Straight Talk Campaign in Uganda:

Parent Survey

Karusa Kiragu1, Cathy Watson2, Medard Muhwezi3,

Richard Kibombo4, Tobey Nelson5, Ann Akia-Fiedler3,
and Milka Juma6

1
Horizons/PATH, Nairobi
2
Straight Talk Foundation, Uganda
3
Formerly Straight Talk Foundation, Uganda
4
Makerere University, Uganda
5
Horizons/International Center for Women, Washington DC
6
Formerly Horizons, Nairobi
 Acknowledgments

The principle investigators for this study were Karusa Kiragu (Horizons/PATH, Nairobi), Tobey Nelson
(Horizons/ICRW, Washington DC), Ann McCauley (formerly with Horizons/ICRW, Washington DC),
and Milka Juma (formerly with Horizons/Population Council, Nairobi). This report was prepared by
Karusa Kiragu. Data collection was supervised by Richard Kibombo, an independent statistician consultant
at Makerere University. Scott Geibel (Horizons/Population Council, Nairobi) was the data analyst for the
study. Alison Lee (consultant, Washington DC) copy-edited the report, and Sherry Hutchinson
(Horizons/Population Council, Washington DC) oversaw the layout.

The research team would like to thank Straight Talk Foundation (STF) for their exceptional support
including Cathy Watson (STF Director), Anne Akia Fiedler (formerly STF Programme director), Medard
Muhwezi (formerly Head, Monitoring and Evaluation Section, STF), and the entire Monitoring and
Evaluation Section.

Special appreciation is extended to the adolescents and parents who answered the questions in this study.
The authors are grateful to the United States Agency for International Development (USAID-Uganda) and
the Department for International Development (DFID) for funding this evaluation.

This publication was developed and produced by the Horizons and Straight Talk Foundation research
teams. This document was reviewed by members of the research team but it did not receive an external
technical review. The information, findings, and recommendations expressed herein do not necessarily
represent the views of Horizons/Population Council. This document is one of four background documents
to the final report, “The Straight Talk Campaign in Uganda: Impact of Mass Media Initiatives,” which can
be accessed at www.popcouncil.org/pdfs/horizons/UgandaStraightTalk.pdf.

This study and final report were made possible by the President’s Emergency Plan for AIDS Relief
and the generous support of the American people through the United States Agency for International
Development (USAID) under the terms of Cooperative Agreement No. HRN-A-00-97-00012-00.
The contents do not necessarily reflect the views of USAID or the United States Government.

Published in September 2007.

This study was also supported by a grant from the UK Department for International Development.

This document may be reproduced in whole or in part without permission of the Straight Talk Foundation provided full source citation is
given and the reproduction is not for commercial purposes.
 Table of Contents

Abbreviations

Abstract 1

Introduction and Background 2

Definition of exposure to STF materials 2

Methods 4
Sample design 4
Ethical clearance and gatekeeper approvals 4
Study tools and administration 4
Interviewer training and data collection 4

Data processing and analysis 5

Limitations of the survey 5

Results 6
Exposure to ST materials 7
Utilization of Parent Talk 7
Utilization of Straight Talk and Young Talk newspapers 7
Utilization of Straight Talk radio 7
Parent-child communication 8
Attitudes toward gender 9
Attitudes toward teaching adolescents reproductive health education in school 11
Knowledge 12
HIV testing 13

Conclusions and Discussion 14

References 16
 Abbreviations

ABC Abstinence, Be faithful, Use condoms

AGI Alan Guttmacher Institute
ASRH Adolescent sexual and reproductive health
BCC Behavior change communication
EA Enumeration area
GYC Gulu Youth Centre
HIV/AIDS Human Immunodeficiency Syndrome/Acquired Immune Deficiency Disease
OVC Orphans and vulnerable children
PT Parent Talk
PMCT Prevention of mother to child transmission (of HIV)
ST Straight Talk
STD Sexually transmitted diseases
STI Sexually transmitted infection
STF Straight Talk Foundation
UBOS Uganda Bureau of Statistics
UDHS Uganda Demographic and Health Survey
UNCST Uganda National Council for Science and Technology
USAID United States Agency for International Development
UHSBS Uganda HIV/AIDS Sero-Behavioral Study
VCT Voluntary counseling and testing
YT Young Talk
 Straight Talk: Parent Survey

Abstract

The purpose of this study was to assess how Ugandan parents are using Straight Talk Foundation
materials designed for their adolescent children as well as for themselves. The materials comprise of a
weekly multi-lingual radio program for adolescents, a monthly multilingual newsletter for older
adolescents, a quarterly English language newspaper for younger adolescents, and an English
language newspaper for parents. The parent newspaper, Parent Talk, was launched in June 2004 and
at the time of the survey, only three issues had been published. Since 2006, STF has been
broadcasting multi-lingual radio programs for parents, and has also launched multi-lingual versions of
Parent Talk. However, these were not in existence during the evaluation and are therefore not
addressed in this report.

