Challenges on sexual health communication with secondary school learners, Limpopo province

A conversation about sexuality is most likely to encourage healthy and positive sexual practices while reducing risky sexual behaviour among adolescents. Traditionally, sexuality is discussed in hushed tones in proverbs and is reserved for adults. On the other hand, adolescents must be well informed about their sexuality to assist them to make informed decisions about their sexual behaviour.Objectives: The study determined parents' views regarding challenges of sexual health communication among secondary school learners in the Limpopo province.Method: A qualitative, exploratory-descriptive and contextual approach was employed for the study. Fifty-six parents were purposively selected, resulting in five focus group discussions that had 8­12 members. One central question was asked, and based on the participants' responses, probing questions followed. Data were analysed using thematic analysis. Trustworthiness and ethical considerations were ensured.Results: Three themes, namely communication concerns, role shifting in imparting sexuality education and poor parent­child relationships, and eight subthemes emerged from the data.Conclusion: This study identified that communication concerns influence parent­child dialogue on sexuality education. Therefore, there is a need to address factors hindering communication such as cultural barriers, role shifting in imparting sexuality education and poor parent­child relationships. This study suggests that parents should be empowered in dealing with children's sexuality.Contribution: Parents should be equipped with reproductive knowledge to enable them to talk freely about sexuality with their children. This should be complemented with broader programmes aimed at promoting sexual health education within the traditional family institution

National age-of-consent laws and adolescent HIV testing in subSaharan Africa: a propensity-score matched study

Objective To estimate the association between legal age of consent and coverage of human immunodeficiency virus (HIV) testing among adolescents in countries with high HIV-burden. Methods We analysed data from adolescents aged 15­18 years, who participated in Demographic and Health Surveys or AIDS Indicator Surveys between 2011 and 2016, in 15 sub-Saharan African countries. To improve balance in the distribution of measured individual- and country-level haracteristics, we used propensity score matching between adolescents in countries with more versus less restrictive ageof-consent laws (≤15 years versus ≥16 years). We estimated the percentage of individuals who self-reported that they have done an HIV test in the past 12 months and compared the differences in such testing rates among adolescents exposed to lower versus higher age-ofconsent laws. We also investigated effect modifications by sex and age. Findings Legal age of consent below 16 years was associated with an 11.0 percentage points higher coverage of HIV testing (95% confidence interval, CI: 7.2 to 14.8), corresponding to a rate ratio of 1.74 (95% CI: 1.35 to 2.13). HIV testing rate had a stronger association with lower age of consent among females than males. The testing rates differences were 14.0 percentage points (95% CI: 8.6 to 19.4) for females and 6.9 percentage points (95% CI: 1.6 to 12.2) for males (P-value for homogeneity=0.07). Conclusion This study provides evidence to support the recent World Health Organization's recommendations that countries should examine current laws and address age-related barriers to uptake of sexual and reproductive health services

Satisfaction des parents accompagnateurs des enfants de moins de 5 ans pris en charge au centre médical de Kokologho au Burkina Faso

La satisfaction des usagers des centres médicaux (CM) au Burkina Faso n'est pas connue. Notre objectif était d´étudier le niveau de satisfaction et les facteurs associés des parents accompagnateurs des enfants de moins de 5 ans pris en charge au CM de Kokologho en 2018. Il s'est agi d'une étude transversale. Réalisée dans l'aire de santé du CM de Kokologho, les cibles étaient les parents accompagnateurs d'enfants de moins de 5 ans pour l´enquête ménage et pour les entretiens qualitatifs les représentants de la communauté, les agents de santé et les leaders administratifs et coutumiers. Les outils de collecte des données ont été construits à partir des référentiels (SAPHORA-job 2014, conseil Québécois d'Agrément 2005). Des scores de satisfaction, Odds Ratio ajustées et IC95 % ont été calculés. Des analyses thématiques ont été effectuées. Le niveau de satisfaction globale des parents accompagnateurs des enfants pris en charge au CM de Kokologho en 2018 était satisfaisant (70,6 %). Les dimensions étudiées étaient l'accueil (47,2 %), le respect (65,3 %), l'empathie (60,5 %), la confidentialité (73,8 %), la fiabilité (71,9 %), la rapidité (51,4 %), le confort (89,0 %), l'accessibilité géographique (97,5 %) et l'accessibilité financière (28,5 %). Le niveau d'instruction non scolarisé, le sexe féminin et la situation matrimoniale mariée étaient significativement associés à la satisfaction globale des parents. Les usagers sont satisfaits des services du CM de Kokologho. Cependant, des efforts doivent être faits pour améliorer l'accueil, la rapidité de l'offre de service et l'accessibilité financière

