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SEMINAR ON THE RIGHT TO DECIDE Sexual and Reproductive Rights

Trends in Knowledge Attitude and Practices of Harmful Traditional Practices in Ethiopia (1997 to 2007) . SEMINAR ON THE RIGHT TO DECIDE Sexual and Reproductive Rights Practices That Affect The Health Of Women And Children 9-10 December 2009 Vitoria- gasteiz (SPAIN)

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SEMINAR ON THE RIGHT TO DECIDE Sexual and Reproductive Rights

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  1. Trends in Knowledge Attitude and Practices of Harmful Traditional Practices in Ethiopia (1997 to 2007) SEMINAR ON THE RIGHT TO DECIDE Sexual and Reproductive Rights Practices That Affect The Health Of Women And Children 9-10 December 2009 Vitoria-gasteiz (SPAIN) Prepared by Mr. Abate Gunduffa (EGLDAM) and Mr. EzanaHaddis (BLIE) Presented by EzanaHaddis (BLIE)

  2. Presentation Outline • Background about the Ethiopia • Introduction • Discussion of trends • The 15 HTP • Detail discussion in the major HTPs • Institutional framework and actors in the Fight Against HTP • Challenges • Conclusion Presenation to Haurralde Foundation

  3. Background to the Nation (Ethiopia) • 73.9 million with only 16% urban population • Covers about one million square kilometers • Found in the horn of Africa b/n 3 and 15 degrees North latitude • And 34 and 48 degrees East longitude • Has more than 80 ethnic groups • It is a federal country, where there are autonomous nine regional states and two city administrations Presenation to Haurralde Foundation

  4. Cont’d Presenation to Haurralde Foundation

  5. Regions of Ethiopia • 1- Addis Ababa • 2- Afar • 3- Amahara • 4- Benishangul Gumz • 5- Dire Dawa • 6- Gambella • 7- Harari • 8- Oromiya • 9- Somali • 10- South Nations, Nationalities and Peoples (SNNPR) • 11- Tigray Presenation to Haurralde Foundation

  6. Health Status and Services Presenation to Haurralde Foundation

  7. Introduction • This presentation is prepared based on two surveys • the Baseline Survey (1997) and • Follow-up Survey (2007) • Which were conducted on the Harmful Traditional Practices in Ethiopia by NCTPE/EGLDAM Presenation to Haurralde Foundation

  8. Introduction: The Surveys Presenation to Haurralde Foundation

  9. Introduction: The Report Presenation to Haurralde Foundation

  10. Introduction: Book [+Amharic adaptation] Presenation to Haurralde Foundation

  11. Objectives of FUSMajor Objective • "to examine/measure changes observed on prevalence, knowledge, attitude, intention and behavior......... towards HTP at national level and to recommend appropriate strategies in future directions". Presenation to Haurralde Foundation

  12. Specific objectives • Assess change & current: • Prevalence, knowledge, attitude, intention & behaviour • Reasons, harmful effect & victims • Impact on HIV • Identify • Major actors in HTP • Activities by different actors • Achievements so far Presenation to Haurralde Foundation

  13. Framework for Methodological Development . • Follow up survey, therefore, as much as feasible same method with the baseline survey • However, adapted because of: • Need to asses the changes over time • New objectives – interventions & organizations • Approaches: • Literature/documents review • Questionnaire surveys • FGD . Presenation to Haurralde Foundation

  14. Methodology Adaptation Process • Conceptualization of the follow up • Framework for social change analysis [Dr Yeraswork] • The nature of change in culture and tradition • Factors/determinants of change and how they interact • The role of change agents (traditional leaders, FBOs, NGO, government etc) and possible assessment of their (differential) impact • Models/methods of assessing changes and their applicability to HTP in Ethiopia • Framework for statistical analysis [Prof Ayenew & Behayelu] • Sample frame in line with the baseline study • Sample size to ensure quantification of prevalence change for, at least, FGM in the stronghold nationalities Presenation to Haurralde Foundation

