Skip to main content
Taylor & Francis Open Select logoLink to Taylor & Francis Open Select
. 2014 Jul 21;13(2):169–178. doi: 10.2989/16085906.2014.945387

‘Mum never loved me.’ How structural factors influence adolescent sexual and reproductive health through parent–child connectedness: A qualitative study in rural Tanzania

Joyce Wamoyi a,*, Daniel Wight b
PMCID: PMC4151808  PMID: 25174634

Abstract

Research in high income countries shows parent–child connectedness to be protective against undesirable sexual and reproductive health (SRH) outcomes among young people. Little has been done to understand the nature of parent–child connectedness, the structural factors that impact on connectedness and parents’ understanding of how connectedness affects their children's sexual behaviour in sub-Saharan Africa and Tanzania in particular. Ethnographic research involved 30 days of observation in 10 households, 9 focus group discussions and 60 in-depth interviews. Thematic analysis was conducted using NVIVO qualitative data analysis software.

The structural factors with greatest influence on connectedness were economic circumstances, gender, social status, state education, and globalisation. Economic circumstances impacted on parent–child connectedness through parents’ ability to provide for their children's material needs, and the time their occupation allowed for them to spend with their children and monitor their activities. Appropriate parent–child interactions were shaped by gender norms and by social status in the form of respectability, adolescents’ adherence to norms of respect/ obedience shaping their parents’ affection. State education affected parents’ preferences between children but also undermined parental authority, as did broader globalisation. Connectedness was related to SRH in a bi-directional way: lack of connectedness was linked to young people's low self-esteem and risky sexual behaviour while unplanned pregnancies seriously undermined young women's connectedness with their parents. Since material provision was perceived to be a central element of parent–child connectedness, structural factors limiting provision made transactional sex more likely both through direct material pathways and emotional ones. Motives for transactional sex were said to be material needs and to feel loved and cared for.

An important pathway by which structural factors shape adolescent SRH outcomes is through parent–child connectedness, especially parents’ ability to spend time with their children and provide for their economic needs. Modifying these structural factors should facilitate parent–child connectedness, which may help delay early sexual intercourse, protect young people against unplanned pregnancy through encouraging communication on contraception use and, overall, promote healthy adolescent development.

Keywords: ASRH, parent–child connectedness, parenting, structural factors, sub-Saharan Africa, Tanzania