A total of 678 mothers and fathers with children between the ages of 10 and 19 years of age were
interviewed in six districts in Uganda through a house-hold survey. In four of those districts, STF has
more intensive activities and are therefore termed as high intensity districts. Data were collected in
August 2005 using a face-to-face questionnaire. The results show that many parents are familiar with
STF activities, and about 60 percent are exposed to the materials. Parents in high intensity districts are
twice as likely to report exposure as those in low intensity districts (65 percent vs 35 percent). Fathers
have more access to STF materials than mothers but being in a high-intensity district equalizes this
gap. About 16 percent of parents had read Parent Talk newspaper; among these, 62 percent had taken
some action as a result and nearly all would recommend it.

Half the parents have ever talked to their adolescent-age children about reproductive health, but 55
percent would prefer that the child go elsewhere for this information. Three quarters feel schools
should teach their children family planning and two thirds feel they should teach about condoms.
Results show an association between parental communication during the respondent’s adolescence,
and whether s/he had ever talked to their adolescent child now: respondents whose own parents had
ever talked with them when they were teenagers were twice as likely to also talk with their own
children. There is also direct correlation between residing in a high-intensity district and having talked
with the child, with 40 percent of those in low-intensity districts having had such a talk compared to
56 percent of those in high-intensity districts.

Parents appear to possess attitudes that may socialize their daughters into male subservience and their
sons into female dominance. For example, nearly a third seemed to feel that boys should be favored in
case of scarce resources, about the same proportion seem to question the intellect of girls relative to
boys, about 40 percent seem to imply that wives should tolerate abuse from husbands, and about half
feel that men should be the final decision makers in terms of sexual activities.

In summary, the study demonstrates that parents are an important audience for STF materials and a
significant proportion uses them. Those who use them seem to like them and so efforts to promote
them to parents may be worth the while. The data also suggest that parents need considerable help
talking with their children, and STF’s efforts to assist them would be greatly welcomed.

1
 Introduction and Background

It is normally expected that parents should socialize their children appropriately and help them
navigate the transition from adolescence to adulthood. Discussions between parents and children
about sexual issues can clarify expected behavior, enable parents to communicate their values, and
provide a chance to educate and inform the child. While some studies have mixed results, most
research shows that parent-child communication is associated with healthier sexual decision making,
delayed onset of sex, and greater likelihood of having protected sex among those who are sexually
active. Parent-child communication can foster a sense of caring between parents, create a supportive
environment, and strengthen the connectedness between parents and children.

The Straight Talk Foundation (STF) has been working in Uganda since 1993, as a voice for
adolescents. It has been implementing a wide array of audience-driven activities to communicate with
adolescents, and to help them re-script their lives into healthier adults. It does this through multi-
lingual Straight Talk (ST) radio programs, multi-lingual ST newspapers for older adolescents (those in
secondary schools), and Young Talk (YT) newspapers for younger adolescents (those in primary
schools). While initially focused on adolescents, STF has increased its activities for parents, teachers
and other adults significant to the lives of Ugandan adolescents. Many STF products address parents
directly or indirectly. They also encourage adolescents to talk with their parents.

In June 2004, STF embarked on an English language newspaper Parent Talk, specifically for parents.
This was followed in 2006 by prints in four other languages. In 2005, STF also started to broadcast
half-hour parent-centered weekly radio programs, also called Parent Talk. Parent Talk radio now airs
in six languages: Luganda, 4Rs, Lukonzo, Lugbara, Lwo and Lumasaba. In addition to promoting
healthy parent-child issues, Parent Talk activities also promote parent-specific topics such as healthy
living and the Basic Care package that has been shown to reduce mortality and morbidity especially
among those infected with HIV. Through scripts, the radio programs address general adult issues,
including parenting. Parents are also being encouraged to form Parents Clubs. STF also conducts
activities in schools, focusing on training teachers to foster a youth-friendly school environment.

In 2005, STF and Horizons/Population Council undertook on a cross-sectional household survey to

document the impact of STF programs on adolescents. An important component of this evaluation
was also to assess the extent to which parents used STF materials and what they thought of them. STF
also wished to assess parental knowledge and attitudes, in order to develop responsive activities.
Therefore a nested parent survey was included, and this report presents its findings.

Definition of Exposure to STF Materials

The main STF materials being assessed in this study are a) Parent Talk newspaper; b) ST radio
programs, and c) ST or YT newspapers. Parent Talk radio was not yet under way and is therefore not
included in this report. In order to assess the dose-response association between exposure to STF
materials and the study outcomes, parents have been classified into four groups: a) those not exposed
to any item, b) those exposed to one item, c) those exposed to two items and d) those exposed to all
three items.

