In Kenya, reproductive health problems among adolescents derive from practicing early and unsafe sex. The absence or presence of parents can affect the ability of adolescents to protect their sexual health. Research suggests that, in particular, the presence of a father in the home can strongly influence an adolescent's sexual well-being.

Researchers with the African Population and Health Research Center analysed data from a cross-sectional survey of 4 564 Nairobi slum households.  Restricting their analysis to a sub-sample of never-married adolescent girls aged 12 to 19, they compared the reproductive health outcomes of those who lived with neither parent, mother only, father only, or both parents.

The researchers assumed that parents influence the reproductive health outcomes of their children through the nature of the parent-child relationship.  In the Kenyan context, the father-daughter relationship is assumed to be authoritarian, in which the father prescribes highly disciplined values to the daughter.  The relationship between the mother and daughter is assumed to be characterised more by companionship, confidentiality and flexibility.

Using these assumptions the researchers found that:

• Where the father is present, adolescent girls were 42% less likely ever to have had sex, 59% less likely to ever have experienced an unwanted pregnancy and 45% less likely to have been sexually active in the four weeks prior to the interview.
• Adolescents who express readiness to ignore parental rules are 3.4 times more likely to ever have had sex, 4.6 times more likely to have experienced and unwanted pregnancy, and 5.4 times more likely to have been sexually active in the four weeks before the survey.
• When the father is present, adolescents are more likely to follow parental rules than where only the mother or neither parent is present.
• There is no significant difference between the reproductive health indicators of adolescents who live only with the mother and those who live with neither parent.
• Reproductive health indicators are similar for adolescents living with only the father or with both parents.

Higher vulnerability among adolescents living without their father may indicate that fathers are better able to protect their children. Alternatively it may suggest that they chase away pregnant or sexually active daughters, or that economic hardship makes these adolescents more likely to engage in commercial sex. Further policy implications include:

• There is a need to target and involve parents in provision of adolescent reproductive health services.  
• Girls living in single-mother households or without their biological parents should be regarded as high risk. 
• Further research is needed into the reasons for the varying degrees of resilience for adolescents in different household structures in the Nairobi slums.  In particular, why are adolescents living with their fathers more resilient?
• There is a possibility that reproductive outcomes influence living arrangements –that pregnant adolescents may be excluded from the father’s household.

In order to implement effective prevention programmes, it would also be useful to discover whether factors which have been identified as crucial in the development of resilience among adolescents in harsh environments, including warmth, affection and high expectations from parents, influence the variations found in the slums of Nairobi.

Source(s):
‘Parental Presence and Adolescent Reproductive Health among the Nairobi Poor’, Journal of Adolescent Health 33:369-377, by P. Ngom, M.A. Magadi and T. Owuor, 2003

Funded by: The Rockefeller Foundation

id21 Research Highlight: 4 March 2004

Further Information:
Pierre Ngom
Family Health International
PO Box 38835
Nairobi
Kenya

Tel: +254 20 713 911/9
Fax: +254 20 726 130
Contact the contributor: pngom@fhi.or.ke

African Population and Health Research Center

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