ADOLESCENTS’ CONDITION IN ETHIOPIAN CULTURAL

The previous literature showed that discipline is the process of teaching children the standard customs, norms, values, and behaviors of their society (Halpenny et al. 2010, Wissow 2002). Among others inductive disciplines are kind of reasoning, providing enough evidence and proof to prove or disprove certain behaviors, making children remember social rules in various settings, and justifying the impact of children’s behavior on others. Inductive discipline is successful in making children internalize attitudes, standards, moral and social values and eventually add into their core values, identity, and lifestyles (Halpenny et al. 2010, Kerr et al. 2004).

Every culture is described and distinguished from each other by deep-rooted and commonly recognized ideas about how one needs to operate in certain cultures satisfactorily as resourceful members in specific culture (Bornstein 2013). Likewise, there are certain moral qualities and manners

that adolescents in Ethiopia must possess and act on and certain behaviors that they must keep out, then adolescents are capable of functioning adequately and normally as members of Ethiopian culture. The process of teaching children the appropriate norms, values, behavior, and social skills is stricter and authoritarian which prevents independence and risk-taking especially among girls (Tefera & Mulatie 2014). Children are considered the most precious natural resources of families, communities, and the nations.

Additionally, previous literature indicated that by the custom in Ethiopia children are regarded as treasure and source of support and indication of continuity (Dolisso 2000) and sources of the feeling of honor and self-esteem for the parents through behaving well (Berhanu 2001).

Children are educated precisely to respect their parents, other elderly, and authority figures. Obedience is highly appreciated, and any anti-social behavior is severely punished (Berhanu 2001). Additionally, Ethiopian families tend to have larger family sizes (many children) by tradition because even some children die because of harsh environmental

conditions (diseases, poor living conditions), still, some children will survive and grow up. Supporting the Ethiopian family cultural beliefs and

perspective, the documented pieces of evidence showed that in a stable, secure and predictable environment the surest strategy is to have a small family size and invest in them, then the likelihood of child survival

increases, and each child is likely to have higher school triumph and personal achievement in the future whereas, in unstable, hazardous and harsh environments, the best strategy would be making many children, many of which may die but some children are likely to survive (Cornwell et al. 2006).

Also, words of address are important methods of communicate that you admired somebody. Children could address the elderly with respectful you-Antu and Irswo. Body language is also used to show respect. Children stand up when the adults come into a room. They do not look an adult in the eyes but bow their head in front of them. They let the adults enter the room first and allow adults they know to walk in front of them in the street.

When other adults visit home, children leave the room when guests arrive (Poluha 2004). Ethiopian children are expected to respect their parents,

adults, and obey their decisions through demonstrating reverence to seniors, obedience to authorities, adults and parents, refraining from questioning and challenging authorities, adults and parents, and desisting talking over parents and interrupting their parents while talking with guests, avoiding calling adults by names and by conducting themselves well (Family life 1998, see on: http://www.tulane.edu/~rouxbee/kids98/

ethiopia3.html). It is our custom to show respect to seniors, authorities, parents, and elderly siblings in Ethiopia, and these valued qualities are schooled through rigorous training and authoritarian way (Berhanu 2001, Rosen 1987).

In Ethiopian culture regarding child-rearing two dichotomies which are opposite namely, “chäwa” (salubrious or socially desirable behaviors) and

“baläge” (impudent behavior or flouting the tradition, custom, rules) exist.

Chäwa children are grown up through rigorous training and discipline (Berhanu 2001, Rosen 1987). Chäwa (good) children exhibit the following behaviors: stand quietly and bend neck down to earth, whenever guests are present and speak softly and in a hardly audible whisper when they have to speak, sit quietly, accept instruction readily, expect to be ordered by his teachers, elderly what to do in any particular situation and shy, Whereas when children are not raised to become Chäwa, it is very likely that they become baläge (bad children) which indicate undesirable traits such as impudent or rude, disrespectful, impolite vulgar or rough, loud, insolent, abusive, aggressive, pushy and straightforward (Berhanu 2001, Rosen 1987). In short, Ethiopian culture inspires qualities such as, politeness, shyness, submissiveness, cautious, and behaviorally

self-possessed among children and these qualities are most liked and accepted by the society, contrasting with the western culture that encourages

assertive and independent behaviors among children as core values (Chen et al. 1998, Chen et al. 1992). Additionally, typical Ethiopian authoritarian parenting style and culture are highly protective, and directive of children and parents are unlikely to encourage and motivate them to explore independently in a novel environment (Chen et al. 1998, Parker 1983).

