THE ROLE OF INDIGENOUS VOLUNTARY ASSOCIATIONS IN ...

ADDIS ABABA UNIVERSITY
REGIONAL AND LOCAL DEVELOPMENT
STUDIES (RLDS)
THE ROLE OF INDIGENOUS VOLUNTARY ASSOCIATIONS IN COMMUNITY
BASED HIV/AIDS INTERVENTION ACTIVITIES
(THE CASE OF IDDIRS IN ADDIS ABABA)
ADVISOR - ALULA PANKHRUST (PHD.)
Prepared by - Wubalem Negash
June 2003

Addis Ababa University
Research and Graduate program Office
Regional and Local Development
THE ROLE OF VOLUNTARY ASSOCIATION IN COMMUNITY BASED
HIV/AIDS INTERVENTION ACTIVITIES
(THE CASE OF IDDIRS IN ADDIS ABABA)
A thesis submitted to the research and graduate program office Addis
Ababa University, Regional and Local Development Studies in partial
fulfillment of the requirement of Degree of Masters in Regional and
June, 2003
Local Development Studies
Advisor- Alula Pankhurst (PHD)
Prepared by – Wubalem Negash

ADDIS ABABA UNIVERSITY
RESEARCH AND GRADUATE PROGRAM OFFICE
REGIONAL AND LOCAL DEVELOPMENT STUDIES (RLDS)
THE ROLE OF INDIGENOUS VOLUNTARY ASSOCIATIONS IN
COMMUNITY BASED HIV/AIDS INTERVENTION ACTIVITIES
(THE CASE OF IDDIRS IN ADDIS ABABA)
A THESIS SUBMITTED TO THE RESEARCH AND GRADUATE PROGRAM
OFFICE ADDIS ABABA UNIVERSITY, REGIONAL AND LOCAL DEVELOPMENT
STUDIES (RLDS) IN PARTIAL FULFILLMENT OF THE REQUIREMENT OF DEGREE OF
MASTERS OF ARTS IN REGIONAL AND LOCAL DEVELOPMENT STUDIES
APPROVED BY BOARD OF EXAMINERS
Board of examiners Signature Date
1. Tegegn G/Egziabher (PHD.) __________________________ _________________
(Chairman)
2. Alula Pankhurst (PHD.) __________________________ _________________
(Advisor)
3. Hirut Terefe (PHD.) _________________________ _________________
(Internal examiner)
4.Damen Haile Mariam (PHD.) ________________________ _________________
(External examiner)

DEDICATION
THIS RESEARCH PAPER IS DEDICATED TO MY LATE
FATHER ATO NEGASH CHERU, WHO HAS GIVEN ME
INSPIRATION, COURAGE AND ENDLESS LOVE
THROUGH OUT MY LIFE.

ACKNOWLEDGMENTS
I would like to give due appreciation for the contribution of different
individuals and organizations for their invaluable support, encouragement
and advise during my entire academic life and while I was undertaking this
thesis. Above all I thank the almighty God for giving me strength and
courage to go through the hardships and accomplish this much in my
academic studies and other aspects of life.
My thesis advisor, Dr. Alula Pankhurst, provides me his invaluable support
and guidance starting from title identification until the finalization of the
research. His comments, inspirations and his patience to correct each draft I
prepare in every section of research undertaking makes this paper as
technically presentable.
My thanks also dedicates for Ato belay Hagos for his patience, valuable
comments and inputs in my thesis. I am also extremely indebted for my
professors in department of Sociology and Social Administration for their
support and inspiration they put in both in my undergraduate and
postgraduate studies.
I am also extremely grateful for those personnel who were working in my
sample NGO for providing me extensive information their comments and
their encouragement while I was conducting data collection. W/o Kassech
Abegaz (From ACORD Ethiopia); Dr. Kidmealem Lulseged, Ato Megerssa
Fida and Ato Genene Bekele (CARE Ethiopia); Sister Enkutatash Bekele
(from CBISDO); Sister Tibebe Maco, W/t Huluhagersh Eshete and W/t
Nafkot W/stadik (from HAPCSO); Ato Yared Dagefu, Ato Dawit Adnew and
Ato Leggesse Annore (from MJATD) and lastly but not least at all, Ato Mesfin
(from ProPride Merkato) are those who deserve my thanks. I am even more
thankful for every Iddir leader for their responses to my interviews and their
advise to my studies.
My many thanks also goes to Ato Aydefer Negash, My brother and my best
friend, for his love, care and encouragement throughout my life in general
ii

and during my post graduate life in particular. Similar appreciation also goes
to my mother w/o Etalemahu Belihu, and my brothers Ato Gezaheghn
Negash and Engineer Asnake Negas for their support and encouragement.
Lastly, but not least in any ways, I am thankful for all my friends, colleagues
and class mates for their moral support and motivation in my studies and
accomplishment of this thesis.
iii

Abstract
Aberrations
Local terms
List of tables, diagrams and graphs
Table of contents Page
number
PART ONE, INTRODUCTION, METHODOLOGY, RESEARCH DESIGN
AND PROFILE OF SELECTED NGOs
CHAPTER ONE
1. INTRODUCTION
………………………………………..………………....………….1
1.1 BACK GROUND……………………………….……..………………..…….……1
1.2 STATEMENT OF THE PROBLEM ………………....…………….……….…..3
1.3 SIGNIFICANCE OF THE PROBLEM………………...…………………….….4
1.4 OBJECTIVES OF THE STUDY …………………….....……..…………….….6
1.4.1 GENERAL OBJECTIVE……………….…………………….…6
1.4.2 SPECIFIC OBJECTIVE……………………….….………….…6
1.5 RESEARCH QUESTIONS…………………………….………..….………….…6
1.6 THE STUDY AREA………………………………………………...……………..7
1.7 ORGANIZATION OF THE PAPER ………………………………..…..……….9
2. CHAPTER TWO : RESEARCH DESIGN AND METHODOLOGY
2.1 METHODOLOGY.………………………………………………
……….10
2.1.1 METHODS OF SAMPLING
……………………..…….10
2.1.2 METHODS OF DATA COLLECTION And
Instrument
Design……………………………………………………
…11
iv

2.2 RESEARCH
2.1.3 METHOD OF DATA ANALYSIS
……………….….…..12
2.1.4 FACTORS CONSIDERED
……….……………………..13
DESIGN………………………………………………….....13
2.2.1 SELECTION OF SAMPLE
NGOS……………..……....13
2.2.2 SELECTION OF SAMPLE
IDDIRS..…………………..15
2.2.3 SELECTION OF GOS IN
2.3 SCOPE OF THE STUDY
SAMPLE………..…………..16
…………………………………………….…..16
2.4 LIMITATION OF THE STUDY
…………………………………………..17
2.5 PROFILE OF THE SELECTED COMMUNITY BASED
HIV/AIDS INTERVENTION IMPLEMENTING
NGOS………………………………………………………………..……
….17
PART TWO: CONCEPTUAL AND THEORETICAL FRAMEWORK AND REVIEW
OF RELATED LITERATURE
3. CHAPTER THREE
CONCEPTS, DEFINITIONS AND THEORETICAL FRAME WORK
3.1 DEVELOPMENT, POVERTY AND HIV/AIDS……….………...…….………..25
3.1.1 DEVELOPMENT APPROACHES AND THE CONCEPT OF
POVERTY ………………………………………………………….25
3.1.2 POVERTY, HIV/AIDS AND DEVELOPMENT ……………...26
3.2 THE CONCEPT OF COMMUNITY AND COMMUNITY DEVELOPMENT
…….…………………………………………………………………….……………..29
v

3.3 THE CONCEPT OF COMMUNITY BASED ORGANIZATIONS
……………………………………………………………………………..………….29
3.4 CONCEPTUALIZATION OF CIVIL SOCIETY
ORGANIZATIONS………………….….………………………………………l…..30
3.5 THE CIVIL SOCIETY APPROACH ………………………………………….…..31
3.6 RATIONALE FOR A COMMUNITY BASED HIV/AIDS INTERVENTION
…………………………………………………………………………………….……33
CHAPTER FOUR - REVIEW OF RELATED LITERATURE
4. LITERATURE REVIEW ON INDIGENOUS ASSOCIATIONS
4.1 THE CONCEPT OF VOLUNTARY ASSOCIATIONS AND IDDIR …………..36
4.1.1 THE RANGE OF VOLUNTARY ASSOCIATIONS IN ETHIOPIA ...36
4.1.2 DEFINING IDDIR
…………………………………………………...…...37
IDDIR ...36
4.1.3. IDDIR AS A POPULAR FORM OF INDIGENOUS VOLUNTARY
ASSOCIATION………………………………………………….……….38
4.1.4 FACTORS THAT LEAD TO DEVELOPMENT OF
4.1.5 IDDIR AND
DEVELOPMENT……………………………..…..40
4.2 LITERATURE ON HIV/AIDS AND IDDIR
…………………………….…..…………41
4.2.1 SPREAD OF HIV/AIDS IN ETHIOPIA
……………….………..……………41
4 2.2 TRANSMISSION OF
HIV/AIDS………………………..………………………..42
4.2.3 AIDS REPORTS IN
ETHIOPIA……………………………………………..…….43
4 2.4 IMPACTS OF AIDS IN
ETHIOPIA……………………………..…………………44
4.2.5. THE THREAT OF HIV/AIDS EPIDEMIC ON IDDIRS
………..……….……47
4.2.6 MAJOR STRATEGIES OF COMBATING
HIV/AIDS...………..……………...49
vi

PART THREE: ANALYSIS, DISCUSSION, SYNTHESIS OF FINDINGS AND
RECOMMENDATION
5. CHAPTER FIVE ANALYSIS AND DISCUSSION OF FINDINGS
5.1 EFFORTS OF SELECTED NGO IN HIV/AIDS INTERVENTION
WITH
IDDIR…………………………………………………………………………………
……….52
5.1.1 THE ACTIVITIES OF HAPCSO
………………………..……………52
5.1.1.1 REASON FOR INVOLVING IDDIRS
…………...…………….53
5.1.1.2 ACTIVITIES OF PARTNER
IDDIRS………………………….53
5.1.1.3.DEGREE OF INVOLVEMENT OF PARTNER IDDIRS
…………………
……………………………………………………………55
5.1.1.4 DURATION OF IDDIR INVOLVEMENT
………………………………………………………………………..……..
58
5.1.1.5 BY LAWS
REVISION……………….……………………………………..60
5.1.2 THE ACTIVITIES OF CARE; ETHIOPIA URBAN HIV/AIDS PREVENTION
AND CONTROL
PROJECT…..…………………………………….….…………60
5.1.2.1 REASON FOR INVOLVING IDDIRS
………………………………...………….60
5.1.2.2.INVOLVEMENT OF PARTNER IDDIR IN IEC AND
BCC……………………61
5.1.2.3.PROVISION OF CARE AND SUPPORT FOR AIDS VICTIMS
……………..62
5.1.3 THE ACTIVITIES OF
ACORD………………………………………………………………63
5.1.3.1.CAPACITY BUILDING ACTIVITIES OF
ACORD……………..……………..65
vii

5.1.4 THE ACTIVITIES OF
MJATD……………….………………….………………..66
5.1.5THE ACTIVITIES OF OF PRO- PRIDE MERKATO
PROGRAM………..……68
5.1.6 THE CASE OF
CBISDO……………………………………………………………68
5.2 THE EFFORT OF SELECTED IDDIRS IN HIV/AIDS
……………83
INTERVENTION……………...……71
5.2.1 INVOLVEMENT OF IDDIRS IN NON BURIAL
ACTIVITIES………………..…71
5.2.2 ACCESS OF IDDIRS TO EXTERNAL ASSISTANCE FOR NON BURIAL
UNDERTAKINGS……………………………………………………………………………..
73
5.2.3 THE SITUATION OF IDDIR CAPITAL, EXPENDITURE ON
DEVELOPMENT, EXPENDITURE ON BURIAL ACTIVITIES AND DEATH
RATES IN SELECTED IDDIRS
………………………………………………………………………………………….75
5.2.4. ANTI HIV/AIDS ACTIVITIES OF IDDIRS
………………………………………83
5.2.4.1 DURATION OF IDDIRS' ANTI HIV/AIDS ACTIVITIES
5.2.4.2 REASONS FOR IDDIRS' INVOLVEMENT AND SOURCES OF
INITIATION………………………………………………………..83
5.2.4.3 REVISION OF IDDIR BYLAWS
………………………………………..86
5.2.5 MAJOR ANTI HIV/AIDS STRATEGIES UNDERTAKING BY
IDDIRS…………………………………………………………………………….….
88
BCC………………………………….….88
5.2.5.1 INVOLVEMENT IN IEC AND
5.2.5.1.1. IMPLEMENTERS OF ADVOCACY SESSIONS
…………..….….90
5.2.5.1.2 . PARTICIPATION OF HEALTH OFFICIALS AND PLWA IN
ADVOCACY
SESSION……………….……………………………………..………91
5.2.5.2. INVOLVEMENT IN PROVISION OF CARE AND
SUPPORT………93
viii

…….…………………94
5.2.5.2.1 KIND OF SUPPORT FOR AIDS PATIENTS
………………………..93
5.2.5.2.2 KIND OF SUPPORT FOR AIDS ORPHANS
5.2.5 MAJOR PROBLEMS FACED BY IDDIRS
……………………...………97
...98
5.2.6 FACTORS HINDER INVOLVEMENT OF NON INVOLVED IDDIR
5.3 EFFORTS OF GOVERNMENT BODIES TO INVOLVE IDDIRS IN HIV/AIDS
INTERVENTION
………………………………………………………………………………..100
5.3.1 ACTIVITIES OF ADDIS ABABA
HAPCO………..……………………………….100
5.3.1.1. MAJOR ROLES OF ADDIS ABABA
HAPCO……………..………..101
5.3.1.2 SOURCE OF FUND FOR ADDIS ABABA
AHPCO…………………105
5.3.2 THE ACTIVITIES OF WEREDA 5 ANTI HIV/AIDS COUNCIL
COORDINATION OFFICE IN INVOLVING IDDIR IN ANTI HIV/AIDS
ACTIVITIES………………………………………………..……………….………1
07
5.3.2.1 FORMATION OF ANTI HIV/AIDS IDDIR COUNCIL AT WEREDA
LEVEL………………………………………………………………………………..
108
5.3.2.2 FORMATION ANTI HIV/AIDS IDDIR COUNCIL AT KEBELE
LEVEL.….……………………………………………………………………………
108
CHAPTER SIX ; SUMMARY, CONCLUSION SYNTHESIS OF FINDINGS AND
RECOMMENDATION………………………………………………………………………………..………1
11
6. 1SUMMARY AND CONCLUSION
…………………………………………………………..…115
6.2 SYNTHESIS OF FINDINGS
……………………………………………………………….…117
6.3 RECOMMENDATIONS
……………………………………………………………………….120
REFERENCES
ANNEXES
ix

LOCAL TERMS
Gigge- A rural gathering meant for provision of assistance in agricultural labor
for families in need.
Iddir - A form of indigenous voluntary association meant for burial, mourning
activities as well as related social security activities.
Iqub - A kind of traditional Rotating Savings and Credit Association (ROSCA),
found in Ethiopia.
Kebele- Smallest local administrative unit in the Ethiopian urban structure of
Kifle-ketema - Sub-city unit, according to the recent urban re-structuring of
Addis Ababa.
Sefer- Small village or villages
Sembete - Religious association among Orthodox Christians meant to feast on
Sundays for religious as well as social purposes.
Teskar - Feast giving ceremony meant for religious dedication of the death of
some one, among Orthodox Christians
Tsewwa - Kind of religious association among Orthodox Christians to feast on
days of Saints as well as for social purposes.
Wereda - Local administrative unit larger than Kebele
Ye-Iddir Dagna- Chairperson of Iddir
Ye-Iddir Tehafy- Secretary of Iddir
Ye-Iddir Sebsaby- Person in charge of chairing the activities of Iddir
Ye-Iddir Genzeb-yaszh - Cashier of Iddir
x

ABBREVIATIONS
ACORD- Agency for Cooperation in Research and Development
AIDS- Acquired Immune Deficiency Syndrome
BCC- Behavioral Change and Communication
CBISDO- Community Based Integrated Sustainable Development
Organization
CBO- Community Based Organizations
CDC- Center for Disease Control
CSOs- Civil Society Organizations
ECR- Expanded Comprehensive Response
EMSAP- Ethiopian Multi Sectoral AIDS Project
GOs- Government Organizations
HBC- Home Based Care
HAPCO- -HIV/AIDS Prevention and Control Office
HAPCSO- Hiwot AIDS Prevention Control and Support Organization
HIV- Human Immune Deficiency Virus
IEC- Information Education and Communication
MJATD- Marry Joy Aid Through Development
MOH- Ministry of Health
MOYCS- Ministry of Youth and Culture and Sport
NACS- National AIDS Council Secretariat
NGO- Non-Governmental Organization
PLWA- People Living With AIDS
ROSCA- Rotating Saving and Credit Association
STD- Sexually Transmitted Disease
STI- Sexually Transmitted Infections
UNICEF- United Nations Children Emergency Fund
VCT- Voluntary Counseling and Testing
WB- World Bank
WFP- World Food Program
YMCA- Young Male Christian Association
xi

Abstract
The purpose of this research is to assess the role played by Iddir in coping with the
HIV/AIDS epidemic in Addis Ababa, and hence to assess the role of non governmental
organizations and governmental organizations in promoting active participation of Iddirs
in the national HIV/AIDS intervention. In this thesis Iddir is considered as the major
community based organization that can ensure the mobilization of every section of the
community in anti HIV/AIDS activities. The activities of governmental organizations and
non-governmental organizations are assessed with regard to their activities in involving
Iddir in HIV/AIDS intervention activities.
Increased mortality rate among majority of Iddirs resulting in increased expenditure on
burial and related activities progressively deplete the financial resources of Iddirs. This
situation in its turn result in limited involvement of Iddirs in poverty reduction and
development activities. In some cases the very livelihood of Iddirs to survive is in
jeopardy. So, involving Iddirs in anti HIV/AIDS activities is timely and reasonable
considering the threat of the epidemic and the role Iddirs could play in mobilizing the
community in such undertakings.
Community based HIV/AIDS intervention that is undertaken in involving Iddirs in anti
HIV/AIDS activities is in its infancy. Few efforts are being made to involve Iddirs in anti
HIV/AIDS activities by certain NGOs and GOs. Very few NGOs are currently working in
the areas of HIV/AIDS interventions with partner Iddirs. The existing attempts are
recently adopted in which very few Iddirs took part. The existing activities of involved
Iddirs are mainly reliant on the technical and financial assistance obtained from NGOs
and GOs. The actives of NGO range from capacity building for local community based
organizations like Iddirs, to provision of IEC, and care and support for AIDS patients and
AIDS orphans. The role of partner NGOs are considerable in initiating the local Iddirs in
taking part in HIV/AIDS interventions, as well as enhancing their role in these activities.
Partner NGOs implement projects, which obviously are limited in resources, time and
area. The sustainability of many of these activities is limited. The activities of GOs include
formation of Iddirs council and facilitate capacity building activities for the local Iddirs in
anti HIV/AIDS activities.
There is large amount of financial resources availed at the national level, which is meant
to enhance the financial capacity of CBOs in their anti HIV/AIDS activities. However,
Iddirs rarely prepared projects proposals to use the EMSAP fund.. Limited technical
capacity of Iddirs is the major factor that hinders the success of such attempts
xii

undertaken by government organization and non-government organization. Certain
suggestions about further improvement in partnership, capacity building and networking
are recommended to improve the situation of identified problems.
xiii

1. INTRODUCTION
1.1. BACKGROUND
CHAPTER ONE
Globally, the HIV/AIDS epidemic is becoming the foremost development crisis
that threatens the demographic, social, economic as well as political stability of
various nations. Developing countries are the major ones to be affected by
different aspects of the AIDS epidemic. Africa is identified as the continent most
affected by HIV/AIDS (UNAIDS, 2001).
In most Sub-Saharan African countries adults and children are infected to a
wide extent by the HIV/AIDS epidemic. The rate at which the infection spreads is
accelerating. East Africa was once the highest infected region but now those in
the southern part of the continent exceed the rates. South Africa has the largest
number of people living with HIV/AIDS in Africa (UNAIDS, 2000).
In African countries AIDS is not only a health problem but rather it also affects
the political and economic sector. AIDS is impeding development and
threatening political stability. It affects every aspect of development and major
economic sectors. It has adverse impacts on population, education, health,
agriculture, economy and business (UNAIDS, 2001).
The latest report produced by Ministry of Health, (2002) showed that the current
estimate for the adult prevalence rate of HIV infection is 6.6 per cent. The report
also indicated that currently there are 15,202 reported AIDS cases; an estimate

of 219,400 AIDS cases and 2.2 million people are living with HIV in the country
during the report year (MOH, 2002).
The national adult HIV/AIDS prevalence rate in the year 2002 was 6.6 which is
less than the prevalence rate for the year 2000, which was 7.3 percent. This
change in prevalence was indicated not to show an actual decline in the
HIV/AIDS epidemic in Ethiopia. However, it was rather the result of a
reclassification of Estie, one of the rural sites into urban center (Ministry of
Health, 2002).
An effective national response to the HIV/AIDS epidemic can contribute to
poverty reduction and to the overall development efforts. According to the
Ministry of Health, the rate of spread of the epidemic is such that, the number of
PLWA will increase to 2.6 million and 2.9 million in the years 2006 and 2010
respectively. Moreover, the prevalence rate is expected to reach 7 percent in the
year 2004. The number of AIDS cases will increase to 322,310 in the year 2014.
Such projections indicate how fast the spread of the epidemic is and how serious
the impact is on the overall development activities.
In Ethiopia, AIDS is eroding progress made in areas of education, access to
health care and economic development. Hospital bed occupancy rate for HIV
cases is increasing. The health sector, military sector and mobile work force
seem to be significantly affected by the HIV/AIDS epidemic (Ministry of Health,
2002).

One out of every 11 people living in Ethiopia is an HIV/AIDS victim. The
epidemic has also an impact on the country's capability to reduce poverty. HIV is
the largest killer disease that affects the most productive age group in the
country and is therefore, becoming the foremost threat to socio economic
development. If it remains unchecked, HIV/AIDS will retard growth, weaken
human capital, discourage investment, aggravate poverty and inequality and
leave the next generation increasingly vulnerable to further socio-economic
impacts of the epidemic (National AIDS Council, 2001).
Therefore, it is suggested that there is a need to mobilize the efforts of the
government and non-government organizations, community based organizations
other stakeholders of the national development in providing care and support to
people affected and infected by HIV/AIDS.
1.2. STATEMENT OF THE PROBLEM
As it is indicated in an extensive research on the role of Iddir in poverty
alleviation, change and development, the threat of HIV/AIDS is identified as one
of major factors that limit the participation of Iddirs in development activities.
The HIV/AIDS epidemic is identified as a major threat for the very existence of
Iddirs as one of grass root social institutions. An increased number of
expenditure on deaths expenses for members resulted at one time they could not
pay for their members " … recently, due to the killer disease HIV/AIDS some
leaders of Iddirs have the fear that it may deplete their financial resources".
Therefore, it is indicated that certain Iddirs in Addis Ababa are at the margin of

disintegration due to high death rates and related financial depletion (Shiferaw,
2002).
Similarly according to survey made by Damen and Pankhurst (2003) increments
in deaths have been experienced in most of Iddirs. In recent situation of
increased mortality assumed to be caused by HIV/AIDS, Iddirs have been
adversely affected in various ways. In the fist place, they have been losing
members, and in addition, increased means greater strain in member in financial
resources. Such stress lead to decreased in membership since majority may not
be able to meet contribution. Eventually it is possible some Iddirs would dissolve.
Therefore, Iddirs are expected to play major role in coping with epidemic along
with efforts made by formal sector. There is no question that Iddirs could be
successful mechanism in involving in the community in multi-sectoral efforts for
the prevention and control of HIV/AIDS (Damen and Pankhurst, 2003).
The participation of Iddirs in coping with HIV/AIDS in Ethiopia is at its infancy.
Considering Iddirs have acquired experience in developmental and community
mobilization activities, there are certain beginnings to involve Iddirs in anti
HIV/AIDS interventions as well. According to PACT Ethiopia (2000), there were
11 NGOs implementing community-based activities, which are undertaken
jointly with Iddirs. The assessment made by PACT showed that there are certain
beginnings to involve Iddirs in HIV/AIDS intervention (Pact Ethiopia, 2000).
Similarly, Damen and Kloos (2003) indicated that Iddirs are taking part in
HIV/AIDS intervention activities along with efforts made by Kebeles, anti

HIV/AIDS clubs, associations of people living with AIDS, non governmental
organizations and similar grass root organizations.
The participation of Iddir in anti HIV/AIDS is suggested as one of potentially
essential for the successful national anti HIV/AIDS intervention. So undertaking
research in the role of Iddirs in coping with HIV/AIDS is timely and reasonable to
assess the impact of HIV/AIDS on the livelihood of Iddirs and the extent of their
involvement in anti HIV/AIDS activities. The major rational of conducting this
study is to assess the impact of AIDS on Iddirs and recommend the better
situation in coping with the impact of HIV/AIDS.
1.3. SIGNIFICANCE OF THE STUDY
A successful national response to HIV/AIDS requires coordinated engagements
of government organizations, non-governmental organizations, as well as
community-based organizations fully and efficiently. Such an effort, in turn, has
to be based on concrete empirical research in order to design realistic strategies
to contain the pandemic and support people living with HIV/AIDS.
Different studies tried to show the medical, epidemiological as well as the
economic impact of HIV/AIDS on the overall development of the country. Only a
few studies have attempted so far to show the social and socio-cultural impact of
the HIV/AIDS epidemic. More importantly, little attention is given to the study of
the role of Community Based Organizations (CBOs) to cope with the adverse
impacts of the HIV/AIDS epidemic.

