Among 212 respondents, sixty percent (60%) were 15-17 years forty percent (40 %) were 18-19 years respectively. The female respondents were more than the male respondents. More than half of the respondents, nearly fifty-seven percent (56.6%), were female, and forty-three percent (43.4%) were male, respectively. Regarding ethnicity, most of the respondents (43.4%) were from Brahmin/Chhetri ethnic backgrounds, followed by Dalits (5.7%), Newars 13.7%, Janajati 35.4%, and Muslims 1.9%, respectively. Most of the respondents (76.4%) followed the Hindu religion, followed by Buddhists (12.3%), Muslims (1.4%), and Christians (9%), respectively.

Similarly, the study found that the majority of the parents (93.9%) were together, while 3.8% were separated, and 2.4% were divorced. Regarding education, the majority of respondents' mothers (73.1%) were literate, and nearly twenty-seven percent (26.9%) were illiterate. Among mothers in the literate group, 18.9% were able to read and write, while 19.8% received primary-level education. Likewise, 10.8% were lower secondary level, 17% were secondary level, 4.2 % were higher secondary level, and 2.4% received bachelors and above-level education, respectively. Similarly, the majority of respondents’ fathers (84%) were literate, while 16% were illiterate. Among fathers in the literate group, 11.8% were able to read and write, while 19.3% received primary-level education. Likewise, 16.5% were lower secondary level, 21.7% were secondary level, 9.4% were higher secondary level, and 5.2% received bachelors and above-level education, respectively. Most of the respondents' fathers (93.9%) were employed and engaged in different sectors. For example, 30.7% were in agriculture, 10.8% were in government/civil service, 5.2% were in private service/NGO/INGO, 20.8 % were engaged in business, 10.4% were in labor, and 16% were foreign employers. Similarly, the majority of mothers, 26.9%, were housemakers while 4.2% were engaged in government/civil service, 5.2% were in private service/NGO/INGO, 12.7 % had engaged in business, 2.4 percent were labor, and 4.2% were foreign employers. (Table 1).

Upon assessing the living arrangements of the respondents, the study revealed that the majority of respondents (64.6%) were living with their both parents (father and mother), followed by living with their mother only (1.4%), living with their father only (3.3%), living with siblings (1.4%), living with friends (1.9%), living with relatives (21.7%) and living alone (5.7%) respectively. Upon assessing the parenting styles of the respondents, the study found that more than half of the respondents (57.08%) perceived an authoritative parenting style, followed by an authoritarian style (32.54%) and a permissive style (10.38%), respectively.

Among 212 respondents, the majority of responses were recorded for pubertal changes (93.9%), menstruation (92.9%), child or forced marriage (91%), pregnancy (93.4%), abortion (57.5%), STI (80.2%), sexual violence (87.3%), and contraceptive devices (82.1) respectively. Upon assessing the level of knowledge, out of 212 respondents, half had an adequate level of knowledge, whereas 50% had an inadequate level.

The study revealed that most respondents, nearly seventy-six percent (75.9%), communicated on SRH topics with their parents, whereas twenty-four percent (24.1%) never communicated results with their parents on SRH topics. The study reveals that, out of 161 respondents, the majority of respondents (47.2%) rarely communicated on SRH topics, followed by sometimes (23.6%) and often (5.2%), respectively (See table 2). The responses illustrated that more than half of the respondents (56.1%) communicated about choosing a life partner. A fair share of respondents (27.4%) sometimes talked, and a small handful of responses (6.1%) had recorded as often. Communication on using birth control was never done by the majority of the respondents (61.3%), while 15.6% of responders rarely talked, a fair share of respondents (15.6%) sometimes talked, and a small handful of responses (6.1%) had recorded as often. Communication about menstruation (50.1%), communication about physical and psychological changes (55.2%), and physical growth of reproductive organs and development (50.5%) had significantly discussed by the respondents with their parents. Topics such as communication on when to start having sex (86.6%), pregnancy (69.3%), how to handle sexual pressure from a partner (85.8%), STI and HIV/AIDs (72.2%), communication about condoms (78.8%) and abortion (82.5%) had never discussed. (See table 3).

This study aimed to assess adolescent-parent communication on sexual and reproductive health and its associated factors among the students of higher secondary schools in Tokha Municipality. Overall adolescent-parent communication on sexual and reproductive health was found to be 75.9%, which was quite good compared to the previous study conducted on Kailali (43%) (9) and Sankhu (55.9%) (13), Nepal. More than half of the respondents (57.08%) had an authoritative parenting style, followed by an authoritarian (32.54%) and a permissive (10.38%), respectively, so it seems that the prevalence of authoritative parenting styles is high in the community, which is a good style for communication. There is no previous study found on adolescent-parent communication regarding SRH with the study variable of parenting style. The present study also reported the association between parenting style and adolescent-parent communication regarding SRH. We can conclude that open communication between parents and their children could encourage and enable children to communicate with their parents regarding sexual and reproductive health issues, challenges, and problems.