References

  1. Babalola S, Tambashe BO, Vondrasek C. Parental factors and sexual risk-taking among young people in Cote d'Ivoire. African Journal of Reproductive Health. 2005;9:4965. [PubMed] [Google Scholar]
  2. Barber BK, Schluterman JM. Connectedness in the lives of children and adolescents: a call for greater conceptual clarity. Journal of Adolescent Health. 2008;43:209–216. doi: 10.1016/j.jadohealth.2008.01.012. [DOI] [PubMed] [Google Scholar]
  3. Bastien S, Kajula LJ, Muhwezi WW. A review of studies of parent–child communication about sexuality and HIV/AIDS in sub-Saharan Africa. Reproductive Health. 2011;8:25. doi: 10.1186/1742-4755-8-25. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Biddlecom A, Awusabo-Asare K, Bankole A. Role of parents in adolescent sexual activity and contraceptive use in four African countries. International Perspectives of Sexual and Reproductive Health. 2009;35:72–81. doi: 10.1363/ipsrh.35.072.09. [DOI] [PubMed] [Google Scholar]
  5. Blum RW. Family connections make a difference in the lives of of youth. 2005 Available at http://www.mnddc.org/extra/risk/family.htm. [accessed 7 July 2014]
  6. Bohmer L, Kirumba E. Socio-economic context and sexual behaviour of Ugandan out of school youth. Culture, Health and Sexuality. 2000;2:269–285. [Google Scholar]
  7. Byers W, Goosens L, Vansants I, Moors E. A structural model of autonomy in middle and late adolescence: connectedness, separation, detachment and agency. Journal of Youth and Adolescence. 2003;32:351–365. [Google Scholar]
  8. Crosby RA, Diclemente RJ, Wingood GM, Cobb BK, Harrington K, Davies SL, Hook EW, 3rd, Oh MK. Condom use and correlates of African American adolescent females’ infrequent communication with sex partners about preventing sexually transmitted diseases and pregnancy. Health Education & Behaviour. 2002;29:219–231. doi: 10.1177/109019810202900207. [DOI] [PubMed] [Google Scholar]
  9. Dittus P, Jaccard J, Gordon V. Direct and non-direct communication of maternal beliefs to adolescents: adolescent motivations for premarital sexual activity. Journal of Applied Social Psychology. 2000;29:37–55. [Google Scholar]
  10. Downing J, Jones L, Bates G, Sumnall H, Bellis MA. A systematic review of parent and family-based intervention effectiveness on sexual outcomes in young people. Health Education Research. 2011;26:808833. doi: 10.1093/her/cyr019. [DOI] [PubMed] [Google Scholar]
  11. Goody J. Futures of the family in rural Africa. Population and Development Review. 1989;15:119–144. [Google Scholar]
  12. Holden GW, Miller PC. Enduring and different: a meta-analysis of the similarity in parents’ child rearing. Psychological Bulletin. 1999;125:223–254. doi: 10.1037/0033-2909.125.2.223. [DOI] [PubMed] [Google Scholar]
  13. Hutchinson MK, Jemmott JB, 3rd, Jemmott LS, Braverman P, Fong GT. The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study. Journal of Adolescent Health. 2003;33:98–107. doi: 10.1016/s1054-139x(03)00183-6. [DOI] [PubMed] [Google Scholar]
  14. Kumi-Kyereme A, Awusabo-Asare K, Biddlecom A, Tanle A. Influence of social connectedness, communication and monitoring on adolescent sexual activity in Ghana. African Journal of Reproductive Health. 2007;11:133–149. [PubMed] [Google Scholar]
  15. Lezin N. Rolleri L. Bean S. Taylor J. Parent–child connectedness: Implications for research, interventions, and positive impacts on adolescent health. Scotts Valley CA: ETR Associates; 2004. [Google Scholar]
  16. Luke N. Age and economic asymmetries in the sexual relationships of adolescent girls in sub-Saharan Africa. Studies in Family Planning. 2003;34:67–86. doi: 10.1111/j.1728-4465.2003.00067.x. [DOI] [PubMed] [Google Scholar]
  17. Markham CM, Lormand D, Gloppen KM, Peskin MF, Flores B, Low B, House LD. Connectedness as a predictor of sexual and reproductive health outcomes for youth. Journal of Adolescent Health. 2010;46:S23–S41. doi: 10.1016/j.jadohealth.2009.11.214. [DOI] [PubMed] [Google Scholar]
  18. Mason J. Qualitative researching. London: Sage; 2006. [Google Scholar]
  19. Mbugua N. Factors inhibiting educated mothers in Kenya from giving meaningful sex-education to their daughters. Social Science & Medicine. 2007;64:1079–1089. doi: 10.1016/j.socscimed.2006.10.008. [DOI] [PubMed] [Google Scholar]
  20. Mccleary-Sills J. Douglas Z. Rwehumbiza A. Hamisi Z. Mabala R. Washington DC: International Center for Research on Women; 2011. Vijana Tunaweza Newala: Findings from a participatory research and action project in Tanzania. [Google Scholar]
  21. Miller B, Norton M, Curtis T. The timing of sexual intercourse among adolescents: Family, peer, and other antecedents. Youth and Society. 1997;29:54–83. [Google Scholar]
  22. Miller K, Kotchick B, Dorsey S, Forehand R, Ham A. Family communication about sex: what are parents saying and are their adolescents listening? Family Planning Perspectives. 1998;30:218–222. 235. [PubMed] [Google Scholar]
