Parental reproductive health education for adolescents in Hanoi city
HNUE JOURNAL OF SCIENCE
DOI: 10.18173/2354-1067.2019-0078
Social Sciences, 2019, Volume 64, Issue 11, pp. 175-185
PARENTAL REPRODUCTIVE HEALTH EDUCATION
FOR ADOLESCENTS IN HANOI CITY
Ngo Thi Thanh Mai
Faculty of Social Work, Hanoi National University of Education
Abstract. As people who have a great influence on the development of children in
general and reproductive health in particular, parents play a big role in educating
their children in this topic. Numerous studies have also confirmed that parents with
effective education will reduce the risk of sexual risk behaviors of children later.
The paper focuses on analyzing survey results on 498 parents at 4 school is in
Hanoi and shows that 72,1% of parents have talked with their children about
reproductive health in the past 6 months, however, the frequency and extent of
communication are still limited. More than a quarter of parents have listened to
their children, but many parents still apply a coercive communication method such
as raising negative situations to deter and preach and educate their children. Parents
also do not have specific instructions for their children on skills. Although the
different topics of reproductive health have been mentioned by parents but the
quality of the discussion is still limited because the level of parents communication
is mostly general and not specific. In order to help parents have better role in
educating their children about reproductive health, parents need supporting to
improve their knowledge and skills in this field.
Keywords: Reproductive health, adolescence, reproductive health education.
1. Introduction
Many studies have been done and proven the influence of parents on sexual
behaviors and reproductive health (RH) of adolescents. According to the National Survey
of Adolescents conducted in 2003 and 2008, parents are prioritized for adolescents share
their story, accounting for the highest proportion (45%), followed by friends (12,8%),
brothers and sisters (4,39%) [1]. This data indicated that there is a close and trusting
relationship between parents and children and this is similar to the opinion of
reproductive health education experts who consider the family to be the environment that
influences the personality of a person and expectations of society and provide knowledge
about reproduction for adolescents [2-5]. Talking about the sexual topic with children is
considered the most effective way to delay the age of first sexual intercourse in
adolescents [6].
Received July 1, 2019. Revised September 6, 2019. Accepted October 11, 2019.
Contact Ngo Thi Thanh Mai, e-mail address: ntmai235@gmail.com
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Ngo Thi Thanh Mai
The purpose of this study was to explore the reality of reproductive health education
activities of parents with children in adolescence at home, the factors affecting education
activities, the need for support of parents in this topic, From that we have a basis for
implementing interventions to support parents.
2. Content
2.1. Methods
To learn about the state of child education about reproductive health in family.
Mixed methods (quantitative and qualitative methods) were used to collect data. We
conducted surveys to 645 parents whose children are attending grades 6 to 9 at 4
survey schools including 2 in the urban and 2 suburban schools. However, only 560
parents responded. In the process of information processing, we have removed 62
sample because it did not meet the requirements of the study. Therefore, the number of
samples for analysis was 498.
Parent opinion is collected at the classroom parent meeting. The parents who
participated in the survey were completely voluntary. However, the proportion of
mothers attending meetings is higher than fathers, therefore, the sample for analysis
does not guarantee gender balance.
Table 1. Characteristics of parents taking part in the survey
Categories
Father
Amount Percentage (%)
174
324
2
34,9
65,1
0,4
Parents Gender
Age
Mother
Under 30 years old
From 30 – 39 years old
From 40 – 49 years old
Over 50 years old
Post-secondary education
Post-graduate
224
242
30
44,9
48,5
6,0
132
102
80
26,5
20,5
16,1
31,5
5,4
Educational level
Intermediate college
High school
157
27
Under high school
Teacher
66
13,3
16,7
5,6
Job
Officer
83
Police, soldiers
Business
28
53
10,6
9,2
Agriculture / Forestry
Freelance
46
81
16,3
176
Parental reproductive health education for adolescents in Hanoi city
Mechanical/construction
Travel / Service
Art
30
1
6,0
.2
1
.2
Banking and finance
Medical
34
4
6,8
.8
Others
71
481
6
14,3
96,6
1,2
1,0
1,2
Married
Marital status
Remarried
Divorce
5
Husband/wife died
6
* Focus Group discussion:
With parent group: We conducted 2 group discussions with parents. The first group
consists of 8 parents whose children are studying in two suburban schools (TD
secondary school and CL secondary school). The second group consists of 8 parents
whose children are studying at two schools in the city (NTT secondary school and DVH
secondary school). The structure of each discussion group is:
+ 4 fathers with children in grades 6, 7, 8 and 9
+ 4 mothers with children in grades 6, 7, 8 and 9
For the children: We conducted 4 group discussions with the children at the 4
schools with the discussion group structure at each school as follows:
+ 4 girls in grades 6, 7, 8 and 9
+ 4 boys in grades 6, 7, 8 and
* In-depth interviews
- 8 in-depth interviews with parents. The in-depth interview parent structure was
divided evenly into 4 surveyed schools and the child's grade level.