  15. Assessing Change: Framework Community • HTP Environment Gov NGO/CBO EGLDAM Presenation to Haurralde Foundation

  16. . Presenation to Haurralde Foundation

  17. 1. Literature/Document Review Geared towards change in the last ten years and new developments • Background • Geography & demography • Political – decentralization • High number of NGO • Economy – poverty • Socio-cultural – gender, children • Education • Health & health services • HTP (5 years because NCTPE 2003) • FGM • Marriage related • Children related • ‘Taboos’/prohibitions • Others Presenation to Haurralde Foundation

  18. 2. Qualitative and Quantitative Methods & Instruments • Cross-sectional sample survey [Q1] • Adult pop (F & M), general info on 20 HTP [Q1a, 100 households from each Kebele] • Prevalence of 5 HTP [Q1b, 20 HH from each Kebele] • Info from opinion makers (20 from Woreda; educated, informed) • Info on 20 HTP (Q2a, mostly close-ended) • Others mostly Food/Work Prohibition (Q2b, open-ended) • FGD, 2 per Woreda (District): • Capital • Kebele/Farmers’ Association Presenation to Haurralde Foundation

  19. Contents of Baseline & Follow Up Surveys Presenation to Haurralde Foundation

  20. Sample Population: Criteria • Same with baseline as feasible • However changesbut no up to date data • Zones (sub-regions) some new ones • Woredas (districts) some merged, some new, special • Kebeles (the smallest local admin) some merged, some new names etc Presenation to Haurralde Foundation

  21. Principles for decision (in field) • Cover all zones (sub-regional entities): 2 woredas (districts) per zone • Use the same woredas (district) & Kebeles (the smallest local admin) as baseline (i.e. same locality) • Include Dire Dawa & zones in Somali • Include additional ethnic groups Presenation to Haurralde Foundation

  22. Study Population Presenation to Haurralde Foundation

  23. DiscussionKAPr 15 HTP 2007 Presenation to Haurralde Foundation

  24. Comparison of knowledge towards the 15 HTP in BLS and FUS Presenation to Haurralde Foundation

  25. Knowledge: FGM by region Presenation to Haurralde Foundation

  26. FGM, Baseline & Current Prevalenceby Region Presenation to Haurralde Foundation

  27. Prevalence of FGM by Age GroupBaseline (BLS) & Follow up (FUS) Surveys Presenation to Haurralde Foundation

  28. Important decrease in prevalence:Prevalence of FGM by Age FUS Presenation to Haurralde Foundation

  29. Map Prevalence of FGM by Region 2007 Presenation to Haurralde Foundation

  30. FGM: Harmful Effects Presenation to Haurralde Foundation

  31. Early Marriage: Knowledge BLS & FUS by Region Presenation to Haurralde Foundation

  32. Early Marriage: Attitude in BLS and FUS by Region Presenation to Haurralde Foundation

  33. Early Marriage Prevalence: BLS & FUS Presenation to Haurralde Foundation

  34. EM: Harmful Effects in BLS & FUS Presenation to Haurralde Foundation

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  42. MBA: Knowledge in BLS and FUS Presenation to Haurralde Foundation

  43. MBA: Attitude in BLS and FUS Presenation to Haurralde Foundation

  44. MBA: Prevalence in BLS and FUS Presenation to Haurralde Foundation

  45. MBA: Harmful Effects in BLS & FUS Presenation to Haurralde Foundation

  46. UC Baseline & Current (ascending order) Prevalence by Region Presenation to Haurralde Foundation

  47. Prevalence of UC by Age: Baseline & Follow up Surveys Presenation to Haurralde Foundation

  48. UC: Harmful Effects in BLS and FUS Presenation to Haurralde Foundation

  49. MTE: Prevalence in Baseline & Follow up Surveys by region (ascending order) Presenation to Haurralde Foundation

  50. Comparison of knowledge with the baseline result(descending order change) Presenation to Haurralde Foundation

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