Some studies (Dejene, 1993; Getenet , 1999; Shiferaw, 2002) have dealt with the
role of Iddirs in overall development activities and related linkages that exist
between poverty reduction and participation of the local community at the grass
root level. However, the role and responses of such indigenous voluntary
associations to cope with the HIV/AIDS epidemics seem to be rarely studied.
Only a few researches (Pankhurst and Damen, 2003) tried to assess certain
beginnings made in involving the grass root community in HIV intervention in
Addis Ababa.
The major purpose of this study is to assess and the role of Iddirs and thus, fill
the research gap concerning the role of community participation in anti
HIV/AIDS activities.
Therefore, this study aims at assessing community-based initiatives undertaken
to cope with the HIV/AIDS epidemic and the role of community based
organizations in anti HIV/AIDS activities and with particular emphasis on the
contribution of Iddirs. In addition, the experience of studying the role of Iddirs
might initiate further efforts in employing participatory approaches in anti
HIV/AIDS activities by involving grass root community based organizations.
Accordingly, the role and the responses of Iddirs for successful anti HIV/AIDS
intervention is the focus of investigation in this study with the above-mentioned
importance and significance.
1.4. OBJECTIVES OF THE STUDY

1.4.1. GENERAL OBJECTIVE
The general objective of this study is to assess roles played by Iddirs in coping
with the HIV/IDS epidemic and undertaking anti HIV/AIDS activities in Addis
Ababa.
1.4.2. SPECIFIC OBJECTIVES
• Assess the magnitude of impact of HIV/AIDS epidemic on the livelihood
of Iddirs.
• Examine the role of NGOs and GOs and local administrative units like
Kebele and weredas to involve Iddirs in anti HIV/AIDS interventions.
• To assess and examine the extent of partnership that exists between
NGOs and GOs with partner Iddirs.
• Examine the major problems faced by Iddirs, NGOs as well as
government bodies to involve actively in community based HIV/AIDS
intervention.
• Assess the degree of involvement of Iddirs and implementer NGOs in
anti HIV/AIDS components and activities.
1.5. RESEARCH QUESTIONS
In order to investigate specific objectives of the research, the following research
questions were formulated.

1. What is the situation of impacts of HIV/AIDS on the overall activities of
Iddirs?
2. What is the extent of partnership between Iddir, NGOs and GOs as well as
local administrators to ensure sustainable community based anti HIV/AIDS
activities?
3. What are the roles of NGO, community leaders, local administrators and
government bodies in anti HIV/AIDS activities undertaken by Iddirs?
4. What are the major anti HIV/AIDS strategy components and activities widely
undertaken by the Iddir in coping with the HIV/AIDS epidemic?
What are the major problems faced in involving Iddirs in HIV/AIDS
intervention?
1.6. THE STUDY AREA
Addis Ababa as the primate city, which is characterized by a concentration of
economic, social and related facilities, which seem to be disproportional to the
rest of other urban centers found in the country. This has resulted in a high rate
of rural-urban migration and congested settlement in the city, which in turn
resulted in ever increasing population pressure in the city.
The population size of Addis Ababa is estimated to be 3 million people, with the
increase rate of 3 per cent per year. This constitutes 5 percent of the total
population size of the country (CSA, 1999).

Currently the urban structure of the Addis Ababa City Government is
restructured into 10 sub cities (Kifle Ketemas) and 184 smallest local
administration sections (kebeles).
Addis Ababa belongs to the major urban centers in the country reported to have
a high prevalence of HIV/AIDS. The average prevalence rate for HIV/AIDS for
urban centers is reported to be 13.7 per cent. The major urban centers with the
highest HIV prevalence are Bahir Dar, Jijiga, Nazareth and Addis Ababa with a
corresponding prevalent rate of 23.4, 19.0, 18.7, and 15.6, respectively (Ministry
of Health, 2002).
Iddirs are the major indigenous associations in which majority of residents are
members and which play role in one-way or another. Iddirs are the major
associations, which govern social integrity of residents of Addis Ababa. There are
more than 2000 Iddirs legally registered by the Addis Ababa Municipality. This
figure only indicates the quantity of registered Iddirs found in the Addis Ababa
(Municipality of Addis Ababa, 2002).
The study population included non-governmental organizations, which are
working closely with Iddirs in the area of HIV/AIDS intervention, Iddirs which
are actively working in the area of HIV/AIDS intervention with partner NGOs or
with out the help of NGOs or governmental organization. Moreover, the study
population includes the government office, which is directly related to HIV/AIDS
in the study area that is Addis Ababa HIV/AIDS Prevention and Control Office
(Addis Ababa HAPCO).

1.7. ORGANIZATION OF THE PAPER
The paper contains three main parts and six chapters. The first part contains
two chapters: chapter one that presents the introduction, and chapter two that
contains the methodology, research design and profile of selected NGOs. Part two
contains two chapters; that is chapter three and chapter four. Chapter three
discusses concepts, definitions and theoretical framework. Chapter four presents
a review of related literature. Part three also contains two chapters, chapter five
and chapter six. Chapter five is considered about findings, analysis and
discussion. Chapter six is the last chapter that contains the conclusions,
synthesis of findings and recommendations.

CHAPTER TWO
2. METHODOLOGY, RESEARCH DESIGN AND PROFILES OF
2.1. METHODOLOGY
2.1.1. METHODS OF SAMPLING
IMPLEMENTER NGOs
Two kinds of techniques of sampling were employed in the research.
1. Multistage cluster sampling that involves the initial sampling of groups of
elements or clusters, which was also followed by selection of elements within
each of the selected clusters. This sampling design is used when it is either
impossible or impractical to obtain complete list of elements comprising the
target population.
Multi stage cluster sampling technique is employed to select samples of
Implementer NGOs. The range of clusters include in the sample unit are those
NGOs which are implementing community base development activities and those
NGOs which are involved in anti HIV/AIDS activities with Iddirs. Similarly,
NGOs whose main component activities are HIV/AIDS intervention are obtained
from the first list. Finally, NGOs who implement community based HIV/AIDS
intervention and who are currently working closely with Iddir were selected.
2. Cluster sampling is the most widely used sampling method in survey
method. It involves successive random sampling of units or sets and subsets.
Cluster sampling is generally used when the elements of the entire population
are difficult to list (Brown, 1983). Similarly, cluster sampling technique is

employed because the list of each Iddir who are involved in anti HIV/AIDS was
no obtained. Selected samples are drawn from group of partners lists from each
implementer NGOs. The list is obtained from the records of Iddir based
HIV/AIDS intervention implementer NGOs.
2.1.2. METHODS OF DATA COLLECTION AND INSTRUMENT DESIGN
Both primary and secondary data were used in the research undertaking. The
following are the major data collection methods employed:
Primary data collection methods like self-administered questionnaire, structured
interviews and unstructured interview were employed.
Three different instruments were used to collect the primary data from each
group of samples.
I. Structured interview guides- were employed to conduct interviews with
the leaders of Iddirs. In this regard Iddir leaders refers to officials who are
currently actively engaged in leadership. (Ye Iddir Dagnas, Ye Iddir
Sebsabi, Ye Iddir Genzeb Yazsh, Ye Iddir Teshafy) are among the officials
who were included in the interviews. 61 interview sessions were conducted
with the leaders of selected Iddirs. The author and assistant data collectors
took part in collection of the primary data.
II. Semi structure questionnaires- were administered for program officials of
implementer NGOs. Project coordinators, administrators and project
officers participated in completing questionnaires. Representatives of six

NGOs completed the distributed questionnaires. Six questionnaires were
used for respective implementer non-governmental organizations.
III. Unstructured interview guides- were used to collect primary data from
government officials namely MOH and Addis Ababa City Government AIDS
Prevention and Control Office (Addis Ababa HAPCO). Three interview
sessions were conducted with the officials of Adds Ababa HAPCO and
wereda 5 anti HIV/AIDS council coordination office.
Secondary data collection methods are used like books, journals, published and
unpublished materials are assessed.
Document analysis- the reports and documents of Iddirs were analyses. Records
of Iddirs with regard to their capital, number of death, amount of spending on
burial and development etc, are included in document analysis.
2.1.3. METHODS OF DATA ANALYSIS
The purpose of data analysis is to reduce data in to intelligible and interpretable
form so that the relation of research problems can be studied and tested.
Interpretation takes the result of analysis, makes inferences pertinent to the
research relations studied and draws conclusion about these relations (Kerlinger,
1973).
Frequency distribution is the major quantitative method of data analysis.
Percentage and graphs are employed in frequency distribution. Triangulation a
major technique that is used in validate the qualities of that data. Triangulation

is a method used verifying the data using different kind of data in which multiple
data collection methods are involved. So, primary data obtained from Iddirs,
NGOs and government bodies are triangulated in such a way the role of Iddirs is
crosschecked in detail. Methods used were structured interviews, unstructured
interviews, observation and questionnaires.
2.1.4. FACTORS CONSIDERED
Dependent factors
Effect of HIV/AIDS on Iddirs
Initiating factors for Iddirs to undertake HIV/ADS intervention
The degree of involvement of Iddir and NGOs in anti HIV/AIDS
Role of government bodies promoting the community based HIV/AIDS
intervention
Capacity of Iddir to HIV/AIDS intervention
Independent Factors
Number of AIDS deaths
Number of AIDS orphans
Amount of spending on burial ceremonies
Number of PLWHA in Iddir
Amount Iddir capital
Situation of human resources in leadership

Initiation and teaching from NGOs and government bodies
Public advocacy and mass awareness programs
Capacity of Iddirs in capital, manpower, material and information,
communication and networking
Availability of training and capacity building
Availability of financial, technical and material manpower assistance
The availability of assistance in networking and technical help
Role of umbrella Iddir associations in HIV/AIDS council on zonal level in
promoting their role
Size of assistance given from international donor organizations obtained at
regional level.
2.2. RESEARCH DESIGN
2.2.1.SELECTION OF SAMPLE NGOs
According to the recent report made by CRDA, there are more than 200 NGOs
working in anti HIV/AIDS and poverty reduction activities in Addis Ababa. 3
percent of the total number of NGOs working in the study areas are included in
the sample. Six NGOs who are closely working with Iddir in HIV/AIDS are
included in the survey using multistage cluster sampling. The list of NGOs
implementing community-based intervention is used as primary cluster from
which the second group is drawn. NGOs who are working with Iddirs in the area
of HIV/AIDS are selected at the second stage. The criteria for selection is entirely
based on the degree of their involvement in each of anti HIV/AIDS strategies with
partner Iddir which are selected according to table 2.1 below. The table

summarizes the selection of Implementer NGOs. Table 2.1 Criteria of selection of NGOs
in sample
Strategies
Information Education
and Communication
Name of partner NGOs
HAPCSO CARE MJATD ACORD CBISDO Pro
-
pride
Behavioral change and - - -
Communication
Voluntary Counseling and
Testing
- - - - -
Care and Support - -
Capacity building - -
Number of currently
active Partner Iddirs
Total number of Partner
Iddirs selected in the
sample
41 21 50 43 13 20
17 14 7 10 5 8
Percentage of Selected 41 % 67% 14% 32% 38% 40%
sample
NGOs
from partner
Source: Compiled from profiles of NGOs Keys: ( -) not involved ( )-Involved
Total
Therefore, a larger number of sample Iddirs are drawn from implementer NGO
that involved in most of anti HIV/AIDS strategies. So, the process of selection of
NGOs and their partner Iddirs follow different stages and the selection is entirely
depend on the degree of their involvement in anti HIV/AIDS activities.
2.2.2. SELECTION OF SAMLPE IDDIRS
According to the response of Addis Ababa City Government Association, Meeting
and Iddir licensing Bureau, there are more than 2300 registered Iddirs in Addis
Ababa during the beginning of 2003. The amount of selected Iddirs in the
research sample is 64, which is 2.8 percent of the total amount of Iddirs found in
Addis Ababa.
61

Sample units are selected for the partner Iddirs working with selected NGOs.
Selected Iddir are identified on the basis of their involvement in anti HIV/ AIDS
activities with partner NGOs or on their own without help of any NGO or
government organization. The criteria for the selection of Iddirs are entirely based
on the degree of involvement of Iddirs in anti HIV/AIDS activities. The selected
Iddirs are summarized in table 2.2.
Table 2.2 Selection of Iddirs in sample
Number of Iddirs
included
Currently actively
involved in all of anti
HIV/AIDS strategies
Source: Compiled from responses of Iddirs
Degree of involvement
Currently
involved
inmost of
anti
HIV/AIDS
strategies
Once actively
involved but
currently
discontinued
31 17 13 61
2.2.3.SELECTION OF GOVERNMENT OFFICE IN SAMPLE
Total number
of selected
Iddirs
Two department from the government bodies was approached. These are Addis
Ababa City Government HIV/AIDS Prevention and Control Office (Addis Ababa
HAPCO) and respective sampled wereda in which the activities of the office seem
to be model for the rest of wereda found in the study area.
So the study tried to look at the role of Iddirs in HIV/AIDS intervention activities
from three different direction activities from three different directions; that is
from government bodies, implementer NGOs and partner Iddirs. Information that

gathered from three different directions was used in analysis of the finding.
Summary of the sampling composition can be summarized in table 2.3.
Table 2.3 Summary of Sampling compositions
Number of Number of Type of
samples taken interviews instrument used
Implementer NGOs 6 6 Semi structure
Iddir 61 61
questionnaire
Structured
Interview guide
Government
2 3 Unstructured
Organization
interview guide
Source: Compiled from sample frame
2.3. SCOPE OF THE STUDY
The research examines the role of community-based initiatives in HIV/AIDS
interventions in Addis Ababa City Administration. The survey is a cross sectional
survey which entirely depended on data collected during the time of data
collection (April and May, 2003). The case of Iddirs is taken as the proxy for the
indigenous community based organizations. Other kinds of indigenous
community based associations like that of Iqub, Mahiber, Tsewa and Gigge and
etc. are not included in the scope of the research.
2.4. LIMITATIONS OF THE STUDY
Time, financial and resource limitations were the major shortcomings faced
while conducting the research.
Recent attempts in restructuring of bureaus of Addis Ababa City Government
cause disorganization of information, which were held at wereda level in to

different kifle- ketema. Moreover, lack of stabilized personnel at each desk
coupled with poor documentation were major limitations that impeded
obtaining further information about the work and achievements of AAHAPCO.
Hence, model weredas were identified, as an indicator for the involvement of
the office in wereda level.
Resistance from Iddirs about disclosing the size of their capital was also
another limitation. Iddirs were asked to give information about the size of
capital and other detailed information for the last ten years. Poor
documentation coupled with unwillingness to provide information about their
capital was the major limitation to obtain full information about the overall
situation of respondent Iddirs.
2.5. PROFILE OF SELECTED NGOs
Implementer NGOs are selected according to their involvement with Iddirs in anti
HIV/AIDS interventions. Hence, six implementer non-governmental
organizations were selected for the sake of explaining their activities working
with partner Iddirs in the areas of HIV/AIDS intervention activities. This section
is about the general profile of the implementers NGOs who are undertaking
community based HIV/AIDS intervention.
The following table shows the general profile of selected NGOs.

Table 2.4 General profile of NGOs
Details
Name of NGO
HAPCSO CARE ACORD MJATD Pro-
Pride
Number of Kebele 9 14 8 3 4 6
Number of Wereda 1 1 2 1 1 2
Name of Sub cities
(Kifle Ketema )
Number of
currently active
Partner Iddirs
Number of
currently non
active Iddir
Lafto
Nefas Silk
Yeka, Arada
and Cherkos
Yeka
and
Akaky
Kolfe
Keranio
Addis
Ketema
41 21 50 43 20 0
0 10 0 0 0 13
Sources: Compiled from responses of each NGO
CBIS
DO
Lideta
NB. The above table contains both wereda description and the name of Kifle-
Ketema to clarify the confusion about the former and the recent restructuring of
the urban administration of Addis Ababa in to ten sub cities.
1. Hiwot AIDS prevention, Control, and Support Organization (HAPCSO)-
HAPCSO is a local non-governmental organization. The project was established
in Dec, 1999 with project duration of three years. The project area is nine kebele

found in wereda 23, which is restructured in Lafto-Nefas-Silk Kifle-Ketema
according to the new urban structure. Seventeen partner Iddirs who were
working with HAPCSO are included in the sample frame. Partner Iddirs are
identified to be working in the areas of Information, Education, and
Communication, Behavioral change and Communication, care and support, as
well as capacity building with close supervision and collaboration of HAPCSO.
HAPCSO is working closely with 41 Iddirs in major HIV/AIDS intervention
strategies.
The major aim of the project is to :
♦ Implement Home based care for AIDS patients
♦ Enhance the collective capacity of the community to provide care and
support
♦ Awareness creation
The major activities carried out by the HAPCSO includes:
♦ Increase mass sensitization
♦ Promote safe sex
♦ STI treatment and counseling
♦ Provision of counseling for PLWA and families
♦ Income generation activities
Twelve staff members and fifteen community leaders as well as ninety volunteers
are involved in the day to day activities of the project. The budget allocation of
the project is indicated in the table below.
Table 2.5 Budget allocation in HAPCSO

Budget
Project Year
2000 2001 2002 2003
Total
(ETB) 185000 836000 841600 1104000 2,966,600
Source: Compiled from the response of HAPCSO
2. CARE: Ethiopia, Urban HIV/AIDS prevention and care project
CARE Ethiopia is an international non-governmental donor and implementers
non governmental organization. Urban HIV/AIDS Prevention project is one of the
projects undetaken by the CARE Ethiopia. Urban HIV/AIDS prevention and care
projects is implemented in 14 kebeles found in the former wereda 15, which is
now restructured in to three different Kifle-ketema that is Arada Kifle ketema,
Yeka Kifle ketema and Cherkos Kifle ketema . The project was established in
April, 2001 with a project duration of three years. The project is found in one of
the areas with high prevalence rate of HIV/AIDS infection.
The overall goal of the project is to reduce the incidence of HIV/AIDS infection
among the target population and reduced the impact of HIV/AIDS on PLWA ands
AIDS orphans.
The specific activities undertaken by the project are:
♦ Behavioral change and Communication
♦ Providing accessible and affordable quality of Voluntary Counseling and
Testing
♦ Building the capacity of the local NGOs and community based
organizations in providing care and support for PLWA and affected families

The project is working actively with 31 partner Iddirs. Partner Iddirs are active
participants in the activities of the project. From the total partner iddirs, eleven
are working with the project as potential partners preparing their own project
proposal in the areas of care and support provision to AIDS orphans and PLWA.
All of the eleven partner Iddirs are secured the grant according to the project
agreement between partner Iddir and the Urban HIV/AIDS Prevention and Care
project. Fourteen selected partner Iddirs are included as respondent for the
research based on the degree of commitment Iddirs showed in implementation of
the project.

Table 2.6 Budget allocation in CARE
Budget
Project Year
2001 2002 2003
Total
(ETB) 1,324,936 1,393,520 1,981,704 4,700,168
Source: Compiled from the response of CARE, urban HIV/AIDS Prevention and Control Project
3. Agency for Cooperation in Research and Development (ACORD), Addis
Ababa CBO support program
The Agency for Cooperation in Research and Development is an international
non-governmental organization. The Addis Ababa CBO support program is
implemented in
2 kebele found in wereda 12 and 6 kebele found in wereda 27. The project was
established in 1997 for the project duration of 5 years. The project period is
extended for the two years with the remaining budget from the previous project
years.
The overall objective of the project is to support and increase the role of
community based organizations in their involvement in development activities.
ACORD is working closely with partner Iddirs in capacity building, awareness
raising and saving and credit programs. There are 50 partner Iddirs working with
the project in different schemes of development. The specific activities are to
increase recognition of CBO in development through the following :
♦ Promote the policy and legal framework for the involvement of CBO in
development

♦ Establish networks, cooperation and linkages between community based
organizations and NGOs as well as government
♦ Contribute to the alleviation of urban poverty using CBOs as
intermediaries
The human resources of the project constitutes 10 staff members. The
involvement of community leaders and volunteers is not seen in the day to day
activities of the project. The following table shows the amount of budget allocated
for the specified project period.
Table 2.7 Budget allocation in ACORD
Budget
Project Year
1997 1998 1999 2000 2001
(ETB) 1,100,000 1,730,000 1,400,000 930,00
Source: Compiled from the response of ACORD
4. Mary Joy Aid Through Development (MJATD)
0
Total
320,000 5,480,000
Mary Joy Aid Through Development (MJATD) is a local non governmental
organization working closely with Iddirs and the community at large in three
kebele found in former wereda 25 which is restructured as Kolfe-Keranio Kifle-
Ketema. The project duration is from 2000 to 2005 with a 4 years project period.
The major goal of the project is to the contribute to alleviate the socio-economic
impacts of HIV/AIDS through effective HIV/AIDS prevention and control
strategies.It emphasis on improving the socio-economic status of those affected

and infected by HIV/AIDS. It targets street children, commercial sex workers,
and widow women as the target group for the project as the most vulnerable
group for the infection of HIV/AIDS. Currently working with 41 partner Iddirs in
development schemes like poverty reduction of the project.

5. Pro Pride Merkato program
Pro Pride Merkato is a local non governmental organization aimed at empowering
the community to reduce the level of poverty at the household as well as the
community level at large. Program is based in the project area 4 Kebele found in
Addis Ketam Kifle Ketema. The project duration is 3 years ( from 1999 to 2003).
The overall objective of the project is to reduce the level of poverty of household
and community level through income generation schemes.
Specific activities are :
♦ Promote income generation at individual and household levels
through a contingency livelihood approach
♦ Improve income of poor household through micro enterprise
development and improve the capacity of petty traders.
There are 4 staff members and 63 community leaders and 3 volunteers actively
engaged in the day to day activity of the projects. The project is working with
twenty Iddirs in promoting the capacity of the community in reducing the level of
poverty among the community in the livelihood improvement sector of the
project. The area of involvement for the partner Iddirs are capacity building, net
working, community based development institution.
The allocation of budget for the project can be summarized as follows
Table 2.8 Budget allocation in Pro Pride
Project period Total

Project
1999 2000 2001 2002 2003
Budget 959,323 1010973 579290 503066 165705 3,218,35
Sources: Complied from the responses of Pro Pride .
6. Community Based Integrated Sustainable Development (CBISDO)
Community based Integrated Sustainable Development is a community based
program that is implemented in 4 kebeles found in wereda 3 and 2 kebeles found
in wereda 4. The project area is restructures in Lideta kifle Ketema. The overall
objective of the project is mitigate the pandemic of HIV/AIDS through mass
health education, support to AIDS patients and bringing behavioral change
about the risky behaviors.
Table 2.9 Budget allocation in CBSIDO
Project
Project period
2000 2001 2002 2003
Total
Budget 82688 86822 91163 95721 356394
Sources: Complied from the responses of CBISDO
The project duration is not specified because it is community based program.
CBISDO provide VCT service for the local community at reasonable fees in an
IHA clinic, which is found in the most affected part of the city. CBISDO used to
work with thirteen Iddirs in during 2001 and 2002. However the effort is
7

discontinued due to various reason both in the side of Iddirs and implementers
NGOs.

