The Effect of Multimedia on Child Marriage in North Ethiopia

TABLE OF CONTENTS

Acknowledgement

List of Tables and Figures

Abbreviations and Acronyms

Abstracts

CHAPTER ONE THE PROBLEM AND APPROACH
1.1. Introduction
1.2. Problem statement
1.3. Purpose and Significance of the study
1.4. Objective of the Study
1.5. Assumptions
1.6. Limitations and delimitations of the study
1.7. Definitions of terms

CHAPTER TWO REVIEW OF RELATED LITERATURE
2.1. Child Marriage
2.2. Prevalence, Cause and Consequence of Child Marriage
2.2.1. Prevalence of Child marriage
2.2.2. The consequence of child marriage
2.2.3. Cultural misconceptions are the main causes of child marriage
2.2.4. Education and women
2.2.5. Large age difference between married couples has effect on girls life
2.2.6. Mother girls are vulnerable to poor health outcomes
2.2.7. HIV/AIDS and Child marriage
2.2.8. Policy, regulations and Child marriage
2.3. Steps taken to stop Child Marriage
2.4. Base line Surveys in North Gondar
2.5. Theoretical models and functions of communication
2.5.1. Diffusion communication model
2.5.2. Participatory communication
2.5.3. Hybrid approach and health behavior change communication
2.5.4. Media functions and principles
2.5.5. Media for behavior change
2.6. Communication for Social change
2.7. Multimedia and Media mix effects
2.8. Radio Program for Behavior Change
2.8.1. National radio
2.8.2. Solving deficiencies of radio
2.8.3. Community radio for behavior change
2.9. Radio Listening Groups
2.9.1. What is listening
2.9.2. Listening group definition, principles, size and leadership
2.9.2.1. Definition of listening group
2.9.2.2. Principles behind group listening
2.9.2.3. Listening group size
2.9.2.4. Leadership in listening groups
2.9.3. Community listening groups, localization and advantages
2.10. Background of the study
2.10.1. The beginning of utilization of radio for education in Ethiopia
2.10.2. Working principles, Interaction method and Listeners of GEMC
2.10.2.1. GEMC principles
2.10.2.2. GEMC interaction methods
2.10.2.3. GEMC Listeners
2.11. Listeners Diary Analysis
2.12. Knowledge, Attitude and Practice as a Framework
2.12.1. Knowledge
2.12.2. Attitudes
2.12.3. Practices

CHPTER THREE METHODOLOGY
3.1. Research Design
3.2. Study area
3.3. Role of the researcher
3.4. Data collection and Instrumentation
3.4.1. Participants of the study
3.4.2. Sampling procedure and sample size
3.4.3. Data collection methods
3.4.3.1. Diaryto collect data
3.4.3.2. Interview to collect data
3.4.3.3. Document review to collect data
3.5. Data Analysis Method
3.5.1. Content analysis
3.5.2. Conceptual and relational analysis
3.5.3. Thematic analysis
3.6. Validity
3.6.1. Trustworthiness
3.6.2. Internal validity

CHAPTER FOUR RESULTS AND DISCUSSION
4.1. Knowledge main category
4.1.1. Knowledge of solutions
4.1.2. Knowledge of problems
4.1.3. Knowledge of concepts
4.2. Attitude main category
4.2.1. Belief change
4.2.2. Regret of doing
4.2.3. Regret of not doing
4.2.4. Resistance
4.2.5. Convinced
4.2.6. Intend to do
4.3. Practice main category
4.3.1. Canceled child marriage
4.3.2. Support victims
4.3.3. Disseminate message
4.3.4. Collaboration
4.3.5. Role models evolved
4.3.6. Decisions made
4.3.7. Giving advice
4.4. Result summary

CHAPTER FIVE SUMMARY, CONCLUSION AND RECOMMENDATIONS
5.1. Summary
5.2. Conclusion
5.3. Recommendations

Reference

APPENDIXES

Appendix 1: Semi structure interview questions for Social agents and Grassroots agents
Appendix 2: Bossie true story from Wogera woreda
Appendix 3: Dasash true Story from Dabat woreda
Appendix 4: Bisrat Radio Program 26 weeks topics for Adults
Appendix 5: Bisrat Radio Program 26 weeks topics for Children’s
Appendix 6: Bisrat Radio Program listeners sample diary one
Appendix 7: Bisrat Radio Program listeners sample diary two
Appendix 8: Bisrat Radio Program listeners Attendance sample one (children group)
Appendix 9: Bisrat Radio Program listeners Attendance Adult sample two ( women group)

ACKNOWLEDGEMENT

This research would not have been possible without the assistance of colleagues at Gonder Educational Media Center and Save the Children International Gondar field office staffs. Particularly my special thanks goes to Sisay Mellese and Kinfe Wubetu.

I would like to express my thanks to Atiklt Kefale, Derebew Azanaw and Sefialem Zerie for their support in this research study. I am also grateful to Bisrat radio listeners and group facilitators in the sample area to their cooperation in filling out and returning the questionnaire.

My appreciation also goes to experts at woreda Women, Children and Youth and Government Information Communication office for documenting the achievements of the intervention and project grassroots workers for their responses to the interview.

LIST OF FIGURES

Figure 1: Process flow in distance radio education program (Lucas, 1999) page

Figure 2: Conceptual framework of knowledge,attitude, and practice as determinants of evaluation of combating child marriage media intervention. / Adapted from Roelens,Verstraelen, Egmond & Temmerman. (2006)./ page

Figure 3: Amhara Region Map page

Figure 4: The thematic analysis result under conceptual framework of Knowledge, Attitude and Practice page

LIST OF TABLES

Table 1: Steps in Coding Text, The Weber Protocol (Weber, 1990) page

Table 2: Braun and Clarke’s (2006) ‘guide’ to the 6 phases of conducting thematic analysis in relation to the present study page

Table 3 : Summary of identified ideas under sub-categories page

ABBREVIATIONS AND ACRONYMS

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ABSTRACT

Many Knowledge, Attitude and Practice (KAP's) studies are used to survey and identify the status of child marriage in Ethiopia particularly in Amhara region indicates its high prevalence and its devastating effects on girls health causing fistula and other complications, marriage instabilities, gender based violence and preventing from the right for education as well as other economic and social problems which are aggravated by plenty of deep rooted cultural misconceptions. This qualitative research aimed at to investigate the effectiveness of multimedia messaging mainly radio broadcast and group discussion to combat child marriage resulting to effect action in three woredas of North Gondar Zone Amhara region.

The study uses KAP's as evaluation framework and radio listening groups diary as a main data collection tool as well as semi-structured interview and report document for triangulation purpose. Participants of the study are 81 radio listening groups diaries are selected purposively from 312 total groups each having 21 members and for interview the available 18 grassroots workers are included. The views and reactions of listeners written on the groups diaries grouped under the three main categories KAP's then using inductive and deductive thematic analysis at interpretive level sub-themes are identified.

The findings of the study revealed that under knowledge main category three sub-themes are identified. And from the data listeners indicated their knowledge about the consequence of child marriage and related laws, and reasons why it was practice. Moreover, they indicated they know the benefits of child protection, equal education for both girls and boys, and the role of children to combat child marriage. Regarding attitude change five sub-themes are identified describing the perceived benefits and harmfulness of child marriage, intention to abandon it, the belief of appropriate age challenges in combating child marriage. Under practice category seven sub-themes are identified which indicates the cancellation of large number of child marriage plans, penalties due to not obeying the law, a number of reports to legal bodies, measures taken by different actors, decision made pro and against child marriage and collaborations effectiveness to combat child marriage. Besides one report of early sexual intercourse some negative actions recorded are the presence of marriage arrangement deals and partners choice by parents.

Based on the study findings some recommendations were drown on: the effectiveness of KAP's as a framework and radio listening groups diary as data collection to evaluate media interventions; multimedia messaging like radio broadcast together with listening group discussion for effective and efficient method for educating the people for behavior change; collaborative action together with local media is very effective strategy in combating child marriage and to bring the desired change at community level; protection, support and encouragement to victims of child marriage, and measures to be taken to sustain and improve the observed changes against child marriage.

CHAPTER 1: INTRODUCTION

1.1. Introduction

Desmond Tutu the retired South African Anglican Church Archbishop and social right activist in the website called http://theealders.org in September 2011 posted the following blog entitled a Message from Desmond Tutu for men and boys;

A few months ago, in Northern Ethiopia, I met a group of young women who had been married around the age of 10 or 12. Many of them had their first children at 13 or 14. It was shocking for me to realize that there are millions of girls around the world who suffer the same fate every year.

I have to confess that I was simply not aware of the scale and impact of child marriage. 10 million girls a year, 25,000 girls a day, are married without any say in the matter, to men who are often much older than they are. These girls almost always drop out of school to attend to household chores, and when they become young mothers themselves face serious dangers of injury and even death in pregnancy and childbirth. Child marriage robs girls of their childhood, of their basic rights to education, security and health(FYI, 2011).

