PARENTAL INVOLVEMENT

Parents play a critical role in promoting healthy behaviors among youth. The roles that parents may play in adolescents’ lives can include guidance on connecting to others, behavior control, respect for individuality and roles in society, modeling of appropriate behavior, and providing for and protecting youth. Parent-child relationships can influence such issues as early sexual initiation, early marriage, substance use, and depression among adolescents. A growing number of programs for adolescents work with parents. Many focus on increasing parent-youth communication, including in regards to reproductive health. Some seek to increase positive parental involvement and monitoring in youth’s lives in general.

A review by the World Health Organization (WHO) identified key roles parents need to play to help protect youth from unhealthy behaviors. The WHO also published a review of existing projects that are working with parents (see links below). Some programs for parents show promising results in improving attitudes, increasing parent-child communication, and decreasing sexual risk-taking by youth. Yet, too few studies have been conducted to warrant firm conclusions about the most effective ways to work with parents so that health outcomes for youth are improved.

Parents also have an important role to play as key stakeholders for youth programs, such as peer education and school-based programs. Involving parents in aspects of these programs may be a valuable way to improve program outcomes and create a more enabling environment.


Programs to Strengthen Parent–Adolescent Communication About Reproductive Health

This systematic review summarized the evidence on the effectiveness of programs designed to increase parent–child communication about reproductive health. The review was used to inform national recommendations on quality family planning services in the United States. Gavin et al found that most programs increased parent–child communication, and several resulted in reduced sexual risk behavior of adolescents (2015).

Let’s Chat: Parent Child Communication on Sexual and Reproductive Health 

This family-based curriculum, developed by the government of Zimbabwe and implementing partners with support from UNFPA, contains 11 units that are designed to enhance parent to child communication on sexual and reproductive health and rights and sexual gender based violence (SGBV) at family and community level (2017).

Role of parents in adolescent sexual activity and contraceptive use in four African countries

Parents have an influence on the sexual and reproductive health of adolescents, but evidence from Sub- Saharan Africa is limited. In this journal article, Biddlecom et al., explore different dimensions of parenting and recent sexual activity and contraceptive use in Burkina Faso, Ghana, Malawi and Uganda (2009).

Helping Parents in Developing Countries Improve Adolescents' Health

This report from the World Health Organization synthesizes a literature review of research on parenting of adolescents in developing countries and discussion from a technical meeting in 2006 of researchers and program representatives. It organizes findings into five key roles for parents, which programs could target to promote and improve adolescent health (2007).


A Review of Studies of Parent-Child Communication About Sexuality and HIV/AIDS in Sub-Saharan Africa

This journal article summarizes the findings from a literature review on parent-child communication in sub-Saharan Africa, including on frequency and content of discussions, factors associated with sexuality communication, communication style and tone, barriers to communication, outcomes, and intervention studies (2011).


Adolescent Sexual and Reproductive Health in Developing Countries: An Overview of Trends and Interventions

This journal article by Hindin et al. summarizes the trends in adolescent reproductive health in developing countries, from early marriage to sexual activity, contraceptive use and pregnancy, and discussing various communication and intervention components—including those working with parents—to advance their health (2009).


Ten Tips For Parents To Help Their Children Avoid Teen Pregnancy

A research-based list of practical tips for parents and adults to help the young people in their lives avoid pregnancy and pass safely through adolescence (2007).


​Resources of interest, but specific to one country: 

Ethiopia:

Adolescent - parent communication on sexual and reproductive health issues among high school students in Dire Dawa, Eastern Ethiopia: a cross sectional study

Assessment of adolescents’ communication on sexual and reproductive health matters with parents and associated factors among secondary and preparatory schools’ students in Debremarkos town, North West Ethiopia

Parent-young people communication about sexual and reproductive health in E/Wollega zone, West Ethiopia: Implications for interventions

Parent-Adolescent Sexual and Reproductive Health Communication Is Very Limited and Associated with Adolescent Poor Behavioral Beliefs and Subjective Norms: Evidence from a Community Based Cross-Sectional Study in Eastern Ethiopia

Tanzania: 

Parent-child communication about sexual and reproductive health in rural Tanzania: Implications for young people's sexual health interventions

Parental control and monitoring of young people's sexual behaviour in rural North-Western Tanzania: Implications for sexual and reproductive health interventions

 

COMMUNITY INVOLVEMENT

Young people's sexuality, sexual behavior, and reproductive health are influenced by the expectations, norms, and practices of peers, parents, and other adults in the communities in which they live. Institutions and informal groups, including religious organizations, schools, and local authorities all influence the roles and responsibilities of young people and their access to reproductive health information and services. Involving members of the wider community, as well as young people themselves, in reproductive health and HIV/AIDS programs is essential in order to build an enabling environment for young people to improve their well-being and health. Involving communities in health outcomes increases the potential to reach youth who are not in school or who are otherwise more at risk (for example, orphans and vulnerable children).
 