A second measure of exposure will be media intensity at the district level (see Box 1 below). STF has
been implementing its activities at varying levels of intensity in different districts; the variations are
largely limited by funding shortage. As Box 1 shows, all districts receive the English STF and the

2
 Straight Talk: Parent Survey

English YT1 newspaper. They also receive the weekly English STF youth radio show. In addition, four
districts, Apac, Arua, Ntungamo, and Soroti receive weekly half hour radio shows in their local
language. They also receive occasional local language versions of the ST newspaper. This varying
response has provided a natural experiment whereby some districts have more activities than others.
For the purpose of this study, districts receiving just the English newspapers and radio show are
characterized as “low intensity”. Those receiving the English language papers and radio shows, AND
also receiving local language newspaper and radio show, are characterized as high intensity. Thus the
main difference between low and high-intensity districts is the presence of local language
programming in the high intensity districts.

Box 1 Definition of district media intensity by parental exposure to STF materials

High intensity districts(Apac, Arua, Low intensity districts
Ntungamo, and Soroti) (Kamuli and Kisoro)

Radio English Straight Talk program English Straight Talk program

Local language Straight Talk program None

Newspapers Young Talk (English) Young Talk (English)

Straight Talk (English) Straight Talk (English)
Local language Straight Talk None

1
YT newspaper is only published in English language.

3
 Methods

Sample Design

A more detailed explanation of the survey and its methods is found on the evaluation’s full report 2.
The survey targeted 2,160 never-married adolescents ages 10 to 19 years in six districts: Apac, Arua,
Ntungamo, Kamuli, Kisoro, and Soroti. These districts were selected to provide a diverse geographic
distribution of ST activities. In about a third of households, a parent or guardian was targeted for
interviewing, generating a sample of 736 parents. During data cleaning, 58 questionnaires were
eliminated due to missing information. Thus this report is based on the remaining sample of 678
parents. Interviews were structured so as to generate a 50/50 gender balance. The parents’ interviews
occurred only in households where an adolescent had been interviewed, in order to facilitate the
relevance of the questions.

The study was conducted in two counties in each district, for a total of 12 counties. Within each
county, a sub-county, parish and eventually enumeration area was identified using random sampling
procedures. The enumeration areas were based on the Uganda Bureau of Statistics (UBOS) system.
The STF survey used the same list recently compiled for a household survey of adolescents conducted
by ORC/Macro and Alan Guttmacher Institute (AGI) (Neema et al. 2006).

Ethical clearance and gatekeeper approvals

The questionnaires and consent forms were approved by the Uganda National Council for Science and
Technology (UNCST). The study protocol had also been reviewed and approved through Horizons’
ethical review procedures. In each district, the study also sought the approval of district officials,
community gatekeepers, and others as appropriate. Each respondent interviewed in the study provided
written informed consent prior to commencement of the interview. Parental/guardian consent was also
obtained for all adolescents participating in the study, regardless of age. The questionnaires and
consent forms were stored separately in order to ensure no identifying information could be linked.

Study tools and administration

Parents were interviewed at their homes using face-to-face questionnaires. Each questionnaire took
about 30 minutes to complete. The questionnaires were translated into six languages: Ateso, Luo,
Lugbara, Lusoga, 4Rs, and Rufumbira. They were administered by interviewers fluent in the local
language. The questionnaires were pre-tested and revised twice before data collection. They were also
reviewed by the data entry team, in order to identify problems that could hamper data entry.

Interviewer training and data collection

Interviewers were trained over a four-day period, in August 2005. Sixty enumerators and 12
supervisors, including six STF monitoring and evaluation staff, were trained. Most of the enumerators
were university students or graduates who had conducted interview research before, and many had
worked with UBOS. Training topics included the research objectives, interviewing skills, household
listing, respondent selection, call-backs, quality control, obtaining consent, and ethics in research. The
2
The full report is available on the Straight Talk Foundation web site at http://www.straight-
talk.or.ug/downloads/downloads.html.

4
 Straight Talk: Parent Survey

interviewer training included a field practicum, after which the questionnaire was revised, finalized,
and printed. In each district, the research team comprised about ten interviewers and a supervisor.
Supervisors received training covering household listing, household selection, field work
management, and other aspects to enhance quality control. Because a purpose of the evaluation was
capacity building, STF staff from the Monitoring and Evaluation department was involved in all
aspects of data collection and fieldwork supervision. Data collection started on August 29, 2005 and
ended on September 7, 2005.

Data processing and analysis

Once the data were collected, the supervisor reviewed the questionnaires and identified any problems
needing correction. At the end of the day, the supervisor collated the questionnaires and entered them
into a data collection registry. Each batch of questionnaires identified district, county, sub-county, and
parish of origin. The consent forms were also collected, labeled, and stored in separate envelopes. The
items were stored in a secure and locked box or room and prepared for shipping to Kampala for data
entry.

Data entry at STF premises began as soon as data collection was over, using EPI-DATA software
version 3.02. The questionnaires were keyed twice to minimize data entry errors. Technical support
for the data entry process was provided by a Makerere University statistician with input from the
Horizons data analyst. Data cleaning yielded 58 unusable questionnaires, reducing the sample to 678
parents. Data were analyzed using SPSS v. 11 and STATA v 9.0 software. Data analysis included
univariate and bivariate methods.