Child marriage, generally defined as marriage before age 18, is not limited to any one country or continent(United Nations, 2000). However, Clifton and Frost (2011) in their research indicated that in the last decade, 58 million young women in developing countries—one in three—have been married before the age of 18, many against their will and in violation of international laws and conventions on women’s rights. The document also stated that according to new figures, one in nine girls, or 15 million, have been forced into marriage between the ages of 10 and 14, with limited education and economic opportunities, child brides are often condemned to a life of poverty, social isolation, and powerlessness, violations on their human rights, health, and well-being. According to WHO Media Center (2013) ending child marriage is closely related to efforts to Millennium Development Goals (MDGs) 3, 4, and 5 i.e., promote gender equality , to reduce child mortality and to improve maternal health respectively. The WHO media center commented that the continued occurrence of child marriage has hindered the achievement of these MDGs, especially in South Asia and Sub-Saharan Africa.

International Center for Research on Women (ICRW) mentioned the reason why countries with the highest prevalence of child marriage are concentrated in Western and Sub-Saharan Africa is due to population size, and the largest number of child brides reside in South Asia(ICRW, 2013). Ten countries have particularly high prevalence rates, with one-half to three-fourths of girls marrying before their 18th birthday. Among them according to UNICEF (2013) Statistics and Monitoring Section, Division of Policy and Strategy Ethiopia has fifths rank with 673 thousands Women age 20 to 24 who were married before 15. Based on the research conducted including Ethiopia, where 49 percent of girls are married by age 18, but in the Amhara region, 74 percent are married by age 18 and half of all girls are married before their 15th birthday(Erulkar and

Muthengi, 2009). Moreover, a study by the same researchers in 2004 in two districts of Amhara found that 14 percent of girls were married before age 10. Generally, girls living in rural areas marry earlier than girls in urban areas(Erulkar and Muthengi, 2004).

Young brides, even below 10 years of age, are married off to adolescent boys and thus the cycle of ignorance, poverty, health hazards continue. Even in the present times there are remote places where people are uneducated and are not equipped with even a little education and knowledge to break a tradition which brings miseries to many of little girls in their land. However, many study results show that support of the community on the eradication of Child marriage and abduction is by far better and higher than other HTP’s. It was identified that an individual abducting a girl Child knows the negative effect of his act on the daughter. But there is a gap that the community should know that all acts they perform on Child marriage related issue are illegal. Using various communication channels to reach communities with messages about the importance of ending child marriage is crucial to raise awareness and change norms. For example, mass media can be an effective tool for educating families and communities about the harmful consequences of child marriage as well as for getting the word out that there has been a policy change regarding age of marriage(Gage, 2009).

Although awareness raising activities are strengthen by government and civic societies, many people lack clear information and positive attitudinal changes to stop Child marriage. To raise awareness Gondar Education Media Center (GEMC) in partnership with SCI has been broadcasting culturally sensitive radio program for over 10 years on Harmful Tradition Practices (HTP’s) including Child Marriage issues.

A baseline survey conducted by SCI on three woredas i.e., Debark, Dabat and Wogera for the project called Combating Child Marriage in North Gondar zone recommended radio education broadcast combined with listeners group discussion as one of intervention activities. So that GEMC executed a two and half year media activities including the weekly radio program having the same program name Bisrat with similar activities but more focusing on Child marriage and related issues where this study was conducted. The program broadcasted every Sunday for 45 minutes from 10:30 - 11:15 AM aiming for children and adult targeted organized listeners.

As stated in the project proposal the three main focuses of Bisrat Radio program to Combat Child Marriage is;

- Primarily on child marriage - with emphasis on the negative impacts of child marriage in culturally approachable manner. As studies indicate the majority (above 80%) are aware that it is a crime, but keep practicing it, which is why the need to focus on awareness creation on the negative impact on children and their families, and the community at large. And promote the men and boys role for abandoning the practice as they are part of the decision making process, and the ones who are getting married to children below the age of 18 years.
- Integrate issues of adolescent reproductive health rights and Reproductive Health education to bring about practice change through information sharing. Because one of the major reasons for parents to give their female children for marriage is forced rape and pre-marital pregnancy.
- Promotion of girl’s education as part of the prevention of child marriage is one of core objective for this project by SCI. It is also an important intervention for empowering girls to protect and decide for themselves, through insuring their empowerment and independence(GEMC, 2010a).

1.2. Problem statement

Media intervention is a powerful strategy for increasing awareness, knowledge, positive attitude and practice. In the present times many community level intervention projects baseline surveys documents recommends media components as a means to achieve the desired behavioral changes. For instance the baseline study of the project recommends designing culturally appropriate strategies through intensive community conversations and dialogues, visual and audio education materials and radio programs (SCN,2011). However, the effects of media on KAPs are less investigated.

Save the Children International in Ethiopia in collaboration with partners from the year 2011 to 2013 implemented “Combating Child Marriage” project in North Gondar Zone (Wegera, Dabat and Debark Woredas) do have media component (i.e., a weekly radio education called Bisrat, radio manual, and face to face group discussion) to change the existing low level of knowledge, attitude and practice (i.e., KAPs) about child marriage. To see the change in behavior due to the intervention activities the baseline document recommends mid-term and final evaluations using predetermined objective indicators. However, the impacts of the multimedia intervention components are less evaluated.

Ignoring to evaluate the specific effects of media components in any intervention will lead to inconsistence and distorted overall result, which intern inhibits to clearly find out key achievements of the goals of the intervention projects. Doing appropriate evaluation to see the media activities impact to attain the desired behavior change could help the actors participating in the project learn every components of the activities and better implement the project next time.

The present study aspires to explore the effects of the multimedia activities in contributing towards changing target audience knowledge, attitude and practice (KAPs) about child marriage in the project area i.e., Debark, Dabat and Wogera woredas of North Gondar zone found in Amhara region in Ethiopia. To do this the researcher carried out radio listening group diary analysis and used it to find out the trends of KAPs change and give possible recommendations.

1.3. Purpose and significance of the study Purpose of the study

This multimedia intervention project with radio messaging, print manual, face to face listeners group discussion, and interaction with media center to serve as a forum for discussion aim to change the target people’s behavior. The question is if these multi-media activities do impacted the KAPs how it happens?

The purpose of this study is to identify changes on target audience by analyzing their reflection statements on the diary book that is provided to them. The study tries to answer the following questions divided in to the three main categories:

Knowledge gained-

- What important information’s do participants get to change their views and opinions?
- What participants feel from dialogue between listening members and with community members?

Attitude changes-

- What informed believe changes towards child marriage and related issues are identified?
- What interactions are identified due to shared stories?

Practice done-

- What practical actions achieved from the creation of radio listening forum for education?
- What exemplary activities are identified so that others can follow them?
- What kinds of collaborations resulting actions are observed due to the presence of multimedia intervention?

Significance of the study

This study has significant contribution for media practitioners and social development initiatives project implementers. The study gives a feedback about which group of the target audience do show what positive change. It give light to use diary analysis method as a means of monitoring progress and evaluating audience participation as a part of solution for social and health problems at community level. In addition to this it attempts to show the possibility of using KAPs as a frame work for evaluating impacts of media intervention. More over it combines KAPs framework and radio diary analysis method to get a better result to evaluate the impacts of media intervention.

1.4. Objectives of the Study General objective

The general purpose of this study is to explore the effects of multimedia on KAPs regarding child marriage.

Specific Objectives

Specific objectives of the present study :-

- To explore the change in feeling, views and opinions on the Child Marriage and related issues of the target population due to their exposure to multimedia intervention.
- To examine the importance of radio listening group as a forum for discussion, initiate dialogue within the community members and improve learning from each other by discussion in group to solve their problem.
- To investigate the presence of change of practice among the community members towards the abandonment of child marriage and improved reproductive health practice and girls education, in target woreds.

1.5. Assumption

Karen, Barbara & Viswanath (2008) citing Blumer & Katz (1974) stated that elaborated media effects research should also looks reactions of audience to media, because audience are not regarded as passive recipient, but also as active seekers and users of information. Though the research presents no specific hypotheses to be tested, there are several assumptions which the researcher expected to be validated by the result of listener’s diary analysis. These were;

- Fundamentally, the mass media are "message multipliers” channels, which increase the number and speed massages sent and the size of audience reached.
- Any message to have an effect, must receive attention, interpretation, acceptance and disposition.
- Radio as a delivery system of message is very useful media because; it is wide spread and democratic, it can entertain and inform at the same time, it can establish a uniform standard of excellence and it is cost-effective.
- When changing behavior, the individual, community, or institution goes through a series of steps—from unaware, to concerned, to sustained behavior change.

1.6. Limitations and Delimitation of the Study Limitations

- The diary analysis methodology requires the availability of well written diaries. So that as much as possible the researcher included all those diaries which are readable and excluded those who are not neat to read.
- Another problem is the absence of literatures done using a diary analysis method in general and group listeners diary analysis. Because of this other types of qualitative and quantitative studies conducted on the area are reviewed.
- The diary data are self-report which are venerable to inconsistency and bias. But by increasing the sample size and triangulating the data with interviews and documents the correctness of the information.