Although there is an acute need for community involvement in youth programs, only a handful of studies have attempted to measure the added value of incorporating such participation into youth reproductive health programming. Though an increasing number of such programs exist, community involvement in youth reproductive health and HIV prevention has not yet been well documented. Thus, understanding the value of community involvement in youth reproductive health and HIV programs, including the most effective ways to encourage, support, and sustain community members' participation in such programs, requires more research.


Community-based reproductive health interventions for young married couples in resource-constrained settings: A systematic review

 This review examines the evidence for the effect of community-based reproductive health interventions for young married couples in lower and middle-income countries. The results suggest that multi-layered community-based interventions can improve the utilization of health services, though with limitations (2015).


Effective Strategies to Provide Adolescent Sexual and Reproductive Health Services and to Increase Demand and Community Support

This study is a descriptive review of the effectiveness of initiatives to improve adolescent access to and utilization of reproductive health services (RHS) in low- and middle-income countries. We examined four RHS intervention types: (1) facility-based, (2) out-of-facility based, (3) interventions to reach marginalized or vulnerable populations, (4) interventions to generate demand and/or community acceptance. Results suggest weak but positive effects for approaches that use a combination of health worker training, adolescent-friendly facility improvements, and broad information dissemination via the community, schools, and mass media; no effect of out-of-facility–based strategies, especially for those delivered through mixed-use youth centers that “demonstrated that RHS in these centers are neither well used nor effective at improving SRH outcomes”; positive if mixed effects for demand-generation activities; and positive effects for efforts focused on increasing approval among gatekeepers. The authors conclude that “packages of interventions that train health workers, improve facility adolescent friendliness, and endeavor to generate demand through multiple channels” are likely to be most successful (2015).


The Gender Roles, Equality and Transformation (GREAT) Project

The GREAT project aims to promote gender-equitable attitudes and behaviors among adolescents (ages 10-19) and their communities with the goal of reducing gender-based violence and improving reproductive health outcomes in post-conflict communities in northern Uganda. The full implementation involved multiple interventions aimed at community norm change, including a serial radio drama called Oteka, working with Village Health Systems and health care providers, and a community mobilization approach known as the Community Action Cycle (CAC) (2010-2015).


PRACHAR: Advancing Young People’s Sexual and Reproductive Health and Rights in India

This project, implemented by Pathfinder International in Bihar, India, emphasized a multi-layer approach to improving the reproductive health of youth. This included directly engaging community members to shift gender norms. Evaluation results indicate improvements in age at marriage, contraceptive knowledge, attitudes, and use.


The Role of Community Involvement in Improving Reproductive Health and Preventing HIV Among Young People: Report of a Technical Consultation

Community involvement is considered an important element of most health and development programs. Local knowledge can inform program design when community members are involved from the beginning, and community action extends the reach and scope of interventions. Experience with programs in many sectors has shown that behavior change to improve people's health and well-being requires changes in knowledge and attitudes not only at the individual level but also at the community level. Community-level shifts in attitudes and social norms create a more supportive environment that enables individual to adopt and maintain new behaviors. Community involvement can also create the sense of ownership necessary to sustain behavior change beyond the life of an externally funded program. Involving both youth and adults in communities is particularly important for youth reproductive health (YRH) and HIV programs. Some degree of youth involvement is essential for such programs to function. Greater levels of youth participation may also increase the impact of reproductive health and HIV prevention interventions. Programs for youth that are designed only by adults tend to be based on an idealized view of how young people should behave. Young people's participation in planning, implementation and evaluation is expected to ground programs in the real needs of youth and the support systems they actually use, making interventions more relevant to their intended beneficiaries (2005).


An Annotated Guide to Technical Resources for Community Involvement in Youth Reproductive Health and Prevention Programs

This guide is a compilation of resources, including documents, manuals, and toolkits that provide advice, approaches, and tools for involving community members, including youth in programs focused on youth reproductive health (2006).