Limitations of the survey

An important limitation of this study is the representativeness of the sample at the district level.
Because the survey did not purport to provide district estimates, no proportionate allocations were
attempted. Therefore conclusions at the district level should be made with caution. A second
limitation was social desirability bias. Even though respondents were informed that the interview was
confidential and anonymous, and each respondent was interviewed in private, it is possible that some
of them gave socially desirable answers. The final limitation derives from the fact that this was a
cross-sectional survey. Therefore it cannot provide evidence of “causality”. Rather it provides
evidence of associations between outcome and predictor variables. The reader is alerted to keep these
limitations in mind.

5
 Results

Among the 678 respondents in the sample, 336 (50 percent) were fathers and 342 (50 percent) were
mothers (see Table 1). They had an average of 6.2 children, which included 6.8 among fathers and 5.5
among mothers (data not shown). Further analysis of family size documented that an average of 2.8
children were between the ages of 10 and 19 years.

When asked about the relationship to the adolescent who was also interviewed, 44 percent of the
respondents indicated the child was their son, 40 percent indicated the child was their daughter, and
16 percent indicated that the child was an “other relative” (grandchild, niece, nephew, brother, sister,
etc.). The majority of respondents (75 percent) resided in rural areas and had lived at their current
resident for over 20 years. About 80 percent had primary or less education, and only 22 percent were
employed outside the home.

Table 1 Demographic characteristics of the respondents

Characteristics Males Females All
(n = 336) (n = 342) (n = 678)
Mean age in years 46.4 39.0 42.8
% reside in urban area 24.1 26.9 25.5
Mean number of years at current residence^ 24.7 16.8 20.5
% employed outside home 28.4 16.5 22.4
Highest level of education
Never attended school 19.1 39.4 29.3
Primary 51.5 47.4 49.4
Secondary and over 29.5 13.2 21.3
% Christian 84.2 82.6 83.4
% married 95.8 76.3 86.0
% living with partner if married 97.8 87.0 93.1
Mean number of children 6.8 5.5 6.2
Mean number of children ages 10-19 3.0 2.7 2.8
District of residence
Low ST intensity district 35.4 34.8 35.6
High ST intensity district 64.6 65.2 64.4
Intensity of exposure to ST materials
Not exposed 34.8 44.4 39.7
Exposed to 1 item 21.1 27.2 24.2
Exposed to 2 items 29.8 21.9 25.8
Exposed to 3 items 14.3 6.4 10.3

^Excludes those who said “always resided here”, i.e., 31.4 percent of men, 23.9 percent of women, and 27.7 percent of all.

6
 Straight Talk: Parent Survey

Exposure to ST Materials

As mentioned earlier, parents were classified by the level of intensity with which ST activities were
being implemented. Based on this classification, about two-thirds of parents resided in districts
considered “high intensity” ST districts (see Table 1). Parents were also asked if they had ever been
exposed to any ST materials, specifically: a) Parent Talk newspaper, b) ST’s newspapers for
adolescents (i.e., Young Talk or Straight Talk), or c) Straight Talk radio programs. Parent Talk was
still relatively new, having been started the year before the survey in 2004, and only three issues had
been distributed by then (one on parent-child communication, the other two on couple
communication).

About 16 percent had been exposed to Parent Talk, 41 percent to Straight Talk or Young Talk
newspapers, and 55 percent to the Straight Talk Radio programs. These responses were further
combined and classified as exposed to 0, 1, 2, or 3 ST items. Using this classification, the data show
that 40 percent of the parents had never been exposed to any ST materials, while 10 percent had been
exposed to all three items (see Table 1). About 65 percent of parents in high intensity districts are
accessing STF materials, compared to 35 percent of their counterparts in low-intensity districts. While
fathers are more likely to access STF materials in general compared to mothers (65 percent vs 56
percent), the differences narrow in high-intensity districts, and fathers are just as likely to access STF
materials as mothers. Thus activities in high intensity districts seem to allow mothers to catch up with
fathers.

Utilization of Parent Talk

The 82 parents who had read Parent Talk were further interviewed to document their use of the
magazine. About 21 percent had read Parent Talk every time or almost every time, 34 percent had
read “a few times,” and 45 percent “rarely.” When asked what kind of information readers obtained,
82 percent said they learned about how to talk to their children, and about parent-child relationships.
About 62 percent (52 parents) said that they took some type of action as a result of reading Parent
Talk. The most common action was talk to other parents/friends (39 percent), talk with child’s friends
(17 percent), recommend the magazine to someone (17 percent), or talk with spouse (13 percent).
Nearly all readers (96 percent) said they would recommend Parent Talk to other parents.