- 8 in-depth interviews with you. The sub-structure for in-depth interviews was
divided evenly across 4 surveyed schools and grade levels.
2.2. Results
2.2.1. Where children look when they need information on reproductive health
When children have problems related to reproductive health, they often turn to
trusted people to share, very few parents (only 2,4%) say that children do not share
with anyone.
According to parents' evaluation, parents are person children want to share
when they have the most gender-related concerns when there is a problem. The next
source is friends (accounting for 15,3%). For others, such as teachers, relatives, or
forums, the level of sharing is less, online forums (10,2%) and siblings (10%).
This also corresponds to SAVY's findings that parents are the first one that
adolescents talk with when they at the puberty state at the highest rate of 45%,
followed by friends (12,8%), siblings (4,39%)
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Ngo Thi Thanh Mai
Figure 1. Percentage of places where parents said children shared
when there were concerns about reproductive health
According to research by Pick de Weiss and his colleague (1995), mothers have
more communication with their children than fathers. The survey results also showed
that mothers are the people who children share more than their fathers with 76,9% and
21,7%, respectively [2]. This also seems to be related to the mother's level of
confidence more than the father analyzed above.
2.2.2. The level of parents talking with their children about reproductive health
When parents were asked, “In the last 6 months, did you talk to your children
about reproductive health issues?” Only more than 359/498 parents, about 72,1% of
parents have discussed, while having up to 27,9% of parents did not discuss this issue
with their children. This shows that the communication of parents with their children
about reproductive health is still limited.
Table 2. Percentage of parents who had conversations
with their children about reproductive health in the last 6 months
Amount
Percentage (%)
Father Mother
Total Father
Mother
Total
244
359
23,1
49,0
72,1
Discussed
115
59
80
139
498
11,8
34,9
16,1
65,1
27,9
Haven't discussed
Total
174
324
100,0
* p-value = .029
There is a difference between father and mother in sharing with children. Out of
359 parents who exchanged with their children, 68% of them exchanged as mothers,
only 32% of exchangers were fathers. Testing the correlation between parents and the
practice of exchanging with children shows that p-value is .029 for reliable results.
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Parental reproductive health education for adolescents in Hanoi city
This finding reinforces the above perception that when children have questions about
gender issues, the person they often share is the mother.
2.2.3. Frequency of conversations between parents and their children about
reproductive health care
359 parents reported that: although they talked with their children about
reproductive health topics, the frequency of parents talking with their children on this
topic was still limited. Only 12,5% of parents perform at the level of “Usually” and
27,5% at the “Often”. The “Sometime” level is most often practiced by parents, with the
number of parents approximately ½ being chosen.
Table 3. Frequency of conversations between parents
and their children about reproductive health
Frequency of conversation
Rarely
Amount
40
Percentage (%)
11,1
49,5
27,5
12,5
100
Sometimes
Often
178
99
Usually
Total
45
359
2.2.4. Method of parents to educate their children about reproductive health
The survey results show that the way of “Talking, listening to children's opinions”
is done by parents at the most frequent rate with the rate of 59,6%, followed by is
“Stating the negative consequences related to love, sex at the age of adolescents to deter
children” (34,5%) and the form “Preach, educate children to be careful” (26,5%).
