Abstract
Background: Adolescent girls in urban Pakistan often lack adequate health knowledge due to limited parent-daughter communication, despite parents recognizing their responsibility for guidance on puberty, nutrition, and sexual/reproductive health.
Objective: To examine parental awareness, barriers, and predictors of regular health discussions with adolescent daughters in Karachi using a sequential explanatory mixed-methods design.
Methods: A cross-sectional survey of 320 parents was followed by five focus group discussions (FGDs). Quantitative data underwent descriptive analysis, chi-square tests, and binary logistic regression (outcome: regular discussion yes/no). Qualitative data were thematically analyzed to explain quantitative findings.
Results: Although 71% of parents reported high awareness of daughters' health needs, only 38% engaged in regular discussions. Cultural taboo was the primary barrier (55%), followed by lack of knowledge (27%). Logistic regression showed high awareness (adjusted OR 2.87, 95% CI 1.72–4.79, p<0.001) and health program exposure (OR 2.14, 95% CI 1.28–3.58, p=0.004) independently predicted regular discussions, while strong cultural taboo perception suppressed them (OR 0.48, 95% CI 0.28–0.82, p=0.007). FGDs revealed parental SRH discussion anxiety, e-Health confidence gains, and support for school/mosque-based interventions.
Conclusion: Parents demonstrate awareness but face cultural barriers limiting health communication. Targeted school- and community-based programs can bridge this gap by enhancing skills and reducing stigma, with potential to substantially improve adolescent girls' health knowledge in Karachi.