Parent-adolescent communication on reproductive and sexual issues and its determinants among parents in Gondar town, Northwest Ethiopia: a mixed-methods study.
Only 39.5% of parents in Gondar town, Northwest Ethiopia reported having discussions on reproductive and sexual health issues with their adolescents, with good parental knowledge, positive attitude, father's occupation, and family size identified as significant determinants.
Key Findings
Results
Fewer than two in five parents reported engaging in communication with their adolescents about reproductive and sexual health issues.
Only 266 out of 673 respondents (39.5%) reported having discussions on reproductive and sexual health issues with their adolescents.
The study was conducted in Gondar town, Northwest Ethiopia, from January 1 to February 28, 2022.
Sample consisted of 673 parents of adolescents aged 10–19 years using an interviewer-administered questionnaire.
Mixed-methods design combined quantitative survey data with 17 in-depth qualitative interviews.
Results
Good parental knowledge of reproductive and sexual health was a strong positive predictor of parent-adolescent communication on these topics.
Parents with good knowledge were significantly more likely to communicate with their adolescents (AOR = 4.45; 95% CI: 2.90, 6.84).
This was the strongest predictor identified among all variables examined.
Qualitative findings corroborated this, indicating that parents' lack of awareness about sexual and reproductive health issues was a barrier to communication.
Results
A positive parental attitude toward sexual and reproductive health was associated with increased likelihood of parent-adolescent communication.
Parents with a positive attitude were more likely to communicate with their adolescents (AOR = 1.62; 95% CI: 1.15, 2.28).
Qualitative data indicated that concerns about conversations encouraging premarital sex reflected negative attitudes that acted as barriers to discussion.
Results
A father's occupation as a merchant was negatively associated with parent-adolescent communication on reproductive and sexual health.
Having a father whose occupation was merchant significantly reduced the likelihood of communication (AOR = 0.45; 95% CI: 0.29, 0.69).
This suggests that occupational factors, possibly related to time availability or social norms among merchants, influence communication behaviors.
Results
Larger family size (more than five members) was negatively associated with parent-adolescent communication on reproductive and sexual health.
Families with more than five members were significantly less likely to engage in these communications (AOR = 0.39; 95% CI: 0.23, 0.66).
This was the second strongest negative predictor identified in the study.
Results
Qualitative findings revealed that sociocultural norms were a key barrier to parent-adolescent communication on reproductive and sexual health.
Seventeen in-depth interviews were conducted and analyzed using thematic analysis.
Qualitative findings revealed that parent-adolescent communication 'occurs infrequently and is influenced by sociocultural norms, and parents' awareness of sexual and reproductive health issues.'
Parents expressed concern that discussing reproductive and sexual health topics might encourage premarital sex among adolescents.
Quantitative and qualitative findings were triangulated for comprehensive insights.
What This Means
This research suggests that open conversations between parents and teenagers about sexual and reproductive health are uncommon in Gondar town, Ethiopia, with only about 4 in 10 parents reporting such discussions. The study found that parents who had better knowledge about reproductive and sexual health, and those with more positive attitudes toward these topics, were much more likely to talk with their adolescent children. In contrast, parents from larger households and fathers who worked as merchants were less likely to have these conversations.
The qualitative interviews added important context, revealing that cultural norms play a major role in silencing these discussions. Many parents avoided the topic out of fear that talking about sex would encourage their teenagers to engage in premarital sexual activity — a concern rooted in local sociocultural values. This suggests the barrier is not just a lack of information, but also deeply held beliefs about what is appropriate to discuss with adolescents.
This research suggests that improving parent-adolescent communication about reproductive health in similar settings will require more than just providing parents with information. Community-based awareness campaigns and school programs offering age-appropriate health education and life skills training could help address both the knowledge gap and the cultural discomfort around these conversations, ultimately supporting adolescents in making informed health decisions.
Gedef G, Andualem F, Takelle G, Anteneh D, Getie K. (2025). Parent-adolescent communication on reproductive and sexual issues and its determinants among parents in Gondar town, Northwest Ethiopia: a mixed-methods study.. BMC pediatrics. https://doi.org/10.1186/s12887-025-06314-z