Ethiopia is a very conservative society, and the corporal punishment method was used to discipline children at home and school in past

however use of physical punishment is dwindling bit by bit at home and it is totally forbidden at schools currently. In line with this, the existing evidence revealed that greater Christian dogmatism was modestly connected to greater approval and use of corporal punishment with preadolescents (Mahoey et al. 2002).

In Ethiopian traditions, the kind of respect that exists between children and parents or adults is uni-directional that is children must show respect to parents, adults, and the elderly but not vice-versa. Despite the western world, family cultures and values underscore the mutual dependence of family members whereas independent lifestyles are not appreciated and valued. Additionally, hierarchical relationships exist in the family, and family members are expected to show honesty toward each other, and junior individuals show respect and obedience to senior individuals (Schwarz et al. 2012, Ishaka et al. 2010, Trommsdorff 2006). However, the weakness of this kind of social contract is that children and adolescents were expected to demonstrate respect and obedience to parents, but not the other way round. Children deserve to get their parents’ respect by being obedient, sticking to and honoring the conventional values and rules in the households and community (Ishaka et al. 2010).

Premarital sexual activity is taboo, especially among unmarried girls in most parts of the world (Molla et al. 2008, Grao 2000). This norm is well-known in rural Ethiopia, in the same way in several conservative societies (Molla et al. 2008, Reminick 1976). It has been noticed that dating and premarital sex are still not cheered but instead regarded as shameful and embarrassing to the family. Good adolescents are expected to indicate humility, compliance to elderly, parents, and authority and ignorant and without knowledge on sexual issues and matters however, the evidence showed that living and acting inconsistent manner with these standards would deprive of the individuals’ opportunities for identity development (Tefera & Mulatie 2014). Consequently, in old Ethiopian culture sexual relations prior to marriage is banned, girls are expected to be virtuous or virginal but in modern Ethiopia, sexual activity before marriage is

widespread especially in urban areas and losing virginity for girls before marriage is not a shameful act anymore (Zelalem 1995). Cultures in

Ethiopia do not tolerate childbearing outside of marriage (Lindstrom et al.

2009) and it seems that the premarital act of sexual intercourse and

becoming pregnant before marriage is forbidden and less tolerated in rural areas compared with urban areas. Previous studies showed that

premarital sexual activity is inspired through formal education and

becoming the leading workforces, migration to cities, and the opportunities and lifestyles in urban areas which boosted up the autonomy of women and weaker family supervision and monitoring over the sexual behaviors of daughters (Lindstrom et al. 2009). In line with Ethiopian culture, several studies revealed that the foundation of the adolescent risk behavior is rooted in the kind of family that the adolescent has been brought up (Azmawati et al. 2015, Okorodudu 2010). Furthermore, changes in sexual norms in the modern world appear to be leading to falling of ages at sexual debut in girls (Guo et al. 2012, Parish et al. 2007, Liu et al. 1998), having several sexual partners across time (Techasrivichien et al. 2014,

Tangmunkongvorakul et al. 2005, Friedman 1992), because of the increasing autonomy for women achieved by formal education and becoming key players in labor markets with that women have got the opportunities and ideas that could encourage sexual tolerance and liberalism (Ip et al. 2001, Chang et al. 1997). Also, new generations are more likely exposed to powerful sexual excitement through social media that could lead to the greater sexual revolution, changing norms in sexual issues and feelings compared to older generations (Techasrivichien et al.

2014, Tangmunkongvorakul et al. 2005, Friedman 1992). So, in certain customs in different parts of the world parents are often blamed and accused of the risk-taking behaviors of their children and adolescents. In some countries, parents are even penalized, punished, and disciplined for the antisocial conduct of their teenagers (Azmawati et al. 2015, Machteld et al. 2009).

The social construction of gender guides the roles, responsibilities, and social behaviors of people. Gender-based discrimination and differences experienced by men and women are context-specific and not uniform.

Some of the discrimination of the rights to employment, property,

education, violence committed, and imbalanced workloads are gender-inspired (Kerr et al. 2016, Ferrant et al. 2015).

