1996_3_communicating about sex

Sexual Health Exchange, 1996 - no. 3

Communicating about sex: adolescents and parents in Kenya

Karungari Kiragu, Emily Obwaka, Dan Odallo and Carol Van Hulzen

With 75% of its population under 25 years of age, Kenya faces a challenge in addressing the problems and needs of a youthful population. In 1994 the Johns Hopkins University Population Communication Services collaborated with the National Council for Population Development and the Central Bureau of Statistics to conduct a national survey on reproductive health issues associated with adolescence there. Because the study wanted to obtain the perspectives of both youth and adults, each group was asked the same questions.

963Tetea HIV/AIDS prevalence has risen sharply in the last few years and is expected to become Kenya's most serious health problem in the next decade. Many adults are thought to have acquired HIV during adolescence, so private and public sector partners have joined to address adolescent reproductive health concerns. To help guide such programmes, a national information, education and communication situation survey was conducted with 1476 adolescents aged 15-19 years and 2894 adults aged 20-54 years.

Parent-to-child communication

To assess communication between parents and their adolescent children, parents with children aged 10-19 years living at home were asked about communication with their oldest child in that age group. Parents were asked whether they had spoken to their child about selected topics during the year preceding the survey. The child was also asked if one of the parents had talked to him or her about these same topics in the same time period.

The findings showed remarkable agreement between the adolescents and their parents. Both parents and youth were most likely to report having discussed school, future careers and alcohol/drug use. Less than half the parents and youth reported a discussion about boy-girl relationships, AIDS/STDs or sexual relations. Less than onethird had discussed abortion, contraception or puberty.

Mothers were more likely than fathers to have discussed reproductive health issues. Fifty per cent of mothers had talked to the adolescent about AIDS/STDs in the preceding year, while only 42% of the fathers had. The pattern was similar for abortion and puberty. Interestingly, slightly more fathers than mothers talked to their children about family planning.

Parents appeared to split roles along gender lines with respect to holding discussions with their children about reproductive health. Mothers reported talking more to their daughters and fathers to their sons about AIDS/STDs, boy-girl relationships, sexual behaviour, family planning, abortion and puberty. Still, the majority of parents had not discussed these subjects in the preceding year and girls were more likely to report discussions than boys. This suggests that interventions to help parents talk with their children may be needed. In addition, alternate avenues to communicate with youth about reproductive health, such as schools and churches, may be helpful.

Communication preferences among adolescents

The adolescents were asked how comfortable they would feel talking about sexual matters to family members. Results showed that males were most uncomfortable talking to their mothers, aunts, fathers, sisters, uncles and members of the clergy, in that order. They were most comfortable talking to their brothers, friends and health care workers, also in that order.

963Abooklet A booklet for policy-makers, a map highlighting the status of youth and fact sheets (also on sexual activity among youth, teenage pregnancy, abortion among teenagers and harmful practices facing girls) comprise the contents of an advocacy package for policy-makers

The results among adolescent females mirrored the adolescent males females were most uncomfortable talking with their fathers, uncles, brothers and members of the clergy. They were most comfortable talking to a sister, friends, their boyfriend and health care workers.

Since adolescents appear most comfortable talking with their friends and siblings, programmes that use these resources may be successful. For example, big brother/sister programmes could be used to encourage youth to talk with their younger siblings, since young people prefer to talk to peers about these issues.

Adolescents also appear relatively comfortable talking with health care providers. This suggests that health professionals are an acceptable information source for an adolescent audience. Strategies that can train them to communicate with and provide care for adolescents may result in greater awareness of young people's health concerns. For example, local health care providers can give lectures in school, initiate extracurricular health activities and have special hours for young people to visit health care facilities, etc.

Teaching family life education

Respondents were asked if it was all right for young people to receive family life education (FLE) in school. Over threequarters of adults and adolescents alike responded that young people should be taught FLE. This supports qualitative research done earlier among policy-makers who said that young people should be taught FLE. However, the policy-makers are often cautious and uncomfortable in advocating this position publicly lest they offend some religious conservatives.

Our data suggest that leaders can secure public support on this issue. It is probably an outspoken and well-organized minority that is the force behind the perceived opposition to FLE. The data indicate that most Kenyans, including parents, do not share these views.

Interventions

Our research shows that parents often do not have correct information about reproductive health (for the most part, they themselves did not receive FLE). Others are simply uncomfortable talking to their children or think that they are taught FLE in school. Traditionally, parents were not the ones expected to educate young people about these matters. Different communities appointed guardians for this role, often associated with initiation ceremonies. Now parents are charged with this task, yet being a parent does not automatically make one graceful and fluent on adolescent sexual matters.

To assist parentchild communication, several activities have been established. The "Youth Variety Show", a weekly hour-long callin radio programme addresses topics such as boy-girl relationships, physiological development, alcohol and drug use, future ambitions and parent-child communication. Youth and guest experts participate; the "Teen Bus" segment involves interviews with teens nationwide and a spin-off newspaper column. Evaluation showed that over 60% of youth aged 15-17 years listen to the programme.

A comic book that encourages teens to talk to their parents has been distributed through youth organizations; it also covers peer pressure, relationships, abstaining from sex and condom use. A booklet for parents suggests how they can talk to their children; it is accompanied by a booklet for youth as it is hoped that dialogue can be stimulated if parents and children read similar materials. A set of print materials has further been produced for policy-makers as part of the project's advocacy activities.

Karungari Kiragu, Population Communication Services, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD 212024012, USA; Tel. 1-4106596236; Fax: 1-4106596266

Note: This article is partly based on previous publications: 1) Kekovole, J. et al., The Kenya IEC Situation Survey Country Report, Baltimore: The Johns Hopkins University Center for Communication Programs, 1996; 2) Kiragu, K., Do adults and youth have differing views?, Population Reports, October 1995, p. 10.