UMEÅ UNIVERSITY MEDICAL DISSERTATIONS

New Series No 1228 - ISSN 0346-6612 - ISBN 978-91-7264-684-1

From the Division of Child and Adolescent Psychiatry, Department of Clinical Sciences,
Umeå University, Sweden

ChildlabourinAddisKetema,Ethiopia:
Astudyinmentalhealth

AKADEMISK AVHANDLING
som med vederbörligt tillstånd av Rektorsämbetet vid
Umeå universitet för avläggande av medicine doktorsexamen
kommer att offentligt försvaras i Sal B, 9 tr, Tandläkarhögskolan
torsdagen den 4 december 2008 kl 13.00

av

DanielFekaduWoldeǦGiorgis

Fakultetsopponent:
Professor emerita Marianne Cederblad
Lunds universitet, Barn- och ungdomspsykiatri

Umeå 2008
ChildlabourinAddisKetema,Ethiopia:
Astudyinmentalhealth
Daniel Fekadu Wolde-Giorgis, 2008

Child and Adolescent Psychiatry, Department of Clinical Sciences,

Umeå University, Sweden

New Series No 1228 - ISSN 0346-6612 - ISBN 978-91-7264-684-1

ABSTRACT
Background: Child labour is a very common global problem. There are an
estimated over 250 million in the world, and about 7.5 million child labourers
in Ethiopia. Most of the studies available to date focus on the social, political,
and economical issues, but very little on mental health or psychosocial
problems of child labourers. There is no study describing the epidemiology of
psychiatric disorders among this group of children.
Aims: 1. to assess the level of awareness and attitude of an urban community
on child labour. 2. to describe the patterns of child labour and the experiences
of child labourers in the informal sector with emphasis to child domestic
labour. 3. to determine the risk factors contributing to child abuse and
psychiatric disorders in child labourers.
Method: An initial qualitative survey, using key informants in a Rapid
Assessment Procedure, was conducted in a central urban area of Addis Ababa,
to determine the knowledge, attitude, and intervention priorities of the people
on child labour. A cross-sectional quantitative study informed by this initial
survey was conducted in a sampled population of 5-15 year old child labourers
and non-economically active controls. Information about possible risk factors,
socio-demography and child abuse were gathered using a questionnaire
different from that used for mental health assessment. An Amharic translation
of the Diagnostic Interview for Children and Adolescents (DICA) was used to
collect data for symptoms of mental disorders and diagnosis was made
according to the American Psychiatric Association (APA) Diagnostic and
Statistical Manual, 3rd edition (DSM-III-R) criteria. Data analysis was done
using Statistical Package for Social Sciences (SPSS) software.
Results: Domestic labour, working in the streets, and in private enterprises
were the three main types of child labour identified. These types of child
labour were identified by 82% (n=158) key informants, who thought child
labour was a social problem, mainly resulting from poverty, and associated
with abuse. In the quantitative study (5-15 year old sample) 528 child labourers
and 472 non-labourers were included in the study. Of the child labourers, 34%
were engaged in domestic labour, 57% working in the streets, and 9% in
private enterprises. Over half of the child labourers worked for more than 9
hours daily. The prevalence of child abuse was 43.9% and 17.2% among child
labourers and controls, respectively (OR=3.7, 95% CI: 2.74, 5.09; p<0.001).
Emotional abuse was the commonly encountered abuse compared to other
types (OR=3.06, 95% CI: 2.23-4.20; p< 0.001). Child domestics and street
labourers were the most vulnerable group. The prevalence of any DSM-III-R
psychiatric disorder was 20.1% and 12.5% among child labourers and controls,
respectively and the difference was statistically significant (OR=1.89, 95% CI:
1.34-2.67, p<0.01). Controlling for all socio-demographic factors, child labour
status was the only significant factor in determining DSM-III-R diagnosis.
Discussion: In a comparable group of child labourers and controls, child
labourers were found to be a high-risk group for different types of abuse and
psychiatric disorders. Although parental unemployment and low maternal
education were associated with child labour, the only factor that was
associated with psychiatric morbidity was being a child labourer. It seems that
poverty is not the only reason for child labour; hence its mere alleviation alone
is unlikely to dramatically improve the risk for child labour and mental health
of the children. There are many motivating reasons to be a child labourer, and
likewise various positive and negative maintaining factors. Therefore, not all
child labourers are prepared to stop their paid job altogether in order to
become a full time student.
Recommendation: Education of all children and parents is a keystone to
prevent child labour and the associated consequences. In enforcing legislations
on child labour, the government, non-governmental organisation (NGO), and
the public should view child labour as a menace in children’s development,
with risk of psychiatric disorders. Policy design should accommodate the
interests of children. It is recommended to do a cohort and a larger size study,
in order to further examine the association of various risk factors, and
psychiatric disorders in a comparative and similar vulnerable group of
children.

Key words: child labour, child abuse, psychiatry, Ethiopia.

 UMEÅ UNIVERSITY MEDICAL DISSERTATIONS 
New Series No 1228 - ISSN 0346-6612 - ISBN 978-91-7264-684-1

From the Division of Child and Adolescent Psychiatry, Department of Clinical Sciences,
Umeå University, Umeå, Sweden

Child labour in Addis Ketema, Ethiopia:  
A study in mental health 
 
 
Daniel Fekadu Wolde‐Giorgis 

Umeå 2008
© Copyright Daniel Fekadu Wolde-Giorgis 2008

Division of Child and Adolescent Psychiatry

Department of Clinical Sciences
Umeå University
SE-901 87 UMEÅ
Sweden

ISBN 978-91-7264-684-1

Printed in Sweden by Print & Media, Umeå 2008

Photographs: Million Tafesse
To all child labourers
ABSTRACT 
Background: Child labour is a very common global problem. There are an
estimated over 250 million in the world, and about 7.5 million child labourers
in Ethiopia. Most of the studies available to date focus on the social, political,
and economical issues, but very little on mental health or psychosocial
problems of child labourers. There is no study describing the epidemiology of
psychiatric disorders among this group of children.

Aims: 1. to assess the level of awareness and attitude of an urban community

on child labour. 2. to describe the patterns of child labour and the experiences
of child labourers in the informal sector with emphasis to child domestic
labour. 3. to determine the risk factors contributing to child abuse and
psychiatric disorders in child labourers.

Method: An initial qualitative survey, using key informants in a Rapid

Assessment Procedure, was conducted in a central urban area of Addis Ababa,
to determine the knowledge, attitude, and intervention priorities of the people
on child labour. A cross-sectional quantitative study informed by this initial
survey was conducted in a sampled population of 5-15 year old child labourers
and non-economically active controls. Information about possible risk factors,
socio-demography and child abuse were gathered using a questionnaire
different from that used for mental health assessment. An Amharic translation
of the Diagnostic Interview for Children and Adolescents (DICA) was used to
collect data for symptoms of mental disorders and diagnosis was made
according to the American Psychiatric Association (APA) Diagnostic and
Statistical Manual, 3rd edition (DSM-III-R) criteria. Data analysis was done
using Statistical Package for Social Sciences (SPSS) software.

Results: Domestic labour, working in the streets, and in private enterprises

were the three main types of child labour identified. These types of child
labour were identified by 82% (n=158) key informants, who thought child
labour was a social problem, mainly resulting from poverty, and associated
with abuse. In the quantitative study (5-15 year old sample) 528 child labourers
and 472 non-labourers were included in the study. Of the child labourers, 34%
were engaged in domestic labour, 57% working in the streets, and 9% in
private enterprises. Over half of the child labourers worked for more than 9
hours daily. The prevalence of child abuse was 43.9% and 17.2% among child
labourers and controls, respectively (OR=3.7, 95% CI: 2.74, 5.09; p<0.001).
Emotional abuse was the commonly encountered abuse compared to other
types (OR=3.06, 95% CI: 2.23-4.20; p< 0.001). Child domestics and street
labourers were the most vulnerable group. The prevalence of any DSM-III-R
psychiatric disorder was 20.1% and 12.5% among child labourers and controls,
respectively and the difference was statistically significant (OR=1.89, 95% CI:
1.34-2.67, p<0.01). Controlling for all socio-demographic factors, child labour
status was the only significant factor in determining DSM-III-R diagnosis.
Discussion: In a comparable group of child labourers and controls, child
labourers were found to be a high-risk group for different types of abuse and
psychiatric disorders. Although parental unemployment and low maternal
education were associated with child labour, the only factor that was
associated with psychiatric morbidity was being a child labourer. It seems that
poverty is not the only reason for child labour; hence its mere alleviation alone
is unlikely to dramatically improve the risk for child labour and mental health
of the children. There are many motivating reasons to be a child labourer, and
likewise various positive and negative maintaining factors. Therefore, not all
child labourers are prepared to stop their paid job altogether in order to
become a full time student.

Recommendation: Education of all children and parents is a keystone to

prevent child labour and the associated consequences. In enforcing legislations
on child labour, the government, non-governmental organisation (NGO), and
the public should view child labour as a menace in children’s development,
with risk of psychiatric disorders. Policy design should accommodate the
interests of children. It is recommended to do a cohort and a larger size study,
in order to further examine the association of various risk factors, and
psychiatric disorders in a comparative and similar vulnerable group of
children.

Key words: child labour, child abuse, psychiatry, Ethiopia.

LIST OF PUBLICATIONS 
This dissertation is based on the following papers that are reprinted with
permission from the respective publishers

Paper I Daniel Fekadu, Atalay Alem. Child labour and emotional

disorders in an urban district, Ethiopia: A rapid assessment on
community perception of child labour. Ethiopian Journal of Health
Development. 15(3):197-202, 2001.

Paper II Daniel Fekadu, Bruno Hägglöf, Atalay Alem. Review of child

labor with emphasis on mental health. Manuscript.

Paper III Daniel Fekadu, Atalay Alem, Bruno Hägglöf. Child abuse in child
labor in urban district, Ethiopia. Child Abuse and Neglect.
Submitted.

Paper IV Daniel Fekadu, Atalay Alem, Bruno Hägglöf. The prevalence of

mental health problems in Ethiopian child laborers. Journal of Child
Psychology and Psychiatry. 47(9):954-959, 2006
ABBREVIATIONS 
APA American Psychiatric Association

CIS International Occupational Safety and Information System

DICA Diagnostic Interview for Children and Adolescents

DSM Diagnostic and Statistical Manual

EAMAT East African Multi Disciplinary Advisory Team

ILO International Labour Organisation

IPEC International Programme for the Elimination of Child

Labour

NGO Non-Governmental Organisations

RAP Rapid Assessment Procedure

SIMPOC- ILO Statistical Information and Monitoring Programme on

Child Labour

UN United Nations

UNCRC United Nations Convention on the Rights of the Child

UNICEF United Nations Children and Education Fund

WHO World Health Organisation

CONTENTS 
1. Introduction and literature review  1 
1.1. Definition  2 
1.2. History of child labour  3 
1.3. Types of child labour  6 
1.4. Prevalence of child labour  6 
1.5. Hazards of child labour  7 
1.6. Theories of child labour  7 
1.7. Psychiatric disorders  9 

2. Aims (Papers I‐IV)  11 
2.1. General aims  11 
2.2. Specific aims  11 
2.3. Hypotheses (Papers II‐IV)  11 

3. Methodology (Papers I, III‐IV)  13 
3.1. Key informant study (Paper I)  13 
3.2. Quantitative study (Paper III‐IV)  15 

4. Ethical considerations (Appendix 4)  23 

5. Results (Papers I‐IV)  25 
5.1. Key informant study result (Paper I)  25 
5.2. Quantitative data result (Paper III‐IV)  28 

6. General discussion (Papers I‐IV)  37 

7. Clinical implication (Papers I‐IV)  39 
7.1. Impact of child labour  39 
7.2. Options for child labour  39 
7.3. Recommendation  40 

8. Summary  43 
8.1. Limitations  43 
8.2 Contributions  44 

9. Acknowledgements  45 

10. References  47 

Appendix 1. Rapid Assessment Questionnaire  53 
Appendix 2. General Child Labour Questionnaire  55 
Appendix 3. Questionnaires & manual in Amharic  63 
Appendix 4. Consent Form  79 

Paper I ‐ IV 
 
 Child labour in Addis Ketema, Ethiopia  1 

1. INTRODUCTION AND LITERATURE REVIEW 
There is abundant information on child labour. Studies on the epidemiology of
psychiatric disorders in child labour are very rare. Most of the available studies
are from diverse disciplines with different perspectives (Alaraudanjoki, 2000;
ILO, 2002). These studies tend to examine the detailed repercussion only from
the respective discipline. This tendency to focus on just one discipline
reinforces the disparate gap of the main policy arguments, of either to abolish
or limit child labour. It may also hinder the effectiveness of existing child
labour interventions in various countries. Although there is an optimism that a
certain degree of consensus could tentatively be concurred through the
assimilation of the research from different approaches, such a process is an
enormous undertaking, the goal lofty, and the premise for the fundamental
arguments controversial.

This dissertation is a culmination and further extension in the synthesis and

critical evaluation of the literature on child labour. It further attempts to
illustrate how the research gap could be filled, and the complexities in
conducting the study of mental health among child labourers be addressed.

This introductory section sets the scene by outlining the essential terms used
in the dissertation first, followed by a description of the history, prevalence,
and various theories of child labour. It then focuses on the relationship of
mental health and child labour.

A systematic literature review was done using various relevant databases and
non-conventional or grey literature (see Paper II).

Grey literature: The following were used as the resources of grey literature.

(a). The International Labour Organization (ILO) library in Addis Ababa.

(b). The ILO bibliography (ILO, 2002). A similar and recently updated, but
more relevant text on health problems was used for cross-reference and
identification of further literature (Forastieri, 2002).

Databases: The following relevant databases were searched exhaustively.

(c). The International Occupational Safety and Health Information Centre

(CIS) and the ILO Statistical Information and Monitoring Program on
Child Labour (SIMPOC).

(d). Other databases, AMED (1985-2008), CINAHL (1982-2008), EconLit

(1969-2008), EMBASE (1980-2008), PsycINFO (1985-2008), Ovid
MEDLINE ® In-Process, and Other Non-Indexed Citations (1966-2008).

(e). A web search of dissertations.

2  1. Introduction and literature review 

Selection criteria: All literature mentioned on (a) and (b) above was manually
perused, and the relevant cross-references were identified. Similarly, relevant
articles in (c) and (d) above with, combination of "Child labour", "Child labor",
"Child Abuse", "Age 5-15 Years", "Prevalence", "Emotional", "Mental" and
"Psychosocial disorders" were selected.

1.1. Definition 
Here selections of relevant contextual terms in this dissertation are described.

1.1.1. The Child 
A child as defined by the United Nations Convention on the Rights of the
Child (UNCRC) & the ILO is a person under 18 years of age (UN, 1992). In
this dissertation the age range of 5-15 years was used in order to allow
comparisons with previous studies done in Ethiopia. There is an argument
among certain social scientists that childhood is a post industrial and post
modernist social construct, which keeps on getting redefined constantly. The
echoes and visions of Dickens’ Victorian time of child maltreatment may be
distant in most Western countries to date, but they are rampant in traditional
cultures such as Ethiopia. The responsibilities, rights and privileges of children
mainly depend on the context of where, how and by whom they are brought
up. The balance of opportunities seem to tip on nurture rather than nature
especially among most children who live in developing countries, and those
that come from deprived families in the developed world. The debates, moral,
ethical, and philosophical discussions in numerous forums, and various global
campaigns on a topic with a wide individual variation eventually led to an
agreement on universal rights of children. As illustrated below, most of these
policies typically precede empirical evidence, which in turn makes them
irrevocable and resistant to challenge.

1.1.2. Child rights 
The UN Convention on the Rights of Children (UNCRC) under Resolution
42/45 is a 54-article document. The five-point Geneva Declaration of the
Rights of the Child in 1924 became a ten point declaration, which was later
adopted in 1959 by the General Assembly. Finally, in 1989 the present
convention was made of 54 articles. This entered into force in accordance with
Article 49 on 2/9/1990. It took many years of revision and process, but was
accepted almost unanimously by all nations. It also forces party states to
observe the articles therein. With only two remaining countries (USA and
Somalia), 192 have already ratified this convention to date.

The UNCRC is presumably built to accommodate a spectrum of legal systems

and cultural traditions across the world, although it is evident that is based on
Western values that were acceptable in the early 20th century. The basic
 Child labour in Addis Ketema, Ethiopia  3 

elements of this convention guarantee the right to survival, such as health and
food, education, especially free elementary education, play and recreation;
developing to the fullest; protection from harmful influences, abuse and
exploitation; and to participate fully in family, cultural and social life. It has
clear stipulations against child labour, exploitation, prostitution, and bondage.
It firmly states that the child should not be subject to exploitative practices,
required or permitted to perform work which may be hazardous or harmful to
education, health, or well being.

There are considered opinions on the lack of the UNCRC to accommodate to

the spectra of global cultural values, adjust to the changing times, needs of
children, and families (Jacquemin, 2004; Pierik & Houwerzijl, 2004; Rubenson,
2005; Woodhead, 1999). The UNCRC is also said to be open for
misinterpretation owing to it being “gender blind,” and that it is inflexible in
incorporating contemporary ethical and moral standards even among the
Western world (Rubenson, 2005). With the gradual decline of nuclear families,
urbanization, and technological endeavours, there is an assumption that
communities have become less cohesive, less spiritual, more materialistic,
relatively free, and liberal in their attitudes. However, it is illusive and naive to
assume that child labour is one of the social ills, or consequences of such
vagaries of modern world.

1.1.3. Child labour 
Generally “child labour” refers to any economic activity performed by a child.
The term stood for the practice of employing young children in factories
during the industrial era. Presently it designates a condition when a child is
involved in exploitative economical activities that are mentally, physically, and
socially hazardous (ILO, 1983; Bequele & Boyden, 1988). Child labour does
not include “child work,” the occasional performing of light work after school,
or formal apprenticeship opportunities. Instead, in “child labour” an
exploitative situation prevails that involves: work at too early an age, full time,
requiring exertion, under bad conditions, with inadequate pay, too much
responsibility, denying access to education, undermining dignity and self
esteem, and detrimental to full social, and psychological development (ILO,
1973; Bequele & Boyden, 1988; Bequele & Myers, 1995).

