Suchergebnisse

Corporal punishment by parents or guardians, family members, and relatives is an accepted cultural practice in Ethiopia. Aside from parents and other family members, many children are also abused (physically and sexually) by other persons who by chance meet them. At the same time, concerned institutions in Ethiopia are making efforts to reduce child abuse. This paper examines the situation of child abuse and its management in Addis Ababa, focusing on the challenges and controversies surrounding this social problem. It assesses pertinent issues involved in child abuse management based on information obtained from case studies of abused children and abusers, agents of the criminal justice system (the police, lawyers, and judges), health professionals, social workers, sociologists, psychologists, etc. Child abuse in Addis Ababa appears mainly related to general conditions of poverty. Further, the main problems in child abuse management seem to be the absence of coordination among various agents, and inadequate resources and institutional facilities.

Objectives: To investigate how male street youths understand and express sexuality and cope with the HIV/AIDS risk in their daily lives.
Methods: In this ethnographic study, three focus group discussions guided by unstructured questions were held by the author and a peer facilitator with 30 street youths aged 15-24 years. Discussion themes focused on their daily problems and life experiences; perceptions of their future; boy-girl relationships; marriage and premarital sex; sexual socialization; sexuality; sexual norms; values and deviance; safe sex; condoms and condom use; and the nature, risk, and prevention of HIV/AIDS. All focus group discussions were tape recorded and transcribed into English, with additional notes taken during unstructured interviews.
Results: The main findings were that (1) HIV/AIDS was of relatively low concern to the street youths due to their preoccupation with survival in an adverse environment, (2) levels of HIV/AIDS knowledge were low, and common misconceptions about the nature, risk, transmission, and prevention of HIV indicated a lack of access to information, (3) contrary to expectations, the study group adhered to the traditional sexual mores and values of society, and (4) individuals were frustrated in their sexuality due to their socially marginalized position and fear of already having contracted HIV.

Conclusion and Recommendations: The precarious situation of street youths may not be conducive to mainstream HIV/AIDS prevention programs that emphasize abstinence and faithfulness. It is necessary first to reintegrate them into society, or at least meet basic food, employment, and shelter needs to render them receptive to health education. In addition, many fear they already have contracted HIV infection and are reluctant to be tested lest their fears be confirmed. Still, fear of HIV infection may be an entry point for prevention initiatives among street youth and other out-of-school adolescents if it is possible to give them hope in life and overcome their reluctance to confirm their HIV status.

Introduction-- Getnet Tadele PART I 1. Contextualizing HIV/AIDS in Sub-Saharan Africa: The Link with Tradition, Religion, and Culture-- Getnet Tadele and Woldekidan Amde 2. Gender Inequalities, Power Relations and HIV/AIDS: Exploring the Interface-- Ayalew Gebre, Tekalign Ayalew and Helmut Kloos 3. Youth Sexuality and HIV/AIDS: Issues and Contentions-- Woldekidan Amde and Getnet Tadele 4. Food Insecurity, Poverty, and HIV/AIDS-- Ayalew Gebre, Sebsib Belay and Helmut Kloos PART II: IMPACTS AND RESPONSES TO HIV/AIDS 5. Socioeconomic and Psychosocial Impacts of HIV/AIDS and Responses at Different Levels of Society-- Ayalew Gebre, Damtew Yirgu and Helmut Kloos 6. HIV/AIDS and the Mining and Commercial Agricultural Sectors in Southern Africa-- Charles Hongoro, Getnet Tadele and Helmut Kloos 7. Access to Treatment, Care, Support, and Prevention Services-- Getnet Tadele, Woldekidan Amde and Helmut Kloos 8. Care and Support for AIDS Orphans-- Woldekidan Amde and Getnet Tadele 9. Mainstreaming HIV Interventions into Educational Systems-- Anne A. Khasakhala 10. Monitoring and Evaluation of HIV/AIDS Prevention Programs-- Anne A. Khasakhala and Helmut Kloos 11. Ethical Issues in HIV/AIDS Biomedical Research-- Anne A. Khasakhala and Helmut Kloos Conclusion and the Way Forward-- Damen Haile Mariam and Helmut Kloos