PART TWO: CONCEPTUAL AND
THEORETICAL FRAMEWORK AND REVIEW
OF RELATED LITERATURE

CHAPTER THREE
3. CONCEPTS, DEFINITIONS AND THEORETICAL FRAMEWORKS
3.1. Development, Poverty and HIV/AIDS: - Concepts and
Frameworks
3.1.1. Development approaches and the concept of poverty
Development is often described as the process of change from less desirable to
more desirable state of being. There are two major approaches in conceptualizing
development. These are economic well being and GNP per capita approach and
human needs approach.
Economic well-being and GNP per capita approach is the dominant approach
employed in defining the concept of development. The argument states economic
change precedes any other form of change. According to economic development
approach all that defines the state of development is the economic growth in
(Todaro, 1994).
The human needs approach gives credit for the realization of human's potential.
As Conyers suggested, " Development is conceived as the state of human well
being rather than the state of national economy". Dudley Seers is the major
proponent of this approach and suggested that " …the realization of the potential
of human personality ... is a universally acceptable aim " of development process
(Seers,1994)

Todaro (1994) has defined the concept development some what inclusive manner
from the two prominent development approaches. According to Todaro,
development is defined as the process that is:
"… Concerned as a multidimensional process involving major changes in
social structure, popular attitudes, and national institutions, as well as
the acceleration of economic growth, with the reduction of inequality and
the eradication of poverty".
The absence of such factors that defines the process of development can generally be referred as
poverty. Webster (1995) suggests that the state poverty must be seen as the deprivation of basic
capabilities rather than merely as lowness of income. Poverty can be considered as the
deprivation of opportunities like education, physical and emotional well being, and cultural
opportunities. The author furthers defining the concept as "… the income below a level that
would sustain a physical and emotional life allowing the individual to take a advantage of
opportunities available given his or her talents and interests".
3.1.2. POVERTY, HIV/AIDS AND DEVELOPMENT
HIV is an acronym given for Human Immuno Deficiency Virus. It is a virus that
causes Acquired Immune Deficiency Syndrome (AIDS). HIV attacks and
progressively weakens or even destroys certain types of white blood cells that are
essential to the body's immune system, which is the biological ability of the
human body to fight infections The infected person is susceptible to a number of
opportunistic infections, such as tuberculosis and pneumonia. (Ministry of
Health, 2000).

According to the World Bank and UNAIDS report (2001), the general linkage
between HIV/AIDS and poverty could be considered as a two-way causal
relation. The linkage is mentioned in the sense that HIV/AIDS can be seen as a
cause of poverty and poverty, at the same time, is a major contributor to
deteriorated impacts of HIV/AIDS (UNAIDS/WORLD BANK, 2001).
The causal relation is, on the one hand, considered in terms of HIV/AIDS being a
cause of deepening of poverty. Intermediate variables are involved in such a
causal relation. These variables include lost productivity, increased health care
expenditure, increased dependency ratio, increased number of orphans with poor
living conditions, lower school enrolment, reduced national income and fewer
national resources for HIV/AIDS control etc.
On the other hand, poverty and income inequalities are considered to contribute
to the aggravated vulnerability and risk behavior in relation to HIV/AIDS. This
relation can be explained through intermediary variables like, lack of access to
prevent interventions, lack of access to affordable care, and lower education
status and lower awareness level (UNAIDS/WORLD BANK, 2001) (see diagram 1).
Although HIV/AIDS is not caused by poverty, but rather it intensifies the poverty
crisis. Inadequate nutrition, low access to health care, lack of education and
inadequate economic activities, these all contribute to the spread of epidemic and
shorten the life span of those infected. The HIV/AIDS crisis intensifies poverty,
reduces household assets, per capita food consumption and child school
enrollment (UNAIDS, 2001).

The strong causal relation between poverty and HIV/AIDS is widely seen in most
developing countries. In Africa the poverty situation is aggravated as it is twined
with prevailing impacts of HIV/AIDS on the socio economic development of the
continent. The fact that poverty is closely associated with multiple impacts of
HIV/AIDS on the community suggests the need to readdress development
paradigm in African context with regard to HIV/AIDS intervention (UNAIDS,
2001).
Diagram 1: - The linkage between HIV/AIDS and poverty
- Lost productivity
- Increased health care
expenditure
- Increased dependency ratio
- Increased AIDS orphans
Source: (UNAIDS/ WB, 2001)
HIV/AIDS
-High risk of infection
-Lack of access to prevent
intervention
-Lack of access to affordable
cares
-Lower health facilities
POVERTY

3.2. THE CONCEPT OF COMMUNITY AND COMMUNITY DEVELOPMENT
One can find a number of definitions given to the term 'community'. UNAIDS
(1999) has adopted a very broad definition. Community is " … a group of people
who have something in common and will act together in their common interest "
(UNAIDS, 1999).
Allan, (1997) has similarly given definition for the term in a detailed
manner. In modern societies individuals maintain membership in a
range of communities based on geography, occupation, social contacts
or leisure interest (Allan, 1997). Community is defined as
" … a specific group of people usually living in a common
geographical area who shares a common culture, are arranged
in social structure and exhibits some awareness of their identity
as a group".
Young, (1999) refers to community development as an approach that involves
placing individual member of the community in the center of a development
process. It also involves helping community members to realize their own
potential for further development activities based on self-initiation. The
community development approach emphases the participation of people from
below, encourage a bottom-up approach and fosters self-reliance on the available
community resources (Young, 1999).

3.3. THE CONCEPT OF COMMUNITY BASED ORGANIZATIONS (CBOS)
The Provincial law in Quebec (Jalberth, 2000) defines community organization as
" … a legal person, duly constituted as a non profit corporation,
whose affairs are administered as a board of directors, made up
in majority from the consumers of the service provided or members
of the community it serves as whose activities are related to the
fields of health and social services" (Jalberth, Pinault, Zuniga,
2000).
Community based organizations can be defined as part of an independent
movement working towards social change. The overall purpose of community
based organizations is to promote the social development, quality of life and
welfare of those they serve. Their mission is not limited to identifying and serving
needs, but to help change social structures; influences political decisions and
identify alternatives that better respond to the needs of the society. The
peculiarity of community based organizations is that they are arranged in a
"bottom-up" approach (Jalberth, Pinault, Zuniga, 2000).
Community based organizations can also be referred as local organizations which
could be viable vehicles for community involvement and participation in project
design and implementation, when appropriate and timely guidance and
encouragement is provided (Shiferaw, 2002).
3.4. CONCEPTUALIZING CIVIL SOCIETY ORGANIZATIONS (CSOS)

There is a wide range of categories, which comprise what is commonly referred to
as civil society organizations. The concept of civil society organization is debated
in terms of two opposing arguments. One approach claims that the total frame
work of civil society organization include both formal and informal organization;
and the other view that argues conceptualization of civil society organization is
impossible outside the formal organization framework.
Dessalegn, (2002) is one among those who argues in terms of the view that civil
society organizations can not be conceptualized outside the framework of formal
organization. Accordingly, the range of civil society institutions include NGO,
advocacy organization, professional associations, cooperatives, trade union,
religious organizations and independent press (Dessalegn, 2002).
Hence, according to Dessalegn, (2002) the conceptualization of civil society
organization excludes informal (or traditional) organizations that are common
both in rural and urban areas and ethnic based self-help and development.
There is lack of evidence, as to what extent these organizations contribute to the
public interest during the last decades. This is the major rationale that has been
provided to justify his argument for exclusion of informal organizations from the
definition of civil society organization.
Shiferaw, (2002) on the other hand, argued that the concept of civil society
organizations might comprise both formal and informal organizations. According
to Shiferaw, the range of civil society might include NGOs at international,
national and local level; church organizations, grass roots and peoples

organizations. This category consist of residential area based associations,
professional associations, burial associations, producers' and consumer's
associations, credit associations trade unions, gender and age based
organizations and various interest groups (Shiferaw, 2002).
3.5. THE CIVIL SOCIETY APPROACH
The civil society approach is a recently growing development paradigm, which
favors the partnership of local communities, NGOs and other development
agencies with indigenous associations and institutions often referred to as
community based organizations (CBOs). The principal aim of the civil society
approach is prioritizing the local needs and involving the local community in
planning, decision making, implementation of development activities (Pankhurst,
2001).
The major rationale for the civil society approach is that it ensures active
involvement of grass root community members from planning, to decision
making, to implementation and evaluation of development projects. It also can
address the needs of the local community. Active participation of local
communities in civil society approach enables communities to take over projects
and contribute to sustainable community development (Pankhurst, A. 2001).
Through the civil society approach, it is believed that the poorest can be reached
more effectively, at lower cost and in more innovative ways for effect equitable,
fair and sustainable development. The civil society approach enables tactful

mobilization of internal and external resources to alleviate poverty, and to
promote change and development (Sietz 1995, Rooy, 1998 in Shiferaw, 2002).
This approach also mobilizes the community more effectively in its bottom- up
development to address mass poverty (Dejene, 1998).
The civil society approach enables citizens to play a major role in their local
development programs. The role of community based organizations are those
either represent the community members in particular, or can reach them more
reliably than the existing government and market approach (Sietz 1995, Rooy,
1998, in Shiferaw, 2002).
There are a number of arguments to show the reason why civil society
organizations could or should be involved in development activities (Pankhurst
(2001), Sietz (1998), Shiferaw (2002) etc.). Pankhurst (2001) has given three
reasons as to why civil society organizations should be involved in development
activities (Pankhurst 2001).
1. Civil society organizations are based on local autonomy and indigenous
ways
2. Civil society organizations have greater legitimacy than institutions set up
external agencies
Civil society organizations provide on-going sustainable structures
3.6. RATIONALE FOR A COMMUNITY-BASED HIV/AIDS INTERVENTION

The urgency of HIV/AIDS and its impacts call for a concentrated effort to utilize
community resources that have been largely neglected by many governments for
health development in the past. In view of the problem of HIV/AIDS, the benefit
community involvement at the grass root level can be immense in all these
dimensions (Damen and Kloos, 2003).
The situation of deepening poverty crisis and recurrent famine condition in north
east Africa require that poverty alleviation programs need to be integrated with
HIV/AIDS prevention and control programs at the community level. HIV/AIDS
seems to be strongly related to the situation of poverty in Ethiopia, as it is so in
any other sub-Saharan African countries (Damen and Kloos, 2003).
A community-based response to HIV/AIDS implies the involvement of people
where they live, in their homes, their neighborhoods and their work place in the
fight against HIV/AIDS. Community projects are as diverse as the people and
culture that make up these communities. Some of the forms of the community-
based responses to HIV/AIDS intervention projects have been identified as "home
grown" and self-sufficient. Some times they can might get assistance from
external agencies like religion centers, medical institutions, and in neighborhood
meeting places (UNAIDS, 2000).
Many of the community-based programs assisting those affected by HIV/AIDS
are developed and run by community based organizations. Community based
organizations generally can be considered as being democratic, represent in the
interest of their members and to be accountable to them (UNAIDS 1999).

In such regard, community based responses take the form of both formal and
informal organizational groupings that are related to community based
organizations. Informal set up, on one hand, include social support group,
saving clubs and self help groups and informal self-help groups. These
traditional or informal groups are said to be effective in HIV/AIDS interventions.
"Traditional indigenous groups are a major sources of support
in community that are experienced the impact of AIDS
epidemic" (UNAIDS 1999).
Formal community initiatives on the other hand, include formal community-
based organizations and AIDS support organizations which rely on external
assistance (UNAIDS 1999).
Similarly, Damen and Kloos (2003) suggested that traditional and indigenous
community based institutions are considered to be the most prominent and the
most effective instruments for the HIV/AIDS prevention and control because
utilizing informal indigenous institutions have multiple importance. Hence, grass
root organizations, both formal and informal, should become the major advocates
and vehicles for community involvement in prevention and control of HIV/AIDS.
This is because indigenous local associations have the track record of winning
the confidence of communities and serve community members during times of
crisis (Damen and Helmut, 2003).

The major importance of focusing on Iddir is that these associations win the
trust of the community in social, cultural and economic activities of the
community. More importantly these associations have served community
members as coping mechanisms during times of economic as well as social
crisis. Moreover, each and every individual family in Addis Ababa obtained the
membership of one or more Iddirs (Helmut and Damen, 2003).
Hence, community based organizations can be considered as one among the
most important mechanisms for the successful implementation of multi- sectoral
response to HIV/AIDS epidemic as they are strategically placed to facilitate the
involvement of the community at the grass roots level (Pankhurst and Damen,
2003).

CHAPTER FOUR
4. REVIEW OF RELATED LITERATURE
4.1. LITERATURE ON INDIGENOUS VOLUNTARY ASSOCIATIONS AND
IDDIRS
4.1.1. THE RANGE OF VOLUNTARY ASSOCIATIONS IN ETHIOPIA
Voluntary associations helped the rural migrants to the urban way of life in an
adaptive process since they provide them with new basis for organization, which
is all the more important because urban centers lack of social integration in
comparison to rural areas (Tessema, 1995). Ottaway stressed on the term
'voluntary' that refers to the state of making decision undertaken by people about
joining an organization upon their own free will considering the advantage of
being a member of specific organization (Ottaway, 1976).
Various studies (Fecadu 1973, Ottaway 1976, Salole 1986, Pankhurst 2001) has
indicated the range of indigenous voluntary associations in Ethiopia.
Fecadu (1973) has identified voluntary associations to be classified in to
traditional and modern typologies. Traditional voluntary associations include
Iddir, Iqqub, regional and ethnic associations, whereas modern associations may
include organizations like sport clubs, professional associations like YMCA and
so on (Fecadu, 1973).
Similarly, Pankhurst, (2001) has indicated the range of indigenous voluntary
organizations or associations that exist in contemporary Ethiopian context.

These indigenous associations include Iddir burial associations, Iqqub credit and
saving association, Mahiber social or religious association, Debo, Wenfel etc
agriculture, labor, migrant associations. The author also indicated that these
voluntary association exist all over the country, though there could be name
difference among different localities or ethnic group (Pankhurst, 2001).
Salole (1986) argued that voluntary associations in Ethiopia has evolved from
traditional and rural form of rotating and saving credit associations, mutual
help organizations, burial and other associations. These are associations which
exists widely throughout rural Ethiopia (Salole, 1986).
4.1.2. DEFINING IDDIR
Iddir is a kind of mutual aid or/ and voluntary association commonly found in
Ethiopia. It is an association originally formed by families who live in the same
neighborhood or vicinity for the primary and expressed reasons of reciprocal aid
in financial and service in times of burial or news of the death of close relatives.
Fecadu (1972) further gives the following definition of the concept:
" Iddir … is a poly-ethnic mutual aid voluntary association which is
formed by families who live in same neighborhood or vicinity (Sefer) for
the primary and expressed reasons of reciprocal aid in finance and
service in times of burial or news of death of close relative "(Fecadu,
1672).

The functions are to contribute some amount of money to cover the cost of
funeral, to assist families in the event of death, illness, in employment or
imprisonment of their bread winners and to help in case of loss due to fire
(Levine, 1965).
Shiferaw has adopted another definition. Iddir can also be defined as:
"an association established to deal with mutual support of its
members for all kinds of their felt needs with basically incorporated
burial service and mourning ceremony at the incident of death among
members and their families or relatives" (Shiferaw, 2002).
4.1.3. IDDIR AS A POPULAR FORM OF INDIGENOUS VOLUNTARY
ASSOCIATION
In Ethiopia, the most important voluntary associations are identified to be Iddir
and Iqub. Iqub are indigenous credit institutions that is usually organized with
the purpose of raising funds for member of the association in need of money. The
prior aim of establishing Iqub is the desire to save some money for certain
specified purpose. Iddir was originally a funeral society, which is progressively
changing in scope and orientation over the years. Providing aid in time of death
and sickness has become a less important function, while development activities
such as taking hand in building street or community development activities like
schools, and above all providing security along with local authorities is assumed
to be more central role (Ottaway, 1976).

A comparison of the different types of indigenous association and institution in
Ethiopia noted that Iddir are the most widespread type and prevalent in both
rural and urban setting (Pankhurst, 1998). Levine, considers Iddir as probably
the oldest and most widely diffused form of the modern association in Ethiopia,
which is sometimes referred to, as is a form of welfare institution (Levine, 1965).

4.1.4. FACTORS THAT LEAD TO DEVELOPMENT OF IDDIR
Iddir is also considered as a result of increased rate of urbanization, social
disintegration and urban crisis that occurred in the capital and neighboring
cities during the Italian occupation. This argument claimed that rapid
urbanization and change of social settings during the Italian occupation might be
the reason for the emergence of Iddir in Addis Ababa (Mekuria, 1973 Alemayhu
1968, Ottaway 1976).
In such regard, Mekuria has stressed on the role of rapid urbanization during
the Italian occupation, which can be considered as a period of crisis and
turmoil, leading to disintegration, and accelerated rate of urbanization. Mekuria
claimed that it is not convincing to accept the argument that Iddir originated
during Italian occupation since there had already been other mutual aid
associations like Debo, Wenfel etc where by farmers help each other during
plowing, harvesting , building houses or looking after their herds (Mekuria,
1973).
Moreover, Pankhurst argued that the monetization and formalization had a
major role in the development of Iddir in urban centers of Ethiopia as the
popular voluntary association (Pankhurst, 2001).
Many Iddirs drew their members from the same ethnic group or people coming
from the same locality. Having planted its roots in the urban society the
association remained for some years, as a means of procuring substantial

assistance mainly during the time of death. However, it begun to take another
shape during the 1950's among factory workers. During those days, workers
had no unions that were legally recognized. They used the Iddir for discussion of
their problem with factory management until the first enunciation a of labor
policy in Ethiopia came with the civil code proclamation in 1960.
4.1.5. IDDIR AND DEVELOPMENT
The principal aim of Iddir is "…to meet death expenses and to avoid a pauper's
funeral as well as to provide a certain measures of social security when financial
crisis has occured in a certain household" (Pankhurst and Endrias, 1658).
Alemayehu, (1968) suggested that cultural settings of Ethiopian society gave rise
to Iddirs in many urban centers. The author put this in his own words:
"…that Iddir came from the emphasis the Ethiopian community give for
the large crowd during funeral and the implication of the social
integration the bereaved individual has with the community."
Tessemma (1995) has indicated that Iddir has played an important role in
community development. The role of Iddir in community development activities is
described to include functions like planning, executing and administering
community affairs, contributing of money, labor and material towards the
consolidation of development and cooperating with police to challenge the ever
increasing rate of crime (Tessemma, 1995).

The function of Iddir are not limited to the provision of insurance and
psychological support to its members; Iddirs are often involved in community
development program such as construction of roads or schools, and installation
of public utilities. The Iddir is considered as an excellent vehicle for the state to
gain direct access to urban population. Similar findings indicate the role of Iddir
further more from burial activities to complex development and poverty
alleviation activities (Fecadu, 1975 Shiferaw, 2001 Getenet, 1999 ).
Functions of Iddir seem to pass through an evolutionary process. During 1960's
meredaja mahibers (kind of Self-help associations) were popular in Addis Ababa.
The majority of these associations were based on development of regions where
members came from. (Mekuria, 1976). Thus, Iddir slowly changed to the poly-
ethnic organization preoccupied with development tasks as well as with mutual
aid, particularly in Addis Ababa. Certain studies carried out afterwards showed
that the original purpose of Iddir was funeral activities and assistance during the
time of emergency.
In addition, the function and aim of Iddir include the provision of local security
measures as well as certain community development function such as the
construction of school, bridges, feeder roads and clinics and important
socializing functions for the new migrants to the city. Iddir serve as important in
social control, ensuring the conformity of members to the accepted norms of the
community (Tessema, 1995).

4.2. LITERATURE ON HIV AND AIDS AND IDDIR
4.2.1. SPREAD OF HIV/AIDS IN ETHIOPIA
The first HIV/AIDS cases were probably started to be reported in Ethiopia during
early 1980's. Compared to other countries in the Great Lakes the region of Africa,
the epidemic moved into Ethiopia sometimes later (Khodakevich, 1990).
The first sero positive cases in Ethiopia were reported in 1986 among hospital
patients two years after since the first evidence of the existence of HIV in the
country, in 1984 According to the report of Ministry of Health, the increase in
the adult prevalence rate for HIV infection was very rapid between 1984 and
1994. A moderate rate of increase was seen during period between 1994 and
2004. The prevalence rate is expected to level off at a rate of 7% starting from the
year 2004 (Ministry of Health, 2002).
Once the epidemic started it began to spread rapidly along the main trading
roads connecting the city of Ethiopia. The HIV/AIDS epidemic exploded quickly
in Addis Ababa and adult prevalence increased rapidly in a relatively brief period
of time following the first AIDS cases in 1986.
4.2.2. TRANSMISSION MECHANISM OF HIV/AIDS IN ETHIOPIA
The major transmission mechanism for the rapid spread of HIV infection in
Ethiopia are identified as follows (Ministry of Health, 2000).
♦ Heterosexual intercourse and multiple sexual partnership- which is identified
as the major means of transmission

♦ Unsafe blood transfusion with unscreened blood. In Ethiopia most blood is
screened for HIV for transfusion.
♦ Unsafe injection - HIV is transmitted by injection with the same needle used
to inject many people with out sterilizing. More over, illegal medical practices
and harmful traditional practices are indicated to be potential means of
transmission.
Prenatal transmission - An infected mother may transmit the disease during
pregnancy, delivery or breast feeding and sharing needle used for injection.
mother - to - child transmission seem to affect 30-40 per cent of babies born
to HIV/AIDS positive mothers (Ministry of Health, 2002).
4.2.3. AIDS REPORTS IN ETHIOPIA
Ethiopian Ministry of Health used the sentinel surveillance method to collect and
analyze up to date data to detect the prevalence of HIV in the population.
Sentinel surveillance is a globally accepted method for obtaining data in
HIV/AIDS detection. It involves in a regular testing of selected groups for
presence of antibodies for HIV/AIDS in order to monitor trends in the infection.
The process constitutes systematic collection, analysis, interpretation and
dissemination of sero prevalence. The sentinel surveillance data are collected

from health facilities that regularly provide antenatal service to pregnant
mothers. (Ministry of Health, 2002).
The existence of better health service and facilities in Addis Ababa has played a
significant role in carrying out research programs to understand the magnitude
of HIV prevalence in the city. The data that has been used for estimating the
extent of HIV/AIDS infection in Addis Ababa was carried out at four sentinel site,
Kazanchis, Teklehaimanot, Gullele and Higher 23 (MOH, 2001).
The Ethiopian Ministry of Health has revealed the reported AIDS cases, actual
AIDS cases, people living with AIDS and the rate of prevalence at national level.
The following table shows these between 1996 and 2002 (Ministry of Health,
1996, 1998, 2000, and 2002). The following table shows that situation of
reported AIDS cases, actual AIDS cases and people living with HIV/AIDS in the
last seven years.

Table 4.1 AIDS reports in Ethiopia
1996 1998 2000 2002
Reported AIDS cases 19,433 51,781 83,487 107,575
Actual AIDS cases 350,000 400,000 400,000 219,400
People Living with HIV 1.7 million 2.5 million 2.6 million 2.2 million
(Source: Ministry of Health, 1996, 1998, 2000, and 2002)
The above table shows that reported AIDS cases seem to be minimum in number
that the number of People Living with HIV/AIDS take the larger in number
during the report years. It also indicates there is a steady increase in the
national adult prevalence rate of HIV/AIDS.
The prevalence rate of HIV/AIDS were reported for the last four editions of
Ministry of Health. The adult prevalence rate was reports to be 0.00 per cent ,
2.7 per cent, 6.2 per cent, 7.1 per cent, 7.3 per cent and 6.6 per cent in the
report years of 1984, 1989, 1993, 1997, 2000, and 2002. The rapid increase in
prevalence rate can be derived form the above reports. The adult prevalence rate
for the year 2002 in Ethiopia is 6.6 per cent which is less than the prevalence
rate reported in 2000 that is 7.3. The change is not resulted in decline in the
adult prevalence of HIV/AIDS epidemic. Rather the it is the result of more
extensive surveillance data and re-classification of Estie as an urban site
(Ministry of Health, 2002).
4.2.4. IMPACTS OF HIV/AIDS IN ETHIOPIA

Demographic, economic and social impacts of HIV/AIDS are identified to be the
major impacts in Ethiopia.

1. Demographic and Health impacts
The major demographic and health care impacts of HIV/AIDS in Ethiopia are
identifies as follows (Ministry of Health, 2002).
♦ Increase in AIDS caused deaths
♦ Increased infant mortality, and child survival
♦ Fall in life expectancy at birth and as older ages. The fall of life expectancy is
indicated that it was projected life expectancies are 45, 53,55, 59 in years of
1989, 2001, 2007, 2014 respectively. However, due to the impacts of
HIV/AIDS the life expectancy falls to 46 and 53 in the years of 2001 and 2014
respectively, in stead of being 50 and 59 as it was projected with out the
impacts of HIV/AIDS (Ministry of Health, 2002).
♦ Decrease in population size due to increased AIDS deaths
♦ Orphans and Vulnerable children
♦ HIV/AIDS and TB- increased rate of infection in TB is exhibited due to
impacts of HIV/AIDS
2. Economic Impacts of HIV/AIDS
♦ Other economic sectors that are severely affect by HIV/AIDS include non
agricultural and industrial sectors. Certainly, Health care and insurance are
likely to be significantly affected. Those sectors with mobile workers like
military, transport workers, extension service and banking are adversely
affected.