1.2. History of child labour 
It is a well recognised historic and cultural fact that children helped parents
and family by working in the farm, market and around their home as soon as
they were able to understand simple commands (Bequele & Boyden, 1988).
The use of child labour was not regarded as a major social problem until the
introduction of the factory system. At that time, orphans and children of poor
parents as young as five years of age toiled for more than 13 hours a day in
cotton mills and mines. In the US, a third of the factory force was children 7-
4  1. Introduction and literature review 

12 years of age in the early 19th century. The outcomes of this exploitative
condition included illiteracy, further impoverishment of poor families, and an
increasing number of malnourished, diseased and handicapped children.
Detailed, vivid, and heart-rending accounts are shown in the classic English
literature by Charles Dickens and William Blake, reminiscent of uneven wealth
distribution during the reign of Queen Victoria.

Children have been indispensable in the economic and social history of

Ethiopia. Earlier records poignantly describe the roles children played in
farming, legal, and political fields (Pankhurst, 1990; Zewde, 1991). Around the
age of seven or earlier, it was not unusual for young boys to leave their family
in order to bring some support by tending other people's livestock, while very
young girls carried out the menial work of fetching water and firewood from a
considerable distance, or taking the task of grinding grain. In times of scarcity
traditional forms of adoption ensured entrusting children to better-off
kinsmen, or even complete strangers.

There is an abundant record of a slave trade in Ethiopia where many children

were sold by parents who were destitute, or unable to pay taxes. Children were
also captured in war, or seized by raiders, and were then sold as slaves.
Pankhurst gives a harrowing account of the precaution families took from the
kidnappers…"children were often made to sleep on beams across the upper
part of their houses or had thick sticks placed over them"…if (the raiders)
were unable to break into a house…they would set fire to the building by
night, having first dug a pit around it…the children would be seized amid the
general confusion" (Pankhurst, 1990). According to the British envoy
Cornwallis Harris, three quarter of the slave caravans ranging 100-3000 were
young children; nine-tenths of the girls were below ten years of age
(Pankhurst, 1990). Emperor Menelik II is renowned for officially abolishing
the slave trade and breaking down its complex system across the country in
1924 (Zewde, 1991, p 94). Ironically, for many years to come, the nobility and
most feudal landlords continued to own slaves, often with their extended
families, until the dramatic demise of the monarchy in Ethiopia 1974.

Children served as “leba shay”, (from Amharic leba-thief, shay-detective), "an

earlier thief detecting system which continued until it was banned by Lej
Iyyasu, the grandson of Emperor Menelik II and predecessor to Emperor
Haile Selassie I. In this traditional mode of detection of criminals, a young boy
would be given a powerful herbal drug and let loose in the neighbourhood; the
unfortunate owner of the house where the boy finally collapsed would be
declared the culprit. The 'leba shay' could also be held in a leash of cloth tied
around his waist, so that he will not go too far from his target, which is
sometimes set up by the people following the boy. Lej Iyyasu is credited for
his efforts to mitigate and end the abuses of the leba shay ..." (Zewde, 1991).

Child labour reformers fought for legal prohibition as early as 1802 in the UK
although the first legislation was not enacted until 1878, rising the minimum
 Child labour in Addis Ketema, Ethiopia  5 

age of employment to 10 years. Earlier legislations appeared in South Asia in

1850’s but became distinct in the first Indian Factories Act of 1881 (Mhatre,
1995). All present-day legislations address illiteracy among child labourers,
establishing minimum working age, maximum allowed working hours, and
restricting child labour in hazardous industries. The early global efforts worth
noting were the first International Labour Conference held in Berlin in 1890
that attempted to formulate standards of child employment, and the
International Association for Labour founded in Basel in 1900 that worked on
statutes on child labour, and pressed for their incorporation into international
labour legislation. Modern laws on child labour in the developed world are
usually tied to educational legislation on school attendance, and prohibit full-
time employment of children in industries and businesses. However many
children are able to work as newspaper deliverers, shopkeepers, cashiers, sales
personnel, part-time workers at home, or even as actors and performers on the
media, and entertainment business (Encyclopaedia Britannica, 2006).

The most important endeavours to eliminate child labour throughout the

world come from ILO, that was founded in 1919, and which has since become
a special UN agency. It establishes and supervises labour standards through
introduction of several conventions among its members on voluntary and
compliant manner, but lacks the power to enforce these conventions. ILO
convention 138 defines “light work” as work that is less likely to harm the
child’s health or development or affect school attendance (ILO, 1973). Whilst
pursuing to eliminate child labour, ILO has recently focussed on the
“intolerable” forms of child labour, such as children working under forced
labour conditions and in bondage; children in hazardous working conditions
and occupations; and very young working children and working girls (Bequele
& Myers, 1995; ILO, 1996b). ILO has 14 conventions that address child
labour alone, including the most recent Convention 182, which bans all
intolerable forms of child labour from the world (ILO, 1999). Vanguard on
this line is ILO’s International Programme for the Elimination of Child
Labour (IPEC), a department that was established in 1992 to assist countries
in the phased elimination of child labour by stimulating them to be parties of
the important child labour conventions, help them prepare their own pertinent
child labour policies and launch associated action programmes.

In addition to ratifying the UNCRC, and ILO conventions 138 and 182,
Ethiopia has important pieces of legislations that address child labour (ILO,
1973; ILO, 1999; Transitional government of Ethiopia, 1991; Transitional
Government of Ethiopia, 1993; Transitional government of Ethiopia, 1995;
UN, 1992). The influence of applied legislation is crucial, and is shown by a
two stage survey of 83 doctors in India, who admitted to employ child
domestics under 14 year of age; after amendment of key laws, this dropped to
nil from 61.1% employment of under 14 year old child domestics (Mishra and
Arora, 2007).
6  1. Introduction and literature review 

1.3. Types of child labour 
As stated in their relevant legal documents, ILO and Ethiopia differentiate two
groups of children, either under or above 14 years, in order to specify what
type of work could be acceptable (ILO, 1973; Imperial Ethiopian government,
1957; Imperial Ethiopian government, 1960). An alternative is to define
intolerable (hence ''tolerable'') forms of child labour as stated in ILO
convention 138 (ILO, 1973). This alternate definition connotes a health, moral
and ethical standard of what is acceptable or not by most people. Although
ILO convention 138 leaves the cut off for minimum age to be made at the
discretion of each country, it provides markers such as school leaving age.
Therefore many countries have different and constantly reviewed age limit.
Most countries have less than 15 years as a cut-off. The studies for this
dissertation aimed at 15 years taking the above discussion into account and
also in order to compare results with previous studies in Ethiopia on mental
health problems in children.

One paper published by UNICEF identifies seven major child labour types,
namely: domestic, forced and bonded, commercial sexual exploitation,
industrial and plantation work, street work, work for the family and girls work
(UNICEF, 1996). Another child labour advocate classifies it as visible:
working on the streets, and invisible: domestic servants and agricultural
workers (ILO, 1996b). The same researcher uses an alternative classification
whether the children work in the formal or informal sector. The former
designates those who are registered legally. The informal or unregulated sector
consists of the following: carpet manufacturing, fishing and sex industries,
selling goods, and begging in the streets (Teferra et al., 1997).

1.4. Prevalence of child labour 
These are only estimates because the existing statistics is largely inadequate and
unreliable for various reasons (ILO, 1995; ILO, 1996a). During surveys
employers are not willing to expose that they have hired children because it is
formally illegal everywhere. Common problems in census and the mobile
nature of their activity, for example, street workers, are also factors that
contribute for incomplete statistics. Recent surveys done by the ILO have lead
to estimate that about 250 million out of the 2 billion children of the world are
child labourers (Bequele & Boyden, 1988; ILO, 1996a; ILO, 1996c; ILO, 2002;
IPEC 1994). The most recent survey showed that there are 167 million child
labourers between the ages of 5-14 years (ILO, 2006). The world’s estimated
90% child labourers are assumed to be in Africa, Asia and Latin America
(ILO, 1996b).

Although it has become a history in the developed countries, North America

and Europe still have some child labourers. This reflects that child labour is
not exclusively linked with poverty (Cooper & Rothstein, 1995; UNICEF,
1996). A survey conducted by the ILO in selected urban and rural areas of
 Child labour in Addis Ketema, Ethiopia  7 

Ghana, India, Indonesia and Senegal showed that every fourth child is engaged
in an economic activity (ILO, 1996a). Although majority of child labourers are
in Asia, the incidence and prevalence is said to be higher in Africa.

A similar recent census conducted in Ethiopia indicated that more than half of
the children were involved in a productive activity; this is higher than the
previous estimate of 41% (Admassie, 2000; Central Statistical Authority, 2001).
According to Tesfay (Tesfay, 2003) who analyzed an 11-year panel data from
ILO, UN and World bank for 75 developing countries, there has been no
significant change in the Ethiopian child labour force. Assuming an annual
economic growth of 2.74%, there would not be a noticeable steady decline of
child labour for another 90 years (Tesfay, 2003).

1.5. Hazards of child labour 
Unlike adults this risk goes beyond working conditions to encompass the
threat to development such as physical, cognitive, emotional, and social
development (Bequele & Boyden, 1988; Bequele & Myers, 1995; Forastieri,
2002; ILO, 1996b; WHO, 1987). Known occupational hazards in domestic
service are physical and sexual abuse, malnutrition, excessive hours of work
and fatigue, child raising responsibilities despite still being children themselves,
heavy loads leading to back problems, knee problems like bursitis and
tendonitis from cleaning on their knees, burns, scalds, dermatitis and exposure
to infectious diseases. Hazards to street workers include increased risk of car
accidents, falls and injuries, exposure to heat, noise, cold, and dust, exposure
to carbon monoxide from exhaust of vehicles, exposure to violence and
criminal activities, risk of being beaten and harassed, involvement in substance
use and trafficking. Generally health risks to child labourers include exposure
to environmental agents, factors relating to working capacities and limitations,
and psychosocial factors (WHO, 1987). Working methods and tools are not
designed with due consideration of children and thus children are more
susceptible to variety of occupational hazard including toxic chemicals, heat,
noise, light and radiation (Cooper & Rothstein, 1995; Dunn et al., 1998;
WHO, 1985). Review of surveys done in South America showed that 29%
(ranging from 15-52%) of the 1510 (Peru 215, Brazil 1096, Paraguay 199)
studied children worked for over 9 hours daily; carried very heavy family
duties; were paid much less than the minimum wage; those who went to
school found it tiresome to concentrate in class (Myers, 1989).

1.6. Theories of child labour 
Substantial contributions on child labour theories are mainly attributed to
experts from socio-economic or education background (Encyclopaedia
Britannica, 2006; Edmonds, 2007). Influential social scientists of note in the
18th and 19th century were Adam Smith, Karl Marx, and Thomas Malthus.
Smith thought labour shortages led to increased fertility. Marx noted that
8  1. Introduction and literature review 

children replaced men, who in turn were replaced by machines during the
Industrial Revolution. Malthus on the other hand believed that increasing size
of families made it harder to meet their basic need, which eventually forced
them to resort to all sources of labour including child labour. In the later half
of the 20th century, Gary Becker, Paul Schultz, Alexander Chayanov and
Milton Friedman focused on the human capital, giving emphasis to resources
that determine the need for child labour input, such as time spent on
education and leisure by children, or time spent by adults in caring for
children. Friedman argued that it is only through mobilising all the family
labour resources, including children, that society could eventually overcome
poverty, poor education, or child labour. The main theories that are based on
large empirical studies and qualitative information are reviewed briefly below.

1.6.1. Poverty of parents 
The supply and demand of child labourers is centrally determined by the
socio-economic status of parents. The global distribution of child labour is
similarly a reflection of the country's economic status, the poorer the country
the higher the prevalence of child labour. Opponents of this theory argue that
expanding economies tend to have a parallel rise in the number of child
labourers, and also contend that developed countries have not eliminated all
types of child labour yet (Tesfay, 2003). Although parents’ economic status
obviously seems to determine the fate of a child, it is not uncommon to see a
rise in many families of unemployed parents and child labourers
simultaneously (Guarcello et al., 2004). This could be maintained by either the
parental attitudes or the predator nature of the market in growing economies
(Tolfree, 1998).

1.6.2. Parent attitudes 
Generally the attitude of parents is variable towards education, work, and
health. Among the poor, some parents condone child labour, others do not.
Educated or families from a middle or higher income are less likely to send
children to work. In a rural economy and deprived urban areas, it may be seen
as a luxury not to have children not help their families. The extent to which
parents allow their children to engage on long, exploitative paid jobs is also
dependent among other things on the degree of parental authority, and need
for supplementary income (Cockburn, 2001; Woodhead, 2004). Whether
children's support is through indirect employment, as in forgoing education
and leisure in order to let their parents work, or directly earn a living, are
somehow under the control of parents, their values, standards, and attitudes.

1.6.3. Economic exploitation 
Children are mainly targeted because they are less likely to join a trade union,
come late, claim sick, confront bullying, demand pay rise, or better working
 Child labour in Addis Ketema, Ethiopia  9 

conditions (Bequele & Boyden, 1988; Bequele & Myers, 1995; Myers, 1989).
They are less likely to malinger, sabotage at work, or resist if they are sacked
(Admassie, 2002). There is also the assumption that their small hands are
suitable for fast and dextrous jobs, such as carpet weaving and football
making, so called “nimble finger” (ILO, 1996b). Cockburn looked at four
main aspects of this issue: impacts of child labour on the physical health and
development of children; the interaction between child labour participation
and school attendance and performance; the process and determinants of
household decisions concerning child labour and school participation; demand
for child labour in rural Ethiopia (Cockburn, 2001).

1.7. Psychiatric disorders 
Although it seems apparent that there would be increased psychiatric
morbidity among child labourers, to our knowledge, there is only one study in
Africa that systematically examined or demonstrated the higher prevalence of
psychiatric disorders where 15% of the 500 surveyed children aged between 5-
15 years were found to have mental disorders, 2/3 of which were emotional
and conduct disorders (Abiodun, 1993). The empirical evidence is scanty,
mooted, and is based on screening questionnaires or qualitative information
(Fekadu et al., 2006; Fekadu and Alem, unpublished manuscript). Neither the
recently published ILO bibliography on child labour, nor another earlier but
very useful compilations on child labour health have no information on the
prevalence of psychiatric disorders, or about its association with risk factors
such as different forms of child abuse (Forastieri, 2002; ILO, 2002).

A study from Brazil has shown an almost 3 fold rate of behavioural disorders
among child labourers compared to controls (Benvegnu et al., 2005). Similarly
a survey from Jordan reported higher rates of substance use in child labourers
compared to controls (Hawamdeh et al., 2001), although a study from
Lebanon did not see any difference in mental health states of cases and
controls (Nuwayhid et al., 2005). Another multi-site study from three urban
areas in Ethiopia showed that the controls had almost two fold prevalence
rates of childhood disorders compared to child labourers which according to
the authors was possibly due to selection bias or healthy worker effect (Alem
et al., 2006). Woodhead has outlined a detailed account of psychosocial
problems mainly based on relevant literature review, and his extensive field
work in Africa and Asia. He has further enriched this with some of his
qualitative data gathered in the streets of Addis Ababa (Woodhead, 2004). The
descriptions and narratives of the subjects in his study fit into a range of
psychopathologies commonly clustered as internalising disorders (emotional
and anxiety symptoms) rather than externalising disorders (conduct and
disruptive behavioural symptoms). Internalising disorders are more likely to be
readily self-reported by child informants and less likely to be easily detected by
teachers and parents, conversely externalising disorders are more likely to be
easily detected by teachers and parents as they are noticeable but reported less
10  1. Introduction and literature review 

by child informants because of poor insight (Bird et al., 1982; Edelbrock et al.;
Herjanic et al., 1975).

Studies based on general child population in Ethiopia and similar countries

elsewhere indicate a wide pattern of psychiatric morbidity ranging from 3-25%
(Abiodun, 1993; Ashenafi et al., 2001; Chandra et al., 1993; Cederblad, 1968;
Giel et al., 1969; Giel & van Luijk, 1969; Giel et al., 1981; Mulatu, 1999;
Shenoy et al., 1998; Tadesse et al., 1995). These studies have varying degree of
strength based on the type of informants and research instruments used
(Fekadu and Alem, unpublished manuscript).
 Child labour in Addis Ketema, Ethiopia  11 

2. AIMS (PAPERS I‐IV) 
The general and specific aims of the studies compiled in the dissertation were
as follows:

2.1. General aims 
To describe the patterns of child labour, child abuse and the experiences of
child labourers in the informal sector with emphasis to child domestic labour
(Papers I-III).

To determine the risk factors contributing to psychiatric disorders within the

child labour group (Paper IV).

2.2. Specific aims 
To understand the public perception and attitude about child labour and areas
of intervention (Paper I).

To identify the reasons that drive children to become labourers (Papers I-II).

To examine the factors that maintains child labour (Paper II).

To identify the child labourers' attitude towards work and future plans
(Paper II-III).

To assess the role of migration of parents on child labour (Paper III).

To study the association of different types of child labour with nature of

upbringing, family educational status and marital stability (Paper III).

To measure the amount and nature of remuneration (Paper III).

To study the types of child abuse, the vulnerable and protective factors
(Paper III).

To study the prevalence and pattern of psychiatric disorders and compare the
findings with non-labourer control group (Paper IV).

To investigate the association of various forms of child labour, child abuse,

and socio-demographic factors with psychiatric disorders (Paper IV).

2.3. Hypotheses (Papers II‐IV) 
There is difference in the prevalence of child abuse and psychiatric disorder
between child labourers and non-child labourers. We hypothesize the
difference to be more marked specifically among the female group, and there
12  2. Aims 

will be a higher rate of internalising disorders among child labourers compared

with controls (Paper III-IV).

Various socio-demographic variables such as being a domestic labourer,

internal migrant or being an orphan influence the outcome, i.e., child abuse
and psychiatric disorder (Paper III-IV).