Utilization of Straight Talk and Young Talk Newspapers

The 41 percent (n=270) of respondents who knew of ST or YT newspapers were asked how they
learned about them, and 30 percent said through the radio, 27 percent said through their children, 22
percent said from other parents, and 9 percent said from the newspapers. When asked whether they
had ever recommended the newspapers to the child being interviewed, 66 percent said they had, 29
percent said they had not, and 5 percent said the adolescent already read them.

Utilization of Straight Talk Radio

The 55 percent (n=367) of parents who listened to Straight Talk Radio were asked whether they had
ever taken any action as a result of the exposure, and 62 percent said they had. For most (90 percent),
the action comprised talking to their children.

7
Parent-child Communication

Parents were asked which one person they thought their children would feel most comfortable talking
to “about growing up, relationships, and sexual matters.” About 39 percent felt that the child would
prefer talking to the respondent himself/herself, and 12 percent thought the adolescent would prefer
the other parent. Thus, about half preferred themself or the other parent to talk to the child. The rest,
or nearly half the parents, believed that their children would feel most comfortable talking to other
individuals about sex, and not themselves.

Parents were also asked who they preferred the child talk to about these issues and 29 percent said
they would prefer that the child come to them, while 16 percent preferred the child go to the other
parent. Thus 45 percent of parents preferred that their child come to them or to the other parent. When
asked to specify who, if not the parent, they preferred their child to go to, those who preferred this
option specified aunts/uncles (10 percent), teachers (8 percent), or brothers and sisters (8 percent) to
talk to the adolescent. Put together, the data suggest that the majority of parents, i.e., 55 percent,
prefer that someone else, rather than themselves, assume the role of educating their children about
sexuality and reproductive health.

Table 2 Parent-child communication

Respondents’ characteristics Percent ever Among talked (n = 344)
talked to child mean age at which talked
Sex
Fathers 50.5 12.1
Mothers 51.3 11.9
Schooling status
No schooling 50.5 11.9
Primary 47.5 11.7
Secondary 59.4 12.6
Current residence
Urban 54.1 12.4
Rural 49.8 11.8
District type
Low intensity 40.8* 12.2
High intensity 56.4* 11.9
Intensity of exposure to ST materials
Not exposed 40.2* 11.8
Exposed to 1 item 58.0* 11.8
Exposed to 2 items 57.1* 12.0
Exposed to 3 items 60.0* 12.2
All respondents 50.9 12.0

* Association between ST exposure and outcome significant at p < 0.05

Parents were also asked whether they had ever talked with the adolescent being interviewed about
“issues related to sexuality,” and half (51 percent) said they had (see Table 2). This is consistent with
the finding that about half the adolescents said that they had held such a discussion with their parents
(see study full report). There was a correlation between residing in a high-intensity ST district and the
parent having talked to the adolescent (p = 0.00). There was also an association between ST exposure

8
 Straight Talk: Parent Survey

and having talked to the adolescent as well (p = 0.000). The average age at which such a conversation
started was when the adolescent was 12 years old. On average, those who had talked to their children
during the year had done so an average of 4.2 times (range 0–20 times), and about half of these had
had a conversation in the previous week (data not shown).

When asked who started the conversation, 92 percent of parents said they did, and 90 percent said
they thought the discussion was very helpful. When asked what the adolescent thought about the last
discussion, 69 percent of the parents said that the adolescent was “happy it had happened,” 13 percent
said the adolescent was unhappy, and 18 percent could not determine.

Parents who already talk to their children appeared confident and comfortable doing so: over 96
percent said they felt “very comfortable” or “comfortable,” 97 percent reported feeling confident
about their ability to hold these talks, and 97 percent considered themselves well-informed and
knowledgeable enough to hold these discussions.

All respondents were asked whether they had ever talked to their own parents about sexual matters
when they were teenagers themselves, and 42 percent had, 56 percent had not and 2 percent could not
remember. There was an association between parental communication during the respondent’s
adolescence, and whether s/he had ever talked to their adolescent child now: 54 percent of those who
said their parents had talked to them had also talked with their child, compared to 29 percent of those
who said their parents had not talked to them (p = 0.000).

Attitudes Toward Gender

Parents were read a series of statements on gender, in order to document their opinions. They could
agree with the statement, disagree, or say they cannot decide. The results are presented in Table 3 and
show that many parents possess attitudes that may socialize their daughters into male subservience
and their sons into female dominance. For example, when read the statement, “If money is scarce and
the family cannot send all children to school, boys should be sent before girls,” 26 percent agreed,
with no sex differences. However, respondents in high intensity ST districts had more gender-
equitable responses than those in low intensity districts. There was also a strong correlation between
exposure to ST materials and possessing more gender equitable responses. A similar pattern was
observed with other statements: for example, when read the statement, “Girls are generally not as
intelligent as boys,” this time 27 percent agreed with the statement, again with no differences between
mothers and fathers. The correlation between gender-equitable responses and ST exposure was also
evident in this question even though it did not reach statistical significance.

