Despite the increasing policy and academic attention given to child poverty in recent years, little is known about children’s perspectives and their experiences of risk, coping and resilience in the context of poverty. The existing child poverty literature is dominated by studies from economics and developmental psychology, which for the most part overlook not only the perspectives of children in poverty but also their use of coping strategies and experiences of resilience. Much can be inferred, however, from studies of the lives of children in developing countries in terms of the active role poor children play in their lives and their families’ lives. Additionally, a small but growing number of qualitative child poverty studies in Europe and North America (e.g. Ridge, 2002) have highlighted the resourcefulness and optimism of many children living in poverty. They have shown the merit of prioritizing children’s perspectives and experiences or minimally setting them alongside the perspectives of adults in order to understand their lives and concerns fully. This thesis builds on these studies by exploring the lives of children living in poverty that go beyond their material disadvantage or survival. It highlights the priorities, concerns and responses of children living in a context different from the one covered by most of these studies. It also explores the theoretical concepts of coping and resilience to establish whether these constructs can be reliably applied in a society that is very different from the one in which they were developed. The study focuses on Ethiopia, one of the poorest countries in the world. It addresses the perspectives and experiences of twenty-six children (11 girls and 15 boys) between the ages of 11 and 14 in Kolfe area, one of the poorest neighbourhoods in Addis Ababa. It employs qualitative research methods such as semi-structured individual interviews, daily diaries, drawings and timelines with the children. The key finding of the study is that the majority of these children perceive that relationships that are characterized by conflict are more damaging than material poverty. This suggests that research and interventions focusing on poverty not only undermine children’s positive experiences and agency but also obscure their real priorities and concerns. The children’s accounts further suggest that the theoretical concepts of “coping” and “resilience” are applicable to Ethiopian children, although as in other contexts how the children understand and experience them is influenced by the culture and environment in which they live.

This study used qualitative research method to examine the values and experiences of parents raising adolescent children in Addis Ababa, Ethiopia. It aimed to understand their perspectives, priorities, practices and concerns. Such contextual knowledge can inform practitioners to help parents achieve their parenting goals. Ethiopia is also undergoing numerous cultural, economic and social changes that call for examining existing approaches to raising adolescent children. Interpretative phenomenological analysis (IPA) guided the process of this study. This qualitative method is useful to study daily experiences that have significance to participants (Brocki & Wearden, 2006). Eight Ethiopian parents from Addis Ababa who raised at least one adolescent child during the period of this study were interviewed. Semi-structured interviews were used to ask parents about their perspectives on an array of topics including the meaning of adolescence, parental aspirations, parental expectations, discipline, parent-child communication and parenting concerns. Nvivo, a Computer Assisted Qualitative Data Analysis Software (CAQAS) was used to manage all data and theme development process. Data analysis generated obedience and marriage, dating and sexuality as superordinate themes. The following subthemes were developed under obedience: culture and family; respect and Relationships; educational and career success; approaches to raising obedient children and challenges against raising obedient children. Findings showed that parents aspire to raise obedient children. The second theme, marriage dating and sexuality showed the emphasis participants gave to delaying dating and intimacy experiences of their children until after their children were closer to getting married or became economically independent. Most parents described the period of adolescence as a time when children show more defiance toward parental expectations and thereby a call for more parental control and monitoring. Participants often used advice giving, supervision, limiting their children’s exposures and punishment to achieve their parenting goals. Few parents advocated for the use of high control on adolescent children while most parents stated that coercive measures do not help to raise obedient children. The results of this study showed that most participants expressed authoritarian perspectives and approaches that impose high expectations on children while providing low parental support that help children achieve parental goals. Recommendations and implications for future research, teaching and practice called for the importance of developing and using contextual knowledge to help parents in Ethiopia raise healthy and successful children.