The “nimble finger” that assumes children are employed because they are
more efficient than adults due to their dexterity is a fallacy. We hypothesize
child labourers; especially those in the private enterprise and small-scale
household industries such as blacksmiths are more prone to get injured (Paper
II-III).

We hypothesize that a child’s capability to work does not have a direct

relationship with being more likely to be fit and relatively stable in mental
health compared with non-economically active control group (Paper IV).
 Child labour in Addis Ketema, Ethiopia  13 

3. METHODOLOGY (PAPERS I, III‐IV) 
There were two main essential and complementary steps in the studies. The
first one was a key informant study. The information obtained from this phase
of the research was used to design the next quantitative studies.

3.1. Key informant study (Paper I) 
In this section we describe the particular type of study we used and the
justifications. We also give details on the sources of data, study subjects, and
the method used in the analysis. The study site was Addis Ketema; the district
where the next main study was also conducted (Papers III-IV).

3.1.1 Key informant study type 
We used a Rapid Assessment Procedure (RAP). This technique enables to
basically estimate general opinions and perception of a population regarding
the subject in question (UNICEF, 1988; UNICEF, 1996; Kifle, 2002). It uses
both qualitative and quantitative data and mainly helps to evaluate the nature,
magnitude and patterns of a problem. The procedure mainly helps to get some
insight into the perceived nature, magnitude and seriousness of a problem. It
also helps to learn public opinion about the preventive methods. Investigators
thought this method was appropriate for the purpose of this study based on
wide experiences (ILO, 1996a; UNICEF, 1988; UNICEF, 1996; Kifle, 2002).

The objective of this study was to assess how far the community in the study
area was aware about the nature and extent of child labour. The second aim
was to learn what respondents thought were the major types of child labour
and the driving elements behind. Thirdly, the study tried to identify perceived
problems associated with child labour, different types of child abuse and
prevention methods. The study was conducted between September and mid
November 1997.

3.1.2 Sources of data 
Respondents were selected by convenience selection method, which is one of
the selection methods used in Rapid Assessment Procedure. 170 respondents
(Key Informants) were selected from three sub-district offices, five schools,
six urban dwellers' association offices, one police station, and two Non
Governmental Organization (NGO) offices located in the district (Table 1).
They were teachers, public service providers and government officers, self-
employed, NGO workers, students, housewives and mixture of others. The
criteria for selecting most of these respondents were based on the following
assumptions: their wide exposure to children in all circumstances, the position
they held in the community, their proximity to appreciate the problems of
child labour and assumed capability to suggest preventive mechanisms.
14  3. Methodology 

Table 1. Participants in the Rapid Assessment Procedure

Characteristics  % (n=158) 
Sex
Male 60.1
Female 30.9
Age (years)
<18 4.5
18-27 38.7
28-37 25.8
38-47 22.6
48+ 8.3
Occupation
Teacher 26.0
Public servant 20.8
NGO worker 16.2
Government office worker 13.6
Housewife 11.7
Self-employed 4.5
Student 4.5
Others 2.6
Sum may not add to 100% due to missing numbers

3.1.3. Questionnaire for the key informant study (Appendix 1) 
Investigators prepared a one-page open-ended questionnaire in a local
language, Amharic, to collect information from the respondents The content
of this questionnaire included respondent's socio-demographic information,
knowledge about child labourers whose age is below 15 years, common types
of work these children engage with and compelling reasons for this. The
questionnaire also contained about possibilities of abuse in these children and
types of abuse. It finally asked the respondents about their perception
regarding the subject in question and possible solutions. The questionnaire
was distributed to potential respondents for self-administration.

3.1.4. Data analysis 
This was divided into two phases and three steps. We used an adaptation of
framework analysis as the primary phase to analyse the information obtained
through the open-ended questionnaire (Appendix 1) (Ritchie & Spencer,
1994). This phase involved the following three steps, namely, familiarisation
with the data through careful double rereading, highlighting, cutting, and
pasting. The second step was identification of a thematic framework. Initial
coding was developed from a priori issues in the way the open-ended
questionnaire was designed, and from emerging issues of the above stage. In
the third step we indexed the data using numerical or textual codes to identify
specific pieces of data that correspond to a range of differing themes.
 Child labour in Addis Ketema, Ethiopia  15 

The second phase was entering the data using computer software, Statistical
Package for Social Sciences (SPSS). Descriptive and thematic analysis was
made.

3.2. Quantitative study (Paper III‐IV) 
Here we describe the type of study, the area, study subjects, research
instruments, and ethics, how the interview took place and the overall data
management. This was the second and main study that was informed by the
key informant study described above. The study type was a cross-sectional
population survey.

3.2.1. Study area 
The study was conducted in Addis Ketema, a district in Addis Ababa city. This
area was selected for a number of reasons. The major one was logistic. The
research was based in Amanuel Hospital, located in the same district. This is
an economically dynamic and very active centre of trade in the city. There is
also good ethnic, labour, and social class diversity comparable to the national
figures. The population is similar to other districts in the city. According to the
1994 census, the population of this district was 314,565. Children 5-14 years
old accounted for 24%. Addis Ketema administration consists of 51 kebeles
(basic units of administration, also called Urban Dwellers Association). Our
study covered 37 kebeles that constituted Addis Ketema district. The major
ethnic groups in the district were Amhara, Oromo, and Gurage. Main religious
groups were Christian and Muslim. There were 29 elementary and junior
secondary schools with a total student population of 49,171; females
accounting for 52.6%. The literacy status in the district was 79.7% and school
attendance 66% (Central Statistical Authority, 1994b). At the time of the study
the schools were mainly run on two shifts during the day, and one at night, to
accommodate the
demands. The state
Addis schools are free while
Ketema the public schools
incur variable rate of
tuition fees. The
Addis Ababa public and most state
schools also run
Ethiopia
evening classes
which are only
available to students
who can afford to
pay the monthly fees.
16  3. Methodology 

3.2.2. Cases (n=528) 
The study populations were child labourers and non-labourer school children
(Table 2). The subjects were selected from schools, houses, streets, and small-
scale private enterprises. Every third school of the 29 schools in the district
was selected. The schools were used as possible sources of domestic labourers,
who invariably attended night shift classes. They also served as the sources for
the sample of non-economically active children.

Table 2. Participants in the child labour study

Characters  Labourers  Controls 

% (n=528)  % (n=472) 
Sex
Male 51.3 36.2
Female 48.7 63.8
Age (years)
5-10 29.2 20.1
11-15 70.8 79.9

Fig 1. A female domestic labourer. She is carrying a baby on

her back, looking after another boy whilst selling potatoes and
onions just outside of the house where she works.
 Child labour in Addis Ketema, Ethiopia  17 

Fig 2. A female domestic labourer. Apart from doing the household chores,
she sells some utensils for her employer.

3.2.2.1. Child domestic labourers (n=180) 
Key informants from schools and kebele administrative offices were used to
identify this group in addition to the census. Out of the 37 kebeles, census for
domestic labourers was carried out in 13 randomly selected kebeles using a table
of random numbers. All 5-15 year old domestic labourers (“advantaged”-
privileged to evening schooling, and “disadvantaged”-homebound and
working all the time) were included in the study. Significant proportions of
female elementary school night-shift attendees were assumed to be either child
domestic labourers, or self-employed. The self-employed could afford to pay
for their tuition. For those who were not, however, this could be part of the
privilege in the contract with their employer. The other minor sources were
self-identifiers in schools. Access into this group was also made possible due
to the favourable early contacts established with local non-governmental
organization (NGO) during the first part of this research (Fekadu & Alem,
2001).
18  3. Methodology 

Fig 3. A group of street and private enterprise labourers. The boy on the far left is collecting used plastic
bags from the tip for recycling. The other one has just lifted a bucket full of rubbish from his wooden
wheelbarrow, to empty near the tip.

Fig 4. A male street labourer. He is carrying a washbasin and lemat, a straw woven container for Ethiopian
pan bread-injera.
 Child labour in Addis Ketema, Ethiopia  19 

Fig 5. A street labourer. She is carrying firewood. A kuli is a term generally used for males that deliver items
by carrying from one place to another for a small fee.

3.2.2.2. Street labourers (n=300) 
These children came from all parts of the town to this big market area.
Detailed description of the lives of street children is well documented in
studies from Ethiopia and East Africa (Lalor, 1999; Woodhead, 2004;
Plummer et al., 2007). They spend their day engaged in various types of street
vending. They were selected on a convenience-sampling basis for interview.
Interviewers approached the subjects on specific identified streets that were
well known for a visible presence of street labourers. Local street children
participated in the active identification of labourers and pointing on alternative
locations for interview.

Fig 6. A team of shoe shiners at work. These private enterprise labourers support each other. They invariably
own the shoebox and its contents, a bench or chair for the customer, and at times a stool for themselves.
20  3. Methodology 

Fig 7. A team of street labourers selling plastic bags near a

state-owned mobile fruit vending shop.

3.2.2.3. Private enterprise labourers (n=48) 
This group included children working in shops, garages, hotels, and
handcrafts. They were selected randomly from kebeles catered by an NGO that
facilitated an earlier research (Fekadu & Alem, 2001). Study subjects were
selected by going to those places within the district and interviewing those
who fulfil the criteria for selection.

3.2.3. Controls (n=472) 
Non-economically active controls were sampled from the schools. Every third
school was chosen as a sampling frame, and then class records were used for
identification through the random table method. The number of females in
the control group was raised in order to balance the exclusively female
domestic labourer in the study group.

3.2.4. Research instruments 
The two instruments used in the quantitative study were a general socio-
demographic questionnaire and a semi-structured diagnostic schedule.
 Child labour in Addis Ketema, Ethiopia  21 

3.2.4.1. General Socio‐demographic Questionnaire (Appendix 2 and 3) 
Informants were the study subjects described in 3.2.2 and 3.2.3 above. A
locally prepared, structured, seven-page questionnaire was used for this study
(Appendix 2 and 3). Its feasibility, reliability, and acceptability were found to
be satisfactory in a small pilot survey in the same study area. It had three main
sections.
The first part dealt with socio-demographic information of the child and the
parents. This included sex, age, education, economical status, ethnicity,
religion, place of birth, parents’ marital status and occupation, family size and
history of migration. The second part dealt with child labour. This section
identified types of child labour, time spent at work, age work started, any
benefit obtained and how it was spent, rate of changing work place and the
underlying reasons for going into labour, and number of people the child
supported from the generated income.
The last section was about child abuse that concentrated on varied types of
physical (beating, being thrown out of home, trauma); emotional (forgotten,
scapegoat, threatened, frisked, suspected, despised, insulted); sexual abuse
(rape, sexual threats or coercion) and neglect (denied food or treatment). Each
type of abuse was rated as present if there was a positive reply to the specific
items. An accompanying manual was prepared to facilitate the interview
smoothly (Appendix 3).
3.2.4.2. Diagnostic Interview for Children and Adolescents (DICA) ‐ 
Amharic version  
The child version of the Diagnostic Interview for Children and Adolescents
(DICA) was another semi-structured instrument used to interview the study
subjects described in 3.2.2 and 3.2.3 above to detect childhood behavioural
and emotional disorders (Herjanic & Reich, 1982). DICA is compatible with
the classification system of American Psychiatric Association's Diagnostic and
Statistical Manual 3rd revised edition, DSM-III-R (APA, 1994). DICA has 16
parts divided into 26 chapters, 461 questions, with probes and explanations on
the frequency, severity, and degree of dysfunction of each item making a total
of 890 items. There is an inbuilt system of “skip” and “cut off” rules for each
cluster of disorders and symptom category that help to avoid unnecessary
interviewing, when the subject does not clearly score for the presence of a
psychiatric symptom. The first two chapters are on the demographics of the
subject while the last two are on psychosocial stressors and information on
reliability of the subject. Accompanying data entry software works through a
system of algorithms to provide a diagnosis according to DSM-III-R (Multi
Health Systems Inc., 1990). DICA has been extensively used and is known for
its reliability and validity (Boyle et al., 1993; Ezpeleta et al., 1997). The
Amharic version of DICA has been used in similar studies and has good
reliability and validity (Kebede et al., 2000; Ashenafi et al., 2001, Desta et al.,
2007). Ten interviewers who had completed high school, and with prior
experience in DICA interview were used for data collection in this study.
22  3. Methodology 

Two psychiatric nurses were supervisors on the field and also helped to
identify children who had psychiatric problems and need immediate help. An
experienced research assistant coordinated the logistics. The researcher, who
worked on the reliability of the psychiatric instrument (DICA) and the
investigators, gave supervisors and interviewers two weeks of rigorous training
on how to administer instruments. Repeated sessions of role-playing were
staged among the trainee interviewers. The instruments were pre-tested on
twenty volunteer street child labourers that were not included in the study. No
major problem was identified with the questionnaire or with the interview
process. Sources of error were amended accordingly before launching the
study.

3.2.5. The interview 
Appropriate technical arrangements were made with the school principals,
kebele officials, and NGO workers to facilitate the process. Interviews were
mainly carried out at schools, kebele, and NGO offices. The control group of
the study and the domestic labourers attending school during night shift were
interviewed in vacant classrooms. Regarding street labourers, we used big halls
in kebele compounds that usually serve as a meeting place for the dwellers. The
maximum and possible effort was made to conduct the interview in quiet and
private places. Simultaneous checking of the completed questionnaires during
data collection was made to identify inconsistencies that were rectified
immediately by the respective interviewer.

3.2.6. Data analysis 
Data were constantly and carefully cleaned at three tiers: two supervisors made
the initial check, the research assistant rechecked their work, and the principal
investigator did the last screen. Verification and re-coding of the few open-
ended questions in the general questionnaire was done before the beginning of
the data entry. Data entry and analysis was done using SPSS.

The data from DICA was entered in special software purchased from MHS
Inc., Canada, which gives the diagnosis based on an algorithm (Multi Health
Systems Inc., 1990). The diagnostic variables generated from the software
were then entered in EPI-INFO and SPSS programmes for univariate and
bivariate analyses, respectively. Chi-squared test with appropriate correction as
necessary, 95% confidence intervals, odds ratio, and p-values were used to
compare the cases and control groups. Dichotomous data were further
analysed for correlations and any associations. This was followed by binary
logistic regression where any DSM-III-R diagnosis was entered as a dependent
variable and various socio-demographic factors including being child labourer
and non-labourer were entered as co-variates in the model (APA, 1994).
Adjusted odds ratio and p-values were used to describe the parameter
estimates.
 Child labour in Addis Ketema, Ethiopia  23 

4. ETHICAL CONSIDERATIONS (APPENDIX 4) 
Formal ethical clearance for the studies was secured both from Amanuel
Hospital and National Ethical Clearance Committee of the Ethiopian Science
and Technology Commission. Consent and assent was obtained from each
child by reading a standard format at the beginning of the interview (Appendix
4). Similarly teachers’ permission was important whenever interviews took part
in schools. It was difficult to obtain informed consent from all parents. Most
children worked far away from parents. Guardians were used for consent in
the kebele child domestic samples. Any child who did not desire to participate
in the study was clearly made aware about their rights. The interviewers
skipped parts of the questionnaire a child did not like to respond to. Children
with medical problems received treatment free of charge.
24  4. Ethical considerations 
 Child labour in Addis Ketema, Ethiopia  25 

5. RESULTS (PAPERS I‐IV) 
The systematic review largely discussed in the Introduction above, showed
that there is abundance of information on the theory, prevalence, and
correlates of child labour, but a limitation of studies on psychiatric disorder
and intervention (Paper II). This comprehensive unpublished manuscript
review is subdivided into studies that describe the prevalence of local, national,
and global child labour, theories of child labour, options for child labour, and
the relationship of child labour and abuse with physical and mental health.

This section mainly deals with both the qualitative and quantitative data. The
qualitative data was first analysed manually using some of the methods from a
framework approach. In the second stage, some of the information was
grouped and tabulated and given numerical value for a clearer understanding
and interpretation.

5.1. Key informant study result (Paper I) 
In this section we give examples of verbatim responses from the preliminary
qualitative study that looked into the knowledge, attitude, and perception of
the community about child abuse and labour using a Rapid Assessment
Procedure. We then present quantitative interpretation of the qualitative data.

5.1.1. Key informant study data verbatim samples 
The whole or partial transcripts from the responses to the open-ended
questions were carefully scrutinized using various techniques such as copying,
highlighting, rereading, cutting, and pasting until main themes were identified.
Examples of transcripts are shown below.

What types of child labour do you know?

The respondents listed numerous types of child labour. None of these jobs are
exactly the same; however they could be lumped into three similar groups.

Domestic labour - this involves working within the house of the employer:
housemaid, child minder, running errands, washing clothes.

Street labour - this is working in the streets: petty trade, shoe shining, street
vendors, daily labourers, selling vegetable in ‘gullit’ (a stall in a small local
market), selling ‘kollo’ (roasted and spicy grain and legumes such as wheat,
barley, peas or beans), collecting iron materials, used plastic or glass bottles in
the village, firewood collection, selling second hand clothes, ‘woyalla’ (taxi boys
calling out for customers or working as cashiers in the minibuses), coin change
collection for the ‘woyalla’, prostitution, selling second hand clothes, begging,
theft and similar criminal activity.
26  5. Results  

Work in private enterprise - this is work in a production or business setting: shop

keeper, washing ‘tej’ (mead) bottles, manufacturing and selling plastic shoes,
work in a garage, manufacturing ironware such as knife, hammer, and
ploughshare.

What are the main reasons for child labour?

“They want to help their parents and themselves, such as paying for school fees.”

“They don’t have enough to eat.”

“Their parents are made redundant from their jobs.”

“They are orphans.”

“Parents that are poor arrange the jobs, and also encourage children to work.”

“They are influenced by the western video films. They also develop habits such as smoking
cigarette or chewing ‘khat’ (an evergreen stimulant leaf widely cultivated and
consumed in Ethiopia). Their parents may have the same habit – therefore the children
need the money to view the films or buy the drugs.”

“The community gives little attention to children. There are not enough football fields or
recreational places in towns.”