Delimitations

The main study participants are 81 Bisrat radio listening group members organized in North Gondar zone three woredas namely Debark, Dabat and Wogera woredas selected by the researcher from 312 groups. They are children, adult men and women mostly living in rural area where many of them are not literate. In adult radio listening group there are very few peoples who read and write, these individuals are chosen to serve as secretaries and group facilitators. But in children listening group many of them are able to read and write. So that everything written in the diaries indicates individuals as well as group views. The other informants are social agents and grassroots workers they do participated in the intervention as a supervisor of the listening activities. The ideas categorized in to knowledge, attitude and practices then sub categorized into main ideas within these three for analysis. The results of this study will not be generalizable to other listeners who do not organized in to radio listening groups.

1.7. Definition of Terms

Child: The term child, as defined by the Ethiopian law refers to any person who has not attained the full age of 18 years.

Child marriage: In this study the term child marriage refers to marriage concluded between female and male in which case one or both have not attained the full age of 18 years.

Radio listening groups: a group of peoples(adult men, women and children) around 21 in number who meet every Sunday to listen radio broadcast and discuss on the issue then reach on decision actions.

Radio education: educational radio program which is produced and broadcasted based on per-designed specification manual for known target audience called listening groups.

Zone, Woreda, and Kebele: Ethiopia follows the federal system and is divided into two chartered cities and nine ethnically based administrative regions, one of which is the Amhara Region.

- Zone is a clustered government administrative system within each Region. Within Zones there are Woredas.
- Woreda represent district level government administration structure within a Zone.
- Kebele these are village level government administrative structures, within Woredas. Definitions of Amharic terminologies:
- Bisrat in Amharic means good news
- Arata abedari in Amharic means illegal loan sharks
- Birr is the unit of currency in Ethiopia
- Kale Awadi is religious manuscript written in Geez
- Diqala mean rootless/fatherless child(UN Women,2012)
- Komo Ker is a person who is unwanted by any one and hopeless (UN Women, 2012)
- Sama is a plant with small stingy spikes which cause painful skin rush

CHAPTER 2: REVIEW OF RELATED LITRATURE

This chapter contains the sociocultural reasons as well as effects of child marriage and theoretical framework which is central concept for conducting the study. It includes the concept and purpose what child marriage and why it is practice; prevalence rate, cultural misconceptions; problems that arise due to child marriage and action that can be taken to stop it. In the last part theoretical models as well as Media intervention models and frameworks for the study.

2.1. Child Marriage

From the Birth, marriage and death Smile (2011) says; are the three key events in most people’s lives only one - marriage - is a matter of choice. He added the right to exercise that choice was recognized as a principle of law even in Roman times and has long been established in international human rights instruments.

According to UN Population Fund Salih (2013) and WHO Media Center (2013) stated that more than 140 million girls will become child brides between 2011 and 2020 which is an estimated 14.2 million young girls marrying too young every year or 39,000 daily. These documents further stated of 140 million girls who will marry before they are 18 and 50 million will be under the age of 15. In Ethiopia Amhara region child marriage rate is among the highest in the world and many young girls whose opportunities and childhood were cut short and become wife then mother-but not yet an adult-whose life often remains invisible to others(Gaynair, 2013). In the research conducted by Population council (2010) the highest rate of very early marriage occurred in Amhara region with 52 percent married by age 15, where 44 percent of them did not want to get married at the time they did(p.34 &35).

For both girls and boys, Child marriage has profound physical, intellectual, psychological and emotional impacts, cutting off educational opportunity and chances of personal growth(Smile, 2011) Child brides often show signs symptomatic of sexual abuse and post-traumatic stress such as feelings of hopelessness, helplessness and severe depression(ICRW,2013).

2.2. Prevalence, cause and its Consequences of Child Marriage

2.2.1. Prevalence of Child marriage

According to ICRW (2013) one third of the world’s girls are married before the age of 18 and 1 in 9 are married before the age of 15. This document also indicated in 2010, 67 million women 20-24 around the world had been married before the age of 18. If present trends continue, 142 million girls will be married before their 18th birthday over the next decade. That’s an average of 14.2 million girls each year(ICRW, 2013). According to UNICEF State of the World's Children, 2013 document Child marriage prevalence is defined as the percentage of women 20-24 years old who were married or in union before age 18. According to WHO Media Center (2013), the 10 countries with the highest rates of child marriage are: Niger, 75%; Chad and Central African Republic, 68%; Bangladesh, 66%; Guinea, 63%; Mozambique, 56%; Mali, 55%; Burkina Faso and South Sudan, 52% and Malawi 50%. Based on this Ethiopia has the rank of 18 out of 20 high prevalent countries having 41 percent prevalence rate(UNICEF, 2013). The prevalence rate of child marriage in Ethiopia varies from region to region. Berihun & Aspen (2009) citing a survey conducted by the Ethiopian Committee against Harmful Traditional Practices (WAT 1992:9), mentioned that the average age of marriage is 14.2 years for 82% of the girls in the Amhara region, 79% in Tigray, and 64% in Benishangul-Gumuz. The survey result of PFI- Ethiopia (2006) indicates fifteen percent of ever-married women in Amhara were married before the age of 12 years. The mean age at first marriage was 14.5 years, and about 44 percent of urban and 53 percent of rural ever-married women were first married between 12 and 15 years(PFI- Ethiopia, 2006). The survey also revealed with no variation by place of residence nearly three-fourths of the ever-married women had married men older than themselves, and the age difference was 10 years or more for half of the women married to older men.

2.2.2. The consequences of early marriage

Many married girl children described painful, unwanted first sexual encounters with their husbands; many didn’t understand what was happening(Gaynair, 2013). According to Population council (2010) study 35% of the total respondents experienced first sex before they had their first menstrual bleeding which is the result of force. The document also states that 99 percent of girls married before age 10 and 90 percent of them had arranged marriage. Particularly in rural areas where 82 percent of marriage were arranged by families; so that they don’t know their husbands until their wedding day. According to Erulkar and Muthengi (2004) over 66 percent had not reached puberty by that encounter.

According to PFI Ethiopia (2006) survey detailed information on the causes and consequences of early marriage was collected from a sample of 2,072 females aged 12-49 years and from focus group discussions and key informant interviews in Amhara region the reported consequences of early marriage include:

Instability of Marriage: The region is characterized with high incidence of marriage instability (27 percent in urban and 19 percent in rural were divorces), and the main reason is often attributed to early marriage. In 38 percent of cases “too young for marriage” was cited as the reason for dissolution of the first marriage.

Poor health: 8.4 percent of women who were married under the age of 14 reported sexual and sex organ related problems.

Fistula and related problems: Almost all respondents in the qualitative survey reported knowing of at least one case of fistula in their lifetime; some reported knowing of up to five fistula cases.

Too Many Children: Women married before age 15 had an average of 5 children, those who married between 15 and 17 years had 4.2, and women who married after age 18 had 3.1.

Main reason for school dropout and less education: Over 78 percent of never married girls under the age of 24 were attending school, as compared to 8.9 percent among the currently married girls. Among those out of school, 28 percent cited marriage and 19 percent cited child bearing as the main reason for not attending school.

Impact on the well-being of children: Early marriage is detrimental to the children of the marriage, when the mother is neither psychologically or physiologically ready to care for her children.

Women’s inequality: Early marriage limits female educational opportunity, thereby reducing their employment opportunity and economic independence. The study has further confirmed that victims of early marriage are vulnerable to gender based violence, high fertility, marital instabilities, and to reproductive health related complications. Women’s lack of decision-making power in their families and communities is exacerbated by the inherent power imbalance between a young girl and her husband, who is often 10 years or more her senior.

In North Gondar zone, 2011 National Follow up Survey of Harmful Traditional Practices showed that 44.2 per cent of girls are married before the age of 15(UN Women,2012). In the baseline survey document SCN (2011); that is conducted by Save the Children Norway in 2010 the researchers find out that; in 1991, 80.6 % of women and 25.5 % of men married before they reach age 18. After 2002, the prevalence of men marrying before 18 years of age has reduced to 3.6 %. The document also indicates the prevalence of women who married under 18 years of age was 53.8 %, showing only a slight improvement(SCN, 2011). The finding indicates that only 53.6% of the respondents had heard information on child marriage related issues. Regarding knowledge about Child marriage parents were less informed than their children, and adolescent girls were found relatively less informed that boys.

2.2.3. Cultural misconceptions are main causes of Child marriage

Patriarchy and traditional norms and practices of discrimination are one of the main drivers. No one religious affiliation was associated with child marriage, according to a 2007 ICRW study. However a variety of religions are associated with child marriage in countries throughout the world(ICRW,2013). There are research findings that indicate religious peoples do participated in influencing the community members. For instance, Berihune & Aspen (2009) mentioned the views of one local priest called Ababaw said rural people have no good knowledge of life; we have a problem to live according to plan and he also further said that girls are not allowed to marry under the age of fifteen (note the age) since the time of Adam and Eve. In most regions and cultures of the Ethiopian society, girls who pass the age of 15 unmarried are socially degraded and dubbed Komo Ker- an offending and humiliating Amharic term meaning “a person who is unwanted by any one and hopeless”(UN Women, 2012). For fear of this social stigma, parents often decide to give their children for marriage at a very early age.

