Daddy knows best? Parental influence on teenagers’ sexual health in the slums of Nairobi

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 564Nairobi slum households.  Restrictingtheir analysis to a sub-sample of never-married adolescent girls aged 12 to 19, they compared the reproductive health outcomes of thosewho lived with neither parent, mother only, father only, or both parents.

The researchers assumed that parents influence the reproductivehealth outcomes of their children through the nature of the parent-childrelationship.  In the Kenyan context, thefather-daughter relationship is assumed to be authoritarian, in which thefather prescribes highly disciplined values to the daughter.  The relationship between the mother anddaughter is assumed to be characterised more bycompanionship, confidentiality and flexibility.

Using these assumptions the researchers found that:

• Where thefather is present, adolescent girls were 42% less likely ever to have hadsex, 59% less likely to ever have experienced an unwanted pregnancy and45% less likely to have been sexually active in the four weeks prior to theinterview.
• Adolescentswho express readiness to ignore parental rules are 3.4 times morelikely to ever have had sex, 4.6 times more likely to haveexperienced and unwanted pregnancy, and 5.4 times more likely to havebeen sexually active in the four weeks before the survey.
• When thefather is present, adolescents are more likely to follow parental rulesthan where only the mother or neither parent is present.
• There isno significant difference between the reproductive health indicators ofadolescents who live only with the mother and those who live with neitherparent.
• Reproductivehealth indicators are similar for adolescents living with only the fatheror with both parents.

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

• There isa need to target and involve parents in provision of adolescentreproductive health services.  
• Girlsliving in single-mother households or without their biological parentsshould be regarded as high risk. 
• Furtherresearch is needed into the reasons for the varying degrees of resiliencefor adolescents in different household structures in the Nairobislums.  In particular, why are adolescentsliving with their fathers more resilient?
• There isa 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 identifiedas crucial in the development of resilience among adolescents in harsh environments,including warmth, affection and high expectations from parents, influence thevariations found in the slums of Nairobi.