“Schools are inaccessible in the country. The family size is large. Therefore they are forced to
migrate to urban areas to get a job.”

What sorts of child abuse are child labourers more likely exposed to?

“They cannot get education. They have very poor school attendance and are forced to drop out
prematurely.”

“Those who work in the street are prone to get car accidents, exposed to bad weather
condition, forced to carry heavy loads, be beaten up or sexually abused by vagabonds, or their
goods are confiscated by police and beaten up” (These could either be the police or in
most of the cases security people employed by the rich shopkeepers to enforce
against “illegal and nuisance” of street trade.)

“They are insulted, punished, or fired without any pay. Some employers forbid food as a
punishment.”

“They work long hours, and are not allowed to have free time to play or study.”

“They become liars, sex workers, mature very early, are isolated and despised by the
community.”
 Child labour in Addis Ketema, Ethiopia  27 

“Harassment and rape is common for female children. The coolies snatch girls’ goods and
money.”

“They are exposed to bad and immoral behaviour such as theft, sex work, not respecting
their elders, cigarette smoking, ‘khat’ chewing, and alcohol use.”

“They worry unduly and are anxious about their parents economically.”

“They are starved therefore susceptible to get diseases.”

5.1.2. Quantitative results from the key informant study data 
Once the main themes were identified through familiarisation with the open
ended-data, they were then grouped into a series of smaller and manageable
data. These were coded and entered in SPSS for analysis.

5.1.2.1. Descriptive key informant data 
Complete information was obtained from 158 subjects (response rate of 93%).
The mean age was 32 years (s.d.=10.5). Community leaders such as kebele
chairmen or administrators accounted for 25%, while teachers were 32% of
the total subjects.

92% of the respondents considered child labour as a social problem. The three
main types identified were domestic labour, working in the streets and in
private enterprises. The commonest stated reasons to be a child labourer were
economic problems; family issues such as instability, lack of education,
divorce, and substance use in parents.

Eighty percent of the subjects stated that various forms of physical and
emotional abuse are very common among child labourers. In terms of
exposure to high-risk of child abuse, they ranked street labour as the highest
followed by domestic labour and work in private enterprises.

Over 80% of the subjects were aware of basic international standards of child
rights such as the United Nations Convention on the Rights of the Child.
Apart from listing the components, they highlighted the most important ones
such as the bare minimum and absolute need to provide education and love to
children. The desired areas of intervention stated by the subjects included
family support to alleviate poverty, provision of free education to children,
raising community awareness about child labour, family planning, legislation,
and law enforcement on child labour.
28  5. Results  

5.2. Quantitative data result (Paper III‐IV) 
As mentioned in the methods section above (Section 3.2.4.) the data on child
abuse and correlates of child labour was obtained through the detailed socio-
demographic and child labour questionnaire. The data on psychiatric disorders
was collected using DICA.

5.2.1. Child abuse and child labour (Paper III) 
A total of 1000 children were interviewed. Of these, 528 were child labourers
(cases) and 472 were non-economically active children (controls). Among the
cases, street labourers accounted for 57%, domestic labourers for 34%, and
private enterprise labourers accounted for 9%. Over 29% of the child
labourers were 10 years of age and below. Major ethnic groups of the cases
were Amhara, Oromo, and Gurage. Christianity was the major (77%) religion
among the cases. About 14% of the cases were illiterate, 78% were 1-6 graders
(primary school level), and only 8.3% had attained grade 7 and above
compared with 25.4% of controls (data not shown in tables). Around 60% of
child labourers’ parents were married compared with 63% of non-labourers’
parents. There was no significant difference in the marital status between the
two groups of parents. However, sex, age, religion of the study subjects, and
level of education and work status of the parents showed statistically
significant association with child labour. Mothers of child labourers were
shown to be less educated than mothers of the controls (Table 3).

As opposed to the assumptions that children work in order to support infirm

parents, the study showed most parents were not handicapped at all. A third
of the children do not give their income to their family and only half of them
give part of it to their family. Only 8% of the child labourers claimed to bear
total economic responsibility of their family. About 70% of the families shared
the income generated by their children and enjoyed their labour and thereby
supporting their exploitation (Table 4). In fact parents appeared to be highly
tolerant of their own children's exploitation if educational level is considered
as one of the indirect indicators that enables to measure ability of recognizing
similar social problems. Parents' educational status may also serve as a good
potential for future intervention since it indicates their easy flexibility for
raising awareness and related public participatory campaigns. Mothers of child
labourers seemed less educated than the controls. Interestingly their fathers
had higher education than their mothers and controls, but did not seem to
have an influence on overall child labour status. Parental working status had
significant relation with child labour (Table 3). The main reasons given by
children to be a labourer were positive and personal, such as better life
standards (29.5%), or pay for tuition (4.1%), while others were prompted by
the financial constraints of their parents (38%).
 Child labour in Addis Ketema, Ethiopia  29 

Table  3. Socio-demographic correlates of child labour, Addis Ketema District, Addis Ababa,
Ethiopia.

Characters  Labourers  Controls  COR1  95% CI2  P‐value 

(n=528)  (n=472) 

  n  %  n  %       
Sex
Male 271 51.3 171 36.2 1.00
Female 257 48.7 301 63.8 0.54 0.41, 0.70 <0.0001
Age (years)
5-10 154 29.2 95 20.1 1.00
11-15 374 70.8 377 79.9 1.63 1.21, 2.21 0.001
Religon
Christian 390 73.9 380 80.5 1.00
Muslim 138 26.1 92 19.5 0.68 0.50, 0.93 0.01
Parent’s marital status3
Married 305 57.8 298 63.1 1.00
Divorced 65 12.3 60 12.7 1.06 0.71, 1.58 N.S
Widowed 156 29.5 114 24.1 1.34 0.99, 1.80 0.05
Educational level4
Mothers: Illiterate 229 43.4 146 30.9 1.00
Elementary 170 32.2 189 40.0 0.57 0.42, 0.78 <0.001
Secondary 68 12.9 107 22.6 0.41 0.28, 0.60 <0.0001
Fathers: Illiterate 141 26.7 87 18.4 1.00
Elementary 178 33.7 149 31.5 0.74 0.51, 1.06 N.S
Secondary 117 22.1 175 7.1 0.41 0.28, 0.60 <0.0001
Parent’s work status5
Yes 381 72.2 402 85.2 1.00
No 142 26.9 70 14.8 2.14 1.54, 2.98 <0.0001
1 COR=Crude Odds Ratio.
2 CI=Confidence interval.
3 Parents of three child labourers were not alive.
4 91 mother’s and 156 father’s level of education from both groups was not known.
5 Work status of 5 parents of labourers was missing. © Blackwell Publishing. JCPP 47:9(2006), 954-959

More than 51% of the child labourers worked for 9 hours or more every day;
and almost 9% toiled for over 12 hours daily. Their mean income was 56
Birr/month (8 USD), which was a third of the minimum adult wage at the
time of the study.
30  5. Results  

Table 4. Working conditions and money utilization of child labourers, Addis Ketema district, Addis
Abeba, Ethiopia.

Conditions  Number of  Per cent 

cases 
Average time spent working daily in hours1
1-4 84 16.0
5-8 172 32.7
9-12 223 42.4
12+ 46 8.8
Money utilization2
Give all to family 76 17.1
Use all to self 143 32.2
Part to parents 225 50.7
Responsibility to family
Yes 42 8.0
No 483 92.0
Relation with employer3
Very good 73 25.5
Good 166 58.0
Bad 47 16.4
Perceived reason for repeating class
No time for studying 27 61.3
Academic setbacks 12 27.2
Economic problems 5 11.4
Future plans
Better job 265 50.4
Better education 216 41.1
Help family 24 4.5
Never thought about it 21 4.0
Total 528 100.0
1 3 children were missing for number of hours.
2 84 children are recorded as not applicable since they are not paid. Of these, 13 and 71 children are
domestic labourers and street labourers respectively.
3 224 children are recorded as not applicable since they are working on the street.

The cases fared better (8% failure rate at the end of year exam), compared to
17% of controls in repeating class. It is possible that only the best children
succeed in attending school, which could explain a lower class repetition rate.
These are probably the most resilient and determined children, who strongly
consider their education as value for the money they pay themselves. It is
worth noting that most of those who work longer hours could only go to the
short evening classes, compared to the longer day shifts. Among those who
had failures in class their main reasons (about 73%) were lack of time to study
and economical constraints. Only 27% complained of academic setbacks such
as poor performance in schoolwork and inability to progress (Table 4).

About 92% of the labourers expressed their wish either for a better job or
education in the future, 50.4% and 41.1% respectively (Table 4).
 Child labour in Addis Ketema, Ethiopia  31 

The lifetime prevalence of child abuse (at least a report of one type of child
abuse as operationally defined in this study) was 43.9% and 17.2% among
child labourers and non-labourers respectively (Fekadu et al., submitted).
Physical abuse (14.6%) was more than twice as likely to occur among child
labourers. This is lower in comparison to other studies of school children in
Ethiopia (Ketsela & Kebede, 1997; Teferra & Daniel, 1997)). Emotional abuse
(37.9%) occurred more than three times, sexual abuse (2.1%) was three times
while neglect (15.5%) was more than nine times among child labourers
compared with the controls. Emotional abuse was the commonest of the four
types of child abuse (Table 5).

Table  5. Types and instances of child abuse in child labourers, Addis Ketema District, Addis
Ababa, Ethiopia.
  Child labourers  Controls  COR  95% CI  P‐value 
  (n=528)  (n=472)       
Physical abuse 77 (14.6) 29 (6.1) 2.61 1.63, 4.18 <0.0001
Beating 65 (12.3) 26 (5.5)
Thrown out 21 (4.0) 7 (1.5)
Trauma 36 (6.8) 16 (3.4)
Emotional abuse 200 (37.9) 76 (16.1) 3.18 2.32, 4.35 <0.0001
Forgotten 65 (12.3) 21 (4.4)
Scapegoat 90 (17.0) 30 (6.4)
Threatened 85 (16.1) 40 (8.5)
Frisked 41 (7.8) 8 (1.7)
Suspected 66 (12.5) 16 (3.4)
Despised 54 (10.2) 13 (2.8)
Insulted 151 (28.6) 46 (9.7)
Neglect 82 (15.5) 9 (1.9) 9.4 4.54, 20.4 <0.0001
Denied food 19 (3.6) 5 (1.1)
Denied treatment 70 (13.3) 6 (1.3)
Sexual abuse 11 (2.1) 2 (0.4) 5.0 1.08, 46.6 0.04
Rape 4 (0.8) -
Sexual threats 10 (1.9) 2 (0.4)
Coercion 6 (1.1) 1 (0.2)
COR = Crude odds ratio
CI = Confidence interval

The child domestics reported most of the abuses. All forms of sexual abuse
(2.1%) were exclusively described by the child domestics (Table 6), and
perpetrated by either the employer or employer's relatives. This is rather low
compared to other studies (Finkelhor, 1994). Eliciting history of child sexual
abuse requires expertise (Jones, 1992). Beating (12.3% in child labourers and
5.5% in controls) was the most frequently reported instance of physical abuse
in this study. Being insulted (28.6% vs. 9.7%) was the commonest variety of
emotional abuse (Table 5). Boy child labourers were more likely to report
physical abuse, while the girls had higher rates of neglect, emotional and sexual
abuse.
32  5. Results  

Table 6. Distribution of child abuse among subtypes of child labour, Addis Ketema District, Addis
Ababa, Ethiopia.
  Domestic labourer  Street labourer  Private enterprise 
labourer 
  (n=180)  (n=300)  (n=48) 
Physical abuse 31 (39.7) 41 (52.6) 6 (7.7)
Emotional abuse 88 (44.2) 96 (48.2) 15 (7.5)
Neglect 54 (65.9) 22 (26.8) 6 (7.3)
Sexual abuse 11 (100) - -
*Figures represent incidents of abuse and those in bracket are percentages within total abused children.

5.2.2. Psychiatric disorders in child labour (Paper IV) 
The aggregate prevalence of childhood emotional and behavioural disorders
among the study population was 16.5%, with child labourers accounting for
20.1% and controls for 12.5% (Table 7) (Fekadu et al., 2006). This difference
was statistically significant. Psychotic symptoms, simple phobia, and gender
identity disorder were excluded from counting for the prevalence figure
because of doubtful validity on those items. Mood disorders and anxiety
disorders were over 6 and 2 times commoner among child labourers than
among the non-labourers, respectively. Rates of elimination disorder were high
while disruptive behavioural disorders were lower; there was no statistical
significant difference between cases and controls in both disorders.

Tabel 7. Emotional & behavioural disorders and psychosocial stressors in child labourers and non-
labourers, Addis Ketema District, Addis Ababa, Ethiopia.
Diagnosis  Labourers  Non‐labourers  OR  95% CI  P‐value 
  Cases %  Cases %       
Any DSM-III-R diagnosis 106 (20.1) 59 (12.5) 1.89 1.34, 2.67 0.0001
Disruptive behaviour disorder 7 (1.3) 3 (0.6) 2.34 0.55, 11.44 N.S
Mood disorders 26 (4.9) 4 (0.8) 6.65 2.20, 22.52 0.0001
Anxiety disorders 31 (5.9) 12 (2.5) 2.63 1.29, 5.46 0.003
Separation anxiety disorder 25 (4.7) 7 (1.5) 3.64 1.49, 9.27 0.001
Elimination disorders 49 (9.2) 44 (9.3) 1.12 0.72, 1.73 N.S
Substance abuse 5 (0.9) 0 - - -
Psychosocial stressors 267 (50.6) 191 (40.5) 1.54 1.24, 1.92 0.0000
Note on Table 7. DSM-III-R Diagnostic and Statistical Manual, third revised edition.
© Blackwell Publishing. J Child Psychology and Psychiatry 47:9(2006), 954-959

Separation Anxiety Disorder was found to be more than 3 times commoner

among the labourers than the non-labourers. The child labourers reported
presence of psychosocial stressors more often than the non-labourer group.
There were 5 cases of substance abuse and all of them were child labourers.
Although the confidence interval was wide, child labour status appears to be
the only statistically significant factor, adjusted OR=5.87, (95% CI=1.94,
17.77; p=0.002) that determined DSM-III-R diagnosis (Table 8). This was
 Child labour in Addis Ketema, Ethiopia  33 

after controlling for various socio-demographic factors among children, their

parents, including orphan status, history of internal migration, family mental
illness, or time of school attendance. Among the female cases the child
domestic labourers had the highest rate of psychiatric disorder (12.8%)
followed by street workers and those working in private enterprises. Similarly,
among the male cases, street workers had the highest rate (19.2%) followed by
those working in private enterprise.
Table  8. Socio-demographic correlates of any DSM-III-R diagnosis in children, Addis Ketema
District, Addis Ababa, Ethiopia.
Characters  Cases  Adjusted  95% CI  P‐value 
  n  %  OR     
Sex
Male 89 20.1 1.00
Female 76 13.6 0.74 0.32, 1.68 0.472
Age (years)
5-10 41 16.5 1.00
11-15 124 16.5 0.40 0.13, 1.22 0.108
Religon
Christian 128 16.6 1.00
Muslim 36 15.7 1.50 0.53, 4.19 0.442
Parent’s marital status
Married 90 14.8 1.00
Divorced 27 23.1 0.88 0.26, 3.01 0.841
Widowed 47 17.7 0.50 0.16, 1.53 0.226
Educational level
Mothers: Illiterate 58 15.5 1.00
Elementary 56 15.7 1.11 0.29, 4.14 0.882
Secondary 33 18.5 0.60 0.14, 2.36 0.456
Fathers: Illiterate 46 20.2 1.00
Elementary 52 15.9 1.43 0.42, 4.86 0.563
Secondary 41 14.2 1.30 0.41, 4.10 0.651
Parent’s work status
Yes 129 16.5 1.00
No 34 16.2 0.73 0.32, 1.68 0.466
School attandance
Day 127 17.9 1.00
Night 32 15.0 2.23 0.71, 6.99 0.170
Child labor status
No 59 12.5 1.00
Yes 106 20.1 5.87 1.94, 17.77 0.002

An age by sex comparison showed that the female cases had higher rates of
DSM-III-R diagnoses compared to controls (19.1% vs. 9.0%, chi-square 12.01,
p=.001); this was marked among the 11-15 year old subgroup (21.5% vs 8.1%,
chi-square 16.65, p=.000) (Table 9). In the younger age subgroup of 5-10 years
the rates of DSM-III-R diagnoses were higher for boys among the control
than the cases. Although this was not statistically significant, this could
possibly be due to the sampling bias in proportionately higher female child
domestics and male street labourers confounding the comparison. The age
34  5. Results  

pattern of a higher rate of nocturnal enuresis and behavioural problems in

younger boys could also account for the reversed findings in the control
group. The trend within the cases was that of higher rate in older age group
that is consistent with higher rates of enuresis found in this and similar studies
in developing countries.

Among the cases, boys had significantly higher rates of nocturnal enuresis
compared to girls (11.8% vs. 5.4%, chi-square 6.7, p=.01), substance abuse
(1.8% vs. 0%) and conduct disorder (1.8% vs. 0.4%, chi-square 2.49, p=.007).
The girl cases on the other hand were characterised by higher rates of most
internalising disorders, anxiety disorder (7.8% vs. 4.1%, chi-square 3.31,
p=.007), and separation anxiety disorder (6.2% vs. 3.3%, chi-square 2.47,
p=.005). Among the cases, boys had overall higher rate of DSM-III-R
diagnoses but this difference was not statistically significant (21% vs. 19.1%,
chi-square .32, p=.5).

Table 9. Age and sex distribution of DSM-III-R diagnoses in child labourers.

