Abstract
BACKGROUND: Sexual and reproductive health problems among adolescents in developing countries are increasing significantly. Assessing parent-adolescent communication is crucial for identifying barriers and fostering supportive relationships to help adolescents make informed health decisions. Therefore, this study aimed to evaluate parent-adolescent communication on reproductive and sexual health issues and its determinants. METHODS: A mixed-methods approach combining both quantitative and qualitative was conducted in Gondar town from January 1 to February 28, 2022. The quantitative data were collected from 673 parents of adolescents aged 10-19 years using an interviewer-administered questionnaire, while qualitative data were gathered through seventeen in-depth interviews. Data were analyzed using SPSS version 25 and qualitative data manually analyzed using thematic analysis. Finally, the qualitative and quantitative findings were triangulated for comprehensive insights. RESULTS: Only 266 (39.5%) respondents reported having discussions on reproductive and sexual health issues with their adolescents. A father's occupation as a merchant (AOR = 0.45; 95% CI: 0.29, 0.69), a family size of more than five (AOR = 0.39; 95% CI: 0.23, 0.66), good knowledge (AOR = 4.45; 95% CI: 2.90, 6.84), and a positive attitude toward sexual and reproductive health (AOR = 1.62; 95% CI: 1.15, 2.28) were predictors. Furthermore, qualitative findings revealed that parent-adolescent communication occurs infrequently and is influenced by sociocultural norms, and parents' awareness of sexual and reproductive health issues. CONCLUSIONS: Nearly two in five parents engaged in parent-adolescent discussions on reproductive health issues. These discussions were influenced by a lack of parental knowledge, sociocultural norms, and concerns that such conversations might encourage premarital sex. To address these challenges, national reproductive health programs should focus on community-centered campaigns to raise awareness and equip parents with comprehensive knowledge, while school-based programs should promote healthy adolescent behaviors through age-appropriate health education and life skills training.