Parents of children with disabilities: a systematic review of parenting interventions and self-efficacy

Background: An increasing body of empirical evidence suggests that early intervention has positive outcomes for parents of children with neurodevelopmental disabilities. Parental self-efficacy has been used as an outcome measure in some empirical studies; however, there is a lack of evidence of the impact of parent training programmes on parenting self-efficacy beliefs. Objectives: This systematic review sought to assess the effectiveness of parenting interventions to increase parental self-efficacy levels in parents of young children with neurodevelopmental disabilities.Method: We conducted a broad literature search, which included grey literature, such as dissertations and unpublished conference presentations, to identify all relevant prospective studies reporting on our study objective. Articles were selected for inclusion using predefined criteria and data were extracted onto a purposely designed data extraction form. Twenty-five articles met our search criteria. We extracted parenting self-efficacy scores before, and on, completion of parenting interventions and performed a meta-analysis using standardised mean difference. We also conducted a risk of bias assessment for all the included studies.Results: Parent training programmes resulted in a statistically significant increase in parental self-efficacy levels(standardised mean difference, 0.60 [95% confidence interval {CI}, 0.38­0.83]; I2, 74%) relative to baseline measurements. Parents of children younger than 5 years demonstrated the highest increase in levels of parental self-efficacy after parenting interventions. Furthermore, this review showed that psychologists and other healthcare practitioners are successfully able to implement training programmes that enhance parenting self-efficacy.Conclusion: Parent training programmes are effective in increasing parental self-efficacy in parents of children with neurodevelopmental disabilities

Challenges faced by parents of children with learning disabilities in Opuwo, Namibia

Background: Parenting children with learning disabilities requires a high level of knowledge and access to resources, information and services.In developing countries, however, these resources and services are not always available. Parents in Namibia, a developing country, therefore face challenges addressing children's learning and other developmental disabilities, including challenges related to preventative and supportive interventions.Objective: This research focuses on challenges faced by parents as they parent children with learning disabilities in Opuwo, Namibia. Method: In-depth interviews were conducted with eight parents regarding the challenges they face in parenting their children with learning disabilities. Thematic analysis enabled the researchers to identify, analyse and report on themes that emerged from the qualitative interview data.Results: Analysis of the interviews indicated that some participants had only a vague understanding of learning disabilities, as they did not have access to essential knowledge about this phenomenon. They also lacked an awareness of the availability of programmes, services and policies meant to benefit their children with learning disabilities. Participants voiced that they, their children with learning disabilities and community members have stereotypes and prejudices regarding learning disabilities. In this study, most of the children with learning disabilities were raised by single, unemployed parents who seemed to have access to less support from external sources than married couples parenting children with learning disabilities. These single parents are usually not married and because of lack of financial support from the other parent, the majority of them indicated that they struggle to meet the financial and material needs of their children.Conclusion: The researchers concluded that the participants in this study experience a range of challenges in parenting their children with learning disabilities. The main challenges emanate from financial instability, as well as lack of knowledge regarding services and programmes for children with learning disabilities. This lack of knowledge on the part of participants could indicate poor policy education by policy implementers at grass-roots level

Mum never Loved me.' How Structural Factors Influence Adolescent Sexual and Reproductive Health through Parent-Child Connectedness: A Qualitative Study in Rural Tanzania

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

Analyse anthropologique de la gestion de la crise d'adolescence par les familles à Yaoundé