In many parts of Ethiopia even though marriage of child girls as early as five years old seems horrific, and it might be difficult to understand that they are practice with good intention(SCNE, 2005). The document added that a girl can be engaged at a very early age, between 4-5 years or even in womb; though the marriage ceremony could follow soon, the bride does not go to her bridegroom's home until she reaches the age of 10 to 13 years or younger. In some parts of the country, the practice is becoming increasingly covert and disguised with other types of festivities for fear of the legal accountabilities(UN Women, 2012). Sometimes the girls stay with her parents or family-in-law until her reach of ‘maturity’, which is 10 to 13 years(SCNE, 2005). The in-laws have the cultural obligation to protect the child from sexual intercourse, a tradition which is called ‘keeping but not touching’. Once married, a young girl is often separated from her family to become a junior member of her husband’s family. Her movements may be restricted and her education ended.

The research conducted in North Gondar three project woredas (i.e., Debark, Dabat, Wogera) SCN (2011) indicated that among the respondents, 42.6% of men, 38.7% of women, and 56% of male youth reported that they were aware of the existence of a legal minimum age for marriage. Of those who expressed knowing the minimum legal age, only half of them were able to state age 18 as the legal minimum age of marriage for girls. Most respondents of the research SCN (2011) saw that appropriate age of marriage for girls was 14 years while it was 18 years for boys. In the base line study SCN (2011) more than two-third of the adolescent and 80% of the parents (both males and females) still have in their mind that child marriage has some advantages/benefits for girls and the family in general.

Berihun & Aspen (2009) points to the fact that historically, Ethiopian royalty married for creating alliances by marrying daughters or sisters of provincial rulers, both Christian and Muslims. Berihun & Aspen further elaborated their idea that women of noble families could be married as early eight or nine years old. May be marriage to create a bond between families trace back to follow what the former leaders was doing. That is indicated in many research findings that major importance is creating a bond with the bridegroom’s family, as well as ensuring the girl marries while she has her virginity(PFI-Ethiopia, 2006). Because of this child marriage is practiced by many parents to prevent their children from having pre-marital sex which brings loss of virginity since a girl who has lost her virginity before marriage is very much disgraced and brings shame on her family. Moreover, there is an old traditional concern that a girl will become too old for marriage, which will represent a failure on the part of her parents(PFI-Ethiopia, 2006). The worst of all shames comes if the girl who had sex before marriage gives birth to a child. The child born under such a situation is dubbed “Diqala” mean rootless/fatherless child(UN Women,2012). Therefore, most parents wouldn't dare to live with such a demeaning social stigma; rather they prefer to give their child for marriage as early as possible. Many poor families choose for marrying their underage girls with an intention of economic gain from the gifts given by relatives, neighbors and friends at the marriage ceremony and dowry. The practice serves also for family extension and continuation and social pride, as many parents want to see their children married at a very early age and have grand children before they pass away. Likewise, parents' need of social fame and prestige which comes from organizing a overgenerous wedding festivity and inviting many people for this event is seen to be a key factor for child marriage. In some parts of the country, parents force their children to marry early for the purpose of strengthening ties with families thought to have influential advantage, either in terms of wealth or social status.

2.2.4. Education and Women

The more girls become educated Ayele (2007), indicated the better they understood the problem and also they have to come to challenge the various socio-cultural constraints passed on them. But researches indicate that married girls receive little or no schooling. The house hold task heavily burdened girls so that it takes their time so that they are not able to do their homework and study at home. Because of this if they become late comers or absentees these eventually make them dropout of school. Many young wives in rural Amhara at present time are dropped out of schools soon after they wed and their reasons are due to the daily routines of fetching water and firewood, cooking, cleaning, and if mothers minding a child(Ayele, 2007 and Gaynair, 2013). Girls in Amhara region who marry young tend to drop out of school and are more likely to bear children during adolescence, thus effectively ensuring that they will not return to school or develop other work skills(PFI-Ethiopia,2006). Seventy-three percent of married women have received no education, compared to 45 percent of never-married women(EDHS, 2005). Those women with no education as Population council (2010) study showed were significantly more likely to experience early marriage, with 38 percent married by age 15(p.34). In SCN (2011) survey Child marriage was one of the major causes for school dropout of girls in the study woredas. The other reason is rape and sexual assault, sometimes even by close relatives, that hinder girls education Ayele (2007), says these makes them ashamed and demoralized so that their academic performance declined afterwards.

2.2.5. Large age differences between married couples has effect on girls life

As a result of early marriage, large spousal age differences are common, which usually limits married girls’ autonomy and decision-making ability. The younger a bride is, the greater the age difference between her and her spouse, promising disparate roles in decision making. The mean age difference between spouses in Ethiopia is 10.1 years(PFI-Ethiopia, 2006). Many girls, and a smaller number of boys, enter marriage without any chance of exercising their right to choose simply forced into marriage at a very Child age by their parent’s decisions(Smile, 2011). Lavish gifts and enticing the girl child and her parents with promises of various opportunities are becoming common ways of persuasion these days(UN Women, 2012). Since the girl is too young and definitely uneducated to even know her rights or what is good for her, she is in no position to make any decisions about her life, spacing of babies, food, rest or sexual preference(Zhang, 2008). According to population council study on the average married females were 7 years younger than their husbands where the younger the girl was when she married, the larger the age difference with her spouse(Population council, 2010, p. 35). Gaynair (2013) said that married adolescent girls are about 60 million in Ethiopia, among these over 5,000 child brides in Amhara region are seeking health and economic needs.

2.2.6. Mother girls are vulnerable to poor health outcomes

Once a girl is married Salih (2013), she is at greater risk of domestic violence, more likely to get pregnant early, more likely to die during pregnancy, and more vulnerable to HIV. According to ICRW (2013) girls younger than 15 are five times more likely to die in childbirth than women in their 20s. Pregnancy is the leading cause of death worldwide for girls ages 15 to 19(ICRW, 2013). If pregnancy continues due to lack of nutritious food and adequate rest leads to a number of complications. It so happens that by the time the girl reaches her twenties, she is already spent and looks close to forty years of age due to multiple pregnancies, household work and inadequate nutrition which take their toll on her(Zhang, 2008). She may be subjected to sexual coercion and expected to prove her fertility by bearing children at an unsafe age. One result of this may be obstetric fistula, a serious medical condition in which a hole develops between the bladder, vagina, and sometimes rectum of a young girl, causing physical suffering, humiliation, and social ostracism(UN Women, 2012).

In the SCN (2011) survey conducted in the three project woredas (Debark, Dabat, and Wogera) one of the major child protection concerns in the studied districts where that in one out of ten households there was a female member suffering from pregnancy and birth related complications, which were identified as “suspected fistula” by the respondents. Absence of effective and timely medical treatment for suspected fistula cases and other teenage pregnancy and birth related complications at the woredas level made girls more vulnerable to further complications. Prolonged and obstructed labor can result in obstetric fistulas, which disproportionately afflict very young and first-time mothers. Population Council (2004) report estimated that 9,000 new fistulas occur annually in Ethiopia. Fistula condition leaves girls and women continually leaking urine and/or feces, frequently leading to abandonment by partners, friends, and family.

2.2.7. HIV/AIDS and child marriage

A combination of biological, socio-economic, cultural, and political factors put young women at greater risk of HIV infection than males. A girl is physiologically more vulnerable to contracting HIV/AIDS, as her vagina is not well lined with protective cells and her cervix may be penetrated easily. A global analysis of the epidemic shows that the prevalence of HIV infection is highest in women aged 15-24 and peaks in men between five to ten years later(PFI-Ethiopia, 2006).

Child brides face a higher risk of contracting HIV because they often marry an older man with more sexual experience. Girls ages 15 - 19 are 2 to6 times more likely to contract HIV than boys of the same age in sub-Saharan Africa(ICRW,2013). Most girls who end up in divorce and are obliged to join their parents, especially those having a child, are often isolated and degraded by their family and the community(UN Women,2012). Some are forced to flee to towns where they end up as domestic house workers or commercial sex workers, becoming vulnerable to different forms of violence and abuse, and subsequent exposure to different sexually transmitted infections including HIV and AIDS. Population council (2004) reported that once married, a girl may be subjected to sexual coercion and expected to prove her fertility by bearing children at an unsafe age; her risk of contracting HIV is higher than for unmarried girls of the same age. These factors reinforce the “feminization” of poverty, and its continuation from one generation to the next(Population Council, 2004).

2.2.8. Policy, regulations and Child Marriage

Whether it happens to a girl or a boy, Child marriage is a violation of human rights. The right to free and full consent to a marriage is recognized in the 1948 Universal Declaration of Human Rights (UDHR) and in many subsequent human rights instruments - consent that cannot be ‘free and full’ when at least one partner is very immature(Smile, 2011). According to Article 144 of the Declaration on the Elimination of Violence Against Women (UN, 1994), gender-based violence is “...violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering of women, including threats of such acts, coercion, or arbitrary deprivations of liberty, whether occurring in public or in private life.” Early marriage creates a number of conditions that expose married girls to poverty and violence. Men’s control over key resources, social isolation, and the low socio-economic status and dependency of women predispose married girls to violence and poverty (Heise & Ellsberg, 1999). Some examples of gender violence that can be exacerbated by early marriage include domestic violence, rape, and emotional abuse.