♦ The agricultural sector that is the major economic sector in Ethiopian
economy is severely affected by the loss of productive manpower usually in
their peak productive and reproductive age.
♦ The impact of HIV/AIDS in industry sector can be explained in loss of workers
and productive labor force due to increased AIDS deaths, lost in work days
due to sickness, lost work days due to funeral leave and increased health care
costs fir AIDS patients.
♦ It also affects the health sector through increased numbers of patients
seeking medical care and expensive expenditure on the medical costs for AIDS
patients. In 1994 health care costs in Ethiopia are increased significantly as
the result of AIDS. It is also predicted that hospital bed occupancy will
increase 28% as the result of AIDS (Abdulhamid, 1994).
♦ Macro economic impacts also can be identified as AIDS deaths leading to
directly to a reduced in numbers of workers available; shortage of worker
leading to higher domestic production costs. Increased spending in foreign
exchange for import of drugs. Lower government revenue and reduced private
savings can cause reduction in savings and capital accumulation. Reduced
worker productivity and investment lead to fewer jobs in formal sector
training (Bollinger, Stover, Seyoum, 1999).
3. Social Impacts of HIV/AIDS
The major social costs of HIV/AID in Ethiopia are manifested as follows (Ministry
of Health, 2002):

♦ Increase in number of orphans putting pressure at the family level with
increased burden of caring for orphans Extended family is the pressured in
taking care of the orphans and dependents of those people who lost their
breadwinner due to AIDS
♦ The structure of family is changed to be headed by orphan children as young
as 10 and 12 years old.
♦ Orphans lost the necessary financial, material and emotional support they
need for schooling.
♦ Increased Vulnerability in women economical wellbeing as they lost their
husbands usually their breadwinners.
♦ Death of member of family resulting permanent loss of income through
treatment, funeral, mourning and Teskar; widows resorting to commercial sex in
order to support their family and orphan children joining street life or
commercial sex.
♦ Breakdown of social institutions
♦ Increased funeral costs
4.2.5. THE THREAT OF HIV/AIDS EPIDEMIC ON IDDIR
As the number of death related to HIV/AIDS increases among certain
communities, the existing local strategies are increasingly under pressure and
these is need to design policies and programs that are capable of providing
support when existing strategies became inadequate (UNAIDS, 1999). Certain
researches (Damen, and Kloos 2003 and Damen and Pankhurst 2002) tried to

indicate the shortage of data on the impact of HIV/AIDS on the day to day life of
Iddir.
Since Iddir are established to contribute money for time of death of members or
of their household members, increased mortality would create financial strains.
Current increase in mortally caused by HIV/AIDS may endanger the very
existence of these grass root institutions. Therefor, Iddir are expected to play
major role in coping with the epidemic along with efforts made by formal sector
(Damen, 2003).
Similarly, Pankhurst, (2003) argued that anti HIV/AIDS responses are important
since Iddir are directly endangered by increased deaths rate, probably caused by
AIDS. This situation may deplete the resources of Iddir or even threaten the
viability of these institutions. Dissemination of information about the danger of
HIV/AIDS is possible considering Iddirs' central focus on death. Moreover, these
are the only grass roots associations, which exist throughout the country. These
are certain attempts of involving Iddirs in joining hands for fight against
HIV/AIDS in Zone 3 and 5 in Addis Ababa, Dire Dawa, Nazareth and Akaky
(ACORD, 2002).
Certain research indicate that Iddir have been severely affected by the epidemic.
The fact that Iddir contribute money during the time of death and misfortune,
makes the existing resources of these institutions vulnerable to financial strains
as mortality increases among members (Pankrust and Damen, 2003). HIV/AIDS
epidemics make an increase in mortality rate among the most productive and

eproductive sections of the community, which makes the very existence of Iddir
as the major community based organization vulnerable in the near future.
HIV/AIDS may endanger the basic structure of the society (Pankhurst and
Damen, 2003).
"… recently, due to the killer disease HIV/AIDS some leaders have the
fear that it may deplete their financial resources". Certain Iddirs in Addis
Ababa are at the margin of disintegration due to high death rates and
related financial depletion (Shiferaw, 2002).
Certain Iddir are currently engaged in the fight against HIV/AIDS. This is a an of
research and important area since Iddir are directly affected by increasing death
rates, which are depleting their resources and even threatening the viability of
some Iddirs. Given their central concern with death Iddir are obvious vehicles for
dissemination of information about the danger of HIV/AIDS. So they can be
identified as the clear stakeholders in coping with the HIV/AIDS epidemics
(ACORD, 2002).
4.2.6. MAJOR STRATEGIES OF COMBATING HIV/AIDS
There are different strategies of HIV/AID intervention indicated by the Ethiopian
Ministry of Health policy on the HIV/AIDS, which was adopted in 1998.
(Ethiopian Ministry of Health, 1998)
1. Information Education and Communication (IEC) refers provision of IEC
materials to all government ministries and institutions, NGOs, mass

organizations, religious organizations, professional associations and the
community at large. This larger coverage of IEC material distribution is meant for
provision of adequate attention to the problem of HIV/AIDS and Sexually
Transmitted Infections treatment and control.
Moreover, intensive and sustainable IEC activities through all possible media,
material and methods taking in to account culture and belief of the community
are also advocated for prevention and control of HIV/AIDS. Participation of
people living with HIV/AIDS in education to the public as well as psycho-social
support to each other is to be encouraged and adequate preparedness and
consent. Community meetings are identified as the most important sources of
information on AIDS by both women and men.
2. Sexually Transmitted Disease (STD) prevention and control
Comprehensive management of STD patients includes risk reduction, education
and counseling education on treatment compliance, condom distribution,
notification and treatment of patients. Improved quality of STD health care
service through training development and promotion of standardized treatment
guidelines and ensuring the availability of effective STD drugs.
3. HIV Testing and screening -to encourage the provision of testing screening
on a voluntary basis. Availability of screening facilities in as many public health
care facilities as possible.

4. Sterilization and dis-infection Provision of adequate sterilization and dis-
infection procedure to ensure adequate sterilization and dis-infection service.
Moreover, provision of training for health care workers about universal
sterilization and dis-infection.
5. Medical care and psychological support- the participation of government,
non governmental organizations, religious organizations, bilateral, multilateral
agencies, private sectors, community based institutions and the community at
large that includes mobilization to support people living with HIV/AIDS and
affected families. Psychological, economic and medical support to PLWA and
affected members that incorporates families and social network at large.
6. Home based Care - According to the Ministry of Health guidelines on
community home based care , which was adopted in 2001, home based care is
defined as
" a program that through regular visit offer health care service to support
the care process in the home environment of the person with HIV infection.
Home visits may be the only service provided or that may be part of an
intended program which offers the patient and his families service in home,
hospital and community".
It is underlined that for the functional and sustainable community home based
care, there is need for gaining the confidence and involvement of the families and
the community where the service is being implemented. The principal aim is to

involve the community, patients and families an community home based care
program. It ranges from medical to psychological and other material support.
The overall context of conducting community home based care for AIDS patients
is described as follows (Ethiopian Ministry of Health, 2001)
• The existing formal health service cannot cope with the demand, given the
severity and prevalence of the epidemics
• The socio- cultural structure in Ethiopia is conducive for such service.
The practice of unified families, extended families, system and culture of
adoption of children by the nearest of kin and others provide greatest
opportunities. Traditional associations such as Iddir can be optimally
utilized.

PART THREE:
ANALYSIS
DISCUSSION, CONCLUSION
SYNTHESIS OF FINDINGS AND
RECOMMENDATIONS

CHAPTER FIVE
5. RESEARCH FINDINGS ANALYSIS AND DISCUSSIONS
INTRODUCTION
This chapter contains research finding and analysis that is organized into three
main parts. The analysis of research is made by data obtained from three
different directions. The first group taken was the efforts of implementer NGOs in
involving Iddirs in their anti HIV/AIDS intervention activities. The second relates
to group effort of selected partner Iddirs towards their anti HIV/AIDS activities.
The third group is the efforts of government offices to promote the role of Iddirs
in anti HIV/AIDS activities. The case of individual implementer Iddirs, individual
NGO as well as the case of government offices are also included in each part of
this chapter.
5.1. EFFORTS OF SELECTED NGO IN INVOLVING IDDIRS IN HIV/AIDS
INTERVENTION
5.1.1. THE ACTIVITIES OF HIWOT AIDS PREVENTION CONTROL AND
SUPPORT ORGANIZATION (HAPCSO)
Hiwot AIDS Prevention Control and Support Organization is currently engaged in
working with 41 Iddirs concerning HIV/AIDS intervention. HIV/AIDS
intervention strategies like IEC, BCC, VCT and care and support are actively
engaged in with most of beneficiary Iddirs. 30 Iddirs are currently engaged in
more than one activity. The remaining 11 Iddirs only took part as participants in
the sensitization and advocacy program.

5.1.1.1. REASON FOR INVOLVING IDDIR IN HIV/AIDS INTERVENTION
Hiwot AIDS Prevention Control and Support Organization (HAPCSO) can be
taken as one of the actively engaging Iddirs in anti HIV/AIDS activities. The
major reason why HAPCSO took Iddirs as partner community based
organizations according to the coordinator of the organization, because " Iddirs
are the nearest associations to reach each individual and they are also a good
way of obtaining community cooperation " (Semi structure questionnaire
administered to project coordinator). The major potentials of Iddirs are identified
as "to be respected by members of community and have manpower resources
that can be mobilized on a voluntary basis."
The total number of 41 partner Iddirs take part in one or more of the major
components of their anti HIV/AIDS strategy, these are in IEC, BCC care and
support, capacity building. Different kinds of support for Iddirs are provided to
enhance the capacity of partner Iddirs. Capacity building and technical
assistance are the major kinds of support which are provided on a uniform basis
throughout the project period. Various trainings are provided for Iddir leaders in
order to enhance the capacity of Iddir leadership in different technical and
administrative issues. Peer educator training is the major kind of training

scheme, which ensures the progressive engagement of Iddirs in major anti
HIV/AIDS strategies.
5.1.1.2. ACTIVITIES OF PARTNER IDDIRS
The total number of partner Iddirs working with HAPCSO being 41, 30 selected
are actively involved in much of the activities as is indicated in Table 6.1. The
table shows the summary of actively involved Iddirs with each component of the
anti HIV/AIDS strategy. Cases of 30 selected partner Iddirs working with
HAPCSO are summarized below with their strategies of intervention and the
degree of involvement.
Table 5.1.The case of 30 partner Iddirs working with HAPCSO
trategies Involved
Iddirs
Non involved
Iddir
Total
IEC 30 0 9119
number of
beneficiaries
Condom Distribution 3 27 Not known
Provision of support for AIDS orphans 12 18 37
Provision of support for PLWA 14 16 22
Encouragement in VCT service 0 30 0
Fund raising for AIDS Victims 23 7 -
Home Based Care 10 20 11
Income generation for AIDS victims 0 30 0
Source: Compiled from responses of HAPCSO
From table 5.1 we can infer that large numbers of beneficiaries are addressed in the
Education Information and Communication (IEC) in only 30 selected Iddirs, who are
identified as active partners of HAPCSO. The involvement of partner Iddirs is in IEC,

Fund raising for AIDS victims, support for AIDS orphans and support for PLWHA,
and Home based care. IEC sessions are conducted during Iddir meetings and the
number of attendants includes the entire members of Iddirs. Minimum involvement
is indicated in condom distribution, while no involvement is reported in income
generation activities for AIDS victims and Voluntary Counseling and Testing (VCT).
From the total number of 23 partner Iddirs who are involved in fund raising for AIDS
victims, 16 contribute 1 ETB per month, in addition to monthly contribution, to be
used for assistance of AIDS victims. Two Iddirs allocated a budget from the Iddir
capital for the same cause. Five Iddirs allocated one third of their budget for care
and support to be obtained for AIDS victims. So one can understand that partner
Iddirs working with HAPCSO are playing a major role in most of anti HIV/AIDS
strategies like IEC, Care and support for AIDS victims as well as home based care for
AIDS patients.
5.1.1.3. DEGREE OF INVOLVEMENT FOR PARTNER IDDIRS
HAPCO has been working with partner Iddirs in mobilizing the community through
local Iddirs in the area of HIV/AIDS intervention activities. Iddirs are taken as the
major vehicles to reach the community in providing preventive and supportive
services against HIV/AIDS. The degree of involvement of Iddir leaders and Iddir
members in each of anti HIV/AIDS activities were assessed and evaluated from the
actively engaged 30 partner Iddirs working with HAPCSO.
The rate of leveling degree of involvement can be operationally defined as follows:

♦ Fully actively involved - Involved as initiates as well as implements the anti
HIV/AIDS activities
♦ Actively involved in most cases - Involved in major activities however the
initiation is taken by partner NGOs
♦ Starting to become actively involved - Involved in recently and their
participation is active
♦ Not yet involved, but participate - Involved as only participators of anti
HIV/AIDS activities.
♦ Not involved at all - Involved in none of the activities and no participation at
all.

Table 5.2 Degree of involvement of Iddir members and leaders
Anti HIV/AIDS
strategies
Degree of involvement of Iddir leaders in each of the strategies
Fully actively
involved
Actively
involved in
most
cases
Starting to be
actively
involved
Not yet actively
involved but
participate
IEC 14 (47%) 9(30%) 3(10%) 4(13%) -
not
involved at
Condom Distribution 1 (3%) - 2(7%) 27(90%)
AIDS orphan support 10 (33%) - 2(7%) - 18(60%)
PLWA support 7 (23%) 8(27%) 2(7%) 1(3%) 12(40%)
Encouragement for
VCT service
Fund raising for AIDS
Victims
Home Based Care
(HBC)
Income generation for
AIDS victims
- - - - 30(100%)
11 (37%) 8(27%) 2(7%) 2(7%) 7(23%)
6 (20%) 2(7%) 1(3%) 2(7%) 19(63%)
- - - - 30(100%)
Source: Compiled from responses of implementer HAPCSO
As it is indicated in table 5.2, the degree of involvement of Iddirs leaders and
respective members is rated in five degrees. It is indicated that the degree of
involvement of Iddir leader is similar to that of members. The level of
participation of leader and members are indicated to be fully actively involved in
conducting information and education communication. 47 percent of the total
selected 30 partners Iddirs are indicated as fully actively involved in IEC
activities. 30 percent are identified as not yet actively but participate. The
remaining 10 percent are starting to be actively involved in IEC.
all

Condom distribution is the activity in which most of selected partner Iddirs are
least involved. Only three Iddirs are involved. The degree of involvement of Iddirs
leaders and members is also identified as minimum in the majority of partner
Iddirs. 6.6 percent are identified to be involved in the degree of involvement not
yet actively involved but participating. Only 3.4 percent (only one Iddir) is
reported to be fully actively involved in condom distribution.
From the total number of 12 involved Iddirs in provision of support for AIDS
orphans 10 responded that their leaders and members are involved fully actively.
This group constitutes 33 percent of the total respondents. Seven percent of
respondents are starting to be involved in provision of support and care for AIDS
orphans. The remaining 60 percent are not involved at all.
With the regard to the provision of care and support for people living with
HIV/AID, 27 percent of the total respondents are identified as involved actively in
most cases. And 23 are fully actively involved in support to PLWA. 40 percent are
not involved at all in provision of care and support. The remaining 7 and 3 are
starting to be involved and not involved, but participate in provision of care and
support for PLWA.
Fund raising refers to the contribution of certain amount of money, which is
undertaken by Iddir members meant to support the infected and affected people
by HIV/AIDS. This is activity, which is similar to the inherent purpose of Iddirs,
it varies only with the purpose being helping affected and infected individual.
Fundraising is the second most widely employed strategy among respondents, in

which 37 percent are involved fully actively. 27 percent are involved actively in
most case. 23 percent are not involved at all. The totals of 7 and 7 percent are
starting to be involved and not yet involved but participate. Some Iddirs started
to allocate a certain amount of budget for such purpose.
Home based care is recommended especially for the internal dynamism and
experience of Iddir in addressing the people at grass root level. According to the
Ministry of Health, the traditional associations like Iddir can be optimally utilized
for such undertaking that that need gaining the confidence and involvement of
families and community at all level. (MOH, 2001). The effort of HAPCSO with
regard to home based care indicated that 20 percent of respondents are fully and
actively involved in home based care. Seven percent of respondents are involved
in most cases in provision of home based care for AIDS patients. Three percent
are participants, but not involved at all: 63 percent are involved in none of the
home based activities.
Income generation activities for the victims of AIDS as well as Voluntary
Counseling and Testing are strategies in which no partner Iddir are involved. The
involvement of Iddirs in VCT only ranges in encouragement and psychological
help to use voluntary counseling and testing.
IEC is the major activity in which the majority of partner Iddirs are widely
involved. Fund raising and money contributions are the second most important
category in which the second largest involvement of respondents are identified as
involved.

5.1.1.4. DURATION OF IDDIR INVOLVEMENT
Community based HIV/AIDS intervention that is undertaken with the
participation of Iddir is said to has started recently. The duration is seen to be a
recently introduced activity for most respondents. The duration of involvement
for each of the activities can be also illustrated in the following table.

Table 5.3 duration of involvement
Strategies
1-3
months
Duration of the involvement
4-6 moths 7-
9months
10-12
months
IEC - 1 7 19 3
Condom Distribution - - 1 2 -
AIDS orphan support - - 3 7 2
PLWA support 2 4 3 3 2
Encouragement for VCT
service
Fund raising for AIDS
Victims
- - - - -
14 4 2 1 2
Home Based Care 7 - 3 - -
Income generation for AIDS
victims
Source; Compiled from responses of implementer HAPCSO
- - - - -
13-15
months
HAPCSO has been working with partner Iddir in IEC for less than 15 month only,
3 Iddir have been involved in IEC for 13-15 months. Nineteen Iddirs were
involved in anti HIV/AIDS activities for only 12 months.
The majority of Iddirs were involved in fundraising activities for AIDS victims for
less than 3 months. HAPCSO has been encouraging partner Iddirs for a long
period of time to contribute to certain amount of money for same purpose, but
the actual activity has been started recently. The same holds true for home
based care for HIV/AIDS patients. Home based care has been the major
component of the HAPCSO involvement. But the involvement of Iddir in home
based care only started recently.

5.1.1.5. REVISION OF IDDIRS' BYLAWS
The selected Iddir are encouraged to make some revision on their bylaws with the
regard to their activities of HIV/AIDS intervention. Accordingly, bylaws of partner
Iddir incorporate a separate article that discusses the need for their involvement
in HIV/AIDS intervention and to help those who are infected and affected by the
epidemic. The bylaws also include the advocacy sessions to be held each month
to raise awareness of members of Iddirs about the prevalence of HIV/AIDS.
5.1.2. THE ACTIVITIES OF CARE ETHIOPIA; URBAN HIV/AIDS
PREVENTION AND CONTROL PROJECT
The CARE Ethiopia urban HIV/AIDS prevention and control project aims at
promoting different HIV/AIDS intervention activities. The major aims include
Behavioral Change and Communication (BCC); provision of accessible and
affordable quality of Voluntary Counseling and Testing (VCT); building the
capacity of local NGOs and community based organization (CBO) in providing
care and support for PLWA and affected families.
5.1.2.1. REASONS FOR INVOLVING IDDIRS
The involvement of Iddirs is justified as follows: " Since Iddirs are working closely
with the community, it is believed that they know members of community who
are affected by HIV/AIDS very well and the kind of intervention required to
address the problem" (Semi structure questionnaire administered to officials to

CARE). According to the reply of officials, the major potentials of involving Iddir
in the AIDS intervention programs are identified as follows
Iddirs can mobilize the community easily
They are respected and recognized among members of the community
They are committed to support of members PLWA or AIDS orphans
They are willing to participate actively in BCC and IEC
The CARE project is working with local Iddirs in different HIV/AIDS intervention
activities. 19 Iddirs were selected which were found in the project area to be
potential partners during the first contact of the iddirs in the project. 36 peer
educators were provided training, which were selected from 19 Iddir. Currently,
there are 10 Iddir which are actively working in Behavioral Change and
Communication (BCC). These are partner Iddirs who held discussion and
advocacy sessions on monthly, quarterly and biannually bases. The dropouts
Iddirs from the first selected ones indicated that the leaders of Iddir are less
committed.
5.1.2.2. INVOLVEMENT OF PARTNER IDDIR IN IEC AND BCC
The CARE project included 20 partner Iddirs actively involved in Behavioral
Change and Communication (BCC). An additional 11 partner Iddirs are actively
involved in care and support. A total of 31 partner Iddirs are currently actively
involved in BCC and care and support. Mainly, the involvement of partner Iddirs
is important in BCC and care and Support.

With regard to the activities of partner Iddirs in information education and
communication 19 potentially active Iddirs were selected for the purpose of
involving them in IEC and BCC activities. Accordingly, 36 individual
representatives of Iddir were recruited for the peer educators training. During the
first period of the training, 19 iddirs were involved in the activities of the project.
Currently, there are 10 Iddirs which are actively working with the CARE project
in behavioral change and communication, and communication and information
education and communication. These are partner Iddirs who held the advocacy
sessions in monthly, quarterly and biannually basis. The level of dropout is very
high. Nine Iddirs are not working currently with the project. It was reported that
the representatives of these Iddirs are not regularly attending the follow up
programs because of their personal commitments. The case of ten currently
involved Iddirs can be cited for the illustration of the efforts of CARE in involving
Iddirs in IEC and BCC.
The total of ten partner Iddirs are reported to have the degree of fully actively
involved in IEC and BCC. The role of Iddir leaders' is a determinant for the
success of the program in such a way that leaders are both initiators and
implementers as they are respected and identified among the community
members.
5.1.2.3. PROVISION OF CARE AND SUPPORT FOR AIDS VICTIMS

Provision of care and support include activities of care for PLWA, AIDS orphans
and home based care for AIDS patients. With regard to the provision of care and
support activities of CARE project, a total number of 263 orphans and 46 PLWA
were beneficiaries are identified as the Iddirs based AIDS. The assessment made
by the CARE on the involvement of partner Iddirs in care and support programs
can be easily indicated in the following table.

