstruation, dating or contraception. These aspects are confirmed by the following statements from the interviewed parents:
“You know….in my culture it is a taboo to talk about sexual issues with children. When my 16-year-old girl fell pregnant, I blamed her mother for not talking to her. The same year my 18 years old son impregnated a 15-year-old. I was dumbfounded, didn't know whom to blame now. I thought it is her responsibility to talk to girls about issues like menstruation, contraception, pregnancy, but I failed too to talk to my son about protection.” (P16, Male, 50)
Communication and discussion of sexual and reproductive health issues with teenagers
Parents expressed that it was difficult to discuss SRH issues with their own children or to answer their children’s questions in this regard. Some parents indicated that they used warnings and threats to communicate with their children. Parents indicated that communication is usually triggered by instant circumstances occurring at a point in time.
“Hmm… it is sometimes difficult but sometimes we try, even though as a parent you feel ashamed to face your child and talk about SRH things” (P4, Female, 52)
“The only time I talk to my children about sex is when someone in the village died of HIV and AIDS, thereby warning them, other than that, I never talk to them.” (P12, Female, 50)
Some participants pointed out positive views that it was important to discuss SRH matters with teenagers so that they could be well informed and also understand the changes in their bodies. Some mothers said that their boys preferred to discuss SRH related matters with them rather than with their fathers. Other parents said that they were the ones who initiated these conversations during family meetings or during informal dialogues.
“Yes, I am open to my children and my children are able to tell me that there is 1, 2, 3 and most of the time I am with them. I always tell them, hey, you people, especially the boys, you play around too much, you must use condoms because there are many diseases.” (P3, Female, 43)
“Since my experience with teenage pregnancy, I vowed that I don't want any of my children to go through what I went through. I always share with them my story and tell them what to do to avoid that. I think they listened because to date none of them is a victim of teenage pregnancy. My firstborn had a child at 24 and the second born at 26. The last born is 23 and does not have a child. So, talking to children is important.” (P7, Male, 60)
“When my girl started menstruating, she was afraid of me, but I sat down with her and said look, I know you are afraid of me as your mother. There is no one who can help you. You must tell me step-by-step what is happening, and I started explaining. Even the boys when they come to me, they come freely, I tell them and say look, let me tell you when you play in the blankets, a baby will come, one, two children. You will end up unable to buy something for yourself because you will be maintaining all these children. I even teach them that every action has consequences which are bad. I am very free to talk to them; I don’t have a problem. They also come to me when they have a problem. They don’t go to their father (laughing), they come to me. They will say mum [mother] because you work at the hospital what do you see there. Then I explain to them and say to them, this and this is not good, things like Metsosha [sexual stimulants], those things are not good. Leave everything to nature as determined by God.” (P11, Female, 52)
Parent-teenager relationship enhances sexual reproductive health discussions
Parents interviewed during the current study indicated that they had good relationships with their teenage children, which made it easier to engage in communication about SRH-related topics with them. However, some parents did not feel comfortable to engage in SRH-related discussions with their teenage children. Some parents indicated that it was easy for them to discuss SRH matters with their teenage children. Both male and female teenagers were more comfortable discussing SRH matters with their mothers than with their fathers. In their own words, the participants said:
“Fortunately, I and my little girl are friends, she is able to [can] share, and I am also able to guide her. It is just like touch-ups. When talking to her I can see that she knows a little bit of something.” (P 13, Male, 56)
“Yes, I as a parent have established a good relationship with my child; we are free to talk anytime. I am able to communicate with him, guide him, give him information about life so that he can know and understand that if he has a girlfriend at that age he will fall into trouble.” (P9, Female, 47)
Some teenagers’ parents, who participated in the current study, indicated that they had good relationships with their children. This enhanced their communication about SRH matters. Female participants reflected that their teenage sons sought advice, related to SRH issues from them rather than from their fathers. This was indicated as follows:
“I am able to communicate with my son, guide him, give him information about life so that he can know and understand that if he can have a girlfriend at that age he will fall into trouble, the trouble of impregnating a girl or contract diseases” (P18, Female, 47)
“I tell them that if they want to start doing such things, they should use disease prevention measures, like hmm… condom. A girl must at least use a condom as well and contraceptives to prevent STIs, HIV and AIDS as well as pregnancy” (P1, Female, 51)
The participants indicated that having a close relationship with their teenage children made it possible for them to be aware of dangerous situations faced by teenagers. The participants also said in some instances that teenagers could not talk about difficult situations, but having close relationships, enabled them to be open. Parents indicated that it is important to have good relationships with their teenage children as this enhanced teenagers’ openness to reveal hidden issues that in actual instances they could not talk about if parents were unapproachable. The current study revealed that some parents could identify situations which affected teenagers and could give support and advice. This was found to be useful to teenagers because their challenges related to SRH were addressed. The following relevant statements from the participants support this finding:
“I teach my teenage girl that she should not allow boys to touch her and that she should run away from older men who take advantage of young girls; they want to ruin their future [sic]. Actually, my girl was telling me that when they come back from school men will stop their cars and call them” (P2, Female, 55)
Another participant said:
“Because we don't know what happens when they get out of the gates and go to school, what kind of friends do they meet, what is it that they tell them what we don't tell them. So, I just keep on telling them this sexual and reproductive health issues for them to be able to protect themselves so that even if they are to engage in sexual relationships, they must protect themselves, they must start engaging knowingly, they must not only protect themselves but knowingly” (P17, Male, 57)