Access to clean and safe drinking water is a fundamental human requirement. However, in many areas of the world natural water sources have been impacted by a variety of biological and chemical contaminants. The ingestion of these contaminants may cause acute or chronic health problems. To prevent such illnesses, many technologies have been developed to treat, disinfect and supply safe drinking water quality. However, despite these advancements, water supply distribution systems can adversely affect the drinking water quality before it is delivered to consumers. The primary aim of this research was to investigate the effect that water distribution systems may have on household drinking water quality in Christchurch, New Zealand and Addis Ababa, Ethiopia. Water samples were collected from the source water and household taps in both cities. The samples were then tested for various physical, chemical and biological water quality parameters. The data collected was also used to determine if water samples complied with national drinking water quality standards in both countries. Independent samples t-test statistical analyses were also performed to determine if water quality measured in the samples collected from the source and household taps was significantly different. Water quality did not vary considerably between the source and tap water samples collected in Christchurch City. No bacteria were detected in any sample. However, the pH and total iron concentrations measured in source and tap water samples were found to be significantly different. The lower pH values measured in tap water samples suggests that corrosion may be taking place in the distribution system. No water samples transgressed the Drinking Water Standards for New Zealand (DWSNZ) MAVs. Monitoring data collected by the Christchurch City Council (CCC) was also used for comparison. A number of pH, turbidity and total iron concentration measurements collected by the CCC in 2011 were found to exceed the guideline values. This is likely due to structural damage to the source wells and pump-stations that occurred during the 2011 earthquake events. Overall, it was concluded that the distribution system does not adversely affect the quality of Christchurch City’s household drinking water. The water quality measured in samples collected from the source (LTP) and household taps in Addis Ababa was found to vary considerably. The water collected from the source complied with the Ethiopian (WHO) drinking water quality standards. However, tap water samples were often found to have degraded water quality for the physical and chemical parameters tested. This was especially the case after supply interruption and reinstatement events. Bacteria were also often detected in household tap water samples. The results from this study indicate that water supply disruptions may result in degraded water quality. This may be due to a drop in pipeline pressure and the intrusion of contaminants through the leaky and cross-connected pipes in the distribution network. This adversely affects the drinking water quality in Addis Ababa.

Over the past two decades a body of scholarship on the Global South has begun to present new ways to conceptualize African cities and their spatio-temporal specificity. Despite this, the city of Addis Ababa in Ethiopia is moving towards the reestablishment of its faded glory through means of aspatial modernization. The city’s aspirations for distinction and visibility can be seen as responses to the variable scales of contemporary urban systems. As ‘place’ is arguably no longer a singular concept, cities are rooted in relational networks rather than in ‘place’ alone. ‘Locality’ thus extends beyond the physical site to include linkages with a network of places around the world. Using an art-based research methodology, this research contributes to the discourse of urban development in the Global South generally, and Addis Ababa specifically. Findings are juxtaposed through documentation that includes theoretical essays, reportage, survey-informed graphics, interviews, and excerpts from a short film series and an existing plan for the Megenegna area. Potentials and challenges of place-based conceptions of urbanism are discussed, linking to the legacy of the 1960s mechanical and social paradigms. The insitutional role of UN-Habitat in the global collective supports is discussed for potential to supports existing resources and demographics for improved mobility and accessibility.

Cette thèse interroge la place des espaces forestiers dans une capitale africaine en mutation. Introduit à Addis Abeba il y a un peu plus de 100 ans l'eucalyptus a permis de répondre aux demandes des populations en bois d'œuvre et bois énergie. Les plantations constitutives de la forêt urbaine et périurbaine ont été développées au rythme de croissance démographique de la capitale. Mais les orientations nouvelles prises par les aménageurs urbains valorisent l'avancée d'un bâti vertical, qui ne s'accorde plus avec le voisinage de ces espaces verts productifs. De plus, l'espèce est décriée pour ses effets supposés néfastes sur l'environnement. Au cours de cette étude nous cherchons à saisir la dualité qui s'installe entre la volonté de valoriser une image moderne de la capitale éthiopienne et la continuité de pratiques forestières populaires, à l'œuvre dans ces territoires boisés. En nous basant sur des enquêtes qualitatives auprès des décideurs urbains et des acteurs de la filière eucalyptus nous interrogeons les nouvelles pratiques de l'environnement à Addis Abeba. La surreprésentation d'instances internationales joue dans la diffusion d'un discours global qui influence les perceptions de l'arbre par les autorités urbaines. Ces dernières discutent les fonctionnalités à valoriser dans ces territoires boisés tout en contrôlant l'accès à la ressource et les pratiques liées à l'eucalyptus. Les tensions qui animent les choix d'aménagement des acteurs urbains montrent les difficultés à concilier enjeux environnementaux et économiques dans la métropole addissienne. / This thesis explores the evolving place of forest areas in a changing African capital. Eucalyptus has been introduced in Addis Ababa more than 100 years ago in order to meet the locals' demand for timber as well as wood fuel. This urban and suburban forest was planted together with the capital's population growth. Yet, the new planning choices made by local authorities promote the advance of a vertical built environment, which is not anymore consistent with the proximity of those productive green areas. Moreover, this variety is highly criticized for its alleged harmful impacts on the environment. This study seeks to give an account of the duality that arise between the will to provide the Ethiopian capital with a modem image and the continuity of popular forestry practices at work on those forest areas. The analysis is based on a qualitative survey of urban authorities and stakeholders of the "eucalyptus' chain" strategies and explores the new environmental practices in Addis Ababa. The over-representation of international stakeholders in the city is an ideal vector for the promotion of global narratives which influence the local authorities' perceptions of that tree. Indeed, local authorities promote some specific functions for the forest, while controlling the access to the resource and the practices linked to the eucalyptus. The tensions that drive the urban authorities' planning choices highlight the difficulties in reconciling environmental and economic stakes in Addis Ababa.