L'adolescence est une période de transition entre l'enfance et l'âge adulte. Elle est caractérisée par un changement physique qui peut provoquer un déséquilibre comportemental, pouvant aller jusqu'à des crises d'hystéries, des dépressions ou des trajectoires de violence. Ce passage peut être une période d'affrontement mais aussi d'identification et d'adhésion. Un adolescent en pleine crise doit se sentir exister, quitte à faire des erreurs. Il a donc besoin de l'aide des adultes, qui eux-mêmes à cheval entre la tradition et la modernité, éprouvent quelquefois des difficultés à apporter une réponse efficace aux besoins des enfants en crise. Aussi l'étude s'est-elle proposé d'interroger les stratégies parentales de gestion de la crise d'adolescence à Yaoundé.MÉTHODES. Nous avons mené une étude transversale analytique d'avril 2011 à Janvier 2012 auprès de 256 parents d'adolescents au quartier "Damase" de Yaoundé. Pour ce faire, à l'aide d'un questionnaire direct, structuré, fermé et administré. Les données ont été traitées à l'aide du logiciel SPSS.16, analysées à l'aide du khi² pour la dépendance entre les variables, et de l'odds ratio pour quantifier le risque de survenue de la crise.RÉSULTATS.Les parents étaient peu outillés pour une prise en charge adéquate de la crise d'adolescence grave. Bien que 83,2% d'entre eux ait entendu parler de la crise d'adolescence, et que 62,1% avait su la définir, seul 13,1% d'entre eux avait entendu parler de la crise d'adolescence pathologique, dont 32,4% de parents d'adolescent en crise pathologique. Les adolescents qui vivaient dans les familles recomposées avait 12 fois plus de chance de développer une crise d'adolescence grave que les autres (OR = 0,08). Le mode de gestion le plus utilisé en cas de crise d'adolescence était le modèle traditionnel à travers le style autocratique (42,4%), bien que les libertés individuelles préconisent l'usage du style démocratique. En l'absence de structures d'aides, 19% des parents avaient opté pour le style désengagé, dont 32,2% de parents d'enfants en crise pathologique.CONCLUSION.L'étude suggère une réponse intégrée et intersectorielle à ce problème de santé publique, qui est ancrée dans une famille camerounaise en transformation. Cette réponse apporterait aux parents une aide structurelle complémentaire pour un accompagnement adéquat de cette phase naturelle du développement de l'enfant, y compris la prise en charge efficace de la crise d'adolescence pathologique

Predictors of Parent-Child Communication among a Nationally Representative Sample in Nigeria

This study explores what constructs are associated with parent-adolescent communication about AIDS/sexually transmitted infections (STIs) and sexual relationships in Nigeria. The analyses use data from the 2007 National HIV/AIDS and Reproductive Health Survey on 2593 men and women who had at least one child over the age of 12 years. The respondents were classified as low; medium; or high communicators. Low communicators were parents who did not talk to their child about either AIDS/STIs or sexual relationships. Medium communicators were parents who discussed only one topic with at least one child. High communicators were parents who discussed both topics with at least one child. Logistic regression was used to compare high communicators with low/medium communicators. There are commonalities and differences among men andwomen in the factors associated with parent-adolescent communication. Age; religion; and knowing where to obtain information about HIV/AIDS were associated with the extent of communication; regardless of the parent's gender. Perceived social support was an important correlate for fathers; while knowledge of female STI symptoms showed a significant association only for mothers. Programmatic and communication implications of the findings include addressing men and women differently; developing strategies to specifically reach younger parents and Muslims; and increasing general awareness of HIV/AIDS information resources. Further research is needed to understand the context; content; and timing of parent-adolescent conversations about AIDS/STIs and sexual relationships and how these factors affect the sexual behaviors of adolescents

Parental HIV Disclosure in Burkina Faso: Experiences and Challenges in the Era of HAART

Increasingly parents living with HIV will have to confront the dilemmas of concealing their lifelong treatment or disclosing to their children exposed to their daily treatment practices. However; limited data are available regarding parental HIV disclosure to children in Burkina Faso. Do parents on antiretroviral therapy disclose their HIV status to their children? What drives them? How do they proceed and how do children respond? We conducted in-depth interviews with 63 parents of children aged seven and above where the parents had been in treatment for more than 3 years in two major cities of Burkina Faso. Interviews addressed parental disclosure and the children's role in their parents' treatment. The rate of parental HIV status disclosure is as high as that of non-disclosure. Factors associated with parental disclosure include female sex; parent's older age; parent's marital history and number of children. After adjustment; it appears that the only factor remaining associated with parental disclosure was the female gender of the parent. In most of the cases; children suspected; and among non-disclosers many believed their children already knew without formal disclosure. Age of the children and history of divorce or widowhood were associated with parental disclosure. Most parents believed children do not have the necessary emotional skills to understand or that they cannot keep a secret. However; parents who disclosed to their children did not experience blame nor was their secret revealed. Rather; children became treatment supporters. Challenges to parental HIV disclosure to children are neither essential nor specific since disclosure to adults is already difficult because of perceived risk of public disclosure and subsequent stigma. However; whether aware or not of their parents' HIV-positive status; children contribute positively to the care of parents living with HIV. Perceptions about children's vulnerability and will to protect them against stigma lead parents to delay disclosure and not to overwhelm them with their experience of living with HIV. Finally; without institutional counselling support; disclosure to children remains a challenge for both parents and children; which suggests a need for rethinking of current counselling practices