Table 5.4 The case of Partner Iddirs working with CARE in provision of care and support
Support and care
programs
Provision of
support for AIDS
orphans
Provision of
support for PLWA
Provision of Home
based care for
AIDS patients
Number of
Involved
Partner
Iddirs
Number of total
beneficiaries
Degree of
involvement of
Iddir leader
11 263 currently
actively involved
11 46 currently
actively involved
11 not known currently
actively involved
Degree of
involvement of
Iddir members
currently actively
involved
currently actively
involved
currently actively
involved
Source: Compiled from responses obtained from CARE; Ethiopia Urban HIV/AIDS prevention and
care project
Table 5.4 shows the involvement of the active part of Iddirs in care and support
program. A total of 11 partner Iddirs are currently engaged in provision of
support for AIDS orphans and PLWA. The degree of involvement of partner Iddirs
member and leaders is reported for those currently actively involved in provision
of care and support. In such regard, partner Iddirs are required to submit their
project proposal for the grant. Accordingly here are eleven partner Iddirs who
have currently secured project funds from the CARE project in the area of
provision of care and support for HIV/AIDS patients and orphans. These are
designed to enhance the sustainability of iddirs involvement in HIV/AIDS
intervention activities.
5.1.3. ACTIVITIES OF THE AGENCY FOR COOPERATION IN RESEARCH
AND DEVELOPMENT (ACORD): ACORD ADDIS ABABA CBO
SUPPORT PROGRAM

The overall objective of the project is to increase the role of Community Based
Organizations (CBOs) in development. Moreover, it was indicated that increased
recognition of CBOs in development can be reached through creation of an
appropriate legal and policy environment for CBOs; and to establish linkages and
cooperation between CBO and NGOs and government, to contribute to the
alleviation of urban poverty by involving community based organization as
intermediaries.
The major components of the ACORD Addis Ababa CBO Support Program
including the following:
Advocacy
Training and capacity building
Joint projects in infrastructure (clinics, utilities like water toilets etc
with partner Iddir)
Savings and credit
Additional cross sectional activities undertaken by the ACORD Addis Ababa CBO
support Program are identified as HIV/AIDS intervention and gender. HIV/AIDS
is identified as not the major component of the ACORD Addis Ababa CBO
Support Program but the extended experience that is obtained in strengthening
the role of community based organizations in development and recent advocacy
program make it appropriate for the research.
The involvement of Iddirs in the program is not limited to HIV/AIDS but also
involves community development work in credit and saving and other related

works. Iddirs are identified to have potentials as it is indicated in the work of
ACORD; Addis Ababa CBO support Program for the following reasons:
They are close to members and have rich experience in the assistance
for members
They are victims of the effects of HIV/AIDS in depletion of their human
and financial resources.
5.1.3.1. CAPACITY BUILDING EFFORTS OF ACORD
The number of partner Iddirs working with ACORD Addis Ababa CBO support
program are identified as 50 Iddirs which are actively involved in Information
Education and Communication. The emphasis and role of the ACORD Addis
Ababa CBO support Program is building the capacity of Iddirs. Different
trainings were provided to enhance the capacity of the partner Iddirs to involve
themselves in HIV/AIDS intervention activities and other development activities.
The following table shows the capacity building training provided for the leaders
as well as the members of partner Iddirs.
Table 5.5 Capacity building activities undertaken by ACORD
Type of training Number of participant
Iddirs
Training workshop 42 93
Net working work shop 54 109
Peer educator training 7 49
Experience sharing visit 14 22
Sources: Complied from the responses of ACORD
Number of individual
participants leaders and
members

The involvement of Iddir in the activities of ACORD is more about the capacity
building activities. Table 5.25 shows the number and kinds of capacity building
trainings that were given for Iddir leaders and members. Through such capacity
building workshops and training ACORD is enhancing the abilities of partner
Iddir to become involved in different development activities. HIV/AIDS
intervention is one of the activities in which partner Iddirs are involved.
5.1.4. ACTIVITIES OF MARY JOY AID THROUGH DEVELOPMENT
(MJATD) IN INVOLVING IDDIR IN HIV/AIDS INTERVENTION
The overall objective of the project is to reduce the socio-economic impact of
HIV/AIDS through establishing effective preventive and control strategies.
Moreover, it was indicated that the specifies objectives of the project are to bring
improvement in the socio economic status of those infected by HIV/AIDS as well
as groups vulnerable to being infected (street children, commercial sex workers,
widows).
MJATD started working with Iddirs in 2000. The role of Iddirs in HIV/AID
intervention activities increases with the advocacy and sensitization program
provided for each of beneficiary Iddirs starting from 2000. A total number of 41
took part in support of members, conducting awareness and advocacy sessions
along with their principal aim of conducting burial activities. A community
worker in MJATD, Ato Leggese Annore, described some of the experiences of his
own Iddir as follows.

The case of a partner Iddir working with MJATD
"In my Iddir, the experience that initiated us to take part in HIV/AIDS intervention
was very tragic. One incident actually initiated the Iddir leaders to take it
seriously. It happen during 2000.
There was an old lady who happened to be a member of our Iddir. She paid
monthly contributions from a small amount of income she got by begging. She lived
on her own no one was there living with her. She got sick once and never
recovered again from the disease. No one knew what was the cause of her illness.
No one took the initiative to help her or to consult her during the time of her Illness.
Finally, she passed away in her little tent. Neighbors and Iddir members give hand
to took her body out and bury it. She had a share of sum of money. We use some
of the money for burial activities. We have to give her share of money to some one
closer to her. No one was there. Finally, we found some one who is a distant
relative of the deceased, and we gave the money to that individual. The next
morning we had a meeting, the incident with the old lady's death touched our
heart. We realize then what is all about the role of Iddir should be taking care of
members while they are alive and give support and care while our members are in
need. So we revised our activities and decided to give support and care for
members who are victims of HIV/AIDS.
MJATD gives assistance for local Iddirs who are working closely with the project.
Training and technical support are the major components of assistance provided
to Iddirs working with MJATD. The provision of assistance is done in a

diminishing manner that shows that gradual decrease as the project duration
increases from 2000 to 2005. This shows quite remarkable indication of the
sustainability of the activities performed by the MJATD with close relation to
Iddirs.
MJATD took the initiative and an active implementer role in Information
Education and Communication and care and support along with partner Iddirs.
37 partner Iddirs are involved in Information Education and Communication
with 8825 individual beneficiaries of the project. However, the involvement of
members and leaders is identified as minimal in care and support as well as IEC
and BCC. Two partner Iddirs are actively involved in support for PLWA with eight
individual beneficiaries that are identified according the current assessment
made by MJATD. It is also indicated that the involvement of MJATD in support
for PLWA and fund raising for AIDS victims recently started in 2003.
5.1.5. ACTIVITIES OF PRO PRIDE MERKATO PROGRAM IN INVOLVING
IDDIRS IN HIV/AIDS INTERVENTION
The project area is located in Addis Ketema Kifle Ketema (kebele 03, 04, 05, and
12). The project has three years duration. The major objective of the project is
poverty reduction at the household and community level through income
generation schemes. Micro enterprise development is the major means of
enhancing the capacity of the community at individual and as well as household

level. The involvement of Iddirs is more cross sectional than in various strategies
of the project.
Iddirs are mainly involved in the livelihood improvement sector in order to bring
about sustainable development through real community participation and
resources allocation. Partners' involvement in HIV/AIDS issues is related to cross
sectional approach. In this regard a total of 20 partner Iddirs were identified, of
which 9 are involved in capacity building, 7 are involved in networking and 4 are
involved in community based development.
Certain efforts were made to work with Iddirs in HIV/AIDS intervention activities.
However, these were discontinued due to various factors from both sides as
leaders of partner Iddirs did not have the required commitment. Moreover,
leaders of partner Iddirs did not have the necessary involvement and
commitment for the HIV/AIDS intervention activities done in collaboration with
Pro pride. Therefore, the human resources were scarce for them to keep on
working with Iddirs.

5.1.6.ACTIVITIES OF COMMUNITY BASED INTEGRATED SUSTAINABLE
IN
DEVELOPMENT ORGANIZATION (CBISDO) IN INVOLVING IDDIRS
HIV/AIDS INTERVENTION
CBISDO is a community-based program actively working in Tekle Haimanot area
Wereda 3 and wereda 4. Six kebele are included in the program areas for
CBISDO that is wereda 3 in kebeles 41, 42, 30, 43 and wereda 4 in kebele 40
and Kebele 29. The overall objective of the organization is to mitigate the AIDS
pandemic through mass health education, provision of support for AIDS
patients and to bring behavioral change among the community concerning risks
of vulnerabilities.
CBISDO has involved the local community through involving Iddirs in IEC and
BCC. Ten Iddirs were engaged as beneficiaries for IEC and three Iddirs were
involved in care and support for PLWA and AIDS orphans. Their effort in
involving Iddirs discontinued and currently Iddirs are not active partners in most
of the activities done in the organization. CBISDO reported that the level of
involvement of these Iddirs was so minimal, much what was than expected.
The discontinuance of the attempt is identified due to resistance from the Iddirs
to be actively engaged in activities and failure to manage the program from the
side of the organization. The reason for failure of this attempt can be seen from
two different directions. From the Iddirs side, there was strong resistance to

incorporate with the NGO. More over there were problem in obtaining fully
committed Iddir leader among partner Iddirs. From the CBISDO side the activity
is launched with out consulting the local community and Iddirs leaders. Proper
planning and well suited experience in working with Iddirs was lacking. So, the
failure can be taken as a major lesson for further involvement.
5.1.6.1. ACTIVITIES OF PARTNER IDDIRS WORKING WITH CBISDO
An assessment was made on the activities of Iddirs in each of the HIV/AIDS
intervention strategies. Six partners Iddirs were included in the assessment and
the following table shows those overall findings.
Table 5.6 Activities of partner Iddirs working with CBISDO
Strategies Currently
actively Involved
partner Iddirs
Once involved but
currently non
active partner
Iddir
IEC 0 6 0
Condom Distribution 0 0 6
AIDS orphan support 0 2 4
PLWA support 0 0 6
Encouragement for VCT service 0 0 6
Fund raising for AIDS Victims 0 0 6
Home Based Care 0 1 5
Income generation for AIDS victims 0 0 6
Source: Compiled from responses of implementer CBISDO
Number of
Iddirs Non
involved at all
Table 5.6 shows the case of 6 partner Iddirs which were selected and identified
as having once been working together with CBISDO. Partner iddirs are referred
as involved in anti HIV/AID activities. There is no partner Iddir that is currently

actively involved in HIV/AIDS intervention activities with the organization. All the
selected number of Iddirs were once involved in Information Education and
communication. Only a few were found to be engaged in support and care
program. The number of Iddirs, which were once active but currently
discontinued, the efforts are 2 and 1 in activities support for PLWHA and home
based care respectively. The role of Iddir members and Iddir leaders were very
limited. The entire initiation and implementation were taken by the active
involvement of the implementer NGO, CBISDO. However the level of participation
from Iddirs was not achieved. This is the reason why the program was
discontinued.
5.2. EFFORTS OF SELECTED IDDIR IN HIV/AIDS INTERVENTION
ACTIVITIES
5.2.1. INVOLVEMENT OF IDDIRS IN NON BURIAL ACTIVITIES
Iddirs perform diverse activities in addition to their principal function that is
covering funeral costs. Iddirs are actively involved in different community
development activities. Kebele and local administrators took the initiative to
involve Iddirs in community development activities like fund raising for
construction of feeder roads, fund raising for local school, clinic water pump or
environmental protection activities. Related social support activities like support
for the disadvantaged, old aged and orphans are also performed by Iddirs. The
response of interviewed Iddir leaders with regards to the involvement of their

Iddir in non-burial activities that are related to community development is
summarized in the following table.
Table 5.7 Involvement of Iddir in community development and burial activities
Name of partner NGO
Degree of
involvement HAPCSO ACORD CARE CBISDO MJATD Pro Pride
Total
(%)
Involved 12 9 6 4 7 4 42
(69%)
Non involved 5 1 8 1 0 4 19
(31%)
Total number 17 10 14 5 7 8 61
(100%)
Source: Compiled from response of Iddir Leaders
The above table shows that the majority of respondents Iddirs are involved in
non-burial activities. 69 percent of total respondent Iddirs are involved in
development activities (The involvement of Iddirs in development can be further
elaborated in the following table) and the remaining 31 percent are involved only
in burial activities.
Table 5.8 Types of community development activities
Involvement of Iddir in development
Number of Iddirs
Only in burial activities 19
Road, Water School and other social utilities
39
Provision of support for the elderly 9
Provision of support for disadvantaged 6
Provision of support for orphans 13
Church construction
Sovereign call from kebele during Ethio- Eritrean war 8
Environment 3
Saving and credit activities 6
10

HIV/AIDS advocacy and care and support 61
Source: Compiled from response of Iddir Leaders
Table 5.8 summarized then activities of Iddirs with regard to their involvement in
community development activities. Iddirs' role in construction of feeder roads , may
range fund raising for the construction for water pumps, public toilets church
construction and other social utilities established for the local community. Moreover,
Iddirs have been the major vehicle to channel local resources, financial, manual and
technical, for sovereignty call during Ethio - Eritrean war.
Iddirs also responded that they are involved in provision of orphans, old aged people
and disadvantaged. Iddir undertake these support program through the best suited
community support program, and raising and contributing money for the use of
support provision. 10 Iddirs responded that they are involved in construction of local
church. These Iddirs are involved in fund raising activities for construction of
'Balewold church' that is located in the nearby area.
Saving and credit activities are also reported to be an area of involvement for 6 Iddir
interviewed. These respondents are partners Iddir, which are working with ACORD.
It is indicated in the previous section that ACORD promotes the role of Iddir in
development through capacity building and saving and credit activities.
5.2.1.1. ACCESS OF IDDIR TO THE EXTERNAL ASSISTANCE FOR NON
BURIAL ACTIVITIES
The very reason why Iddirs are established is to take care of burial activities. The
findings that were compiled from the responses of 61 Iddir leaders shows that Iddirs

are also involved in non-burial activities like the establishment of public utilities like
toilet, feeder roads, construction of churches, fund raising for local school and
clinics etc.
The principal function of Iddir is to undertake burial ceremonies and help can be
seen along with external assistance given to Iddir. NGOs, umbrella Iddir
associations, Private organization and kebele are identified as giving some sort of
assistance. Certain kinds of assistance were found to be provided for these Iddirs to
engage in local community development activities.
Table 5.9 Access of Iddir to external assistance
Access to
Name of partner Iddir
Perc
assistance HAPCSO ACORD CARE CBISDO MJATD Pro Pride Total ent
(%)
Not assistance 8 2 9 5 - 8 32 52.4
5
Partner NGO 6 4 2 - 2 - 14 22.9
5
Wereda and 1 2 3 - 3 -
14.7
Kebele (Local
authorities)
9 5
Umbrella Iddir 2 2 - - 2 - 6 9.83
Private org - - - - -
0
0
Total 17 10 14 5 7 8 61 100

Source; Compiled from response of Iddir leaders
The majority of respondent Iddirs are not provided any kind of assistance at all. This
accounts for 52 percent of the total number of sample. This shows that the majority
of respondent Iddirs are involved in community development by their own capacity
and potential. The remaining 48 percent obtain different kind of assistance in
financial, technical, administrative and net working. Partner NGOs are found to give
assistance to 23 percent of total respondent Iddirs. Local authorities like kebele and
Wereda administrations provide administrative and networking assistance to 15
percent of total respondent Iddirs. Umbrella Iddir organizations like Tesfa
Mahiberawina limat Akef mahiber is the one who give different kind of assistance to
member Iddirs. Networking the efforts of individual Iddirs found in the association
and financial resources is the major assistance given to member Iddirs. Tesfa
Mahiberawina limat Akef mahiber was founded in 2000, and it is actively engaged in
networking the efforts of member Iddir in helping elderly people, orphans
disadvantaged and AIDS victims.
Table 5.10 Provision of assistance given for Iddirs
Kind of assistance
Name of partner NGOs
Total (%)
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
No assistance 8 2 9 5 - 8 32 (52)
Financial 4 - 1 - - - 5 (8)
Technical and
capacity building
3 8 1 - 3 - 15 (25)
Administrative - - 3 - 2 - 5 (8)
Networking 2 - - - 2 - 4 (7)

Total 17 10 14 5 7 8 61 (100)
Source: Compiled from response of Iddir Leaders
The majority of Iddirs are provided with technical and capacity building assistance
like training and workshops. ACORD gives its partner Iddirs training, workshops
and capacity building seminars, which constitute 25 percent of total respondent
Iddirs. The major objective of ACORD Addis Ababa CBO support program is to
enhance the activities and participation of community based organizations like
Iddirs in development.
Table 6.10 indicates the same finding. The majority of respondents Iddirs that are
partners of ACORD are likely to obtain technical and capacity building assistance.
Financial and administrative assistance accounts for 8 and 8 percent of total
respondent Iddirs.
5.2.2. THE SITUATION OF IDDIR CAPITAL, EXPENDITURE ON BURIAL
ACTIVITIES, EXPENDITURE ON DEVELOPMENT ACTIVITIES AND
DEATH RATE IN SELECTED IDDIR
Nine Iddirs, which were willing to provide full information about considered factor for
last ten years, were included in the situational assessment. Factors that were
considered for the situational assessment include Iddir capital, death rate and
expenditure on development as well as burial activities. Iddirs are often resistant to
disclose amount of their capital. Their fear has come from confiscation of their
property against their will by governments bodies during Derg Era. Their resistance
also came from lack of information about the interest of government in involving
Iddirs in different development activities. They replied that they still don’t have trust

about activities of government in involving Iddirs in development. Respondent Iddirs
leader repeatedly underline that" if we disclose about the situation of our capital no
one knows what is going to happen in the future. There is a rumor that government
has intention in bringing our money together to set up bank. Such tendencies forces us
to be close about information about our capital". Thus, there was serious limitation in
obtaining data about the situation of Iddir capital, their spending on development,
burial activities and death rates for the last ten years.
Respondent Iddir leaders were also asked about the situation of AIDS deaths, PLWA
and AIDS orphan very few provide data only for the last two years. This is because
that there is wide spread poor documentation among majority of respondents.
Moreover, the information about the situation of AIDS deaths and PLWA are more
secretly kept that only concerns health officials and the patient. Community leaders
and Iddir leaders are less likely to know such things. Very few identified limited
number of AIDS patients and suspected AIDS patients, but these are not complete
data to make analysis. But the amount of capital and deaths rated as well as their
spending on burial activities may indicated the extent of AIDS and AIDS caused
deaths on the livelihood of Iddirs. The following assessments are derived from the
raw data obtained from selected nine Iddir that were included in the study.
Table 5.11Number of deaths among respondent Iddirs
Iddir
Code
Number of deaths in during years 1986-1994 EC.
1994 1995 1996 1997 1998 1999 2000 2001 2002
001 3 12 18 22 20 29 32 28 30
002 96 85 80 96 120 145 108 55 48
004 7 6 8 7 9 11 8 13 10

006 4 10 8 6 6 15 15 25 19
007 4 4 4 4 16 17 17 20 12
008 4 6 8 7 9 11 8 13 10
009 8 12 12 14 16 15 17 19 20
Source: Compiled from the responses of Iddirs leaders
Table 5.11 shows there is an increasing in trend the number of deaths occur
among the majority of respondent Iddirs. Iddir were coded in 001, 002, 004, 006,
007, 008 and 009nominally since Iddir leaders are very careful to disclose
information about the situation of their capital and related issues. According to
their response the above table summarizes the situation of deaths that occur
during the last ten years.
The trend of steady increase is seen in most of respondent Iddirs. Most of rises in
number of deaths occur between years of 1997 and 1999. The increment ranges
from continuous change in numbers of deaths that cumulatively resulted in a
large number of deaths through the last ten years.
.
As it is indicated in the table 1.1 there is an increasing trend in number of
deaths that occur among the majority of Iddirs. Increase in death rates usually
resulted in increased spending in burial activities and related undertakings. This
is because of the very nature of Iddirs related to take care of deaths. The
principal aim of Iddir is "… to meet death expenses and to avoid a paupers'
funeral as well as to provide a certain measure of social security when financial
crisis has occurred in certain household" (Pankhurst and Endrias, 1658).
Similarly, respondent Iddirs are asked about the situation of their expenditure
on burial activities and related undertakings. The findings of the assessment

about the situation of deaths in seven selected Iddirs can be summarized in the
graphs indicated in Annex. The following table (5.12) summarizes the response of
Iddirs with the regard top their expenditure on burial activities during the last
ten years.
Table 5.12 Iddirs' expenditure on burial activities
Iddir
Code
Percentage of Iddir expenditure on burial activities from the capital in
the last ten years (in %)
1994 1995 1996 1997 1998 1999 2000 2001 2002
001 80 37 36 36 40 43 47 43 47
002 80 86 33 43 65 57 44 25 23
004 48 72 44 - 67 133 - 87 102
006 35 88 70 40 40 53 77 97 94
007 45 40 42 38 40 60 56 54 41
008 51 50 52 43 49 61 48 84 69
009 60 48 55 51 50 48 68 71 50
Source: Compiled from the responses of Iddirs leaders
Table 5.12 shows the situation of Iddirs expenditure on burial activities in
selected seven Iddirs as it is seen during the last ten years. According to the
responses of Iddir leaders, Iddirs expenditure on burial activities constitute
larger amount of their spending through out the last ten years. This might be
explained by the very nature of Iddirs is to undertake deaths expenses among

members. Majority of expenditures made on burial activities ranges more than
half of their existing capital during the reporting year.
In some cases burial expenditures exceeds the total amount of capital that is
available. Respondent Iddir coded as 004 have shown burial expenditures are
more than capital available during years of 1999 and 2002. Iddirs coded as 009
has burial expenditure more than or around the amount of half of Iddir capital.
There is also an increasing trend in the burial expenditure among the majority of
respondent Iddirs. Iddirs coded as 004, 001, 006, and 008 shows steady increase
in their expenditure on burial and related activities. Iddir coded as 002 shows an
increase in burial expenditure during 1998 and 1999. Similarly, such seasonal
increase is seen in Iddirs coded as 007 and 009 during the years of 1999 and
2000. Certain increase in burial expenditure can be explained in increased rate
of numbers in deaths that occur among respondent Iddirs.
Such increased spending on burial activities unable these institutions involve in
non burial activities that has merit for community development. In some cases it
is seen these Iddirs unable to cover their burial expenditure since their capital is
less that what they are supposed to spend on burial activities. Iddir 004 is a good
example for such conditions.
The following table (Table 5.13) shows the Iddir expenditure on non-burial
community development activities.

Table 5.13 Iddirs' expenditure on development activities
Iddir
Code
Percentage of Iddir expenditure on development (Non burial)activities
from the capital in the last ten years ( in %)
1994 1995 1996 1997 1998 1999 2000 2001 2002
001 - - - - - - - - -
002 0.67 0.72 0.62 0.73 0.72 0.89 0.78 16.47 2.8
004 19 10 6.6 - 8.5 - - 0.7 -
006 - - - - - - 7.8 5.9 -
007 - - - - - 2.4 3.5 - -
008 - - - - - - 6 12 6
009 1.1 - - 1.1 3 11 - 0.9 -
Source: Compiled from the responses of Iddirs leaders
Table 5.13 shows that most of respondent Iddirs failed to report their
expenditure on non-burial activities for the last ten years. Only some reported
their spending for limited period of time. Non reported non-burial expenditure
indicated that respondent Iddirs are not involved in non-burial activities or their
spending is not documented. Non-burial activities include in fund raising for
construction of feeder road, local school and local health canter as well as other
social facilities like water. Summarized assessment made on the situation of
Iddirs' expenditure on burial activities can be seen in graphs indicated in annex.
Only Iddir coded as 002 reported their expenditure on non-burial activities. It
indicated that their expenditure on non-burial activities is less than 1% of their
capital available during most of the report year. Only during 2001 and 2002 they
spend 16.47 and 2.8 percent of their capital on non-burial activities respectively.
The remaining respondent Iddirs reported their expenditure on non-burial

activities for the limited years. Those reported expenditures on non burial
activities are very limited amount compared to expenditures made on burial
activities. The minimum spending on non- burial activities can be explained with
the regard to increased deaths among Iddirs that consumes most of Iddirs
resources to be spend on burial activities and related undertakings. These
situations preoccupied further involvement of iddirs in non-burial activities and
forced iddirs to relay on only on burial activities. That in turn resulted in limited
involvement of Iddirs, which are identified as potential vehicles for active
participation of the community at the grass root level in various development
activities, in development activities. In some cases the very survival of these
institutions is in danger due to increased deaths, which directly affect their
capital and human resources.
Similarly, table 1.3 shows there is limited left for Iddirs to spend on non burial
activities, as it is shown in table 1.2 that their expenditure on burial actives is
increasingly growing derived from increased deaths.
The following table (Table 5.14) can clearly make comparison between Iddirs'
expenditure on burial and non-burial activities. From the table one can consider
that there is only very limited expenditure made by Iddirs on non-burial
activities. Much of Iddir expenditures are made on burial activities and these are
showing increasing trend that is assumed to be caused by increase in deaths.
See table 5.14.

Table 5.14 Comparison of Iddir expenditure on burial and non burial activities
Iddir
Percentage of Iddir expenditure on development (Non burial) activities from the
capital in the last ten years ( in %)
Code 1994 1995 1996 1997 1998 1999 2000 2001 2002
001 80
002 80
004 48
006 35
007 45
008 51
009 60
-
0.67
19
-
-
-
1.1
37
86
72
88
40
50
48
-
0.72
10
-
-
-
-
36
33
44
70
42
52
55
-
0.62
6.6
36
43
-
-
0.73
-
40
65
67
-
0.72
8.5
43
57
133
Source: Compiled from the responses of Iddirs leaders
-
-
-
-
40
38
43
51
-
-
-
1.1
Keys: - Bold - Expenditure on burial activities
Unbold -Expenditure on non-burial activities
40
40
49
50
-
-
-
3
53
60
61
48
-
0.89
-
-
2.4
-
11
47
44
-
77
56
48
68
-
0.78
-
7.8
3.5
6
-
43
25
87
97
54
71
-
16.47
0.7
5.9
-
84
12
0.9
47
23
102
94
41
69
50
-
2.8
-
-
-
6
-

5.2.3. IDDIRS AND THEIR ANTI HIV/AIDS ACTIVITIES
5.2.3.1. DURATION OF IDDIRS HIV/AIDS INTERVENTION
ACTIVITIES
The emphasis on the community based HIV/AIDS intervention began recently.
Findings of the study shows that 1999 is the year when interviewed Iddirs started
anti HIV/AIDS activities. The following table shows the year of establishment of
HIV/AIDS intervention activities among Iddirs interviewed in the research.
Table 5.15 Duration of establishment for anti HIV activity among respondent Iddir
Name of partner NGO
Year HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Total (%)
1999 - - - - - 2 2 (3%)
2000 5 3 3 1 - 2 14(23 %)
2001 5 7 5 - 1 2 20(33%)
2002 7 - 6 4 6 2 25(41%)
Total 17 10 14 5 7 8 61(100%)
Source: Compiled from response of Iddir leaders
Most HIV/AIDS intervention attempts started in 2002. 41% of the total number of
respondent Iddirs started to engage in HIV/AIDS intervention activities recently in
2002. 33 percent of the total interviewed Iddirs responded that they started to
engage in HIV/AIDS intervention activities in 2001. 23 percent and 3 percent started
their activities in 2000 and 1999 respectively. One can learn that these attempts are
recently introduced compared to the first incidence of the epidemic in Ethiopia in
1986. However, there are indications that shows that certain kinds of sensitization
workshops have been given before their involvement in anti HIV/AIDS activities.

