Table 3 Analytical themes and meaning

Attributes of Sexual Health Communication

Sub themes: Content, Timing and Frequency, Comfort, Gender differences

Refers to characteristics of sexual health communication and relates to how parents and adolescents describe their experiences of communication sexual and reproductive health issues

“our parents started telling us about sex issues when we were about 12–14 years of age …Our mothers started telling us about these issues because they see us moving in the company of girls in the village… They tell us that our voices have started to be deep and we should not engage in sex with girls but to just be friends with them.”(Muhwezi et al., 2015).-

Adolescent

Example of Timing of sexual health communication (Nambambi and Mufune, 2011)

“I am educated so while telling them about abstinence, unintended pregnancy, and STDs, I also discuss safe sex, boyfriends, condoms, and contraceptives with them. You may not believe it, but I tell them if they ever get pregnant, I should be the first to hear it. This way I do not lose much sleep over them”-Parent

Example of Content (Izugbara, 2008)

Facilitators and Barriers of Sexual Health Communication

Sub themes: Facilitators—importance, perceived benefits, impact on adolescent health

Barriers—Parental factors (Parental absence, self-efficacy, socio-economic status, misconceptions), Trado-cultural norms and religious beliefs, Adolescent factors (Age, fear)

Describes underlying individual and wider level factors that facilitate and hinder sexual health communication between parents and adolescents as inferred from the data

“I do not want any of my daughters to stay in my house and get pregnant. A girl will not get pregnant if she does not have sex. That is why I discuss sex with them from time to time.”- Parent

Example of perceived benefit as a facilitator (Izugbara, 2008)

“The culture doesn’t allow us to talk to children about sex, especially the opposite sex”- Parent

Example of Trado-Cultural norms as a barrier- (Kumi-Kyereme et al., 2014)

Implications for adolescent sexual behaviour

Influence on adolescents’ decision making, Relevance of sex communication

Relates to the relevance of sexual health communication between parents and adolescents, and alternate sources of sexual health information that impact adolescents’ decision making regarding their sexual health

“Because there are so many diseases, and I will get pregnant…I fear it because I have nowhere to go if I get pregnant and also many people at home have high expectations in me”

– Adolescent

Example of influence on decision making (Wamoyi et al., 2010)