Introduction / Helmut Kloos, Getnet Tadele, Worku L. Mulat -- Arya Jawi: a faith-based community development project / Kebebew Daka, Tsegab Kebebew Daka, Aynalem Adugna -- Building household resilience in a village in South Wello Zone using a family approach / Worku L. Mulat, Abate L. Mulat, Cheru L. Mulat, Zewdu L. Mulat, Yirga L. Mulat -- Bridging gaps and building opportunities: reflections on my experiences of engaging in community development in Azena / Getnet Tadele -- Grarbet Tehadiso Mahber, a non-governmental organization in central Ethiopia: its inception and development over the last 20 years / Redda Tekle Haimanot -- Conclusion / Helmut Kloos, Getnet Tadele

People affected by HIV and AIDS face risks which secure livelihood can enable them to avoid. At-risk groups and the type of risks differ between locations and over time. Opportunities to (re)build livelihoods are also diverse and context-specific. Supportive policies and programmes must therefore be responsive to these differences and to people's and communities' innovative capacities. This study assesses how five Ethiopian NGOs: one AIDS service organisation, one PLHIV network, one microfinance institution (MFI), one development NGO, and one faith-based NGO engaged in strengthening livelihoods in communities confronting HIV and AIDS identified at-risk groups, priorities for livelihood support, and responded to needs. Interviews and focus group discussions were conducted with purposefully selected beneficiaries, non-beneficiaries, and key informants. Findings show that the organisations support livelihoods in very different ways and have adopted different approaches in the way they organise, provide and attempt to ensure the sustainability of the support. However, support is often based on limited experience since there are no guidelines and proper monitoring and evaluation and feedback mechanisms are absent. All of the organisations did not conduct meaningful needs assessments, leading to the proliferation of stereotyped responses targeting stereotyped populations while other groups at significant risk of HIV are ignored. The organisations have also largely failed to keep AIDS in perspective since groups facing other challenges are rarely supported. Local innovations and suggestions from beneficiaries and non-beneficiaries are given little attention. This failure to draw on local innovation means that less effective activities are supported and productive relationships between organisations and communities are undermined. Nevertheless, there is an immense opportunity for evaluation and learning from these diverse practices.

Background Podoconiosis is a lymphoedema of non-infectious cause which results in long-term ill health in affected individuals. Simple, effective treatment is available in certain parts of Ethiopia, but evidence indicates that not all patients continue collecting treatment supplies from clinic sites once started. We used qualitative techniques to explore factors related to discontinued attendance at outreach clinics of a non-government organization in southern Ethiopia. Methods A cross-sectional qualitative study was conducted in four clinic sites through unstructured in-depth interviews, key informant interviews and focus group discussions with the involvement of 88 study subjects. Results Discontinuation of clinic visits is common among podoconiosis patients. The reasons were: remoteness from the clinic sites, unrealistic expectation of 'special' aid, worry about increasing stigma, illness and misconceptions about treatment. Conclusions Several of these factors are remediable through community and individual information and education. Appropriate routes to deliver this information must be identified. Certain factors (such as distance to clinic sites and stigma) require substantial expansion of services or liaison with village-level government health services.

Abstract Background Podoconiosis is a lymphoedema of non-infectious cause which results in long-term ill health in affected individuals. Simple, effective treatment is available in certain parts of Ethiopia, but evidence indicates that not all patients continue collecting treatment supplies from clinic sites once started. We used qualitative techniques to explore factors related to discontinued attendance at outreach clinics of a non-government organization in southern Ethiopia. Methods A cross-sectional qualitative study was conducted in four clinic sites through unstructured in-depth interviews, key informant interviews and focus group discussions with the involvement of 88 study subjects. Results Discontinuation of clinic visits is common among podoconiosis patients. The reasons were: remoteness from the clinic sites, unrealistic expectation of 'special' aid, worry about increasing stigma, illness and misconceptions about treatment. Conclusions Several of these factors are remediable through community and individual information and education. Appropriate routes to deliver this information must be identified. Certain factors (such as distance to clinic sites and stigma) require substantial expansion of services or liaison with village-level government health services.