5.2.3.2. REASONS FOR AND SOURCES OF INITIATION
Various reasons were given as a source of initiation for anti HIV/AIDS intervention
undertaken by Iddirs. Increased AIDS deaths and AIDS orphans, initiation and
sensitization from the partner NGO, initiation from kebele other local administrators.
The following table shows the responses of interviewed Iddirs with regard to the
sources of their motivation to be involved in anti HIV/AIDS activities, as it is
observed in their Iddir.
Table 5.16 Reasons for anti HIV/AIDS activity
Reasons for Iddirs
taking part in
HIV/AIDS
intervention
AIDS deaths and
Orphans
Name of partner NGO
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Total(%)
6 4 6 1 4 3 24 (39%)
Public advocacy 3 2 1 - - - 6 (10%)
Initiation from 8 2 5 1 3 4 23 (38%)
partner NGOs
Initiation from local
authorities: Wereda
and Kebele
- 2 2 3 - 1 8 (13%)
Total 17 10 14 5 7 8 61
(100%)
Source: Compiled from responses of Iddir leaders
Reasons for taking part in HIV/AIDS includes for both internal and external
reasons. Internal reasons include increased number of deaths and orphaned
children among Iddir members. External reason includes those initiations
coming from outside bodies like public, partner NGOs, local authorities and
other bodies.
The incidence of increased AIDS deaths and AIDS orphans seem to be the major
reason for the majority of respondent Iddirs to take part in HIV/AIDS

intervention activities. A certain number of respondents indicated that there is a
depletion of their capital due to the increased number of deaths that forced
Iddirs to spend much of their capital on burial activities and contributions made
for the members of Iddir who lost members of families. 39 percent of total
number of respondent Iddirs reported that increased number of AIDS deaths and
AIDS orphans forced them to take part in HIV/AIDS intervention activities.
Awareness raising and sensitization workshops that are conducted by partner
NGOs seem to be reason for some Iddirs to take part in HIV/AIDS intervention
activities and seem to help 37 percent of total number of respondent Iddirs.
Kebele and wereda authorities seem to be source of motivation for 13 percent of
total respondent Iddirs to be involved in anti HIV/AIDS activities. Public
awareness and mass advocacy programs, which are undertaken in different
forms, seem to be also motivate 10 percent of the total number of interviewed
Iddirs to take part in anti HIV/AIDS activities. Table 5.17 below indicates the
sources of the first initiation for Iddirs to involve in anti HIV/AIDS activities.
Table 5.17 Source of the motivation for Iddirs in HIV/AIDS intervention
Sources of initiation
Name of partner NGO
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Total
Iddir members 1 8 6 - - 2 17 (28%)
Partner NGOs 16 2 5 5 7 6 41 (67 %)
Kebele and local
administration
- - 1 - - 1 (2%)
Wereda HIV
secretariat
- - 2 - - 2 (3%)
Total 17 10 14 5 7 8 61 (100%)
Source: Compiled from responses of Iddir leaders

Partner NGOs took the major initiation in involving Iddirs in anti HIV/AIDS
activities for the majority of respondent Iddirs. 67 per cent of total number of
respondents responded that partner NGOs took the lead in initiating them in anti
HIV/AIDS intervention activities. HAPCSO took initiation in 94 percent of
selected partner Iddirs selected in the study. The same holds with partner Iddirs
who are working with Marry Joy Aid Through Development (MJATD). All
respondents from MJATD reported that the initiation came from partner NGO
working with them.
Iddir members and leaders taking initiatives may coupled with the internal
reasons for Iddir that is increased number of AIDS deaths and AIDS orphans.
Iddir members were identified to be sources of initiation for 28 percent of
respondent Iddirs. The majority of initiations that come from Iddir members
belong to partner Iddirs who are working with ACORD. This might be seen with
regard to the emphasis that ACORD gives for the capacity building and technical
assistance for partner Iddirs. in such regard ACORD has been providing different
capacity building and training that helps iddirs to take up such activities by their
own. The initiation that comes from Iddir members refers to initiation that
comes from internal reasons. Usually Iddir leaders took the major role in doing
so.
5.2.3.3. REVISION OF PARTNER IDDIRS' BYLAWS

The principal role of Iddir being burial and related activities, most of interviewed
Iddirs adapted their bylaws long time ago. HIV/AIDS intervention activities are
indicated as recently introduced. The concern of Iddir's bylaws with regard to anti
HIV/AIDS activities needs the revision concerning newly introduced activities.
Revision of Iddir's bylaws in necessary for their function is entirely not related to the
HIV/AIDS intervention activities. The involvement of Iddirs in anti HIV/AIDS
activities is not one of their principal function, so certain kind of revision need to be
made let them incorporate additional activities.
Table 5.18 shows the responses of interviewed Iddirs about the revision made on the
content of their Bylaws.

Table 5.18 Revision of Iddirs Bylaws
Level of
revision
made on
Iddir
bylaws
Name of partner NGO
HAPCSO ACORD CARE CBISD
O
MJATD Pro
Pride
Total (%)
Revised 12 1 7 - 4 2 26 (42%)
Not revised 4 4 4 5 1 6 24(39%)
on the
process of
being
revised
1 5 3 - 2 - 11(18%)
Total 17 10 14 5 7 8 61(100%)
Source: Compiled from responses of Iddir leaders
Potentially large number of respondent Iddirs seem to have made revisions in the
content of their bylaws concerning the need for them to do some thing about
HIV/AIDS and to support and help their member while they are alive. 43 percent of
the total respondent Iddirs revised their bylaws. HAPCSO took the lion's share from
partner Iddir whose made revisions on bylaws to take part in HIV/AIDS intervention
activities. Partner Iddirs, with revised bylaws, who are working with CARE also seem
to be half of the sample taken from partner NGOs.
18 percent of total respondent Iddirs are in the process of revising their bylaws with
regard to their anti HIV/AIDS activities. These are referred to waiting for the general
assembly to make the revised document official. Some others are drafting the
revisions to be official during the general assembly meeting to be held annually or
biannually. The remaining 39 percent of the total respondent Iddirs reported that
their bylaws are not revised. There seems to be a clear trend to update the content of
bylaws of Iddir due to their involvement in different development activities. CBISDO

has discontinued efforts in working with partner Iddirs. So, all of partner Iddirs
working with CBISDO reported that they didn't revise their bylaws. The same holds
true for the majority of partner Iddir working with Pro-Pride. These attempts are
discontinued and their involvement is mainly on poverty reduction.
So we can summarize that revision of bylaws intensifies, as the commitment of Iddir
becomes strongly. That can be justified in that HAPCSO and CARE are working
intensively so that the majority of their partners made revisions of their bylaws to
incorporate certain articles indicating their HIV/AIDS activities. These revisions were
made to undertake both prevention and care and support activities.
5.2.4. MAJOR ANTI HIV/AIDS STRATEGY UNDERTAKEN BY IDDIRS
5.2.4.1. INVOLVEMENT IN IEC AND BCC
Information Education and Communication (IEC), Behavioral Change and
Communication (BCC), Care and Support, and Voluntary Counseling and Testing
(VCT) are the major HIV/AIDS intervention strategies identified as being used in
most implementer NGOs. The following table contains the response of interviewed
Iddirs about their involvement in the major anti HIV/AIDS intervention activities.
Table 5.19 Strategies of HIV /AIDS intervention
HIV/AIDS
intervention
strategies
Name of partner NGO
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Total (%)
IEC and BCC 10 5 4 5 4 5 33(54%)
VCT - - - - - - -
IEC and Care
and support
IEC, BCC, Care
and support(All)
5 4 4 - 3 3 19(31%)
2 1 6 - - - 9(15%)

Total 17 10 14 5 7 8 61
(100%)
Source: Compiled from responses of Iddir leaders
IEC and BCC are the main anti HIV/AIDS strategies that the majority of respondent
Iddirs are currently involved in. 54 percent of total respondent Iddirs reported that
they are involved in Information Education and Communication. 31 percent of the
total interviewed Iddirs are involved in provision of care and support. The remaining
15 percent are involved in IEC, BCC and care and support.
The involvement of Iddirs is identified to be significant in IEC and BCC. Advocacy,
mass sensitization and awareness raising seems to be the major strategy used in
Iddirs as a major anti HIV/AIDS intervention with the regard to IEC. These Iddirs are
reported to hold advocacy sessions during Iddir meetings, mourning ceremonies and
other different situations depending on their access to such services and assistance
from partner NGO. The role of Iddir leaders is undeniable for these sessions
undertaken among the Iddir member and local community in some cases. Table 5.20
shows the activities of Iddirs in IEC and BCC.
Table 5.20 Involvement of Iddir in IEC
situation of IEC
Name of partner NGO
sessions
Unplanned, held
occasionally on meetings
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Total
7 4 4 4 5 8 32(52%
)
Held monthly - - 2 - 1 - 3(4%)
Only during general
assembly meetings
5 4 - 1 1 - 11(18%
)
Planned 5 2 8 - - - 15
(25%)
Total 17 10 14 5 7 8 61
Source: Compiled from responses of Iddir leaders

According to the Central Static Authority, Iddir meetings are said to be the major
means of information and communication about HIV/AIDS (CSA, 2001). Similarly,
responses of interviewed Iddirs show that Iddir meetings are major forums for IEC
sessions to be held to raise the awareness of Iddir members. The majority of
respondent Iddirs held advocacy sessions during occasional meetings in which the
teaching about HIV/AIDS is part of the major discussions. These might be during
funeral ceremonies and other similar gatherings. 52 percent of total respondent
Iddirs held advocacy sessions unplanned occasionally. This includes during monthly
meetings, during mourning ceremonies and other similar occasions, which bring the
majority members together. 25 percent of respondent Iddirs held their advocacy
sessions according to well planned schedule. Partner Iddir working with CARE
seems to hold advocacy sessions in a planned schedule. 5 percent of total
respondent Iddirs held monthly advocacy sessions. This can be seen along with the
role of capacity building sessions and continuous follow up by the partner NGO. 18
percent held advocacy sessions only during general assembly meetings. This is often
held biannually and/or annually in some cases. The trend of conducting advocacy
sessions in an unplanned occasional manner is also observed among the majority of
respondent Iddirs.
5.2.4.1.1. IMPLEMENTERS OF ADVOCACY SESSIONS
Active implementers of IEC sessions held among Iddirs may include Iddir leaders,
volunteers, health officials from partner NGOs and local administrators. The table
5.21 shows active implementers of advocacy sessions held by Iddirs.

Table 5.21 Implementers of the advocacy session held in iddirs
Active
implementers of
Advocacy
Name of partner NGO
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Total
Iddir leaders 7 8 12 - 1 1 29
(47%
Health officials from 9 1 2 5 6 7 30(4
partner NGO
9%)
Employed personnel - 1 - - - - 1(2%
)
Volunteers 1 - - - - - 1(2%
Kebele
administrators
- - - - - -
)
0
Total 17 10 14 5 7 8 61(1
00%)
Source: Compiled from responses of Iddir leaders
The role of health workers from the partner NGOs seems considerable in
conducting the advocacy sessions during Iddir meetings. 49 percent of the total
respondent Iddirs stated that the active implementers of advocacy sessions are
health care workers and officials from the partner NGO. The next largest group
that conducts IEC sessions in Iddir meetings is Iddir leaders. Iddir leaders are
respected and recognized member of the society. They take an active role in
teaching about AIDS during Iddir meetings. 47 percent of the total respondent
Iddirs reported that Iddir leaders are the active implementers of discussions and
teachings about AIDS. Employed personnel and volunteers are involved in only
one Iddir. Partner Iddirs working with ACORD and CARE are the major ones
whose Iddir leaders are active implementers of advocacy sessions. Volunteer and
employed personnel took active roles in implementing advocacy session in 2 and
2 percent of the total respondent Iddirs respectively.
)

5.2.4.1.2. PARTICIPATION OF HEALTH PERSONNEL AND PLWA IN
ADVOCACY SESSIONS
The participation of qualified health personnel and PLWA to provide teachings and
share their experience with the Iddir members was said to be determined the quality
and technical capacity of the advocacy session. The response of interviewed Iddirs
concerning the participation of qualified personnel.
Table 5.22 Participation of health official and PLWA in advocacy sessions during Iddir Meetings
Level of
Name of partner NGO
participation HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Total
No participation 1 5 9 0 0 0 15(25%
of health officials
)
Attendance of 16 5 5 5 7 8 46(75%
health officials
)
Sub total 17 10 14 5 7 8 61
No participation 8 6 11 5 6 5 41(67%
of PLWHA
)
Attendance of 9 4 3 - 1 3 20(32%
PLWA
)
Sub Total 17 10 14 5 7 8 61
Source: Compiled from response of Iddir leaders
The participation of health officials is reported in 75 percent of total respondent
Iddirs while 25 percent reported there is no participation of health officials in
advocacy session. One can recall that technical assistance also seems to play greater
role in engaging the health officials available for advocacy in Iddir meetings. Partner
Iddirs working with Pro Pride, MJATD and HAPCSO the participation of health
officials during advocacy session held at the time of Iddirs meeting. These include
professionals working with partner Iddir. Some Iddir invite health officials by their
own to take part in their advocacy sessions.

Participation of PLWA is reported to be available for 33 percent of respondent Iddirs.
The remaining 67 percent held their sessions without the participation of PLWA to
share their life experience and advice with the community. Similarly with the
participation of health officials, the involvement of PLWA during the advocacy
sessions depends on the assistance of partner NGOs. HAPCSO takes the lion's share
in involving PLWA to take part in iddirs meetings to held advocacy sessions.
Similarly, ACORD, CARE and Pro-Pride follow the same effort in involving PLWA
during advocacy sessions held during Iddirs meetings and separate sessions
Table 5.23 Beneficiaries of the advocacy held in Iddir
Active
implementers of
Advocacy
Iddir members
only
Name of partner NGO
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Total
17 8 12 4 7 8 56(92%)
Non members - - 1 1 - - 2(3%)
Local Community - 2 1 - - - 3(5%)
Total 17 10 14 5 7 8 61(100%)
Source; Compiled from response of Iddir leaders
Iddir members are the prior beneficiaries of IEC session held in Iddir meetings. 92
percent of respondent Iddirs reported that Iddir members are beneficiaries of the IEC
sessions. 5 percent of respondents include the non-members and 5 percent the local
community as the beneficiaries of the advocacy sessions.

5.2.4.2. INVOLVEMENT OF IDDIR IN PROVISION OF CARE AND SUPPORT
Care and support programs are one of the major strategies that are included in
the anti HIV/AIDS intervention. The involvement of Iddirs in care and support
programs can be rated in terms of activities performed concerning AIDS patients,
People living with HIV and AIDS and AIDS orphans, and home based care. The
following section describes the involvement of interview Iddirs for care and
support programs
5.2.4.2.1. KINDS OF SUPPORT GIVEN TO AIDS PATIENTS
The kind of support provided by Iddirs for HIV/AIDS patients may range from
covering medical assistance, allowing some amount of money for the patient to be
used for living expenses while they are alive, to covering the living expenses. The
following table shows the summary of the responses of interviewed Iddirs with regard
to the kind of care provided for AIDS patients.
Table 5.24 kinds of assistance for AIDS patients
AIDS cases
No assistance b/c
no one known
cover Medical
expenses
Allow money while
the patient is alive
Cover living
expenses
Name of partner NGO
HAPCSO ACORD CARE CBISDO MJATD Pro Pride
Total
12 9 6 5 6 5 43(70%)
1 1 1 - - - 3(5%)
4 - 6 - 1 3 14(23%)
- - 1 - - - 1(1%)
Total 17 10 14 5 7 8 61(100%
)
Source: Compiled from responses of Iddir leaders

Table 5.24 shows that 70 percent of respondent Iddirs are not involved in
provision of care and support programs due to the reason that no one knows the
magnitude of AIDS cases in the Iddir. 22 percent reported that they provide the
AIDS patient some amount money from the deposit meant for the purpose of
burial for purposes of medical and living expenses. Five percent reported they
cover medical expenses in supporting the patient. Two percent reported that they
cover living expenses for AIDS patients.
5.2.4.2.2. KINDS OF SUPPORT PROVIDED TO AIDS ORPHANS
AIDS orphans support refers to support provided for orphans who lost their
parents by the for community. Hence AIDS orphans are not clearly identified.
Suspected AIDS cases take the form of death reported by opportunistic disease,
or successive deaths of couples. Similarly to the kind of support provided for
PLWA and the kind of assistance given for AIDS orphans may take different
forms which included covering school fees uniforms, covering house rent, and
guaranteeing them replacement membership rights instead of their parents.
Table 5.25 Kind of assistance given to AIDS orphans
kinds of care
Name of partner NGO
Total
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
Not involved in Orphan
support
13 3 5 3 6 8 38(62%)
Covering school fee and
uniforms
1 4 3 - 1 - 9(15%)
Covering house rent - - - - - - -
Withdraw from monthly
contribution
2 - - 2 - - 4(7%)
Access to medical care - 3 4 - - - 7(11%)
Replacement 1 - 2 - - - 3(5%)
Total 17 10 14 5 7 8 61(100%)
Number of identified
beneficiaries
7 55 167 15 6 - -

Source: Compiled from responses of Iddir leaders
Lack of known AIDS cases also causes no involvement of the majority of Iddirs in
support and care for AIDS orphans. 62 percent reported that they are not
involved in orphan support. Lack of financial resources is the major reason for
the majority of respondent not to become involved in provision of support for
AIDS orphans. Involvement of Iddir in provision of support for AIDS orphan is
reported in 38 percent of respondent Iddirs.
15 percent of total respondent Iddirs are involved in covering school fees and
uniforms. 11 percent are identified as being involved in accessing medical
support for AIDS orphans. Medical care is not the function of Iddirs so the
patient is referred to the medical center with the help of the Iddir members.
Dispensation from the monthly contribution is identified to be another form of
care provide for AIDS orphans by 7 percent of the total respondent Iddirs. Five
percent provide replacement as a means of ensuring the social wellbeing of the
orphans.
Table 5.26 below summaries the responses of interviewed Iddirs with the regard
to their involvement in Home Based Care (HBC).
Table 5.26 Involvement of respondent Iddirs in Home based care
Home based
Name of partner NGO
care HAPCSO ACORD CARE CBISDO MJAT
D
Not involved
in Orphan
support
♦ number of
Involved
Iddirs
13
4
Pro Pride
Total
13 9 7 6 5 53
(87%)
1
1
-
2
-
8
(13%)

♦ Total
number of
beneficiari
es
5 3 2 0 4 0
Source: Compiled from responses of Iddir leaders
Table 5.26 above shows that the majority of respondent Iddirs reported that they
are not involved in provision of Home Based Care for AIDS patients. 87 percent
are identified as not involved in such undertakings at all. The remaining 13
percent of total respondents, are involved in provision of care and support for
AIDS patients. The total number of beneficiary AIDS patients is 14 patients. This
might be taken as the major beginning to involve Iddirs in the provision of home
based care and support for AIDS patients.
To sum up the activities of respondent iddirs in provision of care and support for
infected and affected people, their activities in supporting AIDS patients and
AIDS orphans needs to be considered. The involvement of respondents in the
provision of care and support for people infected and affected by HIV/AIDS that
is PLWA, AIDS orphans and Home Based Care is summarized in the table 5.247.
Table 5.27 summary of activities in provision of care and support
Care and support activity
Provision of care for AIDS
patient
♦ non Involved
♦ involved
♦ Beneficiary
Provision of support for AIDS
orphans
♦ non Involved
♦ involved
♦ Beneficiary
Name of partner NGO
HAPCSO ACORD CARE CBISDO MJATD Pro
Pride
14
3
7
14
3
7
5
5
25
3
7
55
12
2
6
5
9
167
5
-
-
3
2
15
5
2
3
6
1
6
4
4
8
8
-
-

Provision of home based care
♦ Non involved
♦ involved
♦ Beneficiaries
13
4
5
Source: Compiled from response of Iddir leaders
9
1
2
The comparison made on the involvement of Iddir in different care and support
activities, as is summarized in the table above. The biggest group belongs to Iddir
involved in provision of care and support for AIDS orphan. 36 percent or
respondents are involved in support for AIDS orphans. The remaining 64 percent
are not involved in such undertaking at all.
The largest group is Iddirs who are involved in provision of care and support for
AIDS patients. It accounts for 26 percent of the total respondent Iddirs. Iddirs,
which are involved in provision of, care and support for AIDS patients are
identified to be 13 percent of the total respondent Iddirs. According to the
responses of the interviewed Iddir the involvement of Iddir ranges from provision
of care and support for AIDS orphans, AIDS patient to home based care. There is
a significant beginning in involvement of Iddir in home based care for AIDS
patients. However, these activities are in their infant stage and needs further
improvement and commitment.
5.2.5. MAJOR PROBLEMS FACED BY IDDIRS INVOLVED IN HIV/AIDS
INTERVENTION
Considering that community based HIV/AIDS intervention has only recently
been initiated and only a few Iddirs are taking part in such undertakings, certain
13
1
3
5
-
-
7
-
-
6
2
4

problems that are faced by such activities need to be considered. Lack of
awareness, resistance from Iddir members, absence of bylaws and lack of
financial and technical capacity are identified as the major problems faced by
respondent Iddirs. The responses of interviewed Iddirs are summarized in table
2.28 below.
Table 5.28 Problems faced by Iddirs
Problems
Name of partner NGO
HAPCSO CARE ACORD MJATD CBISDO Pro
pride
Lack of awareness 8 3 9 5 3 2 30 (49%)
Resistance form members 7 7 1 2 1 6 24 (39%)
Total
Absence of bylaws to allow 1 - - - - - 1 (2%)
Lack of finance 1 4 - - 1 - 6 (10%)
Total 17 14 10 7 5 8 61
Source: Compiled from responses of Iddir leaders
(100%)
Lack of awareness is the major problem faced by the majority of respondent
Iddirs. Due to lack of education, awareness and information about the
prevalence of HIV/AIDS is reported to be low. That causes a major problem in
the anti HIV/AIDS work undertaken by respondent Iddirs. For 49 percent of
respondents lack of awareness is the major problem for anti HIV/AIDS
intervention undertaken in respondent Iddir. Resistance that comes from Iddir
members to discuss about AIDS accounts for 39 percent of the respondents.
Respondents also indicated that ". We are already exposed to the problem, we
heard about AIDS over the radio and other means. It is a loss of time and our
purpose is not to undertake anti HIV/AIDS activities" However, it is also

indicated that through repeated endeavor to insist the teachings and advocacy
sessions.
10 percent of respondent Iddirs indicated that lack of money, financial shortages
and related limitations are the major problems faced in their anti HIV/AID
undertakings. Financial problems are identified to be acute in the activities of
Iddir in provision of care and support for HIV/AIDS victims. Only 2 percent
mentioned absence of modified bylaws, which can allow the full involvement of
Iddirs with regard to HIV/AIDS interventions.
5.2.6. FACTORS THAT HINDER NON INVOLVED IDDIRS IN HIV/AIDS
ACTIVITIES
Non involved Iddirs include respondent Iddirs who are not involved in any of the
HIV/AIDS intervention activities. This study group is considered as a control
indicator group for the extent of motivation and the activities carried out by
involved Iddirs.
Respondents were asked for the rate of mortality among members. They reported
that there is a steady increase in mortality rates, which occurs mainly among the
youngsters. The situation is depleting the livelihood of these Iddir causing
increment in a monthly contribution made to overcome the shortage of finance.
However, there is no knowledge with regard to causes of deaths. There is only
suspicion of deaths which are caused by opportunistic diseases. Similarly there
are a number of orphan children.