The Federal Democratic Republic of Ethiopia Constitution (1995) Article 9:4 provides that all international treaties ratified by the country are integral parts of the law of the land. Fikremarkos (2008) stated that Ethiopia has signed several international commitments such as ... CRC, Beijing Platform of Action, Convention on the Elimination of Racial Discrimination, Convention Against Torture, and African Charter. In Ethiopia there are plenty of policies and legal frameworks that have statements about women issues.

The National Policy on Ethiopian Women(NPEW) adopted in 1993 was the first policy document that contains statements which promote and protect the rights of women and also declared the government commitment to accept the international laws regarding women and girls right. Fikermarkos (2009) NPEW strategies major focus area Fikemarkos added that includes issues of participation equality of women, harmful traditional practice(HTP’s), importance of creating awareness about and access to basic health care and reproductive health information. Fikermarkos (2009) mentioned about Cultural Policy of Ethiopia (1997) that it address women issues focusing particularly to step by step abolish traditional harmful practice, ensure women active participation in all cultural activities equally and change negative attitudes towards women participation. Ethiopia has launched the National Action Plan for Gender Equality (NAP-GE-2006-2010) Ministry of Women’s Affairs (2006 b) which is an important strategic document for achieving gender equality and mainstreaming it in all sector activities. The Ethiopian Women Development Package developed by Ministry of Women’s Affairs, (2006 a) emphasized the equal participation of women in economic, political and social issues in rural and urban places. It addresses women participation in education, improve their health, eliminate harmful practices, it ensure full implementation of the family law and legal protection of women(Fikremarkos, 2008). The National Population Policy of Ethiopia, NPPE (1993) is another policy document that has got a lot of statements which identified the lower status of economic, social and political participation and mentioned actions to be taken to empower women and enhance their involvement. The Ethiopia Education and Training Policy (1994) address gender issues by putting statement for recruitment of more female teachers, give priority and financial support to female students. Fikremarkos also described another document which stress women issue is the 1997 Education Sector Development Policy (ESDP) among many objectives three of them directly mentioned girls issues which are; to increase 45%, to reform the curricula to make it relevant and gender sensitive, and to reduce the dropout and repetition rate of girls by half.

The Federal Democratic Republic of Ethiopia (FDRE, 1995) constitution Article 34:1 declared that men and women have equal rights while entering, during, and at the time of the termination of marriage without distinction of race, nation, nationality or religion for those who have attained the marriage age defined by law. FDRE Article 35:4 recognizes the effects of past discrimination against women and entitles them to affirmative measures to provide special attention to women, so as to enable them to compete and participate, on the basis of equality, with men in social and economic life as well as in public and private institutions(Fikremarkos, 2008).

Ethiopia has a new Family Code enacted in 2001 that guarantees women equality in marriage and puts the legal age at marriage for both sexes at 18 years old compared to 15 in previous years(FDRE,2000). However, the practice still persists mainly due to poor enforcement and lack of knowledge, only 50 per cent of the population is aware of the existence of a legal age for marriage(UN Women,2012). According to the “Essential Conditions of Marriage” (Section 2, Article 6-16) of the Revised Family Code (Proclamation of 2000), Article 7 specifies the legal marriage age of both boys and girls as follows: “Neither a man nor a woman who has not attained the full age of eighteen years shall conclude marriage.” Despite this law, the country is known for one of the most severe crises of child marriage in the world.

Regarding knowledge about the legal issues the survey SCN (2011), shows that it was 44.2% of men and 34.4% of women who expressed that they knew the existence of the criminal code against child marriage. Among those who expressed knowing the criminal law most lack the details of what it contained. The study also revealed major gap on the enforcement of law. It was only 30% of the men and 27% of women who could recall at least one community member who was punished due to arranging child marriage, or canceled arranged child marriage due to interference by the government and other community initiatives. Moreover it was reported that enforcement of the legal age of marriage by authorities was inadequate(PFI-Ethiopia, 2006).

Quoting from The African Child Policy Forum (2007:71) Berihun & Aspen (2009) stated that in Ethiopian minimum age for marriage (18 years) corresponds with provisions in the Revised Penal Code, Article 627, “that penalize the sexual abuse of children ... with imprisonment from 13 to 25 years for a man guilty of sexual activity with a child below the age of thirteen, and 15 years imprisonment where the child is between the age of thirteen and eighteen”.

Fikremarkos (2008) stated that Amhara, Tigray, and Oromia regional states of Ethiopia adopted the revised family law and abolished most discriminatory actions. The Amhara region Family law gives certain loop of hole so that people can exercise child marriage. The family code of Amhara Region states in article 18.1 that "neither a man nor a woman has not attained the full age of eighteen years shall conclude marriage". However, Article 18.2 grants special rights to courts and states that "Justice Bureau of the Region may, on the application of the future spouses, or the parents or guardian of one of them, for serious cause, grant dispensation of not more than two years"(Amhara National Regional State, 2003). But seriousness of causes is determined upon the application of the parents or guardians, which in essence is a contradiction in terms. Berihun & Aspen (2009) arguments about early marriage is the parents are considered as helping wrongdoers to the illegal marriage arrangements and one function of the new law is that authorities interfere with the decisions of the parents and guardians.

The Ethiopian revised criminal code of the May 2005 includes new and revised provisions relevant to the protection of women’s human rights in general. For instance revised criminal code (The Revised Penal Code, 2004) criminalize: most forms of violence against women and girls including rape (Article 620-628); physical violence with marriage or in an irregular union (Article 564); and early marriage (Article 649). Although legal frameworks provide several rights relevant to women because of several reasons they are not exercised fully by the people as well as the law enforcing bodies(Fikremarkos, 2008). Fikremarkos further explained three problems that influence girls not to report their right violation:

“One problem is there is a great trend to force women and girls to solve their disputes through traditional mechanism by those elderly most of the time who do not treat women and men equally. The second point is lack of awareness about the legal protections of women on the part of the victims and community. The third but not the last point is women and girls do not usually report incidents of violations of their rights but rather they keep, shame, fear of revenge and lack of confidence in the legal system”.

However, according to Helland (2004), people in Northern Ethiopia ... are generally law- abiding in order to be effective in stopping child marriage legal regulations must also be followed up with legal control.

2.3. Steps taken to Stop child marriage

In general, early marriage of girls greatly affects the realization and enjoyment of virtually all of their rights. The imposition of marriage on children or adolescents who are in no way ready for married life deprives them of freedom, opportunities for personal development, health and well-being, education, and participation in civic life.

Ethiopia accepted international laws as well as developed local legal frameworks and implementing multiple intervention strategies including making partnership with international organizations to stop child marriage. One of such initiatives that Ethiopia accepted is Beijing Platform of Action United Nations, (1996) which is the cooperation and collaboration of GOs and NGO’s to gender mainstreaming, advocacy, capacity building and creating grassroots women movements. Based on this many international and local NGOs are involved in different intervention activities including research, training and preventive measures. NPPE also encourage GO’ and NGO’s involved in social and development programs that they incorporate gender and population content in their activities(Fikremarkos, 2008). WHO Media Center (2013), states that despite the fact that 158 countries have set the legal age for marriage at 18 years, laws are rarely enforced since the practice of marrying young children is upheld by tradition and social norms. Salih (2013), coating UNICEF advisor Malhotra said that laws alone have proven ineffective at preventing child marriage for instance countries like Bangladesh, India, and Indonesia have had minimum age of marriage laws for decades but still have under18 age rates of girls married 66.2, 44.5, and 22 percent respectively. Research findings indicate a significant number of persons who strongly disapprove of the child right violation practice publicly, but still follow the practice in their homes(PFI-Ethiopia, 2006). The study SCN (2011) also dismissed lack of knowledge of the consequences of early marriage as a reason for its continued practice. The UN Secretary General Ban Ki-Moon on WHO Media Center (2013), say that “ I urge governments, community and religious leaders, civil society, the private sector, and families- especially men and boys- to do their part to let girls be girls, not brides”. Therefore, coordinated collaborative home grown measures should be implemented to mobilize communities change those norms and to stop it.

Although Economist Magazine (2013), said it is much harder to change norms and practice on societal and cultural level than to adapt or conform to them, particularly with regards to relationships and health people in Ethiopia are open to change. This change in Ethiopia observed especially when changes are beneficial to their children(SCNE, 2005). Particularly, urban women more likely to discuss domestic duties, maternity service and HIV/AIDS with their husbands than were rural women(Population council, 2010). In addition to this there are some indications of Children do fought for their right in rural areas. For instance in a document SCNE (2005) a girl history is a good example;

I heard at school that my parents had planned for me to get married. I was afraid. I didn’t want to get married. When I came home from school that day, I cut off all my hair. Girls with short hair go to school. I thought when my parents saw my hair they would cancel the marriage and let me keep going to school. But when my father saw me, hejust hit me with a stick( story of Kabanesh,p.16).

Kabanesh father hits her because she was against the deep rooted traditional practice. In the same document SCNE (2005), one child described this situation as “ ... our parents don’t intend to harm us. They do these things because they learned them from their ancestors. They simply don’t know better.”