This editorial provides an overview of a thematic series that brings attention to the persistently deficient and unequal access to sexual and reproductive health services for young women in sub-Saharan Africa. It represents an effort to analyze the multifaceted relationship between laws, policies and access to services in Ethiopia, Zambia and Tanzania. Using a comparative perspective and qualitative research methodology, the papers presented in this issue explore legal, political and social factors and circumstances that condition access to sexual and reproductive health services within and across the three countries. Through these examples we show the often inconsistent and even paradoxical relationship between the formal law and practices on the ground. Particular emphasis is placed on safe abortion services as an intensely politicized issue in global sexual and reproductive health. In addition to the presentation of the individual papers, this editorial comments on the global politics of abortion which represents a critical context for the regional and local developments in sexual and reproductive health policy and care provision in general, and for the contentious issue of abortion in particular.

Introduction At the turn of the century, when the Millennium Development Goals placed maternal mortality reduction high on the global agenda, Ethiopia relaxed its restrictive abortion law to expand grounds on which a woman could legally obtain an abortion. This radical policy shift took place within a context of predominant anti-abortion public opinion shaped by strong religious convictions. Drawing upon Walt and Gilson's policy analysis framework, this paper explores the tension between public policy and religious dogma for the strategies chosen by the Ethiopian Ministry of Health and its partners implementing the new policy, and for access to safe abortion services. Methods The study employed a qualitative research methodology. It targeted organizations that are key stakeholders in the field of reproductive health. These included policy makers and policy implementers like ministries, UN agencies and international and national NGOs as well as religious organizations as key opinion leaders. The data collection took place in Addis Ababa between 2016 and 2018. A total of 26 interviews were conducted, transcribed, and analyzed using the principles of qualitative content analysis. Results Our analysis showed that the implementing organizations adopted a strategy of silence not to provoke anti-abortion sentiments and politicization of the abortion issue which was seen as a threat to the revised law and policy. This strategy has facilitated a rollout of services and has improved access to safe abortion care. Nevertheless informants were concerned that the silence strategy has prevented dissemination of knowledge about the revised law to the general public, to health workers and to the police. In turn this has caused confusion about eligibility to legal and safe abortion procedures. Conclusions While silence as a strategy works to protect the law enhancing the health and survival of young women, it may at the same time prevent the law from being fully effective. As a long term strategy, silence fails to expand awareness and access to safe abortion services, and may not sufficiently serve to fulfill the potential of the law to prevent abortion related maternal deaths. ; publishedVersion

Hongoro, Charles; Tadele, Getnet; Kloos, Helmut: HIV/AIDS and the Mining and Commercial Agricultural Sectors in Southern Africa. - S. 127-142

Introduction: Engaging youth as peer educators has yet to be considered to promote literacy concerning conjoint genetic and environmental (G × E) influences on health conditions. Whether youth living in low- and middle-income countries (LMICs) could and would be willing to serve as lay educators of G × E education is unclear. Methods: A cross-sectional survey of youth living in Southern Ethiopia was conducted from August to September 2017. Trained data collectors administered the survey on 377 randomly selected youth who ranged in age from 15 to 24; 52% were female and 95% reported having some formal education. Self-reported willingness and a constructed competency score were assessed. Bivariate analyses tested for factors associated with willingness and competency to serve as lay G × E literacy builders. Results: Competency and willingness were significantly greater (p < 0.05) for youth who were male, had some formal education, and had civic or leadership experience. Differences in median willingness were significant for youth who scored as more competent versus those who scored as less competent (p < 0.001). There were no characteristics that moderated the association of competency with willingness. Conclusion: Youth peer educator programs hold promise for disseminating improved G Χ E literacy and reducing stigma associated with deterministic misunderstandings. Thoughtful recruitment and training strategies will be needed to ensure that the broadest representation of youth in LMIC contexts has the opportunity to serve in this role, particularly girls and those without formal education.