The efforts of Iddirs are not involved in any kind of intervention activities, while
the problem is of such magnitude. The principal aim of their function is to take
care of burial and mourning activities. Even though, the problem of AIDS is
serious their ability to extend their involvement depends on the kind of
assistance that need to be given for them. External financial, technical as well as
capacity building support is missing. Absence of such activities leaves these
Iddirs non-involved in such undertakings by their own capacity.
Leaders of these Iddirs reported that they don’t have time for non-burial
activities. According to a respondent, he explained that " We are business men,
we have businesses to run, a family to lead and other social commitments. We
run out of time to go further than burial activities. So, we are less committed to
such activities." The commitment of Iddirs leaders is assumed to be a
determinant for the success of their activities with the regard to anti HIV/AIDS
activities as well as other development activities.
One of the respondents summarized his view that " The role of our Iddir is not
different from other Iddirs. Much emphasis is given for burial undertakings. If we
are supposed to be involved in any kind of development activities the Iddir
members will be suspicious of us to channel the financial resource to
government bodies. Such things are experienced in the past so, no such
attempts are needed to be done in such kind of situation"(Interview with the
leaders of non involved Iddir).

Therefore, the major problem that was underlined by the respondents is lack of
technical knowledge to run more complex and far reaching development
activities. Lack of access to external assistance, commitment of leaders and
resistance of members for non-burial activities and fear of embezzlement and
confiscation from the government side are identified to be the major reasons why
these non-involved Iddirs are not taking any kind of active involvement with the
regard to HIV/ADS interventions.
5.3. EFFORTS OF GOVERNMENT BODIES IN INVOLVING IDDIRS IN
ANTI
HIV/AIDS ACTIVITIES
5.3.1. ACTIVITIES OF ADDIS ABABA CITY GOVERNMENT HIV / AIDS
PREVENTION AND CONTROL OFFICE (ADDIS ABABA HAPCO)
Addis Ababa HAPCO is a government body, established under Addis Ababa City
Municipality. The project was started in 2000. The office is responsible for
coordinating government organizations, NGOs and CBOs as well as private
organization to network their efforts at a regional level in Addis Ababa.
Addis Ababa HAPCO is directly responsible to the National AIDS Council
Secretariat (NACS), which channels the emergency fund and financial donations
to wereda offices. The major financial resource allocated to the project is from
the Ethiopian Multi-Sectoral AIDS project (EMSAP), donated by the World Bank/

IDA. NACS plays the role of donor organization by channeling the international
funds to regional offices.
Community based HIV/AIDS interventions that are undertaken at Addis Ababa
HAPCO are mainly concentrated at regional, wereda and kebele levels (See the
organizational chart annex). These locality based organizations are identified as a
major stake holders in the community based HIV/AIDS intervention activity
undertaken by Addis Ababa HAPCO.
Representatives of community based organizations are included in anti
HIV/AIDS councils at wereda, kebele and regional level. The range of community
based organizations that are included wereda level AIDS council incorporates
anti HIV/AIDS clubs, reproductive and health clubs, Addis Ababa Youth and
Women's associations (at kebele, wereda and regional level), Iddirs and Iddirs
councils at Zonal, wereda and kebele level and Iddir umbrella organizations. The
office also provides capacity building training for these community based
organizations to enhance their contribution in the HIV/AIDS intervention
activities. Addis Ababa HAPCO organizes wereda AIDS councils wereda at each
(28 wereda according to the former urban structure) found in Addis Ababa. The
council is formed to be include representatives from different sections of the
society.
5.3.1.1. MAJOR ROLES OF ADDIS ABABA HAPCO IN INVOLVING IDDIRS
AND OTHER COMMUNITY BASED ORGANIZATIONS

According to the responses of officials Addis Ababa HAPCO has undertaken
different activities in ensuring the involvement of Iddirs as well as other
community based organizations in HIV/AIDS intervention. The major activities of
Addis Ababa HAPCO can be summarized as follows:
Encouraging CBOs to prepare their project proposals so that they can become
beneficiaries of emergency funds allocated from NACS from each wereda
HIV/AIDS secretariat office (See table 5.29). There is a project fund that is
allocated at wereda level to fund the project documents of these potential
stakeholders. Project documents less than the financial amount of USD1000 are
provided funds at the wereda AIDS council coordination office. If the amount
exceeds USD 1000 the project document will be sent to the main office and the
project review board will decide on the provision and sustainability of these
project documents. EMSAP is availed at wereda level.
Provision of grants for projects prepared at wereda level, which is more than USD
1000, and projects that are prepared above the wereda level. This includes zonal
and regional level. There is a projects revision board established to identify
fundable projects, which usually come from grass root level at each level.
Facilitating the capacity building activities for members and leaders of CBOs.
Training's in TOT, skill training, peer education training for potential and active
participants CBOs. Moreover, technical, financial as well as material assistance
are provided to enhance the capacity of CBO found in Addis Ababa including
financial support provided to beneficiary community based organizations.

Facilitation and advocacy for networking the efforts of community based
organization found in Addis Ababa. In such regard 6 councils were established
composed of the representatives of Iddirs found in kebele level. The same is done
for anti HIV/AIDS clubs and Individual Iddirs. The office also allocates a budget for
the networking activity for partner CBOs working with AAHAPCO. Distribution of
posters, IEC materials, booklets and related publications for potential community
based organizations that is anti HIV/AIDS clubs, Youth and Women Associations
Iddirs etc. Table below 5.29 shows the range of projects implemented by the
community based organizations from the EMSAP project.
Table 5.29 Project fund provided by Addis Ababa HAPCO for beneficiary community based
organizations
Name of project holder Type of
Organization
Amount of Fund
1 Ethiopian anti AIDS Women Association Association 361,006.15
2 Addis Ababa youth Association Association 306,460
3 Amanuel Self help Iddir Iddir 173,740
4 Tesfa Mahiberwi Lemat Akef Iddr Iddir Association 68,250
5 Eshet for Youth unity Association Association 22,282
6 Wereda 4, women Association Association 8,075
7 Wereda 6 Women Association Wereda Association 8,075
8 Wegen Lewegen anti AIDS club Anti AIDS club 7,530
9 Wereda 14 youth Association Wereda Association 7,840
10 Wereda 21 Association Wereda Association 5,794
11 Wereda 19 Youth Association Wereda Association 4,677
12 Wereda 5 youth Association, Wereda Association 3,760
13 Tesfa Meskot help Association Association 2,785
14 Organization for hope of window anti AID
club
Anti AIDS club 2,785
15 Wereda 14 youth Association Wereda Association 2,391
16 Wereda 21 youth Association Wereda Association 1,594
17 Tsedey anti AIDS club Anti AIDS club 1,520
Total amount 988,564
Source: Compiled from the response of Addis Ababa HAPCO

The major beneficiaries who received larger amounts of money from the Addis
Ababa HAPCO EMSAP project fund are identified as associations that are
organized at a wereda level. Only two Iddirs are identified to have prepared their
project document and requested project fund from Addis Ababa HAPCO. However
the beginning of being involved in national HIV/AIDS intervention at such a level
needs to be further encouraged and promoted. According to table 5.29, Addis
Ababa Youth Association and Addis Ababa Women's Associations are the major
stakeholders who managed to obtain a larger amount of fund from the EMSAP
project. These associations are inclusive in membership and they are also
organized at regional, wereda, and kebele level. The situation of wereda level
allocation of the HAPCO project can be summarized as follows.
Financial autonomy that is given for wereda HIV/AIDS Council coordination
offices seems to help quite a large number of beneficiary Weredas to take part in
anti HIV/AIDS activities. From the total of 28 weredas found all over Addis
Ababa there are 16 Weredas which benefited from the emergency fund that is
available at Wereda level.
Addis Ababa HAPCO implements such activities in 16 weredas of Addis Ababa.
The first selected pilot wereda were weredas 5, 7, 15, 19, and 20. An additional
eleven weredas were included in the project after the pilot was finalized. These
16 weredas are provided the funds accordingly (See table 5.30). Table 5.29 shows
the project funds availed for potential community based organizations found in
Addis Ababa who manage to prepare project document.

Table 5.30 summarises the amount of funds allocated to each wereda to promote
HIV/AIDS intervention activities at a grass roots level.
Table 5.30 Number of financial allocations for weredas in Addis Ababa City
Government made by Addis Ababa HAPCO
Name of Beneficiary Wereda Amount of fund
1 Wereda 5 103,740
2 Wereda 7 111,720
3 Wereda 20 109,200
4 Wereda 15 111,720
5 Wereda 19 67,200
6 Wereda 14 55,640
7 Wereda 2 38,520
8 Wereda 4 51,360
9 Wereda 1 29,804
10 Wereda 6 51,360
11 Wereda 16 77,040
12 Wereda 17 55,640
13 Wereda 18 55,640
14 Wereda 23 38,520
15 Wereda 27 34,240
16 Wereda 21 67,200
Total 1,058,544
Source: Compiled from the response of Addis Ababa
HAPCO Keys:- ٱ Pilot wereda
ٱ Not pilot wereda
Pilot weredas received project funds twice since the start of the project. The
remaining eleven weredas only got the fund once. It is also indicated that that
the provision of emergency funds for weredas was discontinued by the
restructuring activities. only activities that were carried out by the collaboration

of NGOs like Family Health international (FHI) are continuing the
implementation of activities.
5.3.1.2. Sources of fund for the Addis Ababa HAPCO
Addis Ababa HAPCO as a government organization has a budget allocated from
the Addis Ababa City Administration. Moreover, different international
organizations take part in assisting the office with financial donations as well as
technical assistance.
The following organizations provide financial donations to the office
♦ United Nations Children's Emergency Fund (UNICEF)
♦ Center for Disease Control (CDC)- for establishment standardized VCT center
at Zewditu Hospital and Abenet Health Center as well as a training center for
health care workers in Voluntary Counseling and Testing service.
♦ Family Health International (FHI)- which is conducting a program called
"Expanded Comprehensive response" in Addis-ketema Kifle-Ketema to provide
comprehensive intervention in provision of care and support for affected and
infected people by HIV/AIDS. The grant is for provision of training and
capacity building, material provision and construction of compounds for the
same purpose in Addis Ababa.

♦ World Food organization (WFP)- An agreement has been signed for the
donation made for AIDS victims and disadvantaged people for the same
cause. The donation will be made according to the agreement i.e 30,000-
40,000 quintal of wheat and edible oil to be provided for people who are
victims of AIDS.
♦ CARE Ethiopia - mainly provisions of technical assistance in building the
capacity of partner Iddirs working in Addis Ababa. Table 5.31below
summarizes the sources of finance of Addis Ababa HAPCO and the major
activities budgeted accordingly.

Table 5.31 Major activities and sources of capital budget for Addis Ababa HAPCO
Activities
HIV/AIDS
surveillance
VCT center at
Zewditu General
Hospital
VCT center and
other facilities
Government IDA Center for
Sources of finance Total
Disease
Control
UNICE
F
World
Food
Progra
461283.66 461283.66
756000 756000.00
1100000 1370140.30 82514 2552654.30
Office facilities 650000 285693.39 9356693.39
Human resources 400000 605333.24 17160 1022493.24
VCT, IEC and care
and support
Sopport for PLWA
and AIDS orphans
1073924 11041466.34 1768156.60 808000 145854 30754400.94
560000 560000
Total 1633924 13652750 4785324 808000 245528 45463526
Source: compiled from responses of Addis Ababa HAPCO
5.3.2. THE ACTIVITIES OF WEREDA 5 ANTI AIDS COUNCIL
COORDINATION
OFFICE IN INVOLVING IDDIR IN HIV/AIDS INTERVENTION
Wereda 5 is restructured into Addis Ketema Kifle Ketema according to the
recent urban re organizations. It used to be one of the Wereda Offices of Addis
Ababa HAPCO. Wereda 5 is identified as the major sample Wereda that can be
considered where major activities are undertaken. The efforts of wereda 5 anti
AID council coordination Office with the regard to involving Iddirs in the anti
m

HIV/AIDS intervention includes the establishment of Iddir councils in anti
HIV/AIDS activities both at the wereda and kebele level.
5.3.2.1. FORMATION OF ANTI HIV/AIDS IDDIRS COUNCIL AT WEREDA
LEVEL
This is undertaken by listing all active Iddirs found in the wereda and providing
them with the capacity building and sensitization workshops. 19 Iddirs were
provided with such training. The council of Iddir in anti HIV/AIDS activities was
established in 2002. 13 kebeles found in the wereda were represented and
respective Iddir representatives were participants in the council membership.
The efforts of Addis Ababa HAPCO, wereda 5 anti HIV/AIDS council coordination
office took the initiative as well as implementer role. A workshop was conducted
during the formation of the council and the leaders of representatives of Iddirs
were included in the training.
However the, efforts of council were not as fruitful as it was expected by the
initiators. The reasons that were indicated are:
♦ Council members lack necessary capacity to run the council due to lack of
technical knowhow and low level of educational capacity.
♦ Election of council members was entirely based on the participation of Iddir
representatives during the first sensitization workshop. No other evaluation
was made to make sure the capacity of leaders was sufficient.
♦ Lack of financial resources in the office that is allocated to the coordination of
Iddirs leaders.

5.3.2.2. FORMATION OF ANTI HIV/AIDS IDDIRS COUNCIL AT A KEBELE
LEVEL
Kebele anti HIV/AIDS Iddirs councils were successfully made in kebele 19
wereda 5. Eleven Iddirs that are found in the kebele were included in the
formation of the Iddir council. The formation of Iddirs council was entirely on
voluntary basis and it was initiated by the members of Iddirs in the kebele. The
role of wereda 5 anti HIV/AIDS council coordination office was to encourage
their activities and the provision of certain kinds of assistance to the council.
Capacity building activities for the stakeholders of the community based
HIV/AIDS in the wereda. The following table summarized the capacity building
training that were conducted by the office in order to enhance the capacity of
Iddirs in the HIV/AIDS intervention.
Table 5.32 Capacity building activities of wereda 5 anti HIV/AIDS Council Coordination Office
# kind of capacity
building activities
Facilitator Number of
participant
1 Workshop Wereda 5 anti
AIDS council
2 2 days workshop Wereda 5 anti
AIDS council
3 2 days workshop Family Health
International
and Wereda 5
anti AIDS
council
4 5 days workshop Family Health
International
and Wereda5
anti AIDS
council
5 2 days workshop Family Health
International
Iddirs
purpose Date
87 role of Iddir
in HIV/AIDS
prevention
87 Project
preparation
21Iddirs 5
anti
HIV/AIDS, 7
sex workers,
1 PLWA
association
20 Iddirs 5
anti HIV
PLWA
associations
and planning
ECR concept
integrated
approach in
HIV/AIDS
intervention
proposal
writing and
financial
management
200 Iddirs Care and
support ,
Nov, 2002
Nov, 2002
Nov, 2002
Dec 2002
May, 2003

and Wereda5
anti AIDS
council
Home based
care
Source: compiled from responses of wereda 5 anti HIV/AIDS council coordination office
The Wereda office conducts capacity building training with the collaboration of
FHI and the regional Addis Ababa HAPCO. Such capacity building activities are
meant to increase the capacity of Iddir leaders in the activities of anti HIV/AIDS
interventions. 87 Iddirs were participants for 2 workshops that were held for the
aim of sensitization about AIDS and the technical knowledge including project
preparation and proposal writing. FHI also took part in enhancing the capacity of
Iddirs in workshops about provision of care and support for infected and affected
individuals.

CHAPTER SIX
6. SUMMARY, CONCLUSION, SYNTHESIS OF RESEARCH
FINDINGS AND RECOMMENDATIONS
This chapter presents a summary of the major findings of the research.
Summaries of the major components of research findings are included in the fist
part of the chapter. Syntheses of the research findings are included in the second
section of the chapter that presents the combined results of research findings.
Certain suggestions are also forwarded to improve the situation of identified
problems. Recommendations are indicated in the third section of the chapter.
6.1. SUMMARIES AND CONCLUSION
The two-way causal relations between poverty and AIDS are clearly seen in the
major findings of the research. AIDS deaths seem to deplete financial and human
resource of Iddirs and resulted in increased amounts of monthly contribution; as
a result increments in monthly contribution seem to put more pressure on the
lives of each members and livelihood of iddirs as an institution. Therefore, the
involvement of Iddirs in further development activities is put in jeopardy. The
minimum participation of Iddir in community development activities due to
preoccupation of impacts of AIDS may further cause deepening of poverty.
AIDS being the major threat to development, poverty reduction cannot be
conceptualized outside the frame of AIDS intervention activities. Hence poverty
reduction and development activities need to be coupled with HIV/AIDS
intervention activities. According to the civil society approach partnership

etween NGOs, Government organizations and Community Based Organizations
as well as local communities determines the qualities of development activities,
hence its success.
The urgency of AIDS calls for the involvement of all stakeholders in the national
anti HIV/AIDS activities. Community based HIV/AIDS interventions require for
the active involvement of community based organization at the grass root level.
Community based HIV/AIDS interventions become possible with the involvement
of people where they live, in their homes, their neighborhood and their work
place. Iddirs are very important vehicles in addressing people where they live and
where they work. Being one of the popular and efficient forms of indigenous
voluntary association Iddirs enable the involvement of the community at the
grassroots level and full mobilization of each section of the community towards
HIV/AIDS intervention.
Iddirs are identified as the major partners for NGOs and government
organizations in HIV/AIDS interventions given their representative nature for
each section of the society. Moreover, Iddirs are one of those institutions, which
are directly affected due to their basic nature which is related to death and
burial. They are thus severely affected by the high prevalence of HIV/AIDS due to
increased death rates and resulting AIDS orphans. However, there are financial
as well as technical limitations in technical and managerial capacities of partner
iddirs.

The research findings indicated that though Iddirs are said to be originally burial
associations their role is progressively changing through time. There is an
increasing trend in the involvement of Iddirs in community development
activities like fund raising for local schools, clinics, and construction of feeder
roads and related undertakings. Such involvement enables them to obtain
improved experience to be involved in non-burial activities like anti HIV/AIDS
work. Involvement of Iddirs in AIDS intervention activities is mainly motivated by
both internal and external factors. An increased number of AIDS deaths and
PLWA and AIDS orphans, and commitment of leaders are identified as internal
factors that drive Iddirs to take part in anti HIV/AIDS activities. External factors
include initiations that came from NGOs, local authorities, and public advocacy.
Technical and financial assistance from NGOs as well as local authorities is very
crucial for active involvement of Iddirs in HIV/AIDS intervention activities.
Anti HIV/AIDS efforts of Iddirs in Information Education and Communication
involves conducting advocacy session during Iddirs meetings. Partner NGOs
played a major role in providing technical assistance and accessing health
officials as well as PLWA during the advocacy session held during Iddir meetings,
which mainly improve the qualities of advocacy sessions carried out with Iddir.
Quite a few attempts are being made by Iddirs to become involved in provision of
care and support. However, these efforts are limited due to shortage of financial
and technical resources which restrict for further involvement of Iddirs in care
and support.

Major problems faced by Iddirs with regard to HIV/AIDS intervention activities
are limited human financial and technical resources. Inadequate awareness and
limited access to capacity building training are also major shortcomings, which
are also evidenced in the findings of the research. The cases of non-involved
Iddirs indicated that lack of external assistance from NGOs, umbrella
organization or GOs local authorities is the major problem in that hinder them
from becoming involved in anti HIV/AIDS activities. Limited technical knowledge,
financial assistance from NGO as well as government bodies and lack of
commitment also resulted in non involvement of Iddirs in anti AIDS activities.
The research findings also identified that NGOs took the major role in initiating
Iddirs to take part in HIV/AIDS interventions in conducting advocacy sessions
during Iddirs meetings, make some revisions in the bylaws concerning their anti
HIV/AIDS activities. Capacity building activities also promote the activities of
Iddirs in anti HIV/AIDS activities. A few attempts are being made to establish
Iddirs councils by implementers NGOs in enhancing the involvement of Iddirs in
anti HIV/AIDS activities. Moreover, government organizations' establishment of
anti AIDS Council at kebele and wereda level representing every section of the
society has been a major part of activities undertaken by Addis Ababa HAPCO.
Such activities in establishment of the Iddirs Anti AIDS Council are being made
with the regard to cultural, social and organizational structures of Iddirs.
However, limited technical capacity of Iddirs being unable to produce projects
proposals with sufficient quality is the major problem that inhibits Addis Ababa

HAPCO from utilizing the EMSAP funds for as much community based
organization as it could.
However, these efforts undertaken in establishment of Iddirs Councils are very
few and are recently started. Partner NGOs also encourage Iddirs to be involved
in provision of support and care for AIDS patients, PLWA, AIDS orphans as well
as provision of home based care. Limited technical capacity of Iddirs to be
working as potential partners with NGOs as well as NGOs is identified as a major
problem.
Government organizations also promote various attempts with regard to
involving Iddirs in anti HIV/AIDS activities. Addis Ababa HAPCO is the major
government agency working with regard to prevention and control of HIV/AIDS
in Addis Ababa. The activities of Addis Ababa HAPCO focus on the provision of
technical and financial support for community based organizations like youth
and women associations.
6.2. SYNTHESIS OF RESEARCH FINDINGS
Effects of AIDS on the livelihood of Iddirs are explained in relation to impacts
resulting in the cause deepening of poverty. Increased mortality rates among
Iddir members with resulting increased monthly contribution; increased financial
spending on burials contributes to lesser involvement in development activities
due to shortage of finances. Increased number of PLWA and AIDS orphans

among Iddir members will cause increased spending in health care and support
for affected and infected people. This situation in turn causes lesser capacity for
Iddirs to focus on development activities. These situation in one or another
results in lesser involvement of community based organizations in development
activities and hence, may lead to deepening of poverty situation (See diagram
6.1).

Diagram 6.1 the impact of HIV/AIDS on the livelihood of Iddirs
Increased
mortality in Iddirs
-Increased spending on burial
-Increased monthly
contribution from members
-Loss of members
-Increased number of replaced
orphan members in Iddir
-Increased amount of time
spent in burial
-Withdrawal from membership
-Large amount of spending on
Iddir from member's income
HIV/AIDS
Increased PLWA
-Increased spending on
health facilities
-Additional burden for Iddir
leaders to look for PLWA
-Allocations of capital to
take care PLWA
Increased AIDS
orphans
-Lesser role played by Iddir in development
- Pre-occupation of Iddir activity on survival issues
Deepening of poverty
-Involvements of elderly
peoples & care takers
-Allocation of budget
for orphan support
-Orphans take replaced
membership

Diagram 6.2 Poverty as a cause for deteriorated impact of AIDS
- Lack of access of
educational information
POVERTY
- Lack of technical
capacities of Iddirs
Lack of awareness -No attempts to cope the
problem Iddir
- Lack of manpower
Stigmatization
Minimum involvement of Iddir in HIV intervention
Deterioration of impacts HIV/ AIDS on Iddirs
- Lack of involvement in
development
- Emphasis only burial
activities

The involvement of Iddir in HIV/AIDS intervention activities is considered with
regard to both internal and external factors. Internal factors are those factors
involved within the activities of the activities of Iddir, such as increased number
of deaths, orphans and commitment of Iddirs leaders. External initiations comes
from NGOs, GOS international donor organizations as well as other community
based organizations (See diagram 6.2)
Diagram 6.3 - Involvement of Iddir in anti HIV/AIDS activities

Diagram 6.3 the Involvement of Iddirs in Anti HIV/AIDS activities.
External initiative factors
- Public advocacy
- Initiation from NGO
- Initiation from NGO wereda
HIV/AIDS secretariat or
kebele
- Experience sharing from other
Iddirs
- Initiation from umbrella Iddirs
Government efforts
- Policy formation
- Network the work of different actors in
community based HIV
Assistance provision
- Training, workshops and
seminars
- Financial grant allocation
from kebele HIV/AIDS
secretariat or
Involvement of Iddirs n HIV/AIDS
intervention.
- IEC
- Condom distribution
- Support for PLWA
- Support for AIDS orphans
- Home based care
- Income generation for AIDS victims
- Voluntary counseling and testing
- Fund raising for AIDS victims
Internal factors
- Increased AIDS deaths
- Increased AIDS orphans- Decreased capital of Iddir
- Increased monthly contribution
- Awareness of Iddir leaders
Role of
international
donors
- Strength the
capacity of local
NGO's
- Allocate grant
for AHAPCO
- Promote public
awareness
- Promote the

6.3. RECOMMENDATIONS
Certain beginnings Iddirs anti HIV/AIDS activities is something that
need to be strengthen both in quality and quantity. Involved Iddirs have
benefit pf dressing the need of the community t the grass root level and
ensure the participation of community at every level. Iddirs closeness to
the community and the trust and commitment of the community to work
with Iddirs in such activities should be cultivated to the maximum level.
However, such activities are done with limited technical, human and
financial capacity of Iddirs NGOs and GOs helped the effort of Iddirs in
anti HIV/AIDS activities to participate in anti HIV/AIDS activities. Their
effort ranges from provision of motivation to local Iddirs in anti HIV/IDS
activities to capacity building and formation of Iddirs councils at kebele
and wereda level. nevertheless, such limited involvement of very few
Iddirs mainly depend on the assistance from NGOs and GOs.
Sustainability of these activities by the effort of Iddirs only is too limited.
Certain suggestions are made on the basis of identified problems. These
were limited financial and technical capacity of Iddirs to become
competent partners for the major stakeholders like non governmental
organizations and governmental organizations. Suggestions are made on
the areas of partnership, networking and capacity building and
empowerment of the capacity of the Iddirs and anti AIDS Iddir councils.

