Abstract
BACKGROUND: Adolescents and young adults in Senegal face several challenges related to their sexual and reproductive health (SRH). International research shows that family communication on SRH can be a protective factor. However, cultural norms and taboos often hinder communication between parents and young people on SRH. This study explores and assesses the state of communication between parents, adolescents and young adults about SRH in the Kaolack region of Senegal, intending to improve their relationships on the issue. METHODS: We set up a qualitative study consisting of 26 focus group discussions with adolescents and young adults aged 10-24, six focus group discussions with parents, 14 in-depth interviews with adolescents and young adults using SRH services and 17 key informant interviews with SRH service providers and local leaders. All transcripts were analysed using Nvivo 12. RESULTS: The state of parent-child communication about SRH varies from effective but selective communication (on some SRH topics) to no communication at all. Most parents do not feel confident or comfortable discussing certain topics with their children, partly because of what they describe as a culture of embarrassment and taboos regarding SRH. Communication is generally gendered, mostly between daughters and mothers. Communication approaches between parents and adolescents range from advice to commands, and communication on sexuality and contraception is almost non-existent. The results show that parents recognise the need to communicate with their children on various adolescent SRH topics. However, they are ill-equipped to do so. Adolescents and young adults also desire to discuss these issues with their parents, whom they consider to be the "closest to their children". CONCLUSION: Effective communication between parents and their children is necessary, yet it currently remains a challenge for many parents in the studied sites. Our findings complement the literature on adolescent SRH in West Africa, which shows that the parent-child relationship is of paramount importance. The study results informed the design and implementation of an intervention focused on training parents to improve their knowledge, skills and confidence to initiate an open and trustful dialogue with their children and better engage in the SRH of adolescents and young adults.