Sex  Age (years)  Cases=  Controls=  Chi‐square  p‐value 
528 (%)  472 (%) 
Male 5-10 14 (15.9) 13 (24.1) 1.45 0.27
11-15 43 (23.5) 19 (16.2) 2.30 0.15
Female 5-10 8 (12.1) 6 (14.6) 0.14 0.77
11-15 41 (21.5) 21 (8.1) 16.65 0.000

There was also no significant difference in the rates of Mood Disorders and
Psychosocial Stressors between boys and girl cases (5.4% vs. 4.4%, 50.2% vs.
51%). There is a conventional contemporary assumption that Elimination
Disorders are better classified as developmental disorders, therefore they
should not be included in computing psychiatric disorders in cross cultural and
population studies, or be seen in routine clinical practice unless complicated by
co-morbidities (Weisz et al, 1987; Clayden et al., 2003). The difference in rates
between boys and girl cases remarkably switched to 8.9% vs. 12.8% when
Elimination Disorders were not accounted for. A further breakdown of the
enuretic cases by age showed they were proportionately more in the older than
the under 10 year old group (9.1% vs. 7.8%, chi-square .231, p=.000). The
pattern seen in this study of a rise in prevalence with age after 10 years does
not fit into the developmental perspective of enuresis, which holds that
enuresis tends to improve with age. Extrapolating this comparison to the cases
and controls in the overall study, the rates of psychiatric disorder would
precipitously fall down to 10.8% vs. 3.2%. There is some semblance to a
recent study in Ethiopia which showed an aggregate prevalence of 17%
DSM-III-R disorders where enuresis accounted for 12.5% (Desta et al., 2007).
Another study that compared child labourers with controls in Ethiopia with a
similar two stage use of research instruments gave an aggregate prevalence of
5.5% DSM-III-R disorders where the prevalence of enuresis was 1% (Alem
 Child labour in Addis Ketema, Ethiopia  35 

et al., 2006). In this same study the prevalence of DSM-III-R disorder among
the cases was 4.9% while among the controls it was 8.8%; the authors thought
this unexpected finding was either a selection bias or healthy worker effect.

In our study there was no correlation between enuresis and the other
psychiatric disorders apart from overall DSM-III-R diagnoses (r=.616,
p=0.01). Higher rates of enuresis are well reported in previous similar
community studies in Ethiopia and elsewhere (Ashenafi et al., 2001;
Cederblad, 1968; Desta et al., 2007; Giel et al., 1981; Malhotra et al., 2002;
Tadesse et al, 1999). Although a number of environmental factors are
implicated (such as poverty, overcrowding, large family size, stressful life
events, delayed toilet training), high heritability, and low night time level, or
poor bladder response to the endogenous hormone vasopressin are well
recognised associations with nocturnal enuresis (Clayden et al., 2003). A case
control animal model study showed that starvation and reduced blood glucose
level cause increased urination (polyuria), mediated by poor urine
concentrating ability, due to slowed activity of the kidney’s collecting duct
water channels called aquaporins (AQPs) (Amlal et al., 2001). This study also
showed a remarkable reversal of this inability to concentrate urine in the
kidney ducts and normal return of AQP expression on re-feeding.

In developing countries whether enuresis could be an indirect clinical marker

of child psychopathology, or it is secondary to common concurrent, or past
urinary tract infections, or just merely associated with starvation needs further
study (Cederblad, 1968; Amlal et al., 2001; Desta et al, 2007).

Conduct disorder correlated with anxiety disorder and substance abuse

(r=.125 and .174, both at p=.01). Anxiety disorder correlated with mood
disorder (r=.092, p=.05), Separation anxiety disorder (r=.893, p=.01) and
conduct disorder (r=.125, p=.01). Encopresis correlated with mood disorder
(r=.216, p=.01). As noted above, enuresis did not correlate with any specific
psychiatric disorder, making the possibility of co-morbidity with other
disorders an unlikely explanation. This finding further supports the argument
made against the elimination disorders above, but more distinctly against
enuresis. Therefore enuresis could be alternatively considered as a separate
cluster of developmental disorder from the other internalising and
externalising disorders discussed above, but with a possible association in
clinical presentation.
36  5. Results  
 Child labour in Addis Ketema, Ethiopia  37 

6. GENERAL DISCUSSION (PAPERS I‐IV) 
The dissertation has described the patterns of child labour and detailed
experience of child labourers in the informal sector with special emphasis to
child domestic labour. It has also examined the risk factors contributing to
psychiatric disorders within the child labour group. A comparative account is
also made with non-economically active children.

Parental
unemployment
Resilience
Poverty & protective
factors

Vulnerability Poor
factors policy
Child labor

Poor
Cultural
maternal
influences
education

Poor mental
Child abuse
health

Fig. 8. Tentative correlates of child labour

In the Key Informant Study (Paper I) through investigation of the perception

and attitude of key informants, such as community leaders and teachers, to
child labour, it was shown that there is sufficient awareness about the different
types of child labour, vulnerability, exploitation and range of child abuse. It
was also possible to show the reasons that drive children to become labourers,
and perpetuate this longer. In this first phase of the study (Paper I), lack of
education, poverty, poor family planning, change in cultural values, such as the
rise in substance use, western video showrooms, and a change in the work
culture and need to supplement expenses such as tuition fees were identified
as main reasons to be child labourers. The key informants noted a consistent
view with regard to the felt need of intervention type.

In the detailed review of child labour and quantitative studies (Papers II, III &
IV) the dissertation demonstrated the prevalence of child abuse, different
types of child abuse, and their patterns, prevalence of psychiatric disorders and
38  6. General discussion  

the association and correlation of socio-demographic factors with child labour

in comparison with non-economically active controls.

Child labourers were found to be a high-risk group for different types of abuse
and psychiatric disorders. Although parental unemployment and low maternal
education were strongly associated with child labour status, the only factor that
was associated in determining psychiatric morbidity was child labour status.
Poverty is not the only reason for child labour. There are many driving
motives in being a child labourer, and various positive and negative
maintaining factors. Therefore not all children are ready to give up earning
their income altogether to be a full time student.

Resilience
& protective
factors

Vulnerability Poor
factors policy

Child labor

Poor
Child abuse maternal
education

Poor mental
health

Fig 9. Correlates of child labour

 Child labour in Addis Ketema, Ethiopia  39 

7. CLINICAL IMPLICATION (PAPERS I‐IV) 

This section focuses on the connotation of child labour, more specifically its
intolerable forms, on mental health. It also explores the various options to
child labour, and finally, recommends further action.

7.1. Impact of child labour 
This dissertation has demonstrated that most child labourers are severely
exploited, working for very long hours under poor working conditions and
remuneration. These children are vulnerable and are more likely to be abused.
They have proportionally more psychiatric disorders, especially internalising
disorders in girls such as anxiety and separation anxiety disorders who are
more vulnerable through the nature of their work as domestics with no relief
or means of escape. Internalising disorders are well known to predict the adult
outcomes of Anxiety and Depressive Disorders (Costello et al., 2003a; Pine et
al., 1998; Shear et al., 2006), and are less likely to resolve dramatically following
poverty alleviation alone (Costello et al, 2003b). The association of the cases
with internalising disorders is marked among the child domestic labourers,
which are one of the intolerable forms of child labour as defined by ILO
(IPEC, 2000). The findings and the pattern in this dissertation are consistent
with a review of health indicators pooled from 83 developing countries that
showed a significant correlation between child labour and measures of
morbidity and mortality (Roggerro et al., 2007). A similar study with a database
of 289,000 children in Indonesia between the ages of 10-15 years showed a
negative association of child labour and health (Wolff & Maliki, 2008).
Therefore this group of children are a very high-risk group that deserve special
attention in any rehabilitative or supportive interventions.

7.2. Options for child labour 
In this dissertation we were able to examine beyond the obvious role of
poverty as the underlying and maintaining factor. There was a direct
association between level of parental, especially maternal education, and child
labour (Nath & Hadi, 2000). This is central in the self-perpetuation of child
labour, as child labour tends to lead to child labour through a trans-
generational educational disadvantage. This has also been well described
previously as “education and the poverty trap” (Barham et al., 1995).
According to this analysis, the future parents, who have poor health and are
educated poorly themselves, are less likely to encourage or provide education
for their children.

Most of the child labourers wish to get a better job or education. This finding
about child labourer’s perception and attitude towards the future is similar to
that reported in a recent survey in Nigeria, where 76% had a positive attitude
40  7. Clinical implication  

towards work, in terms of apprenticeship, support to their family, and

improved income (Omokhodion et al., 2006). A number of previous studies
have reported similar findings (Asogwa, 1986; Jensen & Nielsen, 1997;
Maheshwari et al., 1986; Tabassum & Baig, 2002; Woodhead, 1999). The fact
that most of the opportunity these children could get is limited to unskilled
manual type of work, dictates how many hours they need to do in order to get
a reasonable pay. This in turn affects how much time they have for education.
A recent analysis of education and child labour data form 34 countries showed
a negative correlation between the two, with worst school performance, lower
enrolment and higher drop out rates, which could also be due to lack of
accessible and affordable education (Allais & Hagemann, 2008). A survey of
3115 Ethiopian children followed by a qualitative study of 30 people
highlighted the focus of challenges at child, household, and community level
that fit in with the above recommendations (Woldehanna et al., 2008).

It appears from this dissertation that most child labourers are unlikely to give
up working altogether and change to full time education. Although
compulsory education could play a major role in reducing the rate of child
labour, recognition of children’s views is essential. Therefore skills based or
vocational education may be suitable and attractive to some of them
(Woodhead, 2004). This could be possible through strengthening important
protective factors such as reinforcing their resilience (Luthar & Zelazo, 2003;
Rutter, 1987; Werner, 1996). Technically the enforcement of legislations and
policies on child labour could be achieved by increasing the minimum age and
improving age ascertainment and documentation wherever possible (ILO,
2007). Other more specific measures based on evidence in Uganda and
Zambia include rehabilitating child labourers with health risks, facilitation of
education and apprenticeship, social protection for the affected families and
increasing the community network system (ILO, 2008).

7.3. Recommendation 
Although this dissertation has helped us in a careful examination of child
labourers and identifying the factors that are associated with their mental
health, it is difficult to make generalisation to the rest of the Ethiopian
children or those living in other developing countries. We recommend a larger
sample size study in different parts of the country and replication of similar
methods in other countries. Ideally, we recommend a cohort study of child
labourers and controls using additional informants such as teachers and
parents in order to further examine the impact of working conditions,
education, and family on the course and outcome of psychiatric disorders.
On the basis of this dissertation, we recommend an intervention should take
all the layers of complexities into account. The government and policy makers
should consider firstly, flexibility in the national curriculum and tailoring of the
education provision to the needs of child labourers, such as focus on skill
based and streamlining into vocational training. Secondly, create a clear system
 Child labour in Addis Ketema, Ethiopia  41 

of enforcing the various legislations in working with schools, community

leaders, and NGOs, specifically on most vulnerable groups such as child
domestics and street labourers, whilst fostering their resilience and protective
factors. Thirdly, all development programmes by the government and NGOs
should incorporate and devise a system of supporting parents such as through
capacity building, credit schemes, and job advisory centres. Finally, the
government, policy makers, NGOs, and communities should implement a
reasonable and culturally appropriate forum to keep children’s interest and
raise their participation in any intervention plans.
42  7. Clinical implication  
 Child labour in Addis Ketema, Ethiopia  43 

8. SUMMARY 
In this section we first examine whether the dissertation has addressed the
hypotheses and to what extent followed by an outline the limitations. Finally,
we will look at the contributions of this dissertation to child psychiatric
epidemiology in general and the study of child labour in particular.

We were able to demonstrate that there is a significant difference in the

prevalence of child abuse and psychiatric disorders, specifically internalising
disorders, among child labourers than non-economically active controls. This
was more marked among the female group that were predominantly domestic
child labourers. Although there was significant association of psychiatric
disorder with parental unemployment and low maternal education, there was
no association with internal migration or being an orphan. The only factor that
was associated in determining psychiatric morbidity was child labour status.
We were able to confirm that the “nimble finger” that assumes children are
employed because they are more efficient and dextrous than adults is false.
This was clearer especially with those children working in the streets and in
private enterprises such as blacksmiths, which are more prone to any accidents
and injuries. We were also able to show that there was no difference in the
socio-demography pattern or physical health between the child labourers and
controls, which makes it unlikely to explain the differences in psychiatric
disorder rate between the two groups.

8.1. Limitations 
This dissertation was not impervious to most researches in child labour which
includes difficulties in the identification of study group and source of
information. Although every effort was made to include as many domestic
labourers through census and key informants, underreporting and lack of
access to these children was inevitable. This could be a source of selection
bias. On the other hand, there are technical problems in selecting street
children due to their mobile nature. Some types of child labour, such as
domestic labour are almost exclusively found in females (Banerjee et al., 2008).
Therefore we had to increase the size of our controls proportionately at the
expense of creating an apparent mismatch in the sex distribution among cases
and control groups. As it is obviously difficult to contact the parents, our
DICA data was obtained only from single information source. Previous
studies have concurred that the findings cluster around disorders that are
internalising, externalising or both, depending on whether the primary
informants are children, adults or a combination, respectively (Bird et al., 1992;
Brunshaw and Szatmari, 1988; Edelbrock et al., 1985; Edelbrock et al., 1986;
Herjanic et al., 1975; Herjanic & Campbell, 1977; Herjanic, 1984; Weissman et
al., 1987). Therefore any interpretation in this dissertation should take the
above limitations into account.
44  8. Summary  

8.2 Contributions 
This dissertation, in combining both a qualitative and quantitative methods in
the study of child labourers, has shown that they suffer a higher rate of child
abuse and psychiatric disorder than controls. A closer examination of the
various socio-demographic correlates has shown that education of parents and
children needs urgent attention, and that mere alleviation of poverty is unlikely
to improve their mental health. Through a detailed synthesis and examination
of the available literature, it has made a connection among various disciplines.
It has also highlighted that any intervention in dealing with child labour should
take children’s interest, such as provision of skill based and vocational training,
support to their parents, and a system of protection of these hidden and
vulnerable children.
 Child labour in Addis Ketema, Ethiopia  45 

9. ACKNOWLEDGEMENTS 
This dissertation would not have been completed without the help of many
people and institutions to whom I am so grateful. I want to express my special
gratitude to the study subjects, teachers, schools, and institutions that took
part in this study. Special thanks go to Million Tafesse, my diligent research
assistant whose passion for work has significant contribution to the
completion of this dissertation and beyond. Many thanks go to the dedicated
supervisors, Kinfe and Abebe, and all the enumerators.

I am highly indebted to my mentor and supervisor Dr Atalay Alem who

guided and supported me in psychiatry research. I would like to thank my
supervisor Professor Bruno Hägglöf. Professor Hägglöf’s astute and sharp
wisdom, boundless respect, patience, and willingness to share whenever I
managed to get hold of him were vital in my dissertation. This tender love and
care extended to his generous family, especially his wife Ann-Britt, who made
it her personal duty that I felt at home in Sweden. I am grateful to Professor
Lars Jacobsson and Professor Gunnar Kullgren who showed interest in my
work on child labour and facilitated my registration at Umeå University.
Professor Jacobsson’s readiness to help and availability for support with his
reflective thoughts was a privilege I enjoyed during my brief stays in Umeå, at
our meetings in London or on the world wide web. Professor Jacobsson took
a key role in finalising my dissertation.

I would like to send my deepest appreciation to Professor Eric Taylor.

Although he was not a named co-supervisor, he gave me his full support
throughout my PhD especially in the final write up of this dissertation. His
easily accessible encyclopaedic expertise, patience, frankness, benevolence,
humility, and modesty were the main substrates that I flourished upon during
my higher specialist training at the Institute of Psychiatry and the Maudsley. It
is a great privilege to be your pupil Eric.

I am also indebted to Professor Derege Kebede who gave me constant

support and extremely useful feedback from the outset of the research to the
completion of this dissertation.

My friends Dr Tekabe Ayalew, Alemu Asfaw and Dr Abebaw Fekadu Wasie

helped from the inception of the study through the dissertation in the
methodology and write up in addition to their moral support and sincere
conviction in me. Similar thanks go to Million Belay, Hailu Mekonnen and Dr
Eyob Kamil for their early inspiration.

I am thankful for the encouragement and inspiration from Professor Robert

Giel, Professor David Goldberg, Professor Rob Howard, Professor Robert
Goodman and Dr Fuller Torrey. Dr Torrey also helped in the initial literature
search and gave me invaluable comments on the dissertation.
46  9. Acknowledgements  

I am thankful to the International Labour Organisation and Umeå University

for supporting and funding this study as well as this PhD project. My special
thanks go to the staff at ILO, Geneva and Addis Ababa offices, especially to
Dr Assefa Bequele, Dr Benjamin Alli, Dr Valentina Forastieri, Kebebew
Ashagrie, Mr Berhan and Ms Isabelle Guillet.

All my colleagues at Amanuel Hospital, especially Dr Menelik Desta helped in

the setting up and smooth running of the research. I would like to send my
special thanks to Woizero Dejytnush Yigezu and the late Sister Tirgalem
Asnake for their support in the research that led to this dissertation.

Equally I am grateful to my fellow PhD students and all staff at the Institute
of Psychiatry, Umeå University especially, Krister (and Ingela) Fredin, Anna
Zashikhina, Spyridoula Lekkou, Menelik Desta, Karin Nilsson, Mats Karling,
Jeanette Sigurdh, Olof Semb, Mesfin Araya, Negussie Deyassa, Aijaz Farooqi,
and Kenneth Ögren, who always made sure there was time for everything. I
would like to extend my special thanks to Birgitta Bäcklund and Urban
Bäcklund for their generous hospitality. Birgitta took total care in dealing with
all necessary administrative matters during my stay in Umeå and other
conference venues. Birgitta tirelessly compiled the typset and format of the
final dissertataion book. Margaretha Lindh also helped in simplifying the
administrative issues. Thanks to Hans Stenlund for combining statistics with
Socratic questioning. Personal thanks go to Ellinor Salander Renberg, who
breathed life to the seminars and my short stays in Umeå.

Numerous people at the Institute of Psychiatry, King’s College London and

Maudsley Hospital were supportive and helpful, especially my friends Dr
Declan Lyons and Dr Rick Fraser, my inspiring clinical supervisors Dr Sarah
Bernard, Dr Patrick Byrne, Dr K.A.H. Mirza, and Dr Partha Banerjea. Sonya
Lipczynska from the Institute of Psychiatry helped us in the literature search.
Dr Lynn McDonald edited the dissertation and gave me invaluable comments.