Text in English with questionnaire in Amharic / Purpose: The purpose of the study was to evaluate the effectiveness of the tuberculosis directly observed treatment, short-course (DOTS) strategy with respect to patient centeredness and satisfaction, and propose a model in support of the DOTS strategy in Addis Ababa, Ethiopia. Method: The study was conducted in Addis Ababa, Ethiopia using a mixed-method approach. An interviewer-administered questionnaire was used to collect quantitative data from 601 randomly selected TB patients who were on TB treatment followup in 30 health facilities.Three focus group discussions were conducted with 23 TB experts purposefully selected from 10 sub-city health offices and health bureau. Moreover, telephonic interviews were conducted with 25 defaulted TB patients who had been attending TB treatment in the health facilities. The quantitative data were described using mean, median, percentage and frequencies. Logistic regression and exploratory factor analysis were used to extract associated factors using SPSS version 21 software. Thematic analysis was used for qualitative data analysis. Deductive and inductive reasoning was used to propose a descriptive model with substantiating literatures. Findings: Of the 601 TB patients included, 40% of them perceived they had not received a patient-centred TB care (PC-TB care) with DOTS strategy. Gender (AOR=0.45, 95%CI 0.3, 0.7), good communication (AOR=3.2, 95%CI 1.6, 6.1), treatment supporter (AOR=3.4, 95%CI 2.1, 5.5) were associated with the perceived PC-TB care. Thirty-seven percent of TB patients were following their TB treatment with feeling of dissatisfaction with DOTS strategy. Gender (AOR=2.2; 95%CI 1.3, 3.57), place of residence (AOR=3.4; 95%CI 1.6, 7.6), presence of symptoms (AOR=0.6, 95%CI 0.40, 0.94) and treatment-supporter (AOR=4.3, 95%CI 2.7, 6.8) were associated with satisfaction of TB patients. TB experts and defaulted TB patients pointed out that DOTS strategy is not providing comprehensive PC-TB care except the provision of facility choice where to follow during initiation of the treatment. DOTS delivery system inflexibility, loose integration, HCPs’ characteristic, communication skill and motivation and the community awareness were explored factor with patient centeredness of DOTS. DOTS delivery system, incompatible of diagnosis and patient beliefs were the identified categories to default. The proposed PC-TB care model core constructs are patient, community, health care providers, health care organisation and TB care delivery system. The core constructs are directed by policy and monitoring and evaluation components. Conclusion: DOTS strategy is limited to provide fully integrated PC-TB care and did not provide full satisfaction to TB patients. Therefore, a support that makes the TB care patient-centred are important and the proposed PC-TB care model needs to be tested, practiced and evaluated for its performance toward increments of patient centeredness of TB care. / Health Studies / D.Litt. et Phil. (Health Studies)

Introduction: Suicide is a global public health and social problem affecting the most productive age group, and the elderly. In Addis Ababa, despite high suicide rates there is no proper registration and certification that is meant for public health purpose. This study is conducted to look into the incidence and explore societal views towards suicide in Addis Ababa. Methods: Secondary data was collected from registers of Forensic Pathology Department at Menilik II Hospital and Homicide Crimes Investigation Unit at Addis Ababa Police Commission. Qualitative data was also collected from experts having experience in helping suicide victims.   Results: Between January 01 and December 31st 2015, 267 residents of Addis Ababa, majority of who are males, died due to suicide. Hanging being the most frequently used means, social isolation, mental illness, family conflict, economic problems and lack of religious commitment are perceived causes of suicide. Unavailability helping institutions and individual preference as to the method of suicide and individual nature of suicide are conditions that get the attention. While respect for social and religious values is considered as protective factors, the act of suicide is religiously criminal act. The victims of suicide include family and community members.   Conclusion: There is a need to consider policy and programmatic actions directed towards suicide prevention and control. In addition to conducting community wide research in suicide, it is important to preserve social and cultural values; institutionalize traditional family conflict resolution practices and strengthen mental health institutions. / <p>Enbart abstract.</p>