  23. Murphy E, Dingwall R. Informed consent, anticipatory regulation and ethnographic practice. Social Science & Medicine. 2007;65:2223–2234. doi: 10.1016/j.socscimed.2007.08.008. [DOI] [PubMed] [Google Scholar]
  24. Ngom P, Magadi MA, Owuor T. Parental presence and adolescent reproductive health among the Nairobi urban poor. Journal of Adolescent Health. 2003;33:369–377. doi: 10.1016/s1054-139x(03)00213-1. [DOI] [PubMed] [Google Scholar]
  25. Parkhurst JO. HIV prevention, structural change and social values: the need for an explicit normative approach. Journal of the International AIDS Society. 2012;15(Supp. 1):1–10. doi: 10.7448/IAS.15.3.17367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Phetla G, Busza J, Hargreaves JR, Pronyk PM, Kim JC, Morison LA, Watts C, Porter JD. ‘They have opened our mouths’: increasing women's skills and motivation for sexual communication with young people in rural South Africa. AIDS Education and Prevention. 2008;20:504–518. doi: 10.1521/aeap.2008.20.6.504. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Plummer M. Wight D. Young people's lives and sexual relationships in rural africa: Findings from a large qualitative study in Tanzania. Lanham: Lexington Books; 2011. [Google Scholar]
  28. Poulsen MN, Miller KS, Lin C, Fasula A, Vandenhoudt H, Wyckoff SC, Ochura J, Obong'o CO, Forehand R. Factors associated with parent–child communication about HIV/AIDS in the United States and Kenya: A cross-cultural comparison. AIDS and Behaviour. 2010;14:10831094. doi: 10.1007/s10461-009-9612-4. [DOI] [PubMed] [Google Scholar]
  29. Resnick MD, Bearman PS, Blum RW, Bauman KE, Harris KM, Jones J, Tabor J, Beuhring T, Sieving R E, Shew M, Ireland M, Bearinger L H, Udry JR. Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Mediacl Association. 1997;278:823832. doi: 10.1001/jama.278.10.823. [DOI] [PubMed] [Google Scholar]
  30. Seeley J, Watts CH, Kippax S, Russell S, Heise L, Whiteside A. Addressing the structural drivers of HIV/AIDS: A luxury or necessity for programmes? Journal of the International AIDS Society. 2012;15:17397. doi: 10.7448/IAS.15.3.17397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Sieving RE, Mcneely CS, Blum RW. Maternal expectations, mother-child connectedness, and adolescent sexual debut. Archives of Pediatrics and Adolescent Medicine. 2000;154:809816. doi: 10.1001/archpedi.154.8.809. [DOI] [PubMed] [Google Scholar]
  32. Silberschmidt M, Rasch V. Adolescent girls, illegal abortions and ‘sugar-daddies’ in Dar es Salaam: vulnerable victims and active social agents. Social Science and Medicine. 2001;52:1815–1826. doi: 10.1016/s0277-9536(00)00299-9. [DOI] [PubMed] [Google Scholar]
  33. Twa-Twa J. The role of the environment in the sexual activity of school students in Tororo and Pallisa Districts of Uganda. Health Transition Review. 1997;(7 Suppl):67–81. [PubMed] [Google Scholar]
  34. UNICEF Education equity and quality in Tanzania. UNICEF. 2009 Available at http://www.unicef.org/tanzania/6911_10874.html.
  35. Vandenhoudt H, Miller KS, Ochura J, Wyckoff SC, Obong'o CO, Otwoma NJ, Poulsen MN, Menten J, Marum E, Buve A. Evaluation of a U.S. evidence-based parenting intervention in rural Western Kenya: from parents matter! To families matter! AIDS Education & Prevention. 2010;22:328–343. doi: 10.1521/aeap.2010.22.4.328. [DOI] [PubMed] [Google Scholar]
  36. Wamoyi J. University of Southampton; UK: 2008. Family context and the complexity of parenting: A focus on the influence on young people's sexual behaviour in rural Tanzania. PhD Thesis. [Google Scholar]
  37. Wamoyi J, Fenwick A, Urassa M., Zaba B, Stones W. Parent–child communication about sexual and reproductive health in rural Tanzania: Implications for young people's sexual health interventions. Reproductive Health. 2010a;7:6. doi: 10.1186/1742-4755-7-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Wamoyi J, Fenwick A, Urassa M., Zaba B, Stones W. Socio-economic change and parent–child relationships: implications for parental control and HIV prevention among young people in rural North Western Tanzania. Culture Health and Sexuality. 2011;13:615–628. doi: 10.1080/13691058.2011.562305. [DOI] [PubMed] [Google Scholar]
  39. Wamoyi J, Wight D, Plummer M, Mshana GH, Ross D. Transactional sex amongst young people in rural northern Tanzania: an ethnography of young women's motivations and negotiation. Reproductive Health. 2010b;7:2. doi: 10.1186/1742-4755-7-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. WHO (World Health Organisation) Helping parents in developing countries improve adolescents’ health. 2007 Available at http://hrweb.mit.edu/worklife/raising-teens/parenting-adolescents.html [accessed: 18 July 2007]

Articles from African Journal of AIDS Research are provided here courtesy of Taylor & Francis

RESOURCES