The Girl students’ club in Schools is one structure, which works to teach the community about early marriage and other harmful traditional practices (HTP); through literary stories, dramas and lecture(Berihun & Aspen, 2009). However, sometimes these clubs faces problem, Berihun & Aspen added that in some places it may create much social tension that the club members gather information secretly (about early marriage) and passes it to government officials in addition to disseminating message to create awareness. Berihun & Aspen (2009) discussed a case in Amhara region a rural place called Adisge of early marriage arrangements (for an eight year old girl and 18 year old husband) in 2006 where at the wedding day the parents were arrested by the police. The local school had attempted to intervene before the wedding by sending some of Girls’ student club members to discuss the issue with the parents, but was chased away by dogs deliberately released to scare them off the area. Although Berihun and Aspen mentioned they herd rumor that this particular marriage continued in secret. It is unacceptable generalization because School clubs are important agent in vanguard vulnerable children even in remote places and go to the last end to stop child marriage. In such cases club members become successful in stopping that marriage by reporting the case to their school administrator and local legal bodies. This shows the extent to which schools and students are fighting child marriage. This indicate that as Ayele (2007) stated Children are not simple recipient of knowledge they have their own agency so that they must be seen as actors who have the capacity to transform the structures that affect their lives and initiated new one

The document written by Berihun and Aspen concluded that in Ethiopia Amhara region where they conducted their research campaign against early marriage lacks clarity and other unexplained objectives are added in it because of this appears to lack a proper planning and execution strategy and denies the right of the rural population to decide for itself(Berihun & Aspen, 2009). Another research conducted by Lisa Bowen and her callings in titled Child Marriage in Amhara, North Ethiopia: Characteristics and Effects on Reproductive Health concluded the need for media program that should focus on educating the community on the negative impacts of child marriage, and with the supports of influence members of the community such as religion leader and medical persons, to support parents to have informed decision for abandoning the practice(Bowen, Dawit, & Misganaw, 2005). However, both documents didn’t mention how to evaluate the achieved desired behavioral changes.

2.4. Base line Surveys in North Gondar

Issues like Child marriage as Adam & Hartford (1999) stated that are subject to socially and culturally determined perceptions and unless you understand local attitudes and base your media intervention (including broadcast) on them, there is a danger that the audience will regard any education and advice as irrelevant. Based on this sense Save the Children developed and implemented several intervention projects base on preliminary baseline surveys in North Gondar Ethiopia focusing women and children.

In this sub topic two base lines conducted in 2006 and 2010 will be discussed. Both of them are done by professional experts hired by Save the Children focusing mainly on Female Genital Mutilation and Child Marriage respectively but the studies also assessed other related harmful traditional practices. Debark, Dabat and Wogera woredas are included as a study area in both of the studies. The specific objectives of both surveys were to evaluate the causes of child marriage by exploring local knowledge, attitudes and practices. The reference team deliberately asked the incorporation of similar question items for both studies so that it show the magnitude difference of child marriage and other HTPs within 5 years.

The first study SCN (2006) is baseline survey on Female Genital Mutilation and the Harmful Traditional Practices, in North Gondar zone six woredas on total respondents 2400 people i.e., from East and West Belesa, Ebinat, Dabate, Debark, and Wogera, done by Amare Dejene and Aster Birhaneselase in 2006 which is sponsored by SCN-E indicated that over 30 different types of harmful traditional practice are identified, among these Child marriage, uvuloctomy, milk teeth extraction, excessive feast, bloodletting and female genital mutilation are more common. The prevalence of Child marriage in the area is 68%, 90 % of study subjects consider Child marriage as harmful traditional practices and support its eradication. The result of prevalence of Child marriage, married less thanl6 year, by district shows that Debark 70.8%, Dabat 66.2%, and Wogera 70.3%. The interesting thing is that Child marriage existence in the community when over 80% support its eradication, which shows respondents are not performing what they say but what they think inside their mind. Some informants mentioned the presence of some families who want to give their children for marriage under cover i.e., like showing for the witness the older child when they are trying to give for marriage their younger child. This shows that the practice of Child marriage is extremely deep rooted especially in the rural community where repeated and intensive intervention is required to change the mind of the people internally(p.56). The finding also verified that the major harmful effects of Child marriage is obstructed labor leading to fistula, school dropouts and other psychological problems. The researchers indicated that even though the participants supported the eradication of Child marriage from the community some religious leaders, adults, some youth and girls claim that the limit or cut off point for marriage should be 16 year and above. Their argument is that if a girl reaches to the age of 16 she can be biologically and mentally mature to run the house. They feel that waiting after 16 years until 18 is waste of time and exposing the girl for premarital sex and losing her virginity(p.73).

Based on their findings the researchers, Amare & Aster, in SCN (2006) suggested that; when intervention strategy is designed at Debrk, Dabat, and Wogera the first priority should go to Child marriage followed by others(p. 85). The monitoring and follow up component should be strong for successful achievements. Encourage muti-sectoral integrated intervention approach. Improving the IEC-BCC strategies during intervention must be considered. Creating community decision through community conversation can enhance the reduction and eradication of HTPs. Appropriate and additional information dissemination must be encouraged: use the younger and the educated groups as change agents during intervention, encourage interpersonal communication, use the available local institution during information dissemination, and give prizes or award for community member who contributed significant achievements during intervention programs. Look for individuals with positive deviance behavior and present the case to the public is also a good strategy to have role models of groups among the community. The community still needs additional and repeated information on HTPs. For this the mass media play a significant role. Among the elements of the mass media radio education can have a wider coverage both in the urban and rural communities. The experience of HTP project also shows that the radio education is a very important tool to overcome the problem and address the majority of the population. Assist victims of HTPs and encourage them to share their experience to show practically the effect of HTPs. Improve the Legal illiteracy of the community and advocate the implementers for continuous and proper implementation. In general the awareness raising program both by mass sensitization and interpersonal communication through peer education must continue.

The second study SCN (2011) title is Child Marriage in North Gondar Zone of Amhara Regional State Ethiopia which is sponsored by Save the Children Norway conducted by Abamela Business Private Limited Company in 2010 and published on 2011. This is a baseline study for the project "Combating Child Marriage in North Gondar Zone of Amhara Region, Ethiopia". This baseline survey is conducted in six adjacent Woredas of North Gonder Zone namely, Wegera, Dabat, Debark, Adi-Arkay, Tach-Armachiho, and Metema. A total of 1,623 people from 716 households participated. Out that of the total 3,416 people in surveyed households, 57% of those above 18 years of age were illiterate. Female’s illiteracy was much higher than male’s (46.4% of males against 68% females). Illiteracy among household members within the age bracket of 7-18 was 15.6%, while the illiteracy was higher in Tach Armachiho district as compared to other districts. In 1991, 80.6 % of women and 25.5 % of men married before they reach age 18. After 2002, the prevalence of men marrying before 18 years of age has reduced to 3.6 %. The prevalence of women who married under 18 years of age was 53.8 %, showing only a slight improvement. Only 53.6% of the respondents had heard information on child marriage related issues. Parents were less informed than their children, and adolescent girls were found relatively less informed than boys. The major source of information for the majority of the population was non printed media: schools/teachers, education events at health facilities, community meetings/gatherings, radio and television were among the most common sources of information on child marriage. The result indicated that among the respondents, 42.6% of men, 38.7% of women, and 56% of male youth reported that they were aware of the existence of a legal minimum age for marriage. Of those who expressed knowing the minimum legal age, only half of them were able to state age 18 as the legal minimum age of marriage for girls. Most respondents saw that appropriate age of marriage for girls was 14 years while it was 18 years for boys. More than two-third of the adolescent and 80% of the parents (both males and females) still have in their mind that child marriage has some advantages/benefits for girls and the family in general. It was 44.2% of men and 34.4% of women who expressed that they knew the existence of the criminal code against child marriage. Among those who expressed knowing the criminal law most lack the details of what it contained. The study revealed major gap on the enforcement of law. It was only 30% of the men and 27% of women who could recall at least one community member who was punished due to arranging child marriage, or canceled arranged child marriage due to interference by the government and other community initiatives. Child marriage was one of the major causes for school drop out of girls in studied woredas. One of the major child protection concerns in the studied districts where that in one out of ten households there was a female member suffering from pregnancy and birth related complications, which were identified as “suspected fistula” by the respondents. Absence of effective and timely medical treatment for suspected fistula cases and other teenage pregnancy and birth related complications at the woredas level made girls more vulnerable to further complications.

Base on their findings in SCN (2011) the researcher’s recommendations included the following ideas: Designing culturally appropriate strategies through intensive community conversations and dialogues, visual and audio education materials and radio programs. The community based initiatives, mainly by government sector offices, schools, community based groups, and churches in studied districts, should be explored further and built up. Families who stand against the child marriage practice and delayed marriage for their children, and those girls who refused for child marriage should receive some form of recognition as role models. Response intervention programs for those victims of child marriage should be designed.

Both of these surveys recommended appropriate awareness creation activities including communications using conversation, dialogue, radio programs that will eventually brings the desired behavior change.