L'annonce du statut VIH de l'enfant : experiences des meta 232 res et interpretations des soignants au Burkina Faso

Full Title: L'annonce du statut VIH de l'enfant : expe riences des me res et interpre tations des soignants au Burkina Faso (Disclosure of infant HIV status: mothers' experiences and health workers' interpretations in Burkina Faso) L'annonce du statut serologique d'un enfant constitue une situation particuliere qui ne peut pas obeir aux recommandations generales pour le counseling definies pour des adultes; elle est tres peu normee. Alors que les programmes de Prevention de la Transmission Mere-Enfant (PTME) devraient induire environ 700 000 annonces du statut d'enfants nes de meres seropositives chaque annee en Afrique; les effectifs des enfants qui ont ete testes sont beaucoup plus faibles et les conditions de realisation de cette annonce et ses aspects sociaux sur le terrain sont tres peu connus. L'article a pour objectifs de decrire et d'analyser l'experience de l'annonce du statut serologique des nourrissons et enfants a partir d'entretiens realises avec des meres et des equipes de services de PTME au Burkina Faso. La methode a repose sur des entretiens repetes aupres de 37 meres et aupres de professionnels de sante. Leurs propos revelent toute la complexite de l'annonce dans un contexte marque par l'incertitude. Ils montrent d'abord les retards lies aux difficultes des prelevements veineux et aux ecueils des methodes de diagnostic et de gestion de l'information dans les services de soins. Les acteurs de l'annonce ne se limitent pas au medecin du programme PTME; mais relevent egalement d'autres fonctions professionnelles ou institutions. La mere joue un role cle; y compris pour solliciter l'annonce; le pere n'est generalement informe que secondairement; malgre sa responsabilite legale concernant l'enfant. L'analyse des interactions revele certaines ambiguites de l'annonce; a propos des informations que les medecins gardent secretes; des attentes reciproques entre medecins et femmes en matiere de communication; des interpretations que font les meres d'indices concernant la sante de leur enfant; et des situations de transmission d'informations incertaines. Le sens de l'information transmise est souvent charge d'une dimension culpabilisante pour les meres; l'evocation du suivi ulterieur ne tempere pas cet effet. Ces observations conduisent a solliciter l'elaboration d'un modele de conseil (counseling) specifique; qui permette d'apporter aux meres les elements d'information generale; d'interaction personnalisee et de soutien dont elles ont besoin pour gerer l'annonce du statut VIH de leur enfant

Vecu psychologique des parents accompagneurs d'enfant hospitalises en oncologie pediatrique

La survenue d'un cancer chez un enfant entraine de nombreux bouleversements de la structure familiale. Il nous a paru important d'etudier les contours psychologiques de cette situation en milieu hospitalier a Abidjan. L'etude a ete retrospective; descriptive; sur une periode de douze mois. Elle a concerne 30 accompagnateurs majeurs d'enfants hospitalises dans l'unite d'oncologie du service de pediatrie du CHU de Treichville. Les donnees ont ete recueillies a partir des entretiens isoles ou en groupe avec des accompagnateurs et du dossier medical de l'enfant. 33;4 pour cent des parents accompagnateurs ont attribue l'origine de la maladie a un mauvais sort ou a une malediction; pour 66;6 pour cent il s'etait agi d'une maladie comme une autre. Notre objectif a ete de decrire les aspects psychologiques engendres par ce vecu hospitalier afin d'aider a l'amelioration de l'atmosphere autour de l'enfant lors de sa prise en charge

Parental factors and sexual risk-taking among young people in Côte d'Ivoire

Côte d'Ivoire is the country worst affected by the HIV epidemic inWest Africa, and young people in this country are a particularly vulnerable group. This study examined the relation between parental factors and sexual risk-taking among young people using logistic regression and survival analysis methods. Three parental factors (living in the same household as the father during childhood, perceived parental disapproval of early and premarital pregnancy, and parent-child communication about sexual abstinence) were positively associated with primary sexual abstinence (defined as yet to experience sexual debut), secondary sexual abstinence (defined as sexual abstinence subsequent to sexual debut) and reduced number of sex partners. The findings suggest that parental monitoring and control are important predictors of youth sexual behaviours and underscore the need to target parents and guardians in efforts to promote responsible sexual behaviours among adolescents. It is important to promote parent-child communication about sexual issues and empower parents and guardians to communicate effectively with their children and wards about sexual issues