Table 4. Method of parents to educate their children about reproductive health
Activities
Usually
Sometimes
Rarely
Never
No
(%) No
(%) No (%) No (%)
Introduce
sources
of
information
(books,
newspapers, and internet) 64
and let the children find out
for themselves
17,8 168 46,8 50 13,9 77
21,4
Talk around so the children
can
understand
by 49
13,6 146 40,7 50 13,9 114 31,8
themselves
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Ngo Thi Thanh Mai
Stating
consequences related to
love, sex at the age of 124 34,5 158 44,0 17 4,7
the
negative
60
16,7
adolescents
children
to
deter
Preach, educate children to
be careful
95
26,5 141 39,3 50 13,9 73
20,3
5,8
Talking,
listening
to
214 59,6 109 30,4 15 4,2
21
children's opinions
Instruct and practice with
children related skills
70
64
19,5 100 27,9 63 17,5 126 35,1
Share with your child
stories and experiences
about your past relationship
with your spouse
17,8 114 31,8 57 15,9 124 34,5
However, the qualitative survey shows that the method used by parents is more
deterrent than talking to their children openly. The fear of having children with risks
such as being late for school, unwanted pregnancy, and having to drop out of school
has been passed on to their children by their parents during conversations.
“I often tell my children to be careful, to be in love also to be careful. If you fall in
love and become pregnant, you will have to skip school. If you love and don't know
how to take care of them, they will only have terrible results” (Deep interview, 44-
year-old mother, CL school)
“There are so many stories like that! Love then doesn't care about study at all,
jealous fighting. I ban. Just study, it's never too late to love” (Group discussion, 45 -
year-old father, TD school)
Students opinions also show that most of the messages they receive from their
parents also focus on the negative effects of love relationships and deterring children
from avoiding.
“My parents only talk about negativity. My parents said falling in love and then
forgot to study, thinking about lover all the time. Then my parents said that my parents
didn't want to be grandparents soon” (Deep interview, male student in 9th grade,
DVH school).
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Parental reproductive health education for adolescents in Hanoi city
“My mother said that if a girl not picky, then there is no worthy later. Mom told
me to be careful not to fall in love and get pregnant, then embarrass your parents. I
went out with my friend, my mother also reminded. Sometimes I feel very
uncomfortable because my parents do not believe me” (Deep interview, 9th grade
female student, NTT school).
This information is similar to study of Khuat Thu Hong and her colleague (2010)
when it is found that in most Vietnamese families, sexual education is only a warning
and a threat. It is this attitude that makes adolescents not dare to seek answers from
parents whenever they have things to ask [7].
However, a positive sign is that parents have used appropriate ways to
communicate with their children, making them feel comfortable and open to share.
“My dad taught me how to reject my friends when I didn't want to. My friends
invited to go to the internet, then watch porn movies. I don't like it but I find it hard to
refuse because it's difficult. I have asked my dad, he show me how to talk to my friends
so I wouldn't offend them and that I don't be invited anymore. Whenever something is
difficult, the person I think of is my father” (Group discussion, male student in grade 8,
NTT school).
“I would love to hear about how my mother and father love story. My mother said
that she is like me now, sometimes confused about how to handle friends. I find my
mother very understanding” (Group discussion, female student in grade 7, CL school).
Some gender issues are also mentioned by parents.
“My father taught me about the responsibilities of men in relationships. What
should I do to share with girls” (Deep interview, 9th grade male student, DVH
school).
2.2.5. Education content of parents' reproductive health issues with children
Figure 2. Topic reproductive health issues parents have shared with children
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Ngo Thi Thanh Mai
Find out what parents discuss with their children, the results in the table show:
The topic most talked about by parents was “Friendships” (55,4%), followed by
“Puberty and body transformation” (52,6%). The least frequently discussed topic was
“Sexual orientation” (19,2%). It can be seen that despite the various topics covered by
parents, however, the percentage of parents discussing these issues is still limited.
With the most mentioned topic being friends, there were still nearly half of parents not
exchanging. Other important topics still have a large proportion of parents not sharing
with their children such as “Sexual harassment and abuse” (55%), “Love relationships,
children's dating” with (63%)%, “Sexually transmitted diseases” (58,8%)%) or
“Mechanism of pregnancy and childbirth” (72.7%).
The quality of the parent-child talk is still limited. With topics parents talk to their
children, the level of communication is still in “general level”. The two topics that
parents mentioned most specifically and related to their children's issues are
“Friendships” (32,2%) and “Love and dating relationship” (28,2%) is also very
limited.