2.5. Theoretical models and functions of communication

Human communication Karen et al., (2008) citing Gerber (1985) defined as the production and exchange of information and meaning by use of signs and symbols which involves process of encoding, transmission, reception( decoding ), and synthesis of information and meaning. He added that mass communication plays a crucial role in health or other social issues to educate individuals and community to bring behavior changes. Media stations are key socializing agents and play crucial roles because they select, organize, produce and disseminate information(Karen et al., 2008). But media messages development and dissemination in interventions design to yield desirable change Grol and others (2007) said can best be done with an understanding of theories of behavior change and an ability to use them skillfully in research and practice. Karn, Barbara, and Viswanath (2008) said that theory, research and practice which are essential to health education and behavior change; are a continuum along which the skilled professional should move with ease. Phillips (2011) stated that planned communication theory and practice that combine transmission/diffusion and dialogue/ participation models within a framework primarily based on the social psychology tradition supplemented with elements of the socio-cultural tradition are at the diffusion and of the continuum of approaches that have taken on board some elements of dialogue.

2.5.1. Diffusion Communication Model

The diffusion model, derived from Everett Rogers’ (1962) “ diffusion of innovations” theory, regards behavior change as the goal of a communications campaign, and views the purpose of communication campaigns as to persuade individuals to change their behavior by providing them information. Within the diffusion model fall such activities as entertainment-education and social marketing where the standard formulation of the model Rogers (1962) added that is Knowledge/Attitude/Practice, or KAP: information provides Knowledge, which leads to a change in Attitude, which in turn leads to Practice- the desired behavior change. As Waisbord (2000:5) explains, the diffusion model has evolved in a participatory direction since its initial formulation; however these projects necessarily involve some element of information transfer but most of the time development communication projects tend to identify themselves quite clearly as belonging in one or other camp.

As Tigist (2010) described Diffusion innovation is one of the known methods in which several scholars suggested it in bringing about change at the community level and it describes how new ideas and opinions are disseminated in order to change attitudes and behaviors of the people in a community. Diffusion interventions according to Boeren (1992:47), Kalipeni and Kamlongera, (1996) focus on mass media and, at times, their relationship with interpersonal communication channels. Participatory campaigns almost exclusively concern interpersonal channels where their principal communication channels are group meetings, workshops, and sometimes localized ‘small media’ such as Community Theater(Boeren 1992; Kalipeni and Kamlongra 1996). However Servaes (1999) as cited in Tigist (2010) mentioned the criticism of innovation of diffusion as a model which assumes as a new idea/innovation always comes from the outside not from within. Servaes noted there is a need for an understanding for the existing local beliefs, traditions, culture and interpretation life before any new idea or innovation takes place.

2.5.2. Participatory Communication Model

According to Wasibord (2000:17) the participatory model emerged in part as a reaction to underlying assumptions of the diffusion model. Wasibord said participatory model holds that development communication is not a vertical process of information transmission from the knowledgeable to the less- knowledgeable, but rather a horizontal process of information exchange and interaction. Servaes (1999) underlines that in order to share information, knowledge, trust, commitment, and a right attitude in development projects, participation is very important in any decision-making process for development. Proponents of participatory model approach stress the model of empowerment adopted from the work of Brazilian educator Paulo Freire (1970). According to him this model posits that the purpose of development is to empower people to have greater control over decisions that affect them and in this way to foster equality and democratic practices. Servaes (1999) said the more important thing is that participation is made possible in the decision-making regarding the subjects treated in the messages.

The participatory approach as Cornwall (1995:1670) stated sees development interventions, “less as means to end than as offering ends in themselves: the emphasis is not on outcomes but on processes.” The essence of the participatory approach, according to Cornwall (1995) lies in working with community members to determine their needs and design programs to address them, rather than imposing an intervention from above. In participatory approach Cornwall (1995) said people are regarded “as agents rather than objects; capable of analyzing their own situations and designing their own solutions”. The participatory nature of a program as Wright et al., (1997: 631) described, consisted of collaboration with community members starting from initial research and the preparation of materials, and “numerous attempts... to facilitate local discussion of the issues”. Participatory communication analyst Susan B. Rifkin in her research mentioned “community participation can be seen as a set of views and activities which reflect a solution to specific set of circumstances where the process under which solutions develop might have some universal characteristics but the solution itself will be local” (Rifkin, 1996:89).

Bessette (2004) defines participatory communication as a planned activity, based on the one hand on participatory process, and on the other hand on media and interpersonal communication, which facilitates a dialogue among different stakeholders, around a communication development problem or goal, with the objective of development and implementing a set of activities to continue to its solution, or its revitalization, and which supports and accompanies this initiative. Participatory communication according to Morris (2003:226), is not a vertical process of information transmission from the knowledge to the less knowledgeable, but rather a horizontal process of information exchange and interaction which is similar to a method used by Paulo Freire dialogue as a catalyst for individual and community empowerment. There are many mechanisms according to Peruzzo (1996: 177-178), that can promote popular participation in media such as:

- Have meetings, with the participation of the community, to discuss the programming or even pan a radio program, to establish the guidelines for a small newspaper, to evaluate
- Keep reporters in change of collecting and covering local, regional or national events
- Allow people direct access to microphones or to newspapers so that they can give their opinions.
- Keep programs, or sections of them, supported by ample and democratic participation
- Open a system to collect complaints and suggestions
- Introduce participatory planning in the medium and/or program planning, e.t.c(Peruzzo, 1996: 177-178).

One problem of Paulo Freire ‘dialogical pedagogy’ theory of communication as Servaes & Malikho (2005:96) mentioned is it is based on group dialogue rather than such amplifying media as radio, print and television. But Hall (2004) stated that the experience of participatory communication goes back at least 50 years and takes radio as the medium of this movement. DaCosta & Jayaweeya (2007) citing Servaes (2002) described that people can obtain information from radio and television, this information has relatively little effect on behavioral changes in addition to this many research show that more is learned from interpersonal contacts. But DaCosta & Jayaweeya (2007) say before people can discuss and resolve problems; they must be informed of the facts and information that the media provide.

2.5.3. Hybrid Approach and Health behavior change communication

According to Morris (2000) participation and diffusion approaches have differing underlying frameworks where diffusion projects focus on knowledge transfer leading using mass media to behavior change; participatory projects focus on community involvement as a catalyst for individual and community development which centered on interpersonal interaction. Laverack et al., (1997) noted that participatory and diffusion methods “are often presented as mutually exclusive,” make a case for combining them: “a suitable strategy for many programs will probably be a practical mix of both approaches,” a combination they term “semi participatory” (p.26) The gap between diffusion and participatory approaches is being bridged by proponents of both models, who knowingly or unknowingly have borrowed elements from one another. Waisbord(2000 p.36) observes that further integration may grow out of “the realization that communities should be the main actors of development communication.”

Morris (2003) identified that most development communication projects define themselves as either as diffusion-based or participatory, and participatory communication tends to define itself in opposition in the diffusion model. However, Morris (2003:227) says “the two are not polar opposites” and the diffusion model has in fact developed in a participatory direction and participatory projects often contain an objective in line with diffusion. There are a wide range of hybrid approaches that combine transmission of diffusion models and models labeled participatory or dialogic. Phillips (2011) described such mixed approach as;

On one side of spectrum, communication is conceived and enacted as both dialogue and knowledge diffusion and the strategic goal is still individual attitudinal and behavioral change; at the other end, the communication is conceived and enacted solely in terms of a discourse of dialogue, participation and empowerment and the strategic goals are followed of individual and community empowerment and social change in the direction of greater social equity; and at various point on the spectrum, diffusion and dialogue models are combined and integrated to varying extents in hybrid approaches(Philips, 2011).

Many health and development communication have been developed in hybrid methods. Health education field is ideal for ‘reflective practitioners’ who can ensure that theories and practice build on each other(Schon, 1983). Research and practitioners may differ in their priorities, but the relationship between research and its application can and should move in both directions(D’Onfrio, 1992; Freudenberg & others,1995) According to Karn, Barbara, and Viswanath (2008), the person who know theory and research comprehends the ‘why’ and can design and craft well-tailored interventions and he constantly creates new and adopt mixed methods depending on the circumstances, based, preferably, on evidence about the intended audience and previous interventions. They added that both media practitioners and researchers are accountable for results, whether these are measured in terms of participants’ satisfaction with the programs, or changes in their awareness, knowledge, attitudes, beliefs, or health behaviors, or in their improved decisions regarding it, or change in institutional norm, integration and quality of life. In addition to this according to Bartholomew, Parcel, Kok, and Gottlieb (2006) in health communication, the circumstances that interventionist can modify are based on the nature of the target audience, the setting, resources, goals, and constraints which are the backgrounds of the problem in question.