Respondents were also read statements assessing the extent to which they would accept domestic
violence against women (see Table 3). The results show that 66 percent of respondents agreed with
the statement that “women should tolerate abuse from her husband in order to keep the family
together”, with mothers themselves more likely to agree so than fathers. There was no correlation
between abuse tolerance and exposure to ST activities (ST materials had not addressed domestic
violence among adults). When read the statement, “There are times when women deserve to be
beaten,” 35 percent agreed, with mothers as likely to agree as fathers. There was no association
between ST exposure and responses to this question.

The data also suggest that many parents harbor attitudes that could socialize males into domination.
For example, when read the statement, “When it comes to sex, it is the man who should have the final
word,” 47 percent agreed, with only minor sex differences. Exposure to ST materials was associated
with more egalitarian attitudes, but only at the highest level, suggesting that these opinions are deeply

9
Table 3 Attitudes

Respondents’ % agree that % disagree % agree that girls % agree that a % agree that % agree that % disagree that % disagree that % agree that in % disagree that Summary of
characteristics when money that it is OK are generally not woman should when it there a girl who it is ok for girls Uganda, men who a school boy gender score
is scarce and for boys to as intelligent as tolerate abuse comes to there are times becomes to have sex have many women who makes a (out of 10
the family have sex boys from her sex, it is the when women pregnant while before marriage are considered schoolgirl possible points)
cannot send before husband in man who deserve to be in school should “powerful” pregnant should
all children to marriage order to keep should have beaten by their be expelled be expelled from
school, boys her family the final husbands school
should be together word
sent before
girls
Sex
Fathers 23.6 92.8 25.9 62.3* 44.0* 34.5 39.4 93.7 24.2* 45.5 6.3*
Mothers 28.5 94.1 27.9 70.4* 49.4* 34.4 30.9 92.3 21.1* 38.9 5.9*

Schooling status
No schooling 33.0* 94.4 30.6 66.2 52.8* 32.3 27.4* 92.4 26.7* 33.2* 5.6*
Primary 26.7* 93.1 27.0 69.5 50.9* 37.0 34.2* 93.4 23.3* 43.1* 6.0*
Secondary or more 16.7* 93.0 22.2 39.7 29.9* 31.5 46.9* 93.0 16.1* 51.7* 6.9*

Current residence
Urban 15.7 95.4 17.4* 64.5 40.4 32.7 37.2 92.4 18.1 41.9 6.5*
Rural 29.5 92.8 30.2* 67.0 48.9 35.1 34.4 92.3 24.2 42.3 6.0*

District type
Low intensity 28.2* 91.6 28.3 69.8 41.6* 33.2 33.9 93.3 26.5* 36.9 5.8*
High intensity 24.8* 94.5 26.2 64.5 49.5* 35.2 35.8 92.9 20.6* 45.1 6.2*

Intensity of exposure
to ST materials
Not exposed 31.7* 91.4 28.7 70.8 48.5* 33.3 31.0* 91.8 27.1* 38.1* 5.7*
Exposed to 1 item 25.2* 93.9 27.0 63.4 51.2* 36.0 30.9* 94.4 18.8* 38.1* 6.1*
Exposed to 2 items 25.6* 96.0 29.7 62.1 46.6* 34.7 39.4* 93.7 23.4* 43.4* 6.3*
Exposed to 3 items 8.6* 94.3 12.9 67.1 30.0* 34.8 50.0* 92.9 12.9* 64.3* 7.2*

Straight Talk: Parent Survey

All respondents 26.0 93.5 26.9 66.4 46.7 34.5 35.1 93.3 22.7 42.2 6.1
*Association between ST exposure and outcome significant at p < 0.05; statistical significance could be reflecting variations in “agree”, “disagree” or “cannot decide”.

10
 Straight Talk: Parent Survey

engrained. When read the statement, “In Uganda, men who have many women are considered
powerful,” 23 percent agreed, again with only minor sex differences. These data suggest that large
proportions of parents in the survey held views conducive to serious gender inequities, inequities that
could leave both their sons and daughters at great risk for HIV.

In order to assess gender variation in the acceptability of premarital sex, respondents were read the
statement, “It is OK for boys to have sex before marriage.” Nearly all (94 percent) disagreed,
suggesting strong opposition to premarital sex among adolescent males (see Table 3). Similarly, they
were read the statement “It is OK for girls to have sex before marriage,” and again, nearly all (93
percent) disagreed. Respondents were also read a statement to explore attitudes toward pregnancy-
related school expulsion and whether they had different attitudes toward pregnant schoolgirls and
schoolboys who made schoolgirls pregnant. The first statement was, “A girl who becomes pregnant
while in school should be expelled.” About 35 percent of the parents disagreed with this statement,
with sharp differences by education and exposure to ST materials. When asked the same of boys (“A
schoolboy who makes a schoolgirl pregnant should be expelled”), 42 percent disagreed, also with
sharp differences by education level and exposure to ST materials. Put together, the results suggest a
less punitive response to school-related pregnancies. But the results also indicate parents are more
willing to allow the boy to remain in school than the girl.