In line with this, there are obvious patterns in the division of labor according to gender (men’s work and women’s work) both in the

households and in the wider community, especially in rural Ethiopia. The girls as mothers’ assistants usually involved in domestic work, such as cleaning homes and fetching water, and cherished for their skillfulness in household chores, craftwork, and looking after babies while the boys are directed to work outdoors with their fathers in the garden preparing the land to sowing seeds, planting flowers, trees, removing weeds, and looking after domestic animals. Division of labor is diminished in urban areas since women work outside the home and for an extended period of their life (Family life 1998 see on: http://www.tulane.edu/~rouxbee/kids98/

ethiopia3.html). Several studies worldwide showed that many adolescents in the early adolescent period begin to work various jobs such as

babysitting, shoveling snow, cutting grass. usually in their own

neighborhoods. During the middle adolescent period, most adolescents are inclined to have worked at cafeterias, supermarkets, and sanitary services (Mortimer 2010). Thus, most adolescents are active laborers however employment during high school years is tiresome, especially for adolescents who should work many hours every week (Mortimer 2010, Bills et al. 1995). Employment helps adolescents to learn and develop the

capacity to take responsibility, to plan and budget their time and money, and to become socially skillful to deal with adults, peers, and friends that are priceless assets in the future, however, it can negatively impact their academic life (Mortimer 2010, Mortimer 2003).

Throughout Ethiopia, everybody in the community assumes the responsibility of looking after each child and protecting them from any threats when biological parents are not available close to the children (Poluha 2004). Girls are usually more often monitored and supervised by parents until they get married. Girls have no right to choose their

husbands and it is possible that girls marry at age 10 and above in rural parts of Ethiopia. On the other hand, boys are expected to be tough and kind of aggressive to meet their needs at the same time demonstrate good

temperaments, such as optimism, resilience, hope, and confidence.

Furthermore, boys can independently make decisions with whom they want to marry, and male boys can marry at the age of eighteen (Parker 1995). The existing evidence worldwide showed that the behaviors of adolescents are believed to be manipulated and shaped by the social environment and the characteristics of the households and communities (Azmawati et al. 2015, Okorodudu 2010). Thus, families are primarily crucial in the progress of children’s values, formation of individuality, and the way of coping with everyday life. Additionally, by action, by example, and modeling, families shape the lives and behaviors of their children from birth through adulthood (Azmawati et al. 2015, Smith 2002).

Harmful traditional practices (HTPs) are widely practiced (Parke 1995).

Female Genital Mutilation or Cutting (FGM/C), abduction or forced marriage, and child marriage are the most widespread abusive behavior against girls in Ethiopia (UNICEF 2015). FGM/C is a destructive

well-established customary practice on very young girls. All procedures relating to limited or complete elimination of female outward organs for

nonmedical justifications is genital mutilation (Salam et al. 2016, Berg &

Denison 2012). Harmful traditional practices genital mutilation, child marriage, and abduction for marriage are widespread in rural and remote parts of Ethiopia. However, Ethiopian law strictly forbids child marriage and abduction for marriage, female genital mutilation, traditional harmful practices are exercised in secrete in rural and remote areas. The current study suggested that for about 70% of girls FGM/C have been performed in Ethiopia (Salam et al. 2016, Yoder & Kahn 2008). Female genital

mutilation/cutting (FGM/C), without medical explanation, posed a global public health crisis to 140 million girls worldwide (Wagner 2015).

Fortunately, the Ethiopian government renewed its commitment and obligation to eradicate and abolish harmful traditional practices in all their forms in 2014 by 2025 (UNICEF 2015). In line with Ethiopian cultural

conditions, African traditional belief showed that FGM/C is practiced to protect/guard girls from promiscuity (having sexual relations on a casual (unplanned) basis) (Nkwo & Onah 2001) and the social expectations for girls to be silent, modest/shy, and chaste (pure) (Gilligan 1982), and African

societies socialized young girls to remain virgins until they get married (Blank 2007). However, FGM/C is known for the development of risk for suffering from severe grief, blood loss, shock, complexity in excreting wastes and poisonous substances from the body, and infections among girls, rapidly after the surgery. Equally, long-term impairments that can be instigated by FGM/C are persistent chronic pain, sexual dysfunction, and psychological disorders (Salam et al. 2016, Berg & Denison 2012). A study done in 13 African countries showed that susceptibility to STIs, genital problems, and the likelihood of getting married at an earlier age were risen by 24%, 15%, and 13% respectively among girls who have undergone FGM/C compared to girls who did not have genital mutilation (Wagner 2015).

The existing evidence indicated that social taboos on sexuality and lack of knowledge on sexuality have largely restricted the parents’ participation in sexual and reproduction health (SRH) communication with their children (Dessie et al. 2015, Bastien et al. 2011). Culturally, Ethiopian mothers and older females in the extended family including aunts, sisters and

grandmothers pass and teach to their daughters or young female adolescents about the various aspects of the lifecycle including puberty, sex, menstruation, childbirth, breast-feeding and childcare as well as positive health behaviors that are vital resources for health maintenance, prevention, and promotion (Mendlinger & Cwikel 2006).

3.3 CULTURAL HEALTHCARE PRACTICE AND HEALTH BELIEFS IN