Finally I would like to thank my late mother Woizero Tadelech Gebre-Sellasie,

my brother Berhane Fekadu, and very special friends Peter and Hailu
Ourgessa for their encouragement and continuous support.

My wife Dr Souci Mogga Frissa, my son Nebiy Daniel and daughter Kiya
Daniel were the lights that shone in every step of my way. Thanks for
providing me sustenance with your unconditional love, patience, and
understanding that were all essential to finish off this work.
 Child labour in Addis Ketema, Ethiopia  47 

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Weissman, M.M., Wickramaratne, P., Warner, V., John, K., Prussof, B.A., Merikangas, K.R.,
Gammon, G.D. (1987). Assessing psychiatric disorders in children. Discrepancies between
mother’s and children’s reports. Arch Gen Psychiatry, 44: 747-753.
Weisz, J.R., Suwanlert, S., Chaiyasit, W., Walter, B.R. (1987). Over- and under controlled
referral problems among children and adolescents from Thailand and the United States: The
wat and wai of cultural differences. J Consult Clin Psychol, 55: 719-726.
Werner, E.E. (1996). Vulnerable but invincible: High risk children from birth to adulthood.
Eur Child Adolesc Psychiatry, 5: Suppl 1, 47-51.
WHO. (1987). Children at work: special health risks, Technical Report Series 756. Geneva:
WHO.
Woldehanna, T., Jones, N., Tefera, B. (2008). The invisibility of children’s paid and unpaid
work: Implications for Ethiopia’s national poverty reduction policy. Childhood, 15: 177-200.
Wolff, F.C., Maliki. (2008). Evidence on the impact of child labor on child health in
Indonesia, 1993-2000. Econ Hum Biol, 6: 143-169.
Woodhead, M. (1999). Combating child labour: Listen to what the children say. Childhood,
6: 27-49.
Woodhead, M. (2004). Psychosocial impacts of child work: a framework for research,
monitoring, and intervention.
http://www.ucwproject.org/pdf/publications/psychosocial_impacts_cw.pdf
Zewde, B. (1991) A History of Modern Ethiopia, 1855-1974, pp 94, 121-2. Addis Ababa:
Addis Ababa and Ohio University Press.
Appendix
 Child labour in Addis Ketema, Ethiopia  53 

APPENDIX 1. 
Key Informant or Rapid Assessment Questionnaire 
Questionnaire prepared for a rapid assessment on targeted group of
respondents in Addis Ketema district

1. Id. Code of the questionnaire _________________________________

2. Age of the respondent ______________________________________

3. Sex _____________________________________________________

4. Level of education _________________________________________

5. Types of occupation ________________________________________

6. Address of the respondent ___________________________________

1. School 2. College/University
3. Religious organization 4. Government organization
5. NGO's 6. Service giving organization
7. Community leader 8. Members of the community
9. Other
7. Are children in this area, whose age ranges between 5-14, involved in child
labour activity?
1. Yes 2. No

8. What are the types of activities children are involved in?

9. Why do you think children are involved in these types of activities?

10. Are there any psychical or psychological abuses children encounter

because of their involvement in these activities?
1. Yes 2. No (If the answer in 2, go to question13)

11. Can you tell us the types of abuses you know that children face?

12. What types of activities expose children for abuses?

13. What do you know about children rights?

14. In your opinion what do you think are the prevention method to protect
children for joining child labour activity?
54  Appendix 1. Rapid Assessment Questionnaire 
 Child labour in Addis Ketema, Ethiopia  55 

APPENDIX 2. GENERAL CHILD LABOUR QUESTIONNAIRE 

General questionnaire about child domestic laborer's 
mental conditions 

Date Month Year Code interviewer

Code of interviewee
Respondent's name
Respondent's Address: Woreda Kebele House number
Supervisor's signature

Part I ‐ Demography 

1. Number of family members

2. Sex 1. Male 2. Female
3. Age (years)
4. Ethnic group
1. Amhara 2. Oromo 3. Tigre 4. Gurage
5. Hadia 6. Kembata 7. Wolayta 8. Other (specify)
5. Religion of the respondent
1. None 2. Orthodox 3. Protestant
4. Catholic 5. Other Christian 6. Muslim 7. Other (specify)
6. Birth place
7. Are you currently working?
1. Yes 2. No
8. Have you ever worked before?
1. Yes 2. No

If the answer is No for question 7 & 8, don't ask part 3

9. Who brought you up?

1. Parents 2. Relatives 3. Non-relatives
10. Were your families living in Addis Ababa, 6 years before?
1. Yes 2. No
If the answer is 1, go to question 12.
56  Appendix 2. General Child Labour Questionnaire 

11. If you have come to Addis from other places, what was your reason to leave
your pervious living place?
1. To look for a job demobilization 2. Family transfer
3. Due to the ex-soldier 4. To get better education
5. Due to famine 6. I followed my families
12. What were you doing before you came to this town?
1. Student
2. Was living with my families (was not student)
3. Trader
4. Sho-shining, street vendor, working in a garage or domestic worker
5. Other (specify)
13. Do your parents live together ?
1. Yes 2. No
14. If the answer is No for question 13 ask the reason for not living together
1. Divorce 2. Widowed 3. Separated 4. Other (specify)
15. Do your parents or guardians usually have verbal quarrel or physical fight?
1. Yes 2. No
16. Are your parents working?
1. Yes 2. No
17. Who is currently working from your parents?
1. Both 2. Only one of them
18. Do your parents or guardians have any known mental illness?
1. Yes 2. No
19. Do you have brothers or sisters below 15 years old?
1. Yes 2. No

Part II ‐ Education  
In this part I will ask you about yourself and your families educational
background
1. Have you ever enrolled in school or are you currently learning?
1. I am currently learning 2. I used to learn 3. I never went to school
If the answer is 3 ask question 2 and go to question 6
If the answer is 1 & 2 ask question 3
2. What is your reason for drop out or not to go to school?
(Multiple codes are possible)
1. To help families in the household activity
2. I can not cover my school expense
3. Due to health problem
4. Education does not help me to job
5. Other (specify)
 Child labour in Addis Ketema, Ethiopia  57 

3. What is your level of education?

1. Reading and Writing only 4. 4 6
2. Religious or cultural education 5. 7 9
3. 1 3 6. 10 12
4. How old were you when you joined school?
5. Have you ever repeated class?
1. Yes (why) 2. No
6. Do you have a problem in understanding your lesson?
1. Yes 2. No
If the answer is yes, state the reason
7. Which type of school you are learning?
1. Government school 2. Private (Public) school
If he/she is learning in private or public school, ask how much
he/she pays for the school fee.

8. In which shift are you attending school?

1. Day 2. Night
9. What is the level of education of your mothers' or guardian's?
1. Reading and writing only
2. Religious or cultural education
3. 1 3
4. 4 6
5. 7 9
6. 10 12
7. Above grad 12 (specify)
10. What is the level of education of your father's guardian's?
1. Reading and writing only
2. Religious or cultural education
3. 1 3
4. 4 6
5. 7 9
6. 10 12
7. Above grad 12 (specify)
58  Appendix 2. General Child Labour Questionnaire 

Part III ‐ Employment condition 
This part deals with the employment condition of the respondent
1. Why are you working? (Multiple codes are possible)
1. To improve my working condition
2. To pay my school fee
3. Because my parents do not have job
4. My parents are not able to work
5. My parents are not capable of helping me
6. Other (specify)
2. What is you main activity? (Multiple codes are possible)
1. Domestic servant (maid)
2. Errands
3. Shopkeeper
4. Garage apprentice
5. Assistant for the taxi driver
6. Restaurant or hotel
7. Other (specify)
3. What was you main activity if you had previous wok experience?
1. Domestic servant (Maid)
2. Errands
3. Shopkeeper
4. Garage apprentice
5. Assistant for the taxi driver
6. Restaurant or hotel
7. Other (specify)
4. If you had previous work experience, what was your reason to leave the job?
1. The job was tiresome
2. The nature of the job did not have break time
3. My employer used to insult me and beat me
4. My employer did not pay me
5. My employer did not give me food
6. My employer forced me for sexual intercourse
7. Other (specify)
5. How old were you when you started working for the first time?
6. On average how many hours do you work in a day?
1. From 1-4 2. From 5-8 3. From 9-12 4. More than 12hr
7. Have you ever worked above the mentioned hour on question 6?
1. Yes (specify the hour) 2. No
 Child labour in Addis Ketema, Ethiopia  59 

8. What do you benefit from your work?

1. I do not get any benefit. I work for free.
2. I am an apprentice
3. I am paid (cash, in kind)
If the answer is 1 or 2 go to question 12

9. When do you receive you salary?

1. Per day 2. Every week 3. Every fortnight 4. Per month
5. Other (specify)
10. How much do you get paid?
11. How do you spend your salary?
1. I give it to my parents or guardians
2. I use it for myself
3. I give part of it for my family (half, a quarter)
4. My employer pays me part of it and deposit the rest to buy me what I need
5. Other (specify)
12. How do you get your meal?
1. The employer provide me meal
2. I get meal from my families
3. I buy my meal not have money
4. I buy if have money and I share with my family if I do
5. I beg either food or money from people
6. Other (specify)
13. How many weeks do you usually stay in one type of activity once you
started it? Reason
14. What is the term of your work?
1. All day 2. Only for a specific hours in a day
3. Permanent employee 4. Temporary employee
5. Seasonal 6. Other
15. If the type of work is not permanent employee, ask the reason
16. Do you usually think about your job security?
(i.e about lay off salary deduction)
1. Yes 2. No
17. Do you have any family responsibility?
1. Yes 2. No
18. How many people do you support financially?
19. Do you usually find it difficult to save money?
1. Yes 2. No
20. Do you usually have financial problems to cover your schooling medical
and clothing expenses?
1. Yes 2. No
60  Appendix 2. General Child Labour Questionnaire 

Part IV ‐ Abuse 
 
Finally I am going to ask you about any kinds of physical or mental abuse you
have encountered.

1. Have you ever experienced any one of the following physical abuse?
1.1 Do you usually be beaten?
1. Yes 2. No
1.2 Have ever been driven out of your house/fumigate with pepper?
1. Yes 2. No
1.3 Has ever been any physical injury on your body?
1. Yes 2. No
2. Have you ever experienced any one of the following emotional abuse?
2.1 Have you ever been neglected of forgotten?
1. Yes 2. No
2.2 Are there any times when people blame you for their mistake?
1. Yes 2. No
2.3 Has ever been any physical injury on your body?
1. Yes 2. No
2.4 Have you ever been searched by people?
1. Yes 2. No
2.5 Have you ever been suspected by any one?
1. Yes 2. No
2.6 Have you ever been mistreated by any one?
1. Yes 2. No
2.7 Have you ever been insulted by any one?
1. Yes 2. No
3. Have you ever experienced any one of the following neglect?
3.1 Have you ever been denied food?
1. Yes 2. No
3.2 Are there time when you were not taken to hospital while you needed it?
1. Yes 2. No
4. Have you ever experienced any one of the following sexual abuse?
4.1 Reaped by your parents, guardians or employer?
1. Yes 2. No
4.2 Threatened by your parents or guardians or employer?
1. Yes 2. No
4.3 Forced by your parents or guardians or employer?
1. Yes 2. No
 Child labour in Addis Ketema, Ethiopia  61 

5. If the answer is 1 by whom?

5.1
5.2
5.3
6. Do you rate your relationship with your employer?
1. Yes 2. No (why)
7. How do you rate your relationship with your employer?
1. Very good
2. Good
3. Bad (why)
8. What do you think for the future regarding your job?
62  Appendix 2. General Child Labour Questionnaire 
 Child labour in Addis Ketema, Ethiopia  63 

APPENDIX 3. QUESTIONNAIRES & MANUAL IN AMHARIC 

eKT>c\ Ií“„‹ G<’@ SÑUÑT>Á SÖÃp

1. ¾SÖÃl ¢É lØ`
2. ÉT@
3. ï
4. ¾ƒUI`ƒ Å[Í
5. e^
6. ¾}ÖÁm¨< ›É^h (}sU)
1. ƒUI`ƒ u?ƒ 2. ¢K?Ï 3. ¾GÃT•ƒ É`σ
4. ¾S”Óeƒ É`σ 5. ¾Ów[c“à }sU
6. ÓMÒKAƒ cÜ 7. ¾TIu[cw S]
8. ¾TIu[ew ›vM 9. K?L (¾Öke)-----------
7. u²=I ›Ÿvu= ÉT@Á†¨< Ÿ5-14 ¾T>Å`c< Ií“„‹ }kØ[¨< ¨ÃU ÅÓV
¾^d†¨<” e^ Ãe^K<;
1. ›− 2. ¾KU
8. Ií“„‹ uU” ›Ã’ƒ e^ Là ’¨< ¾T>cT\ƒ ;

9. Ií“„{ ¨Å²=I ›Ã’ƒ e^ uT>cT\ƒ KU” ÃScKAM;

10. Ií“„‹ ¨Å²=I ›Ã’ƒ e^ uScT^†¨< ¾T>Å`cv†¨< ¾›"M

¨ÃU ¾›Ua uÅK ›K ;
1. ›− 2. ¾KU SMc< 2 ŸJ’ ¨Å ØÁo 13 H>É
11. ŸT>Å`cv†¨< uÅM ¾T>Á¨<lƒ” (¾T>ÑU~ƒ” ) ¾uÅM ›Ã’„‹ u=’Ó\”

12. uÅM ¾T>Å`cv†¨< Ií“„‹ u}Kà uU” ›Ã’ƒ e^ Là ¾}cT\ƒ “†¨<;

13. `f KMЋ SÅ[Ó eLKuƒ M¿ ”¡w"u? ¾T>plƒ ’Ñ` ›K;

14. u`f ›SK"Ÿƒ Ií“„‹ ÉT@Á†¨< dÃÅ`e ¨Åe^ ›KU ›”ÇÃÑu< U”

SÅ[Ó ›Kuƒ ÃLK<;
64  Appendix 3. Questionnaire & manual in Amharic 

SeŸ[U 5 1997
¾SÖÃp ›VLM SÓKÝ

›ÖkLÃ SÓKÝ
1. ŸMЋ Ò` nK UMMe ŸSËS\ uòƒ ¾}KÁ¿ ²È−‹” uSÖkU
TÓvvƒ“ SÅóð` ›cðLÑ> ’¨<:: (KUdK? ¾T>Ö¾lƒ eKƒUI`†¨<!
eKe^ ! eKu?}cv†¨< SJ’<” SMf‰†¨<” T”U ”ÅTÁ¾¨<“
¾SdeK<ƒ” uS”Ñ` TÅóð`)
2. KÖÁm¨< ›eðLÑ> ¾J’< SÓKÝ−‹ Ÿ”Ç”Æ ØÁo ›ÖÑw up”õ ¨<eØ
}kUÖªM:: ’–>I“ SS]Á−‹ KSŸ}M um Ø”no ›É`Ó::
3. nKUMMc<” e"H>É uÁ”Ç”Æ SÖÃp ¨<eØ ¾cð\ƒ” ØÁo−‹
›Ñvw KSk¾` ›ƒV¡`:: (KUdK? ! ƒUI`ƒ }U[I ¨<nKI;
¾T>K¨<” ØÁo ƒUI`ƒ ›ƒT`U ›ÃÅM; wKI ›ƒÖÃp ) ØÁo−‹”
KTw^^ƒ V¡` ”Í= ¾SMe õ”ß ›ƒeØ::
4. SÖÃl ŸS"H@Æ uòƒ uÖÃl” uÅ”w ›É`Ô SLMf TØ“ƒ
ÁeðMÒM::
5. K›w³—−‡ ØÁq−‹ ›T^ß SMf‹ }²`´[ªM:: ŸØÁo¨< òƒ Kòƒ
¨ÃU Ó`Ñ@ ¾}K¾ SS]Á "M}cÖ ue}k` SMf‡” K}ÖÁm¨<
›ekÉSI ›ƒ”Ñ`:: ØÁo−‡” eƒÖÃp SLj‡ ’í“ ÓMî J’¨<
”Ç=SMc<MI ›É`ÑI Ö¾p::
6. u›T^ß ¾k[u<ƒ” SMf‹ uØ”no ›”wuI Ÿ}ÖÁm¨< SMe Ò`
¾T>××S¨<” uSU[Ø ›”ÅG<’@¨< ¾SMc<” ƒ¡¡K— lØ` ›¡wu¨<::
}cÖ¨< SMe u›T^ß Ÿk[u<ƒ ¨<ß ŸJ’ ¨Ã”U SJ” ›KSJ’<”
Ÿ}Ö^Ö`¡ #K?L$ ¾T>K¨<” uSU[Ø uòƒ Kòƒ vK¨< vÊ x
¾}cÖI” SMe íõ::
7. SMf‡” Síõ "KwI uK?L c¨< K=’uu< ”Ç=‹K< uØ”no íó†¨<::
8. }ÖÁm¬ G<Kƒ SMf‹ uŸ<M ›Ã” ¾T>SKŸƒ ŸJ’ ”ÅU”U ›”Æ”
”Ç=KÃMI ›É`Ó::
9. J’ }wK¨< ŸT>²KK< ØÁl−‹ ue}k` G<K<U ØÁo−‹ SSKe
›Kv†¨<:: SS]Á¨< ŸT>Á²¨< ¨<ß ØÁo−‹” vÊ ›ƒ}¨<:: }ÖÁm¨<
SSKe u=Áp}¨< ”"D” SSKe ›M‰KU wKI íõuƒ::
 Child labour in Addis Ketema, Ethiopia  65 

10. nK UMMc<” Ú`eI }ÖÁm¨<” ŸTe“uƒI uòƒ SÖ¾p ÁKv†¨<

ØÁo−‹ uS<K< SSKd†¨<” ›[ÒÓØ::
11. ŸSËS]Á eŸSÚ[h ¾›=ƒ¿åÁ¨<Á”” ¾²S” ›q×Ö` }ÖkU::
12. ›ÖnLà ¢Ê‹
™ ›L¨<pU (I don't Know )...............99
™ ØÁl¨<” SSKe ›MðMÓU ( Not willing to answer )...............88