Table 5. The quality of the parent-child talk
Discussion level
Topics
Specific but
doesn’t go to detail straight to the details
Specific and go
General
123
40
26
Puberty
and
body
transformation
65,1
21,2
13,8
43
25
1
Sexual
orientation
(homosexual, heterosexual,
bisexual, transgender)
62,3
36,2
1,4
112
56,3
68
23
11,6
24
64
32,2
38
Friendships
Love
and
dating
relationship
52,3
56
18,5
28
29,2
14
Mechanism of pregnancy
and childbirth
57,1
28,6
14,3
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Parental reproductive health education for adolescents in Hanoi city
35
25
5
Contraceptive methods
53,8
38,5
7,7
112
27
9
Sexually
transmitted
diseases, HIV / AIDS
75,7
18,2
6,1
The explanations for the “General” explain is that: “Usually I only generally give
them information and let they understand by themselves. Sometimes talking
specifically will make them shy” (Group discussion, father 47 years old, TD school).
“I don't know how to tell my daughter better. For example, you should not love
and get pregnant early, I also tell her that you be careful and don't know what to teach
more. Sometimes her questions make me unable to answer and I also feel that she is not
comfortable with my answer” (Group discussion, 39-year-old mother, NTT school).
Explaining for this, it can be seen the fact that parents feel uncomfortable or
unskilled to be able to communicate more specifically is the main reason that parents
only sharing or respond generally. Parents also worry that children will feel confused
and shy if the stories are too specific and makes it difficult for parents to reach.
However, research shows that if children and parents build a positive, close
relationship, children tend to share with parents more about their problems.
2.2.6. The reasons why parents not talking to their children
Among 136 parents who have not discussed with their children in the past 6
months, we have asked questions to find out the causes and get the following results:
Figure 3. The reasons why parents not talking to their children
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Ngo Thi Thanh Mai
The chart above shows that the cause of the non-communication comes mostly
from the parents. Among many reasons given by parents, the two leading causes are that
parents think that “Children are young, not suitable for exchanging information like
this” (91,9%) and parents are “Too busy and have no time” (77,2%). In addition, many
parents also said that they do not need to discuss because “Their children go to school
and have learned about this topic so they do not need their parents to teach them
anymore” (59,9%)
A very remarkable reason is that 90.4% of parents “do not know how to
communicate with their children” and a not less than 25% of parents think that if they
share about this topic, their children will love and have early sex. However, studies
show that educating children about reproductive health does not increase risky
behaviors, but the knowledge and skills they have will help them delay sex and know
protect themselves. Besides, 8.09% of parents feel ashamed to talk to their children
about this. This is an important information and need interventions to improve the
knowledge and skills of parents.
Thus, not talking to children in the age of in adolescents about reproductive
health issues comes from the perceptions and thoughts of parents, or many parents do
not know the proper way and skills to talk. This shows that it is necessary to have
practical activities to provide knowledge and skills for parents in educating their
children in this topic.
3. Conclusion
Through surveys with parents in Hanoi city, it can be seen that parents have had
practice in educating children about reproductive health at home. However, the
frequency, extent and quality of parent-child conversations on this issue are still very
limited. More than half of parents are adopting a coercive manner, such as raising
negative situations to deter and preach, and educate their children, which are still applied
by many parents. In addition, parents do not have specific instructions for their children
on necessary skills related to reproductive health. The content parents talk about the most
is “Friendships” and “Puberty transforms”. The topic of contraception and sexual
orientation is least mentioned by parents.
With nearly 30% of parents not talking to their children about reproductive health
in the past 6 months, the reason is that parents think that their children are too young to
be taught about it or do not know how to communicate with their children or that parents
are too busy. Besides, ¼ parents are concerned that teaching children about reproductive
health will make them fall in love and early or think that they have already learned
enough at school so they do not need to teach about it at home anymore.
With this situation, it can be seen that parents have not yet clearly shown their
important role in educating their children about reproductive health and helping them to
protect themselves and have healthy relationships. Inadequate knowledge and skills for
parents to feel confident to talk with their children is one of the causes need to be
concerned. Therefore, supporting and providing parents with knowledge and skills about
this topic is a necessary job.
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Parental reproductive health education for adolescents in Hanoi city
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