An aggregate gender score was developed by awarding a point for each response that demonstrated
gender equity. The ten questions in Table 3 were used to construct the scale and points ranged from 0
(strongly gender biased) to 10 (strongly gender equitable). The mean score was 6.1, suggesting a just-
above-average level of gender-equitable attitudes. There was a strong correlation between ST
exposure and the gender score: respondents in high ST intensity districts had a gender score of 6.2,
compared to those in the low intensity district with a score of 5.8 (p = 0.000). There was also
relationship between number of items a respondent had been exposed to and the mean score: mean
score for those exposed to 0 items was 5.7, those exposed to one item was 6.1, those exposed to two
items was 6.3, and those exposed to three items was 7.2 (p = 0.000).

Attitudes Toward Teaching Adolescents Reproductive Health Education in

School

Parents were asked whether they thought adolescents should be taught various topics in school. The
overwhelming majority of parents (94%) felt that their children should be taught about HIV/AIDS,
abstinence (92 percent), and being faithful (86 percent). The majority also felt that their children
should be taught about family planning in school (74 percent), boy-girl relationships (72 percent), and
sexuality (70 percent). About two-thirds (66 percent) felt that their children should be taught about
condoms in school (see Table 4).

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Table 4 Percent who agree that young people should be taught the following topics
Respondents’ Family Sexuality HIV/ Condoms Abstinence Being Boy-girl
characteristics planning AIDS faithful relationships
Sex
Fathers 77.4 70.3 93.7 64.3 93.9 87.8 70.0
Mothers 71.0 70.2 94.7 68.2 89.2 85.0 74.5
Schooling status
No schooling 75.3 68.5 90.8 65.3 89.6 87.1 69.6
Primary 74.2 69.8 95.2 66.7 92.4 84.9 70.9
Secondary or more 72.0 73.9 96.5 64.3 93.0 88.9 78.9
Current residence
Urban 66.1 70.8 96.0 68.4 91.2 86.0 74.3
Rural 76.9 70.0 93.6 65.6 91.7 86.5 71.6
District type
Low intensity 73.0 65.8 93.1 66.7 90.7 86.9 67.4*
High intensity 76.3 72.8 96.2 66.1 93.2 86.1 75.0*
Intensity of exposure to
ST materials
Not exposed 75.4 66.9 94.4 66.0 91.3 84.2 68.2
Exposed to 1 item 72.7 68.4 92.0 61.0 88.7 83.7 70.0
Exposed to 2 items 73.6 74.4 93.7 69.5 92.0 89.7 78.2
Exposed to 3 items 74.3 75.7 100.0 71.4 98.6 92.9 78.6
All respondents 74.1 70.2 94.2 66.2 91.6 86.4 72.3

* Association between ST exposure and outcome significant at p < 0.05

Knowledge

Six true/false questions were included in the questionnaire, to document the level of knowledge
among parents. They comprised the following (percent correct shown in parenthesis):
A person can get the AIDS virus by having sexual intercourse without a condom (81 percent).
A person who looks healthy can be infected with the AIDS virus (90 percent).
The AIDS virus can be passed from a pregnant mother, if she is infected with HIV, to her unborn
child (75 percent).
Using condoms usually prevents pregnancy (75 percent).
A girl cannot get pregnant if she has sex the first time she has intercourse (59 percent).
If used correctly and consistently, condoms are effective in preventing HIV transmission (69
percent).

The results show that the parents were informed about some of the questions listed above but suggest
gaps in others. For example, the data suggest that a quarter of parents are not aware of perinatal
transmission of HIV, the same proportion is not aware that using condoms can prevent unwanted
pregnancy, and about 30 percent are not aware that using condoms correctly and consistently can
prevent HIV transmission. In addition, nearly 40 percent are not aware that a girl can get pregnant the
first time she has sex.

An aggregate knowledge score was developed by awarding a point for each correct answer, and the
scale ranged from 0 (all answers incorrect) to 6 (all answers correct). The mean score was 4.2. There
was a correlation between ST exposure and the knowledge score: respondents in high ST intensity
districts had a mean knowledge score of 4.4, compared to those in the low intensity district with a
mean score of 3.8 (p = 0.000). There was also relationship between the number of items a respondent
had been exposed to and the mean score: those exposed to 0 items had a mean score of 3.7, those

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 Straight Talk: Parent Survey

exposed to one item had a mean score of 4.5, those exposed to two items had a score of mean 4.5, and
those exposed to three items had a mean score of 4.3 (p = 0.000).

HIV Testing

Parents were asked whether they had been tested for HIV and 19 percent said they had. Those in high-
intensity districts were more likely than those in low-intensity districts to have been tested (23 percent
versus 11 percent; p = 0.000). There was also a strong association between HIV testing and the
number of materials one had been exposed to: 10 percent of those exposed to zero items had been
tested, compared to 18 percent of those exposed to one item, 27 percent of those exposed to two
items, and 33 percent of those exposed to three items (p = 0.000).