¡õM ›”É e’TIu^©

ØÁo ›”É ¾u?}cw ›vKƒ” w³ƒ ¾T>ÖÃp ’¨<

ØÁo G<Kƒ ¾}ÖÁm¨<” ï ÃSKŸM K¨”É 1 Kc?ƒ 2 ÃVLM
ØÁo Zeƒ ÃI ØÁo ¾}ÖÁm¨<” ÉT@ uSÖ¾p ¾VLM:: ”Ç”È
MЋ ÉT@Á†¨<” uƒ¡¡M LÁ¨<lƒ ËLK<:: ÃI ‹Ó`
uT>•`uƒ Ó²? K=¨c< ¾T>‡K< ›Ò×T> G<’@−‹”
uSØke ƒ¡¡K—¨<” ÉT@ KTÓ–ƒ SVŸ` ›Kuƒ::
KUdK? ›=I›ÈÓ ›Ç=e ›uv c=Ñv ! u77 É`p Ó²? ! ue”ƒ
›SƒI ƒUI`ƒ ËS`¡ ¨²}...
ØÁo ›^ƒ ÃI ØÁo ¾}ÖÁm¨< ²` SKŸM:: Ií’< Ÿ›”É uLà ²`
ŸK¨< ¾›v~” ²` ”¨dÇK”:: KUdK? MÌ u›v~ ƒÓ_ J•
u“~ *aV u=J” ¾MÌ ²` ƒÓ_ ”ÅJ’ „Ø[” ƒÓ_
¾T>K¨<” ¢É ”VLK”
ØÁo ›Ueƒ ¾MÌ” (u?}cu<”) GÃT•ƒ ÖÃk” ”VLK”
ØÁo eÉeƒ ¾MÌ” ¾ƒ¨<MÉ x” ÖÃk” ”VLK”
ØÁo cvƒ MÌ u›G<’< ¨pƒ e^ ¾c^ ’ÅJ’“ ”ÇMJ’“ ¾T>ÖÃp
’¨<::
ÃI ØÃo vKð¨< ›”É ¨` ¨<eØ ÁK¨<” Ó²? TK‹”
’¨<::
ØÁo eU”ƒ MÌ Ÿ²=I uòƒ e^ }kØa ¨ÃU u^c< c`„ Á¨<p
”ÅJ’ ÃÖÃnM:: Ÿ²=I uòƒ e”M Ÿ›”É ¨` uòƒ
TK‹” ’¨<:: KØÁo 7 “ 8 SMc< 2 ŸJ’ eKe^
¾T>ÖÃk¨<” ¡õM 3 ” ›ƒÖÃp::
66  Appendix 3. Questionnaire & manual in Amharic 

ØÁo ²Ö˜ MÌ ÉÑ~ Ÿ¨LЇ Ò` ! Ÿ²SÉ ¨ÃU ŸvÇ Ò` ”ÅJ’

¾T>ÖÃp::
ØÁo ›e` ÃI ØÁo eKMÌ u?}cw ¾eŃ ( Migration ) ]¡
¾T>ÖÃp ’¨<:: u?}cx‡ Ÿ 6 ›Sƒ uòƒ Õ\ ¾’u[¨<
²=G< ›Ç=c ›uv ”ÅJ’ ÖÃp:: SMc< ›”É ŸJ’ 11 “
12 ” ›ƒÖÃp
ØÁo ›e^ G”É KØÁo ›e` SMc< 2 KJ’’ u?}cx‡ ¨Å²=I Ÿ}T
¾}cÅÆuƒ” U¡”Áƒ ƒÖÃnKI::
ØÁo ›e^ G<Kƒ MÌ Ÿu?}cx‡ Ò` ¨Å²=I Ÿ}T ŸScÅÆ uòƒ U” ÁÅ`Ó
”Å’u` ÖÃp::
ØÁo ›e^ feƒ ÃI ØÁo eK u?}cx‡ ¾Òw‰ G<’@ ¾T>ÖÃp ’¨<:: ¾MÌ
“ƒ “ ›vƒ ›”É Là S•^†¨<”“ ›KS•^†¨<” ÖÃp
ØÁo ›e^ ›^ƒ KØÁo 13 SMc< 2 ŸJ’ ( ›”É Là ›Ã•\U ŸJ’ ) ›”É
Là ¾TÕ\uƒ U¡”Áƒ ”ÅJ’ ÖÃp
ØÁo ›e^ ›Ueƒ ÃI ØÁo ¨LЇ ¨ÃU ›dÇÑ>−‹” ›w³—¨<” Ó²? uƒ”g<U
uƒMlU ’Ñ` ÃÚnÚl ”ÅJ’ ¾T>ÖÃp ’¨<::
ØÁo ›e^ eÉeƒ ¨LЇ e^ ”ÇL†¨<“ ›”ÅK?L†¨< ¾T>ÖÃp ’¨<
ØÁo ›e^ cvƒ ŸG<K~ ¨LЋ ›”Å—¨< w‰ ŸJ’ e^ ¾T>c\ƒ ¾ƒ—¨<
”ÅJ’ ¾T>ÖÃp ’¨<
ØÁo ›e^ eU”ƒ ¨LЇ ¾›Ua ISU ”ÇKv†¨< ¾T>ÖÃp ’¨<::
ØÁo ›e^ ²Ö˜ ÉT@Á†¨< 15 ÁMVL ¨”ÉV‹“ I„‹ ›K<ƒ

¡õM G<Kƒ ƒUI`ƒ

ÃI ¡õM eK MÌ “ u?}cx‡ ¾ƒUG`ƒ ¡ƒƒM G<’@ ¾T>ÖÃp ’¨<::

ØÁo ›”É MÌ ƒUI`ƒ }Ua Áp ”ÅJ’ “ ”ÇMJ’ ÖÃk¨<::
SMc< ¢É 3 ŸJ’ ØÁo G<Kƒ” ÖÃp “ ¨Å ØÁo 6
Kõ:: SMc< ¢É 1 “ ¢É 2 ŸJ’ ¨Å ØÁo 3 Kõ::
ØÁo G<Kƒ MÌ ƒUI`ƒ }Ua ¾TÁ¨<p ŸJ’ ÁM}T[uƒ” U¡”Áƒ
ÃÖ¾p::
ØÁo feƒ SÚ[h ÁÖ“kk¨<“ ¡õM Å[Í ÖÃp::
ØÁo ›^ƒ ƒUI`ƒ u?ƒ c=Ñv ÉT@¨< e”ƒ ”Å’u[ Ö¾p::
ØÁo ›Ueƒ MÌ uƒUI`~ ¨Éq Á¨<p ”ÅJ’ ÖÃp::
 Child labour in Addis Ketema, Ethiopia  67 

ØÁo eÉeƒ MÌ ƒUI`ƒ ›MÑv ÃK¨< ”ÅJ’ ÖÃp:: SMc< ›− ŸJ’

U¡”Á~” ÖÃp ::
ØÁo cvƒ MÌ ¾T>TS[¨< U” ›Ã’ƒ ƒUI`ƒ u?ƒ ¨<eØ ”ÅJ’
ÖÃp:: ¾T>T[¨< ¾S”Óeƒ ƒUI`ƒ u?ƒ ¨ÃU ¾ÓM
¨ÃU ÅÓV ¾I´w ƒUI`ƒ u?ƒ ”ÅJ’ KT¨p ’¨<::
ØÁo cU”ƒ MÌ ¾T>T`uƒ” ¾ƒUI`ƒ ð[n ¨ÃU u¾ƒ—¨< iõƒ
”ÅJ’ ÖÃp::
ØÁo ²Ö˜ eK¨LЋ ¾ƒUI`ƒ Å[Í ÖÃp:: “~ (›dÇÑ>¨<) eŸ
e”}— ¡õM É[e }U[ªM::
ØÁo ›e` ›v~ (›dÇÑ>¨<) eŸ e”}— ¡õ É[e }U[ªM::
¡õM feƒ e^
ØÁo ›”É MÌ e^ Ãc^ ”ÅJ’ ¾T>c^uƒ” U¡”Áƒ ÖÃp:: MЋ
u}KÁ¾ U¡”Áƒ ¨Å e^ ›KU ¨<eØ eKT>Ñu< ¨Å e^
¾T>ÁcÑ’u<›†¨<” U¡”Á„‹ KT¨p ’¨< ØÁo ›”É
¾T>Ö¾k¨<::
ØÁo G<Kƒ MÌ u›G<’< ¨pƒ U” ”ÅT>c^ ¾T>ÖÃp ’¨<:: uJ‚M
u?ƒ ¨<eØ ¾T>K¨< U`ß Ÿƒ“”i hà u?„‹ ËUa
cŸƒLMp J‚KA‹ KTKƒ ’¨<:: KUdK? uƒMMp J‚KA‹
¨<eØ Ií“„‹ uSLLŸ ! ›MÒ uT”Öõ “ ›ªm−‹”
uS`ǃ Ãc^K<:: uƒ“”i hà u?„‹ ¨<eØU hà uTõLƒ
! UÓw uSe^ƒ uSdeK<ƒ ¾e^ ²`ö‹ ¨<eØ Ãd}óK<::
ØÁo feƒ ÃI ØÁo Ÿ›G<” uòƒ e^ c`„ ¾T>Áp ŸJ’ U” ›Ã’ƒ
e^ Ãc^ ”Å’u[ ÃÖÃnM:: MÌ u›G<’< Ó²? e^
¾TÃc^U u=J” ÃÖ¾nM::
ØÁo ›^ƒ Ÿ²=I uòƒ e^ e`„ ¾T>Á¨<p ŸJ’ ¾uòƒ e^¨<”
¾Kkkuƒ” U¡”Á ÖÃp::
ØÁo ›Ueƒ KSËS] Ó²? e^ }kØa Se^ƒ c=ËU` ÉT@¨< e”ƒ
”Å’u[ ¾T>ÖÃp ’¨<::
ØÁo eÉeƒ uk” e”ƒ c›ƒ ”ÅT>e^ ¾T>ÖÃp ’¨<::
ØÁo cvƒ ØÁo 6 Là ŸÑKì¨< c›ƒ uLà c`„ Áp ”ÅJ’ ¾T>ÖÃp
’¨<::
ØÁo eU”ƒ ŸT>c^¨< e^ eKT>ÁÑ–¨< ØpU ÖÃp:: SMc< u’í
TÑMÑM ¨ÃU KMUUÉ ŸJ’ ¨Å ØÁo 12 H>É::
68  Appendix 3. Questionnaire & manual in Amharic 

ØÁo ²Ö˜ u¡õÁ ŸJ’ ¾T>c^¨< u¾e”ƒ Ó²? ”ÅT>ŸðK¨< ÖÃp::

ØÁo ›e` ¡õÁ¨< e”ƒ ”ÅJ’ ÖÃp
ØÁo ›e^ ›”É ÃI ØÁo MÌ ¾T>ŸðK¨<” Ñ”²w KU” ”ÅT>Á¨<K¨<
¾T>ÖÃp ’¨<:: MЋ ¾T>Ñ–<ƒ” Ñu= Ku?}cx‰†¨< K=cÖ<
ËLK<! K^d†¨< w‰ K=ÖkS<uƒ ËLK< ¨ÃU ÅÓV
Ku?}cx‰†¨< K=ÁŸõK< ËLK<:: eK²=I ”ȃ
”ÅT>ÁÖó¨< ÖÃp::
ØÁo ›e^ G<Kƒ MÌ UÓu<” ¾ƒ ”ÅT>SÑw ÖÃp:: ¾²=I ØÁo ›LT
›”Ç”É Ó²? MЋ UÓv†¬” ›c]−‰†¨<
”ÅT>Ák`u<L†¨< ¨Ãe uT>ÁÑ–<ƒ Ñ”²w ”ÅT>SÑw
KT¨p ’¨<::
ØÁo ›e^ feƒ MÌ ›”È ¾ËS[¬ e^ Là e”ƒ Ó²? ’ÅT>qà ÖÃp::
¾²=I ØÁo ›LU MЋ ¾e^ ªe“ ”ÇK›¨<“ ”ÅK?L†¨<
KT¨p ¾T>[Ç ’¨<::
ØÁo ›e^ ›^ƒ eKe^ pØ` G<’@ ÖÃp:: ¾pØ` G<’@ e”M e^¨< S<K<
k” ’¨< ! ÓTi k” ’¨<! uk” ¬eØ K}¨c’ c›ƒ w‰
’¬ ¨Ãe ¨p© ’¬ (¨p© c”M KUdK? ¡[Uƒ LÃ
¨ÃU ƒUI`ƒ u?ƒ c=²Ò ¾SdcK¨<” TK‹” ’¬)
¾T>K¨<” KT¨p ’¬::
ØÁo ›e^ ›Ueƒ ¾e^¬ ›Ã’ƒ ¾Ó²=Á© pØ` ¨ÃU uk” ¬eØ K}¨c’
c›ƒ w‰ ¾c\ SH@É ŸJ’ KU” S<K< k” K=c^ ”ÇM‰K
U¡”Áƒ ÖÃp::
ØÁo ›e^ eÉeƒ MÌ eKe^ IM¬“ Áew ’ÅJ’“ ”ÇMJ’ ÃÖÃnK:: ¾e^
IM¬“ e”M eKÅV´ q[× ! ÅV´ u¨p~ ›ŸóðM “
Ÿc^ Sv[`” ¾SdcK<ƒ” ÃSKŸM::
ØÁo ›e^ cvƒ MÌ ¾u?}cw GLò’ƒ ”ÇKuƒ ÃÖÃnM:: ¾u?}cw GLò’ƒ
c”M MÌ ¾c^ uT>Ñ–¬ ¾Ñ”²w Ñu= ¾T>[dž¨< ¾u?}cw
›vKƒ ’ÇK< ”ÖÃnM”::
ØÁo ›e^ eU”ƒ MÌ ¾u?}cw GLò’ƒ "Kuƒ e”ƒ c¬ ”ÅT>Áe}ÇÉ`
ÖÃp::
ØÁo ›e^ ²Ö˜ MÌ ŸT>ÁÑ–¨< Ñ”²w KTÖ^kU ¾VŸ[ ›MÖ^kU
ÁK¨< ÆÑ` ”J’ ¾T>ÖÃp ’¬::
 Child labour in Addis Ketema, Ethiopia  69 

ØÁo GÁ MÌ ¾T>Ñ–¬” Ñ”²w KMwe KƒUI`ƒ u?ƒ KI¡U“ “

KSdcK<ƒ ›Mun ÁK¨< ÆÑ` ”ÅJ’ ÖÃp::

¡õM ›^ƒ uÅM

ÃI ¡õM ŸLà ›`e~ ”ÅT>ÑMì¨< eK}KÁ¿ ¾uÅM ›Ã’„‹ ¾T>ÑMî ’¬::
¾uÅM ›Ã’„‹ e”M ¾›ŸM uÅM ! ¾S”ðe uÅM ! “ ¾¨c=w uÅM TK‹”
’¬:: ’²=I ¾uÅM ›Ã’„‹ MÌ Là ¾T>ÁdÉ\ƒ” } KT¨p ¾}²ÒË
SÖÃp ’¬::

ØÁo ›”É MÌ uU`ݨ< ¬eØ Ÿ}²[²\ƒ ¾›"M uÅKA‹ ¨ÃU K?L

›Ã’ƒ uÅKA‹ Å`c¬uƒ ¾T>Á¨<p ŸJ’ U” ›Ã’ƒ uÅM
Å`fuƒ Áp ”ÅJ’ ÖÃp:: ¾Å[cuƒ ¾uÅM ›Ã’ƒ ›”É
Ó²?U w‰ u=J” um eKJ’ ÃÖ¾p::
ØÁo G<Kƒ uU`ݨ< ¨<eØ Ÿ}²[²\ƒ ¾›ŸM uÅKA‹ ›Ã’ƒ ¨ÃU
K?L ›Ã’ƒ uÅM Å`fuƒ ¾T>Áp ”ÅJ’ ÖÃp:: ¾S”ðe
uÅM TKƒ MÌ K=Ñv¨< ŸM‰K U`ݨ< ¬eØ ÁK<ƒ”
¾Öke¡ ›w^^Kƒ::
ØÁo feƒ uU`Ý ¬eØ Ÿ}²[²\ƒ ¨ÃU K?KA‹ ›Ã’„‹ ¾S²”Òƒ
uÅM Å`fuƒ Áp ”ÅJ’ ÖÃp::
ØÁo ›^ƒ MÌ ¨ÃU MÏ… u›c]Á†¬ ¨ÃU u›c]−‰†¬ MЋ
(²SÊ‹) ¾¨c=w uÅM Å`fv†¬ Á¬p ”ÅJ’ ÖÃp::
¾¨c=w uÅM e”M ›cÑÉÊ SÉð` “ ›cð^`„ SÅð`
TK‹” ’¬::
ØÁo ›Ueƒ ›eÑÉÊ ¨ÃU ›eð^`„ SÅð` Å`fuƒ(vƒ) ¾T>¬p
ŸJ’ uT” ’ÅJ’ ÃÖke::
ØÁo eÉeƒ u›G<’< c›ƒ ¾c^ ÁK¬” ¾e^ ›Ã’ƒ èŬ ’ÅJ’
ÖÃp::
ØÁo cvƒ u›G<’< c›ƒ Ÿ›c]¬ Ò` ÁK¬” Ó’<–’ƒ ÖÃkI S<L::
ØÁo eU”ƒ e^¬” ›eSM¡„ eK¨Åò~ ÁK¨<” ›c}dcw ¾T>ÖÃp
’¬::
70  Appendix 3. Questionnaire & manual in Amharic 