According to Hiatt and Rimer,(1999);Sallis,Owen,and Fotheringham, (2000) health improvement using behavior change is better described as a cycle of interacting types of activities, including fundamental research on determinants and development of methodologies, intervention research aimed towards change, surveillance research on population wide trends including maintenance of change and program delivery. Barbara and Glanz (2005) described the possible paths through which a health communications message can influence someone’s beliefs and/or behaviors are: immediate learning ( people learn directly from the message), delayed learning (the impact of the message is not processed until sometime after it has been conveyed), generalized learning ( in addition to the message itself, people are persuaded about concepts related to the message), social diffusion (messages stimulate discussion among social groups, there by affecting beliefs), and institutional diffusion(messages instigate a response from public institutions that reinforces the messages impact on the target audience). In Summary, Barbara and Glanz (2005) said there are two approaches basically to address health problems which are change people’s behavior or change the environment. Barbara and Glanz suggested that the most useful health promotion and behavior change intentions integrate these two approaches and treat them both as essential because individual behavior both influences, and influenced by the environment so it is better to design multidimensional and effective intervention program.

Therefore the task of health behavior and health education as Karn, Barbara, Viswanath (2008) described it is both to understand health behavior and to transform knowledge about behavior into effective strategies for health enhancement so that it will be judged by its contribution to improving the health of population. Therefore, as Grol and others (2007) mentioned it as understanding of theory may guide users to measure more carefully, cleverly and quickly in order to assess the impact of intervention. Because;“if we want more evidence based practice, we need more practice based evidence”(Green & Glasgow, 2006).

There are plenty of practical experiences regarding mixed utilization of participation and diffusion approaches. Hyndman (2001) made a research in titled Health Communication and community Mobilization: Complementary Strategies for Health Promotion, in that by using face to face communication combined with media effectively promoted healthy behavior and reduced health risk behaviors among low income people in South East Texas such as prevent smoking, cancer risk, reduce alcohol abuse, increase physical activities etc. Hyndman used two main strategies: the use of media messages through print materials and face-to-face communications by trained community members as well as television programs, news paper articles, discussion at churches and sport groups. The result of Hyndman research includes changes in medical checkups by people, stopping smoking, weight loss and the initiation of exercise group. Another example is a radio drama broadcast in Zambia which includes the message that married people should discuss AIDS with their spouses and children where evaluation of the project suggested that exposure to the program did spark family conversations about AIDS(Yoder, Hornik and Chirwa, 1996). Again the second study Wright et al., (1997) of a campaign to promote breastfeeding on the Navajo research in Arizona used techniques drawn from both social marketing and participatory frameworks where at the community level, the intervention took the form of a social marketing campaign featuring radio spots, an infant t-shirt, a prominently-located billboard, and a slide tape shown at local health fairs and in clinics and at individual level education materials were produced for new mothers. In Arizona study a layer of interpersonal communication was built in to the project: an elderly volunteer from an existing tribal “Forest Grandparent” program visited the maternity ward of the Indian Health Service hospital to talk with mothers about the benefits and procedures of breast feeding. The third study is a family planning campaign in The Gambia found that exposure to an entertainment-education radio drama “was associated with interpersonal communication about contraceptives with partners or friends” and that these discussions, rather than the radio programs directly, led to increased clinic visits(Valente et al., 1994,p.99). A family planning campaign in Ghana(Hindin et al., 1994), and family planning and AIDS campaign in Tanzania(Rogers et al., 1999; Vaughan et al., 2000) reports similar findings.

Social learning and decision-making are not limited to the contents of media messages but also involves listening and exchanging opinions with a number of different sources, interventions do complement media to achieve the desired behavior change. Waisbord (2005) indicated that media are very important in rising awareness and knowledge about a certain problem not only to create conversation between targeted audience but also to others who are not exposed. Karen et al., (2008) said use of multiple strategies together create synergy making it more powerful in accomplishing behavior change than if each were used alone (the effect of the whole being greater than the sum of the parts). Use of multi-media strategy compensate one media weakness by other strength; for instance small group discussion strong in presenting intensive, interactive experience but does not cover large area. To solve this problem mass media that reach large number of people can be combined with group discussion.

Albert Bandura suggested that the ‘power’ of any single channel of communication (mass media or interpersonal) might depend on the complexity of the behavior change being added. “The less complex the change, the more the influence of a single channel, leading to performance of the behavior” (Bandura, 1994). Which means the more complex the behavior, the greater the need for multiple exposure to multiple source. In complex behavior the influence of any single channel is relatively less. Waisbord (2005) citing UNAIDS (1999) communications framework, which recommends the integration of multimedia and interpersonal communication since interpersonal communication is fundamental in persuading people about specific beliefs and practice. Because Waisbord (2005) added the media have powerful effects only indirectly, by stimulating peer communication and making it possible for messages to enter social networks and become part of everyday interactions.

Hyndman (2000) citing from Boeren (1992) suggests that communication channels, both interpersonal and media are used to make community group members aware of shared health concerns and to mobilize them to action. He added citing Farquhar et al., (1977) that evaluations of “media-alone’ interventions have consistently found little or no impact on behavior. By contrast, significant changes in health behavior have occurred when media appeals were combined with community-based activities.

2.5.4. Media functions and principles

Media have the functional ability to reach mass audiences and capacity to affect personal as well as social behavior for positive change. But Nwesbold (1995) stated that there has been a less publicized focus on the media’s potential for positive or “pro-social” effects. According to Lucas (1999) when people are able to express themselves through media and when their concerns are heard, considered, and acted upon, their dignity and self-confidence increases. When self confidence improves Lucas added that by well packed edutainment and educational informative programs that captures interest people develop an appreciation of the medium as an important resource for their own development where this by itself is an essential change towards development. Mytton (1999) described the potential of electronic media as:” they cut across social and economic barriers and provide equal access to educational and other information by which people can improve their own personal circumstances”(p.12). In addition to this Mohanty (1992) on his study on primary school educational programs produced and broadcast by the All India Radio, based on a sampling of schools from Uttar Pradesh and Cuttack District, says broadcasting has assumed an important role in the development of children and young people, not only because of its effectiveness as a source of information and as a developer of attitudes, but also because of its ready availability vertically to the whole community. According to Lucas (1999) electronics media at present days has taken over the role of teacher, preacher and parent so that it is one of the most influential educational tools in modern life. Young people according to UNESCO (2005) document are said to be much attuned to mass media for information and cues on how to behave. So that one has to use media potential for teaching young people to combat any social problems. The UNESCO (2005) document also stated that the available data so far support the effectiveness of mass media to increase knowledge, improve self-efficacy, influence some social norms, and increase the amount of inter-personal communication. Khanal (2011) stated citing FAO (2005) research that farm radio has contributed in terms of strengthening social unity, enhancing communicative ability, giving knowledge about locality, preserving environment and solving the problems that arise in the communities. In another document Nakabugu (2010) point that rural radio gives farmers an opportunity to interact with each other and with relevant authorities like extension workers, crop and animal experts through formats like talk shows, phone in programs and local broadcasts and also it is used to mobilize people towards community development activities. Another idea stated by Rogers (1971) is new ideas invention in a closed system like a small village is a rare event, until there is communication of ideas from sources external to the village, little change can be occur in that local people knowledge, attitudes, and behavior so that communication is central to modernization in such circumstances(p.48).

In order to be truly of service to the under privileged and rural poor Lucas (1999) says that mass media must therefore create conditions and mechanisms that can provide people with genuine access to media. Such mechanisms, Lucas added, will offer ways in which people can express their sentiments, opinions, views, dreams and aspirations, their fears and insecurities, their strengths and capabilities, as well as their potential for development.

Merrill (1994) described that media is used to disseminate information, to entertain, to persuade, service to the economic system and transfer of the culture. One of the main functions of mass media emphasized by Gamble,T.K. & Gamble, M(1999) is its service as an agent of socialization, they further elaborated in that; “ the media now a day plays an instrumental role in showing us how others expect as to behave, by teaching us a day-to- day norms of our culture and by helping us to internalize its reality”(p.38). The socializing agent role of media supported by Ganesh (1995) in that especially radio has a role to play in molding children and youth.

According to McQuail (1994), media respond to the demand to and from society for information and entertainment and, at the same time, stimulate innovation and contribute to change socio-cultural climate, which sets of new demands for communication(p.63). Further more Licht (2003), described GEMC principle citing Getnet (2006:p.6) in that to have an effect any message must receive attention, interpretation, acceptance and disposition. McQuail (1994) citing Noble (1975) emphasized the sociability of ‘audience behavior’ has several aspects, including: attending to media in order to maintain peer-group relationship; the widespread reference to media experience as a basis for conversational exchange of informal social contact. To create an effect in changing the behavior of a given audience media has to be more interactive. This interactivity nature of media defined by Rogers (2003), as Interactivity is the capacity of reciprocal, two-way communication attributable to the capacity of medium or relationship. Interactivity allows for mutual adjustment, co-orientation, finer control and greater efficiency in most communication relationships and process(p.497).

Many scholars suggested different ideas about the functions of media the following are three of them which summarize the main points. The first is Diaz-Bordenaue (1977) four functions of communication media that may contribute significantly to a participative society:

1. Help in the development of a community cultural identity;
2. Act as a vehicle for citizen self-expression;
3. Facilitate problem articulation;
4. Serves as tools for diagnosis of communications problems.

The second is Kawl and Michel Gamble (1999) five functions of mass media that contribute to the society:

1. Serves as a source of information and surveillance;
2. Sets our agenda and help structure and interpret our life’s;
3. Help us to connect with divers groups in a society;
4. Act as a socializing agent;
5. Serves as a entertainment means.

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