Regarding the knowledge among 212 respondents in the present study, the majority of responses were recorded for pubertal changes (93.9%), menstruation (92.9%), child or forced marriage (91%), pregnancy (93.4%), abortion (57.5%), STI (80.2%), sexual violence (87.3%), and contraceptive devices (82.1) respectively. The previous study conducted in Ethiopia (14) reported that (74.4%) of the respondents had knowledge about STIs, followed by (74.2%) of the respondents about contraception methods and (72.8%) when the first menstrual period started. While comparing the present and the previous study, the knowledge among respondents was quite good in the present study conducted in the Tokha among higher secondary level students. The SRHR knowledge of different SRHR topics was good among the respondents in this study due to having various sources of information such as radio, television, the internet, and social media, as well as the changing and updated curriculum of the school regarding sexual education. Regarding the level of knowledge among the respondents (n=212) in the present study, 50% had adequate, whereas 50% had inadequate SRH knowledge. Therefore, comprehensive sexuality education, through clubs and peer groups, seems essential to organize health education sessions that will help improve SRH-related knowledge.

Correspondingly, more than half of the respondents (56.1%) communicated about choosing a life partner, followed by using birth controls (38.7%), communication about physical and psychological changes (55.2%), about physical growth of reproductive organs and development (50.5%), and communication about pregnancy (30.7%), communication on when to start having sex (13.4%), communication on how to handle sexual pressure from a partner (14.2%), communication on STI and HIV/AIDs (27.8%), communication about condoms (21.2%), and on abortion (17.5%). It showed that topics such as choosing a life partner, birth control, menstruation, physical and psychological changes, and communication on the physical growth of reproductive organs and development had significantly been discussed by the respondents with their parents. SRH topics such as communication on when to start having sex, how to handle sexual pressure from a partner, STI and HIV/AIDs, and communication about condoms had never been discussed by the majority of the respondents. But in the study conducted in Sanku, Nepal, menstruation was discussed a lot by 9.9%, followed by pubertal changes by 3.8%, and birth control by 2.8% (13). Also, relationships with the opposite sex, abortion, sexually transmitted infections, and fertilization had never been discussed with their parents by 80.8%, 70.4%, 59.6%, and 49.3%, respectively (13). Correspondingly, the cross-sectional study conducted in Kailali, Nepal, showed that 16.2% were communication on pubertal change, followed by menstruation (17.8%), safe sex (5.9%), unintended pregnancy (9.9%), contraceptive devices (10.1%), STI/HIV/AIDS (14.8%), and condoms (3.2%) (9). Similarly, the study conducted in Ethiopia reported that 46.6% were communicated on pubertal change, followed by premarital sex (32.5%), contraceptive devices (43.3%), STI/HIV/AIDS (56.1%), unintended pregnancy (49.2%) and condoms (25.3%). So we can conclude that there are quite good communication practices in the present study population. It may be because they have had good knowledge of different SRH topics. Living with the guardian also enables and encourages communication between parents. In Nepalese society, most parents don't feel comfortable talking to their kids about sexual health but rather concentrate on safe topics. Cultural taboos, shame, poor communication abilities, embarrassment, fear of parents, their lack of responsiveness, their unwillingness to accept young people due to a lack of understanding, sociocultural norms, and their conviction that talking about such topics encourages premarital sex are just a few things that hinder parent-child interaction 9.

In the present study, living arrangements (p = 0.01), parenting style (p = 0.04), and knowledge (p = 0.01) had a significant association with adolescent-parent communication on sexual and reproductive health. A similar study in Sankhu, Nepal 13, reported a significant association between age, gender, close parent, and adolescent-parent communication on SRH. The observed differences could be due to the present study being more recent and the fact that males felt more comfortable communicating about SRH topics than females. Similar research conducted in Woreta town, Northwest Ethiopia, was significantly associated with knowledge (p<0.05) 14. But the study conducted in Vientiane reported that gender (p<0.05) was significantly associated with adolescent parent communication on SRH 15. It may be due to cultural variations affecting parenting education and communication. Likewise, the study conducted in Ethiopia reported that the study grade (p<0.05) was significantly associated with adolescent parent communication on SRH 16 because the grade 12 students thought that they had enough knowledge as compared to 11, so they did not communicate with their parents.