Population Council Research that makes a difference

16th International Conference on AIDS
and Sexually Transmitted Infections in Africa (ICASA)
4–8 December 2011

Abstract

"Developmental Bible: Theology and public health working hand in hand in the Ethiopian Orthodox Church"
Tekle-Ab Mekbib, Abebaw Ferede, Ayehualem Tamiru, and Aschalew Kassie

Background
The Ethiopian Orthodox Church (EOC), the oldest traditional provider of education also serves as the only institutional contact in the rural areas. It has 45,000 Churches and monasteries; 500,000 priests and deacons that can be used to shape the way people think. Sunday school youth (SSY) is estimated at 7 million, and women Church association members (WCAMs) reach 10 million. In addition to providing spiritual direction to its members, EOC has become a source of information on issues affecting the lives of most Ethiopians. To leverage this huge potential, the Developmental Bible, based on the 'Metsihafe Gitsawie'—the Lexicon of the Church was drafted by decree to incorporate developmental messages including HIV/AIDS, reproductive health (RH) and gender equity in the daily teachings of the Church. The objective of this study is to show knowledge, attitude and practice (KAP) of priests, SSY and WCAMs on developmental issues to serve as a benchmark for measuring impact in the next evaluation study.

Methods
The research design is quasi experimental. A baseline survey in purposefully selected seven dioceses in 87 Churches, and four dioceses with 34 comparison Churches in Addis Ababa, Amhara, Tigray and Southern Peoples Region was conducted from December 2008 to January 2009. A structured closed ended questionnaire was prepared for the study. Priests, SSY and WCAMs served as respondents. Data was analyzed using SPSS software. This report describes the findings of the survey among priests, SSY and WCAMs that broadly present KAP on HIV/AIDS, RH, harmful traditional practices particularly early marriage and female genital mutilation/cutting (FGM/C).

Results
In all, 3303 priests, SSY and WCAMs aged 10 and above were interviewed, representing 94% response rate. Most were knowledgeable about abstinence (78%). Less than half had adequate knowledge about faithfulness—having a single partner and condom use. Avoiding promiscuity was the least known method (14%). Attitudes towards people living with HIV/AIDS were positive (range 82% to 95%). Stigma remains an issue when it comes to personal reputation (65%). Fully 1/3 of women who ever had VCT were tested alone and had no partner. Majority of respondents wanted early marriage to discontinue (96%). Most respondents have heard about FGM/C. Women respondents accepted wife beating compared to others (22% versus 14%). When SSY was further disaggregated by male and female, more female seem to accept wife beating. Majority of priests counseled couples for pre-marital VCT. Less than 1/3 of priests advised families to delay marriage of their daughters and abandon FGM/C.

Conclusions and recommendations
Women's knowledge in HIV prevention methods is low. Women still accept wife beating suggesting their low-self esteem, status and limited ability in decision making. Girls and women education programs should address their rights for better health and social development. Establishing outreach VCT services in Church compounds could increase access and use especially for couple VCT. Priests trained in the Developmental Bible are playing crucial role in bringing behavioral change among SSY and WCAMs in a short period of time.

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