SeŸ[U 15 1997

ÉT@Á† K5-15 ÁK< I퓃” ¾Y^ G<’@ ÖpLL SÖÃp

1. ¾}ÖÁm¨< S<K< eU
2. ¾}ÖÁm¬ SKÁ lØ`
3. ݃^h
3.1 ¾Y^ Ÿ}T ¨[Ç kuK? ¾u?ƒ lØ`
3.2 ¾S•]Á Ÿ}T ¨[Ç kuK? ¾u?ƒ lØ`
4. ¾ÖÁm¬ S<K< eU
5. ¾ÖÁm¬ SKÁ lØ`
6. SÖÃl ¾}VLuƒ k” ¨` ›S} UI`ƒ
7. ¾}q××]¬ ò`T
¡õM ›”É c’SIu^©
SÓu=Á: eKY^I“ eKu?}cuI ¾’<a G<’@ ”Ç”É ØÁq−‹” MÖÃpI
1. ¾u?}cw w³ƒ
2. ï 1. ¨”É 2. c?ƒ
3. ÉT@
4. w’@` 1. ›T^ 5. GÇ=Á
2. *aV 6. ŸUv
3. ƒÓ_ 7. ¨LÁ
4. Ñ<^Ñ@ 8. K?K (ÃÖke)
5. GÃT•ƒ 1. ¾KU 4. "„K=¡
2. *`„Ê¡e 5. K?L ¡`e+Á”
3. ýa‚e”ƒ 6. eLU
7. K?L (ÃÖkc)
6. ¾ƒ¬MÉ x
7. u›G<’< Ó²? e^ ƒc^KG(ÁKi)
1. ¾c^G< ’¬ 2. ›Mc^U

8. Ÿ²=I uòƒ e^ c`}I ¨<nKI;

1. ›− 2. ¾KU
Kcv}—¬U KeU”}—¬U ØÁo SMc< 2 ŸJ’ ¡õM 3 ” ›ƒÖÃp
 Child labour in Addis Ketema, Ethiopia  71 

9. ÉуI ŸT” Ò` ’¬ ;
1. Ÿ¨LЋ 2. Ÿ²SÉ 3. ŸvÇ 4. ŸK?L (ÃÖkc )
10. Á”}(ˆ) u?}cw Ÿ 6 ›Sƒ uòƒ ¾T>•\ƒ ²=G< ›Ç=e ’u`;
1. ›− 2. ¾KU
SMc< 1 ŸJ’ ¨Å ØÁo 12 H>É
11. ¾SÖ<ƒ ŸK?L x ŸJ’ U¡”Á~ U”É” ’u`;
1. Y^ óKÒ 5. uÉ`p U¡”Áƒ
2. uu?}cw Y^ ´¬¬` 6. K?L (ÃÖke)
3. ¾Å`Ó Ù` uSu}’<
4. uƒUI`ƒ U¡”Áƒ
12. ¨Å²=I Ÿ}T ŸSUׁ†G< uòƒ U” Å`Ó ’u`;
1. }T]
2. uu?}cxŠ (Ÿ²SÊŠ) Ò` ’u` ¾U•[¬ (›MT`U)
3. ’ÒÈ
4. K=eƒa ! Ò²?× ›³D] ! Ò^Ï c^}— ! c¨< u?ƒ c^}—
5. K?L (¾Öke)
13. “ƒ“ ›vƒI(g) ¾T>•\ƒ ›”É Là ’¨<;
1. ›− 2. ¾KU
14. KØÁo 13 SMc< 2 ŸJ’ U¡”Áƒ U”É’¬;
1. }ó}¨ ’¨<
2. uVƒ }KÁÃ}¬ ’¬
3. dÃó~ }KÁÃ}¨ ’¬
4. K?K (¾Ökc )
15. ›vƒ“ “ƒI ¨ÃU ›dÇÑ>−‹I ›w³—¨<” Ó²? Ã×LK< ¨ÃU
ÃÚnÚnK<;
1. ›− 2. ¾KU
16. ¨LЋI Y^ ›L†¬ ;
1. ›− 2. ¾KU
17. Ÿ¨LЋI e^ ¾T>c^¨< T” ’¬ ;
1. G<K~U 2. ›”dž¬ w‰
18. Ÿ¨LЋI ¨ÃU ŸdÇÑ>−‹I ¾¨k ¾›Ua ISU ÁKuƒ ›K;
1. ›− 2. ¾KU
19. ›e^ ›Ueƒ ›Sƒ ÁMVL†¬ I„‹I“ ¨”ÉV‹ ›K<I;
72  Appendix 3. Questionnaire & manual in Amharic 

1. ›−” (w³†¨< ÃÖke ) 2. ¾KU

¡õM G<Kƒ ƒUI`ƒ

SÓu=Á: ›G<” ÅÓV eL”}“ eKu?}cx‹I ¾ƒUI`ƒ G<’@ MÖÃpI
1. ƒUI`ƒ }U[I ¬nKI (¾}T`¡ ’¨<);
1. ¾}T`Ÿ< ’¬
2. T` ’u` ›s`Û›KG<
3. ›M}T`Ÿ<U
SMc< 3 ŸJ’ ØÁo 2 ” ÖÃp“ ¨Å ØÁo 6 H>É
SMc< 1 “ 2 ŸJ’ ØÁo 3 ” ÖÃp
2. ƒUI`ƒ ÁM}T[uƒ (Ás[Öuƒ) U¡”Áƒ U”É’¬; (›”É uLà SMe
K=•[¨< ËLM)
1. u?}cu?” ¾u?ƒ Y^ KS`ǃ
2. ¾ƒUI`ƒ u?ƒ ¨Ü” KSgð” eKTM‹M
3. uÖ?“ ‹Ó` U¡”Áƒ (ÃÖkc)
4. ST` Y^ KSÓ–ƒ eKTÃ[Ç
5. K?L (ÃÖke)
3. cŸe”}— ¡õM É[e }U[HM;
1. T”uw“ Síõ w‰
2. (¾u?}¡`c=+Á” ! l^” ) ! vIL©
3. Ÿ1-3
4. Ÿ 4-6
5. Ÿ 7-9
6. 10-12
4. ƒUI`ƒ u?ƒ ue”ƒ ›SƒI ÑvI;
5. ¨ÉkI ¨<nKI; 1. ›− (KU” ) 2. ¾KU
6. ƒUI`ƒ ›MÑv ÃMGM;
1. ›− 2. ¾KU
SMc< 1 ŸJ’ KU”
7. ¾UƒT[¨< ¾ƒ ’¬;
1. ¾S”Óeƒ 2. ¾ÓM(¾I´w) (u¨` e”ƒ ƒŸõLKI)
8. ¾UƒT[¨< u¾ƒ—¨< c›ƒ ’¬ ;
1. ¾k” (uð[n S<K<k”) 2. ¾T
 Child labour in Addis Ketema, Ethiopia  73 

9. “ƒI(i) ¨ÃU ›dÇÑ>I(i) cŸe”}— É[e }U[ªM;

1. T”uw“ Síõ w‰
2. ¾u?}¡`e+Á” ! l^” ! vIL©
3. Ÿ 1-3
4. Ÿ4-6
5. Ÿ7-9
6. Ÿ10-12
7. Ÿ12 uLÃ (ÃÖkc)
10. ›vƒI (i) ¨ÃU ›dÇÑ>I (i) eŸe”}— É[e }U[ªM;
1. T”uw“ Síõ w‰
2. ¾u?}¡`e+Á” ! l^” ! vIL©
3. Ÿ 1-3
4. Ÿ4-6
5. Ÿ7-9
6. Ÿ10-12
7. Ÿ12 uLÃ (ÃÖkc)

¡õM feƒ Y^
SÓu=Á :eŸ= eKY^I G<’@ ÅÓV ›”Ç”Æ G<’@−‹ MÖÃpI
1. ¾Uƒc^¨< KU”É’¬;( Ÿ›”É uLà ¢É K=•[¨< ËLM)
1. ’<a” KThhM
2. ¾ƒUI`ƒ u?ƒ ¡õÁ KTTELƒ
3. ¨LЊ e^ eLqS<
4. ¨LЊ Se^ƒ eKTËK<
5. ’@” S`ǃ eKTËK<
6. 6 K?L (ÃÖkc)
2. u›G<’< c›ƒ ¾Sƒc^¬ ¾e^ ›Ã’ƒ U”É ’¨<; (u›”É ¢É K=•[¨<
ËLM)
1. ¾c¨< u?ƒ c^}—
2. }LLŸ=
3. c<p ¨<eØ (ÃÖkc )
4. Ò^Ï e^}—
5. ¡c= c^}—
74  Appendix 3. Questionnaire & manual in Amharic 

6. J‚M u?ƒ ¨<eØ

7. ¾k” e^}—
8. K?L (ÃÖke)
3. Ÿ²=I uòƒ e^ c`}I ¾Up ŸJ’ ¾c^¨< ›Ã’ƒ U”É” ’u`; (Ÿ›”É
uLà ¢É K=VL ËLM)
1. ¾c¨< u?ƒ c^}—
2. }LLŸ=
3. c<p ¨<eØ (ÃÖkc )
4. Ò^Ï e^}—
5. ¡c= c^}—
6. J‚M u?ƒ ¨<eØ
7. ¾k” e^}—
8. K?L (ÃÖke)
4. Ÿ²=I uòƒ K?L e^ c`}I ¾Up ŸJ’ ¾SËS]Á e^I” ¾Kk¡uƒ
U¡”Áƒ U”É” ’u`; (Ÿ›”É uLà ¢É K=VL ËLM)
1. e^¨< ›É"T> eK’u[
2. e^¨< ¾[õƒ Ó²? eLM’u[¨<
3. ›c] eKT>dÅw“ eKT>T
4. ›c] ÅV²?” eKTßõM
5. ›c]Â UÓw eKTÃcÖ˜
6. ›c] KÓw[ eÒ Ó”–<’ƒ eST>ÁcÑÉŘ
7. K?L (ÃÖkc)
5. KSËS]Á Ó²? }kØ[I(i) ¨ÃU u^cI(i) e^ eƒËU`(]) ÉT@I(i)
e”ƒ ’u`;
6. u›T"à uk” e”ƒ c›ƒ ƒc^KI (ÁKi)
1. Ÿ1-4 2. 5-8 3. 9-12 4. Ÿ12 uLÃ
7. "Là Ÿ}Ökc¨< c›ƒ uLà c`}I(i) ¨<nKI (mÁKi)
1. ›− (c›~ uvÊ x¨< Là ÃVL)
2. ¾KU
8. ŸUƒe^¨< e^ ¾UÑ–¨< ØpU U”É” ’¨<;
1. u’í ’¨<
2. KMUUÉ ’¬
3. u¡õÁ ’¬ (uÑ”²w u›Ã’ƒ)
 Child labour in Addis Ketema, Ethiopia  75 

SMc 1 “ 2 ŸJ’ eK¡õÁ ƒÖÃpU ( ¨ÅØÁo 12 H@É)

9. KUƒe^¨< e^ ¡õÁ ¾U}Ñ—¨< u¾e”ƒ Ó²? ’¨<;
1. uk” 2. udU”ƒ 3. u15 k” 4. u¨` 5. K?L (ÃÖke)
10. ŸLà KÖkcŸ¨< Ó²? e”ƒ ßðMGM
11. ¾T>ŸðMI” Ñ”²w U” [ѪKI
1. S<K< uS<K< Ku?}cxŠ c×KG<
2. S<K< uS<K< K^c? ’¨< ¾UÖkUuƒ
3. Ku?}cxŠ ¾}¨c’¨<” c×KG< (ÓTi' \w)
4. ›c] ¾}¨c’¨<” ¾cÖ˜ ¾}¨c’¨<” ÁÖ^kS
¾T>ÁeðMÑ<˜” ’Ña‹ ÃѳM—M
5. K?L ---------------------- (ÃÖke)
12. UÓw ¾UƒSÑu¨< ¾ƒ ’¨<;(Ÿ›”É uLà ¢É K=VL ËLM)
1. ›c] UÓu?”U ËK—M
2. u?}cxŠ Ò` ’¨< ¾USÑu¨<
3. Ñ´Š ’¨ ¾USÑu¨<
4. dј Ñ´Š d× Ÿu?}cx†‚
5. Ÿc¨ Ñ”²w ¨ÃU UÓw KU“G<
6. K?L -------------- (ÃÖke)
13. u›T"˜ ›”È ¾ËS`Ÿ¨< ¾Y^ ²`õ Là e”ƒ Ñ@²? ƒqÁKI; -------------
- KU” --------------------------------------
14. ¾Uƒc^¨< ¾Y^ ›Ã’ƒ ¾ƒ—¨<” ’¨<;
1. S<K< k” ’¨<
2. uk” ¨<eØ K}¨c’ d›ƒ w‰
3. sT> pØ` ’I
4. Ó²?Á¨< pØ` ’I
5. ¨p© Y^ ’¨<
6. K?L -----------------------(ÃÖke)
15. ¾e^¨< ›Ã’ƒ (pØ\) uk” K}¨c’ c›ƒ w‰ Ó²?Á© ¨ÃU ¨p©
ŸJ’ U¡”Á~ ÃÖ¾p; ---------------------------------------
16. eKe^I IM¨<“ (Sv[` ! ÅV´ q[× ) w²< ƒcÒKI;
1. ›− 2. ¾KU
17. ¾u?}cw GLò’ƒ ›Kw;
1. ›− 2. ¾KU
76  Appendix 3. Questionnaire & manual in Amharic 

18. e”ƒ c¨< e}ÇÉ^KI;

19. Ñ”²w G<K? ›MÖ^kU ÃMGM;
1. ›− 2. ¾KU
SMc< 2 ŸJ’ U” ÁIK<” (\w! ÓTi)
20. KMweI ! KƒUG`ƒ u?ƒ ¨ÃU KI¡U“ G<K? ƒ†Ñ^KI;
1. ›− 2. ¾KU
¡õM ›^ƒ uÅM
uSÚ[hU eKT>Å`c<wI ›”Ç”É uÅKA‹ MÖÃpI
1. Ÿ‹ Ÿ}²[²\ƒ ¾›"M uÅKA‹ ›Ã’ƒ ¨<eØ Å`fwI ¾T>Á¨<p
¾›"M uÅM ›K;
1.1 w²< Ñ>²? ƒÑóKI (ƒÅvÅvKI) 1. ›− 2. ¾KU
1.2 u`u_ Ø’I ¨ÃU ¨<ß ›dÉ[¨<I ÁnK< 1. ›− 2. ¾KU
1.3 uc¨<’ƒ Là ¾Å[c Ñ<ǃ ’u` 1. ›− 2. ¾KU
2. Ÿ‹ Ÿ}²[²\ƒ ¾S”ðe uÅKA‹ ›Ã’ƒ ¨<eØ Å`fwI
¾T>Á¨<p ¾S”ðe uÅM ›K;
2.1 ‹L wK¨<I ÁnK< 1.›−” 2. ¾KU
2.2 v”} ›du¨< ÁnK< 1. ›−” 2. ¾KU
2.3 ›cð^`}¨<I ÁnK< 1. ›−” 2. ¾KU
2.4 Sð}g 1. ›−” 2. ¾KU
2.5 SÖ`Ö` 1. ›−” 2. ¾KU
2.6 T”sgi 1. ›−” 2. ¾KU
2.7 SeÅw Å`fwGM 1. ›−” 2. ¾KU
3. Ÿ‹ Ÿ}²[²\ƒ ¾S²”Òƒ uÅKA‹ ›Ã’ƒ ¨<eØ Å`fwI
¾T>Á¨<p ¾S²”Òƒ uÅM ›K;
3.1 UÓw ¾ŸK¡K<GM 1. ›−” 2. ¾KU
3.2 eƒSU ›Ád¡S<IU 1. ›−” 2. ¾KU
4. Ÿ‹ Ÿ}²[²\ƒ ¾¨c=w uÅKA‹ ›Ã’ƒ ¨<eØ Å`fw” ¾T>Á¨<p ¾¨c=w
uÅM ›K;
4.1 u¨LЋ ¨ÃU vdÇÑ> }Åó[i Á¬mÁKi 1. ›−” 2. ¾KU
4.2 u¨LЋ ¨ÃU vdÇ=Ñ> Teð^^ƒ Å`fui Á¬nM
1. ›−” 2. ¾KU
4.3 u¨LЋ ¨ÃU vdÇÑ> TcÑÅÉ Å`fwi Á¨<nM
1. ›−” 2. ¾KU
 Child labour in Addis Ketema, Ethiopia  77 

5. SMc< ›”É ŸJ’ uT”;

5.1
5.2
5.3
6. ›G<” ¾c^I ÁK¨<” ¾e^ ›Ã’ƒ ƒ¨ÅªKI;
1. ¨ÅªKG<
2. ›M¨Å¬U (U¡”Á~” ÃÖkc<)
7. Ÿ›c]I Ò` ÁL‹G<’ Ó”–<’ƒ ”ȃ ’¨<;
1. u×U Ø\ ’¬
2. Ø\ ’¨<
3. SØö ’¬ (U¡”Á~ ÃÖkc<)
8. K¨Åò~ e^I” ›eSM¡„ U” evKI;
78  Appendix 3. Questionnaire & manual in Amharic 
 Child labour in Addis Ketema, Ethiopia  79 

APPENDIX 4. CONSENT FORM 

Respondent Participation Consent 
You are requested to participate in a research Project on Emotional Problems
in Child Domestic Labourers. The purpose of this research is to find out what
the principal problems of child labour are in Ethiopia, particularly in Addis
Ketema district. For this purpose, you will be asked questions regarding
yourself, your family conditions, your education, work and sexual experiences.
Your participation will enable the study to identify the magnitude of child
labour and also what actions should be taken to eliminate child labour in the
country.

Your participation in this study is voluntary and will be compensated free

medical treatment if you are identified as ill person. You will also be given
financial incentive to compensate the time you loose during the interview. The
answers to be given by a respondent and the identity of the respondent will
not be disclosed to any party for the purpose of other than strictly research
harmless to the respondent.

The research outcome that may be possible through this questionnaire is

believed to contribute to the objective of elimination of child labour in
Ethiopia.

If you decide to participate in this project, please understand that your

individual privacy will be maintained in all published or written work resulting
form the study.

This research is funded by International Labour Organization (ILO). If you

have questions about the study, please contact: Dr Daniel Fekadu, Amanuel
Psychiatric Hospital, Addis Ababa, Tel 137971