This study assessed healthcare providers’ knowledge, attitudes and practices towards IPT provision for people living with HIV (PLHIV) in Addis Ababa, the capital city of Ethiopia. A quantitative, descriptive, cross-sectional study design was used for the study and data was collected using a self-administered questionnaire from 104 clinicians working in ART clinics. The findings show that healthcare providers who participated in this study had a mean value of high knowledge, positive attitude and good practice towards IPT provision for PLHIV. Significant association was found between knowledge and attitude (P=0.000) but no significant associations were found between knowledge and practice, attitude and practice as well as between the type of facility (public/private) and level of practice. This implied that, the low level of IPT implementation in Addis Ababa doesn’t seem due to health care providers’ lack of knowledge and resistance to provide IPT for people living with HIV. As a result, the researcher recommends for further researches of other possible factors like; the reliability of IPT information/data management, drug supply and the leadership and governance of the health system that IPT program is a direct concern. / Health Studies / M.A. (Public Health (with specialisation in Medical Informatics))

Poor people benefit from microfinance and positively improve their poverty and socio-economic conditions. Microfinance support serves as development tool to redress the exclusion of the poor from the development process and outcomes in the mainstream intervention frameworks. As developing countries and poverty context are diverse and contextual, comprehensive knowledge about and empirical evidence on the impact of microfinance is scant. Specifically, the impact of microfinance services on the development of micro and small enterprises (MSEs) owned by women is scant. The findings of available studies and policy practice reports on microfinance in Ethiopia are not holistic in terms of a theoretical lens and methodological pluralism. Available studies do not consider the impact of microfinance and non-financial services on women-owned MSEs at household, individual and enterprise levels thereby reducing the poverty context and holistic empowerment at these levels. This study used multiple theoretical and conceptual frameworks: Hulme’s (2000, p. 79 - 81) microfinance impact assessment tool, debates on survivalist and growth-orientation perspectives of MSEs (Harvie, 2003, p. 27; Snodgrass & Biggs, 1996, p. 43; Hallberg, 2001, p. 19; Nichter & Goldmark, 2005, p. 67), women empowerment continuum model of interpretation (Filmon, 2009, p. 87) and policy practice at the epicenter of governance and policy decision-making (Addis Ababa, Ethiopia’s capital). The assessment considered three elements of microfinance impact assessment, generating primary evidence from 120 micro and small business owners (women entrepreneurs) whose firms stayed two years and above in the market and as clients of selected microfinance institutions. The clients considered were those who accessed at least two loan cycles and above. The respondents were randomly selected from three randomly selected microfinance institutions and a survey questionnaire was administered. The data sets were analysed using multiple tests (non-parametric statistical tests such as Pearson Correlation, Paired-Sample, Chi-Square, Wilcoxon Rank and McNemar tests) as well as parametric tests were conducted using logit econometric model. These tests were conducted to determine statistical difference of microfinance services after program intervention and the contribution of total loans taken on expenditure and businesses investment. The results indicated both developmental or survivalist firms. The result also indicated the empowerment of the women (MSEs owners). A significant number of women entrepreneurs owning MSEs improved their living house, cash savings, household income, child education, household health, household food and diet, business investment, and decision making status in their households. In terms of policy support, the study identified that there were specific affirmative interventions (as stipulated in the policy documents) to support women entrepreneurs owning MSEs in terms of targeted financial service, provision of working and selling premises, designing and implementing training and skill development programs, market networking and tax support on their products and sales. The study recommends that different institutions that work on women empowerment and women associations have to design women focused affirmative policy and strategy interventions to scale-up the positive results (growth-orientation of the MSEs) and address the bottlenecks that limit women entrepreneurs who own MSEs from accessing services that can transform the survivalist MSEs to profitable and empowering businesses for women. The recommendations are proposed to link women empowerment with working policy support. / Development Studies / D. Ph. (Development Studies)

The adoption of eHealth is very slow despite evidences showing its benefits. This research examines the individual, clinical, technical and organizational challenges for eHealth adoption from healthcare provider‟s perspectives. A cross-sectional study design with a quantitative paradigm was used. The study was conducted on 312 doctors and nurses randomly selected from ten hospitals in Addis Ababa, Ethiopia. Most respondents viewed eHealth positively with no significant differences in terms of profession or gender. Computer skill, workload, patient interaction, management support, cost and infrastructure were the main concerns. Privacy and security were not the main concerns. Knowledge of eHealth applications and utilization was low, even for evidence-based medicine and online databases. Specialists and males were better aware of eHealth applications. The study showed that eHealth acceptance was good. Increasing eHealth literacy was recommended as a cost effective means for improving access to updated information to improve the quality of healthcare. / Health Studies / M.A. (Public Health (Medical Informatics))