Health  Vol.8 No.6 , April 2016
Caretaker’s Perceptions on Caretaker-Adolescent Communication on Sexual and Reproductive Health in Unguja-Zanzibar: Implication for Intervention
Abstract: Caretaker-adolescent communication is an appealing source for influencing adolescents’ knowledge, attitudes and behavior, because caretakers are an accessible and often willing source of information for their children. With the realization of the importance of caretakers in influencing adolescent behaviours, it becomes interesting to explore their perceptions about caretaker-adolescent communication on Sexual and Reproductive Health (SRH). An exploratory qualitative research design was conducted in all six districts of Unguja-Zanzibar. Twelve focus group discussions (FGDs) with caretakers who were purposively selected were conducted. Thematic analysis guided the interpretation of the data. The main themes that were identified are perceived the risk of adolescents; , time and content of communication; barriers to parent-child communication on SRH; and helping our children pass through adolescence safely. The findings show that participants have acknowledged the apparent risky sexual behaviors of their adolescents, and that information on SRH should be offered to children before they reach puberty. Participants had the opinion that communication on SRH should be in the form of warning, threat and unidirectional. Topics such as teenage pregnancy, STIs and HIV, and drug and alcohol were proposed to be openly discussed. However, topics on condom and contraceptives use faced strong opposition. Lack of favorable time, caretakers’ limited knowledge and skills, myth on SRH communication, and being uncomfortable were among the caretaker-adolescent communication barriers identified by caretakers. The findings suggest that participants are keen to help their adolescents to avoid SRH problems, most importantly they emphasised on the need to empower caretakers by equipping them with knowledge of SRH, good communication skills and religious knowledge. Communal parenting on the other hand has been identified as the major weapon in shaping adolescents’ behaviour. This information provides insight in designing family-based intervention aiming at increasing communication about SRH between caretakers and adolescents.
Cite this paper: Seif, S. , Kohi, T. and Mselle, L. (2016) Caretaker’s Perceptions on Caretaker-Adolescent Communication on Sexual and Reproductive Health in Unguja-Zanzibar: Implication for Intervention. Health, 8, 518-530. doi: 10.4236/health.2016.86055.

[1]   United Nation Population Fund (UNFPA) (2008) Generation of Change: Young People and Culture. Youth Supplement to UNFPA’s State of the World Population Report, New York.

[2]   World Health Organization (WHO) (2007) Helping Parents in Developing Countries Improve Adolescent’s Health. World Health Organization, Geneva.

[3]   Anarfi, K. (1992) Sexual Networking in Selected Communities in Ghana and the Sexual Behaviour of Ghanaian Female Migrants in Abidjan, Cote d’Ivoire. In: Dyson, T., Ed., Sexual Behaviour and Networking: Anthropological and Socio-Cultural Studies on the Transmission of HIV, Derouaux-Ordina Editions, Liege.

[4]   United Nation (UN) (1990) Patterns of First Marriage: Timing and Prevalence. United Nations, Department of International Economic and Social Affairs, New York, 7-18.

[5]   Bledsoe, C.H. and Cohen, B. (1993) Social Dynamics of Adolescent Fertility in Sub-Saharan Africa, Population Dynamics of Sub-Saharan Africa. National Academy Press, Washington DC, 45-56.

[6]   Population Council, Tanzania Commission for AIDS (TACAIDS), Zanzibar AIDS Commission (ZAC) and UNICEF Tanzania (2015) The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People, Tanzania 2009-2012. Dar es Salaam: Population Council, TACAIDS, ZAC and UNICEF Tanzania.

[7]   Kumi-Kyereme, A., Awusabo-Asare, K., Biddlecom, A. and Tanle, A. (2007) Influence of Social Connectedness, Communication and Monitoring on Adolescent Sexual Activity in Ghana. African Journal of Reproductive Health, 11, 133-149.

[8]   Zhang, L., Li, X., Shah, I., Baldwinc, W. and Stanton, B. (2007) Parent-Adolescent Sex Communication in China. The European Journal of Contraception and Reproductive Health Care, 12, 138-147.

[9]   Lefkowitz, E.Z., Sigman. M. and Au, T.K. (2000) Helping Mothers Discuss Sexuality and AIDS with Adolescents. Child Development, 71, 1383-1394.

[10]   Bastien, S., Kajula, L.J. and Muhwezi, W.W. (2011) A Review of Studies of Parent-Child Communication about Sexuality and HIV/AIDS in Sub-Saharan Africa. Reproductive Health, 8, 25.

[11]   Burgess, V., Dziegielewski, F.S. and Green, E.C. (2005) Improving Comfort about Sex Communication between Parents and Their Adolescents: Practice-Based Research within a Teen Sexuality Group. The Journal of Brief Treatment and Crisis Intervention, 5, 379-390.

[12]   DiClemente, R.J., Wingood, G.M., Crosby, R., Cobb, B.K., Harrington, K. and Davies, S.L. (2001) Parent-Adolescent Communication and Sexual Risk Behaviours among African American Adolescent Females. Journal of Pediatrics, 139, 407-412.

[13]   Feldman, S.S. and Rosenthal, D.A. (2000) The Effect of Communication Characteristics on Family Members’ Perceptions of Parents as Sex Educators. Journal of Research on Adolescence, 10, 119-150.