The details regarding these suggested recommendations may be
indicated as follows:
♦ Iddir played a significant role mobilizing the community to take part in
HIV/AIDS intervention activities. However, there are still limitations in
financial, technical and manpower resources of involved iddirs in
HIV/AIDS intervention. Promotion of the capacity building activities of
Iddirs need to be considered for the sake of successful community based
HIV/AIDS interventions. Further empowerment activities needs to be
strengthened in order to enhance the technical capacity and manpower
resources of Iddir both in terms of members and leadership.
♦ Partnership of the major stakeholders in HIV/AIDS interventions is
something to be improved for the sake of successful national response
for HIV/AIDS. Iddirs need coordinated assistance and capacity building
and networking with the efforts of non governmental as well as
governmental bodies and other community based organizations and
umbrella Iddirs association.
♦ Successful HIV/AIDS interventions need multi-sectoral partnership of
each stakeholder in fighting AIDS together. The efforts of Iddir cannot
be seen alone, without considering efforts of GO, NGO, and other
CBOs. Partnership of the major stakeholders i.e. government
organizations, non-government organizations as well as community
based organizations needs to be strengthened in their efforts towards
the HIV/AIDS interventions.

♦ Iddirs are one of the wide range of community based organizations.
The efforts of individual Iddir need to be channeled along with efforts of
other Iddirs. The role of umbrella Iddirs associations played a major role
in channeling the effort of member Iddirs into further organized effort.
However the umbrella organizations effort is in its infancy. There a need
to further strengthen the capacity of umbrella Iddirs associations and
further efforts should be done in involvement of more anti AIDS Iddir
councils.
REFERENCES
Alemayehu Seifu 1968. "Eder in Addis Ababa: A Sociological Study",
Ethiopia Observer12 (1): 8-33.
Annania Admasu (2002) "Coping with AIDS: the Social dimension of the
epidemic in Selected area of Addis Ababa", MA thesis in Social
Anthropology, Addis Ababa University (Unpublished).
Andrew Webster, 1990, Introduction to the sociology of development,
second edition , London
City Administration Health Bureau ,1999, "HIV/AIDS in Addis Ababa,
background, projects, implementation and interventions",
Addis Ababa.
Central Statistics Authority, 2001, Ethiopia, Demographic and health
survey 2000, ORC Macro, Calverton, Maryland
Damen Hailemariam and Helmut kloos, 2003, Community based
organizations and agents and poverty reduction program in
HIV/AIDS Prevention control in Ethiopia: a preliminary survey,
Addis Ababa University.

Dan Allan, T, 1997, Concepts, Definitions and models for community
based HIV/AIDS prevention Research in Canada, University of
Toronto, Toronto.
Debrework Zewdie, Lev Khodkevich, 1999, Global AIDS situation and
Projections to the year 2000, Addis Ababa, The Ethiopian
journal of Health Development HIV infection and AIDS in
Ethiopia, V4, No. 2
Fecadu Gedamu, 1972, Ethnic Association in Ethiopia and maintenance
of urban/rural relationship, with special relation to the
Almgena-Walamo Road construction Association, PHD thesis,
university of London(unpublished).
Fekadu Gedamu 1974 ‘Urbanisation, polyethnic group voluntary
associations and national integration in Ethiopia’ Ethiopian
Journal of Development Research 1: 71-80
Felcity Young, 1999, Tool box for building strong and healthy
Community organization working in HIV/AIDS and sexual
health, (Part one), South Africa Department of Health, South
Africa
Fred N. Kerlinger, 1973, Foundation of behavioral research,
second Edition, Newyork.
Getinet Assefa 1999, "A Study on Indigenous Institutions and Local
Development Initiatives. Case studies from selected Gurage
Areas of Ethiopia", MA thesis, Addis Ababa University, School
of Graduate Studies, Regional and Local Development
Studies(unpublished).
Gerry Salole, 1986, "Ikub, Iddir, and Meredaja Mahiber as potentional
development tools in Addis Ababa", Sumposium on the century
of Addis Ababa.
----- 2000. "Report of Research on CBOs umbrella organization", ACORD
- Ethiopia, Addis Ababa CBOs Support Program.

Hunter, Susan. 2002, Reshaping societies HIV/AIDS and social change,
Hudson Run publishers
Jalbert, Y. Lyse P. Richardo Z. "Self evaluation guide for community
organization", SIDA Epilson,
Kebebew Daka 1978 “The cooperative movement in Ethiopia”,
Department of Applied Sociology, Addis Ababa University.
Kloos, Helmut and Damen Haile Mariam 2003. “Selected community
organizations and agents and poverty reduction programs in
HIV/AIDS prevention and control in Ethiopia” Northeast
African Studies (forthcoming).
Koehn E. and Koehn P. 1975 “Eder as a vehicle for urban development
in Addis Ababa”. In Marcus H, ed. Proceedings of the First
United States Conference of Ethiopian Studies, East Lansing:
African Studies Center, Michigan State University.
Lankester, T. 2002, "Setting up community health program ; a practical
manual for use in developing countries", London, Macmillan
publishers.
Levine, Donald 1965 "Wax and Gold; Tradition and Innovation in
Ethiopian Culture. "Chicago: The University of Chicago Press.
Mekuria Bulcha, 1973 "Eder; its roles in development and social change
in Addis Ababa". Senior essay in social work. Addis Ababa
University.
Michael, Todaro, 1994, Economic development, Fifth editions
NewYork , longman
Ministry of Health (1996) AIDS in Ethiopia, Background projections
Impacts interventions, Addis Ababa: Epidemiological and AIDS
Department Ministry of Health (Second Edition).
Ministry of Health (1998) "AIDS in Ethiopia, Background, projections,
Impacts, interventions", Addis Ababa; Epidemiological and
AIDS Department Ministry of Health(Second Edition)

Ministry of Health (2000) "AIDS in Ethiopia, Back ground, projections,
Impacts, interventions",: Addis Ababa: Disease prevention and
control Department , Ministry of Health (Third Edition).
Ministry of Health( 2002) "AIDS in Ethiopia", Ministry of Health,; Addis
Ababa Disease prevention and control, Ministry of Health
(Fourth Edition).
Ministry of Health, Federal Democratic Republic of Ethiopia, National
AIDS Control Program, 1999, Addis Ababa.
Ministry of Health, 1998, Policy on HIV/AIDS of the Federal Democratic
Republic of Ethiopia, Addis Ababa, Ethiopian Federal
Democratic Republic
Ministry of Health, 2001, Guideline on community home based care for
AIDS patient in Ethiopia, Addis Ababa: Disease Prevention and
Control department HIV/AIDS and other STD Prevention and
Control Team
National AIDS Council, 2001, Strategic framework for the National
Response to HIV/AIDS in Ethiopia (2001-2005), Addis Ababa.
Meillassoux C. 1968. Urbanization of an African Community Voluntary
Associations in Bamako, Seattle; University of Washington
Press, 1968.

Ottaway, Marina, (ed.) 1976. " Urbanization in Ethiopia: A Text with
Integrated Readings", Department of Sociology and Anthropology,
Addis Ababa University.
Pact Ethiopia, 2000," Assessment study of HIV/AIDS implementing
organizations", Ethiopia , Addis Ababa(Unpublished).
Pankhurst, A (2002) Iddir Umbrella Organizations, in ACORD, voice of Iddirs,
Addis Ababa
________1998. The role of indigenous associations in development: their past
involvement in and potentials for development with particular
emphasis on burial, credit, migrant and religious/social
associations. Paper presented to the ESSSWA Workshop “The role
of indigenous associations and institutions in Development”.
-----2001" The Role and Space for burial associations to participate in the
Development of Ethiopia". Paper presented at the workshop on the
Role of local associations in development organized by ACORD
Ethiopia, Addis Ababa, 21 December.
Pankhurst Alula and Damen Haile Mariam, 2003, “The Iddir in Ethiopia:
historical development, social function and potential role in
HIV/AIDS prevention and control” Northeast African Studies
(forthcoming).
Pankhurst Richard and Endreas Eshete 1958 ‘Self-help in Ethiopia’
Ethiopia Observer vol2No.11 Page 354-364
Shiferaw Tesfaye 2002. "Civil society organizations in poverty alleviation,
change and development: the role of iddirs in collaboration with
government organizations: the cases of Akaki, Nazareth and Kolfe
area of Addis Ababa (1996-2002)". MA thesis in Social
Anthropology, Addis Ababa University.
Sheerdhar J, 2002, "Broadening the front: NGO response to HIV and AIDS in
India".
UNAIDS, 199, Evaluation of National AIDS program a methods package
prevention of HIV/AIDS infection, Switzerland

UNAIDS, 2001, AIDS in Africa A crisis of leadership Breifing on the starategy
to stop the spread of HIV/AIDS in Africa, The Hunger Project ,
Switzerland.
UNAIDS/ WORLD bank, 2001, AIDS, poverty reduction and debt relief, A
toolkit for main Streaming HIV AIDS program in to Development
instrument, UNAIDS/WORLD BANK, Switzerland.
UNAIDS, 2002, Report on global HIV/AIDS Epidemics, Switzerland
USAIDS, 1999, A review of household and community responses to the
HIV/AIDS epidemic in the rural areas, Switzerland
Teigist Lemma Dessalegn; (2000). "Economic Analysis of Social Networks:
Empirical study on Selected Women Iddir in Addis Ababa" MA
thesis, School of Graduate Studies, Addis Ababa University.
Tim Allen, and Alan Thomas, (editors), 1992, Poverty and Development in
1990s, New York Oxford University Press
Young, Fellcity. 1999, Tool box for building strong and healthy community
organizations working in HIV/AIDS and sexual health (part one) ,
Department of Health

ANNEX ANNEX I
I
ADDIS ABABA UNIVERSITY
SCHOOL OF GRADUATE STUDIES
REGIONAL AND LOCAL DEVELOPMENT STUDIES (RLDS)
Unstructured questionnaire prepared for organizations implementing community
based HIV/AIDS intervention activities with Iddirs
Recall! The project refers to the anti HIV/AIDS project implemented by your organization with local
community organizations (Iddirs)
1. What is the name of your organization/project?
(Specify)________________________________________________________________
_
2. What is the target area of the project?
_____________________________________
3. What is target population of the project?
___________________________________

4. What is the project duration?
______________________________________________
5. What is the date of establishment of the project?
(Specify)__________________
6. What comprises the human resources of the project? ( specify in the table
below)
Staff members
Community leaders
Volunteers
Others (Specify)
Number of
personnel
Level of Qualification
1 2 3 4 5 6 7 8 9
Keys- (1)BA and above (2)Diploma (3)High school (4)High school incomplete
(5)Elementary complete (6)Elementary incomplete (7)Illiterate
8. What is the total amount of budget allocated to the project for each
project year?
Year Amount of budget Remark
(Please use the space provided (Remark) for additional information)
9. What is the over all goal of the project? (Specify)
____________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
____________________
10. What are the specific objectives of the project? (Specify)

_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
________________
11. What are major and specific problems that initiate the project?
(Specify)
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
________________
12. Why does your organization use Iddirs as major partner for anti
HIV/AIDS intervention program? (Specify)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________
13. What are the major potentials of Iddirs to be a major tool for HIV/AIDS
intervention program (As it is observed in your project)? (Specify).
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________
14. What major strategies are currently used in the project? (Specify in
table provided).
Strategies Number of Iddirs
involved
Information Education
and Communication
(IEC)
Behavioral Change and
Communication (BCC)
Voluntary Counseling
and Testing (VCT)
Care and Support (CS)
Other
Remark

Strategies
15. What is the level of partnership of your organization with Iddirs, duties
Information
Education and
Communication
(IEC)
and responsibilities of each partner? (Specify)
Behavioral Change
and
communication
(BCC)
Voluntary
counseling and
Testing (VCT)
Care and Support
(CS)
Other
Duties and responsibilities of each partner
NGO Iddir
1* 2* 3* 4* 5* 1** 2** 3** 4** 5**
Keys- (1*) Non involved (2*) Passive implementers (3*) Only donor (4*)Active
implementers (5*)Initiator and Active partner (1**) involvement at all (2**) Non
involved (3**) Passive beneficiary (4**)Active implementers and beneficiary 5**) Initiator
and active partner
16. What kind of support is provided for partner Iddirs to implement
HIV/ADS intervention activity in each strategy? (Please specify in the
table)
Activities
Support provided in each project period(Phase)
Phase I Phase II Phase III Phase IV Phase V Phase VI

Information,
Education and
communication
Condom distribution
Support for AIDS
orphans
Support for PLWHA
Voluntary counseling
and Testing
Home based care for
victims
Income generation for
AIDS victims
Fund raising for AIDS
victims
Others
17. How is it planned to ensure the sustainability of the project and
empower the local Iddirs' capacities to take over the project? (Attach your
plan if possible separately)
____________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
___________
18. What are the major outcomes of Iddir based HIV/AIDS intervention?
(Specify in the space provided)
♦ Information and
Communication_______________________________________________________
♦ Behavioral change and
Change___________________________________________________________
♦ Voluntary counseling and testing
_______________________________________________________
♦ Care and
Support_______________________________________________________________________
♦ Other
________________________________________________________________________________________

19. What are the major problems that limit the role of Iddir in anti HIV/AIDS
activities (As it is observed in your project)? (Specify)
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
________________
20. What other preconditions should be considered to involve Iddirs
actively in HIV/AIDS intervention activities?(As it is observed in your
project)
_____________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________
21. Please provide your general observation and additional comment on
the Iddir based HIV/AIDS intervention as it is observed in your project?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
______________________________
Date__________________________________________________
_
Name of
respondent___________________________________
Position in the organization
__________________________

Addis Ababa University
Regional and Local development Studies
To be filled by representatives of community based HIV intervention activities implemented
with Iddir(For each Iddir involved )
Activities
1. Information Education
and Communication
2. Condom distribution
3. Support for AIDS
orphans
4. Support for PLWHA
5. Voluntary Counseling
and Testing
6. Fund raising for AIDS
victims
7. Home based care and
support
8. Income generation
activities for AIDS
orphans and care takers
9. Psychological support
10. Others( specify)
Kind of
support
provide
d for
Iddir
Duratio
n for
involve
ment
# of
benefici
aries
Iddir leader's
involvement
Iddir members
involvement
1 2 3 4 5 1 2 3 4 5
Keys- (1) Fully actively involved (2) Actively involved in most cases (3) Starting to actively engaged (4) Not
yet active but participate (5) Not involved at all

ADDIS ABABA UNIVERSITY
SCHOOL OF GRADUATE STUDIES
REGIONAL AND LOCAL DEVELOPMENT STUDIES (RLDS)
Structured interview guide for Iddir Leaders
1. The involvement of the Iddir in non burial development activities
A. Involved ___________________
B. Non involved_______________
2. Kind of development activities carried out by the Iddir ___
3. Assistance the Iddir get from other bodies for development activities
A. Assistance provided _____________________
B. Assistance not provided _________________
4. What is the alliance organization
5. Kind of assistance
A. NGO________________________________
B. Kebele and Wereda HIV prevention Office______________
C. Iddir umbrella organization ____________________________
D. Private organization ___________________________________
E. Omit__________________________________________________
A. Financial assistance ___________________________________
B. Technical advice,_______________________________________
C. training and capacity building __________________________
D. Net working ____________________________________________
E. Administrative __________________________________________
6. Financial sources for development activities carried out by the Iddir
A. Monthly contribution of members __________________________
B. Grant from NGO____________________________________________
C. Income generation
activities___________________________________
7. Involvement of Iddir in anti HIV activities
A. Currently actively involved in anti HIV activities
_______________

B. Once it has been involved but now discontinued
_______________
C. Non involved at all
__________________________________________
8. Date of establishment of the anti HIV activities
____________________________
9. Concern of the Iddir By-laws for anti HIV AIDS activities
A. It is revised _____________________________________
B. It is not revised _________________________________
C. On the process of being revised __________________
10. Reason that initiate the anti HIV activity
A. AIDS deaths ______________________________________
B. AIDS orphans ______________________________________
C. Public advocacy______________________________________
D. Initiation from NGO___________________________________
E. Kebele and wereda level initiation ____________________
11. The sources of initiation for anti HIV activity
A. Iddir members and leaders ___________________________
B. Partner NGOs________________________________________
C. Kebele and local administrators ______________________
D. Wereda HIV secretariat ______________________________
12. Sources of money for anti HIV activities
A. Monthly contribution _________________________________
B. Grant from NGO______________________________________
C. From Wereda HIV secretariat ___________________________
D. We don’t need money, we do the job voluntarily __________
E. Kebele __________________________________________________
13. Human resources of the anti HIV activities
A. AIDS clubs ____________________________________________

B. AIDS committee_______________________________________
C. Iddir leaders __________________________________________
D. Qualified employed personnel __________________________
E. NGO personnel_________________________________________
14. Strategies of anti HIV activities
A. Information Education and communication_____________
B. Behavioral change and communication _________________
C. Voluntary counseling and testing ______________________
D. Care and support ______________________________________
E. Other _________________________________________________
15. Active implementers of the advocacy
A. Iddir leaders __________________________________________
B. Health officials ________________________________________
C. Employed personnel___________________________________
D. Voluntary personnel___________________________________
E. Kebele administrative _________________________________
16. Time table of the advocacy program
A. Unplanned occasionally________________________________
B. Monthly ______________________________________________
C. During assembly meetings _____________________________
D. Planned _____________________________________
17. Frequency of the advocacy______________________
18. Beneficiaries of the advocacy program
A. Iddir members only ___________________________________
B. Also non members _____________________________________
C. Local community _______________________________________
19. Participation of qualified health officials in advocacy I n the Iddir
A. No attendance ____________________________________
B. Number of attendance ____________________________

20. Participation of HIV+ in the Iddir
C. No attendance ______________________________________
D. Number of attendance ________________________
21. Means of awareness creation in the Iddir
A. Integrated method in participatory education and entertainment
________
B. Discussion only _________________________________________________
22. Availability of teaching materials and
A. Yes _________________
B. No___________________
23. Dealt with other questioner
24. Known HIV+ cases
A. Yes ____________
B. No one exposed himself _________________
25. Kind of support for AIDS patient
A. No assistance b/c no one is known___________________
B. Cover medical expenses ______________________________
C. Allow some money to use while he is alive______________
D. Food donation _______________________________________
E. Give Social support ______________________________
F. Cover living expenses , like food, clothing and
shelter_________
26. Number of assisted AIDS patient________________________
27. Number of beneficiaries in home based care ____________
28. Kind of support for AIDS orphans
A. Cover school fees and uniforms __________________
B. Cover house rent _________________________________
C. Withdraw from monthly contribution_______________ _
D. Provide medical assistance _________________________
E. Exempt from payment _____________________________
F. Replacement ______________________________________
29. Number of assisted AIDS orphans _________________________________

30. Assistance given for implementers Iddir
A. Assistance availed _________________
B. Not assisted_________________________
31. Kind of assistant giving organization
A. ACORD__________
B. CBISDO__________
C. Hiwot ____________
D. CARE_____________
E. Marry Joy _________
F. Umberalla organization ____________
G. AAHPCO or wereda level __________
32. Kind of assistance
A. Financial ____________________
B. Technical know how , capacity building and training
__________
C. Material assistance _____________________________
D. man power assistance __________________________
E. Net working_____________________________________
33. Problem faced during the project
Thank you
A. Lack of awareness to brake the silence _____________________
B. Resistance from the Iddir members to accept the teaching
due to cultural
problem_________________________________________
C. No problem -_____________________________________________
D. Lack of By-laws that allow the activity____________________
E. Lack of money ___________________________________________

Annex II
The Situation of Iddir capital, Spending on burial activities , development activities,
for the last ten years compiled for nine indicator Iddirs
Code 001 1986 1987 1988 1989 1990 1991 1992 1993 1994
capital 4000 34400 55000 68600 77200 79800 79200 75200 76200
Kebir 3200 13000 20000 25000 31000 34200 37600 32600 36000
Number
of Death
3 12 18 22 20 29 32 28 30
Number of
death
news
1 5
15 20 26 28 23 30
code 002 1986 1987 1988 1989 1990 1991 1992 1993 1994
capital 59836.21 55209.68 43237.65 54726.65 55117.32 45444.08 51656.95 69146.68 76649.16
Kebir 48454.45 47725.75 14408.35 23752.24 36058.4 26088.08 22723.35 17593.15 17481
Lemat 400 400 400 400 400 400 400 1139 2160
Number
of Death
Number of
death
news
96 85 80 96 120 145 108 55 48
Code003 1986 1987 1988 1989 1990 1991 1992 1993 1994
cap 1250 4200 6200 7900 10002 11400 18300 14600 28300
Kebr
Lemat
400
Number of
Death
1 1 1 2 - - - -
Number of -
death
news
- - - - - - - -
AIDS
death
1 - - - - - - 2
AIDS orph - - - - - - - 2
Replace - - - - - - - 2

code004 1986 1987 1988 1989 1990 1991 1992 1993 1994
capital 12160.92 17124.72 27664.07 73193 32758 19055.33 19055 25221.63 25144.5
Kebr 5865 12340 12220 22120 25440 22150 25675
Lemat 2364 1837.45 191.65 2800 196
Number
of Death
7 10 9 21 19 23 21
Number of -
death
news
- - - - - - -
AIDS
death
- - - - - - - - -
Suspect - - - - - - - - -
AIDS
orphan
- - - - - - - - -
Replace - - - - - - - - -
code005 1986 1987 1988 1989 1990 1991 1992 1993 1994
cap - - - - - - - 18000 20000
Kebr - - - - - - - 13000 17000
Lemat - - - - - - - 3000 4000
Number of -
Death
- - - - - - 6
Number of -
news
- - - - - - - -
AIDS
death
- - - - - - - - -
AIDS
orphans
- - - - - - - 4 -
Replace - - - - - - - 1 -
code006 1986 1987 1988 1989 1990 1991 1992 1993 1994
cap 14724 14724 14724 19632 19632 38490 30600 40088 31050
Kebir 5200 13000 10400 7800 7800 20310 23500 37500 29340
Lemat 2400 2400
Number
of Death
4 10 8 6 6 15 15 25 19
suspected - - - - - - - 10
PLWA - - - - - - - -
AIDS orph - - - - - - - -
Replace - - - - - - - -

code007 1986 1987 1988 1989 1990 1991 1992 1993 1994
cap 1000 1500 1900 2100 9079.8 12218.78 16933.44 28245.05 38.376.3
7
Kebir 450 600 800 800 3648 7315 9500 15120 15800
Lemat 300 600
Number of
Death
4 4 4 4 16 17 17 20 17
Suspected
PLWA
AIDS
orphan
Replace
4
code008 1986 1987 1988 1989 1990 1991 1992 1993 1994
capital 11258.5 15800 17600 18180 19343 19896.2 16725.37 18250.04 17500
Kebir 5802 8000 9100 7800 9509 12252.75 8056 15342 12100
Lemat - - - - - - 1000 2000 1000
Number
of Death
4 6 8 7 9 11 8 13 10
suspect - - - - - - - - -
PLWA - - - - - - - - -
AIDS
Orphans
- - - - - - - - -
Replace - - - - - - - - -
code009 1986 1987 1988 1989 1990 1991 1992 1993 1994
capital 25380 27420 30460 35650 42240 46570 32440 32323 48620
Kebir 15320 13240 16780 18348 21342 22418 22231 23215 24310
Lemat 300 - - 400 1350 5400 - 300 -
Number of
Death
8 12 12 14 16 15 17 19 20
suspect - - - - - - - -
PLWA - - - - - - - -
AIDS
orphans
- - - - - - - -
Replace - - - - 1990 - - -
Keys: -
Code: - Contextual code given for respondent Iddirs
Capital: - Iddir capital
Kebir- Expenditure on burial activities
Lemat: - Expenditure on development activities
Replace: - Number of orphans who got replacement membership

disease
Suspect: - number of people suspected to die of AIDS or opportunistic
Declaration
I declare that this thesis is my original work and has not been presented for
a degree in any university and all the sources of material used for the thesis
are duly acknowledged.
Name- Wubalem Negash
Signature- _________________________
Date- ______________________________
Place - Addis Ababa University
This has been submitted for examination with my approval as a university
advisor .
Alula Pankhurst (PH.D)____________________________________________