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 Conclusions and Discussion

It is often desired that parents be able to communicate with their children about sexual matters, so that they
can impart parental expectations, nurture values, and strengthen the relationship between themselves and
their children. However, many factors mediate the extent to which parents can converse effectively with
their children including parental knowledge, communication skills, and beliefs. In Uganda, STF has been
implementing activities to educate parents about adolescent sexual health, as part of a broader program to
help adolescents navigate their own course from childhood to adulthood. This paper presents the extent to
which parents have utilized STF materials, and the extent to which these materials are associated with
selected outcomes.

The results show that many parents are familiar with STF activities, and about 60 percent are exposed to
the materials. This means that STF messages about parents and children are being accessed by more than
half the parents in the study area. About 65 percent of parents in high intensity districts (i.e. districts
receiving both English and local language programming) are accessing STF materials, compared to 35
percent of their counterparts in low-intensity districts (receiving English language programming only).
While fathers are more likely to access STF materials in general compared to mothers (65 percent vs 56
percent), the differences narrow in high-intensity districts, and fathers are just as likely to access STF
materials as mothers (around 65 percent each). Thus adding local language programming seems to allow
mothers to catch up with fathers. Given the crucial role mothers play in the upbringing of their children,
the benefit of implementing activities in a language that they can understand is clear. About 16 percent of
parents had read Parent Talk newspaper and among these, 62 percent had taken some action as a result,
suggesting that parents found useful information to act on. Nearly all who read Parent Talk said they
would recommend this newspaper. The results also show that many parents like ST youth publications and
66 percent had already recommended it. About 55 percent of parents also listen to ST radio.

Half the parents have ever talked to their children about ASRH, comparing well with the figures in
companion the adolescent survey that found that half the adolescents had ever talked with their parents.
However, it means that half have not, a cause for concern since all parents interviewed had an adolescent
between the age of 10 to 19 residing in the household. There is a direct correlation between residing in a
high-intensity district and having talked with the child: while only 40 percent of those in low-intensity
districts had had such a discussion, this rises to 56 percent for parents in high-intensity districts. This
suggests that STF efforts to help parents talk to their children are essential.

Strengthening the ability of parents to talk to children is particularly important because most already say
they are uncomfortable doing so, and 55 percent would prefer that the child go elsewhere for this
information. Results show an association between parental communication during the respondent’s
adolescence, and whether s/he had ever talked to their adolescent child now: respondents whose own
parents had ever talked with them when they were teenagers were twice as likely to also talk with their
own children. This implies that the efforts parents invest in today, will make it simpler for their children to
talk with their own children in the future. In addition, those parents who communicate with their children
feel that these discussions are useful, suggesting that activities to encourage parent-child communication
are likely to lead to a good experience for parents. The companion report to this study also documents that
adolescents whose parents had talked with them found the experience to be a positive one (Adamchak et al,
2007), indicating a win-win outcome for both parent and their children.

Parents appear to possess attitudes that may socialize their daughters into male subservience and their sons
into female dominance. For example, a quarter feels that boys should be favored in case of scarce
resources, a similar proportion questions the intellect of girls relative to boys, two thirds say that wives
should tolerate abuse from husbands, a third feel that “there are times when women deserve to be beaten
by their husbands”, and about half feel that men should be the final decision makers in terms of sexual
activities. These beliefs point to the need for parent-centered activities that can help mothers and fathers to

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 Straight Talk: Parent Survey

deconstruct their values and examine them in the context of how they are socializing their children. Mass
media activities can provide important triggers for self-reflection and discussion, but the Parents Clubs that
STF is promoting can go a step further in providing an environment where parents can talk with peers.
These activities can be more effective if they are strategically guided and build on behavioral theories such
as Social Cognitive Theory, and social structural theories such as the Theory of Gender and Power
(DiClemente et al, 2002).

Many parents feel that adolescents should be taught reproductive health in schools, with three quarters
feeling they should even be taught about family planning in school and two thirds be taught about
condoms. Thus many parents are open to schools taking on many sensitive topics and this information may
be of interest to teachers.

In summary, the study demonstrates that parents are an important audience for STF materials and a
significant proportion uses them. Those who use them seem to like them and so efforts to promote them to
parents may be worth the while. The data also suggest that parents need considerable help talking with
their children, and STF’s efforts assist them would be greatly welcomed.

15
 References

Neema, S. et al. 2006. “Adolescent sexual and reproductive health in Uganda: Results from the 2004
Uganda national survey of adolescents,” Occasional Report no. 25. New York: Guttmacher Institute.

DiClemente, RJ., Crosby, RA and Kegler (eds). 2002. Emerging theories in health promotion practice
and research. San Francisco: John Wiley and Sons.

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