[14]   Downing, J., Jones, L., Bates, G., Sumnall, H. and Bellis, M.A. (2011) A Systematic Review of Parent and Family-Based Intervention Effectiveness on Sexual Outcomes in Young People. Health Education Research, 26, 808-833.

[15]   Adu-Mireku, S. (2003) Family Communication about HIV/AIDS and Sexual Behaviour among Senior Secondary School Students in Accra, Ghana. African Health Sciences, 3, 7-14.

[16]   Amoran, O.E., Onadeko, M.O. and Adeniyi, J.D. (2005) Parental Influence on Adolescent Sexual Initiation Practices in Ibadan, Nigeria. International Quarterly of Community Health Education, 23, 73-81.

[17]   Babalola, S., Tambashe, B.O. and Vondrasek, C. (2005) Parental Factors and Sexual Risk-Taking among Young People in Cote d’Ivoire. African Journal of Reproductive Health, 9, 49-65.

[18]   Biddlecom, A., Awusabo-Asare, K. and Akinrinola, B. (2009) Role of Parents in Adolescent Sexual Activity and Contraceptive Use in Four African Countries. International Perspectives on Sexual and Reproductive Health, 35, 72-81.

[19]   Wamoyi, J., Fenwick, A., Urassa, M., Zaba, B. and Stones, W. (2010) Parent-Child Communication about Sexual and Reproductive Health in Rural Tanzania: Implications for Young People’s Sexual Health Interventions. Reproductive Health, 7, 6.

[20]   Wamoyi, J., Fenwick, A., Urassa, M., Zaba, B. and Stones, W. (2011) Socio-Economic Change and Parent-Child Relationships: Implications for Parental Control and HIV Prevention among Young People in Rural North Western Tanzania. Culture, Health & Sexuality: An International Journal for Re-search, Intervention and Care, 13, 615-628.

[21]   Bakari, M.A. (2001) Democratisation Process in Zanzibar: A Retarded Transition.

[22]   Fisher, J.D. and Fisher, W.A. (1992) Changing AIDS-Risk Behaviour. Psychological Bulletin, 111, 455-474.

[23]   Laerd Dissertation (2012) Purposive Sampling.

[24]   Bill Supplement to the Zanzibar Government Gazette Vol. No. CXXI I 6486 of 23th October (2014).

[25]   Braun, V. and Clarke, V. (2006) Using Thematic Analysis in Psychology. Qualitative Research in Psychology, 3, 77-101.

[26]   Kachur, R., Mesnick, J., Liddon, N., Kapsimalis, C., Habel, M., David-Ferdon, C., Brown, K., Gloppen, K., Tevendale, H., Gelaude, D.J., Romero, L., Seitz, H., Heldman, A.B. and Schindelar, J. (2013) Adolescents, Technology and Reducing Risk for HIV, STDs and Pregnancy. Centers for Disease Control and Prevention, Atlanta.

[27]   Hoff, T., Rzepka, J., Cullins, V. and Friedman, A. (2010) Successes and Lessons Learned from the National GYT: Get Yourself Tested Campaign, a Public-Private Partnership Effort to Promote STD Testing among Sexually Active Youth. Panel Presented at the National Conference on Health Communication, Marketing, and Media, Atlanta.

[28]   Kessy, F. and Omar, M. (2014) Status and Progress of Human Development and Implications for Achieving Zanzibar Development Vision 2020. THDR 2014: Background Paper No. 10 ESRF Discussion Paper 55, Economic and Social Research Foundation.

[29]   Seif, S.A. and Kohi, T.W. (2014) Caretaker-Adolescent Communication on Sexuality and Reproductive Health: My Perceptions Matter; A Qualitative Study on Adolescents’ Perspectives in Unguja-Zanzibar. Health, 6, 2904-2917.

[30]   Obasi, A.I., Cleophas, B., Ross, D.A., Chima, K.L., Mmassy, G., Gavyole, A., Plummer, M.L., Makokha, M., Mujaya, B., Todd, J., et al. (2006) Rationale and Design of the MEMA kwa Vijana Adolescent Sexual and Reproductive Health Intervention in Mwanza Region, Tanzania. AIDS Care, 18, 311-322.

[31]   Wikipedia the free encyclopedia (2016) Zanzibar.

[32]   Quran, Chapter Israa (17:32).

[33]   Mbugua, N. (2007) Factors Inhibiting Educated Mothers in Kenya from Giving Meaningful Sex-Education to Their Daughters. Social Science & Medicine, 64, 1079-1089.

[34]   Poulsen, M.N., Miller, K.S., Lin, C., Fasula, A., Vandenhoudt, H., Wyckoff, S.C., Ochura, J., Obong’o, C.O. and Forehand, R. (2010) Factors Associated with Parent-Child Communication about HIV/AIDS in the United States and Kenya: A Cross-Cultural Comparison. AIDS and Behavior, 14, 1083-1094.

[35]   Guilamo-Ramos, V., Soletti, A.B., Burnette, D., Sharma, S., Leavitt, S. and McCarthy, K. (2012) Parent-Adolescent Communication about Sex in Rural India: U.S.-India Collaboration to Prevent Adolescent HIV. Qualitative Health Research, 22, 788-800.

[36]   Mahajan, P. and Sharma, N. (2005) Parents’ Attitude towards Imparting Sex Education to Their Adolescent Girls. Anthropologist, 7, 197-199.