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Child labour in Addis Ketema, Ethiopia: a study in mental health
Umeå University, Faculty of Medicine, Clinical Sciences, Child and Adolescence Psychiatry.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

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

Aims: 1. to assess the level of awareness and attitude of an urban community on child labour. 2. to describe the patterns of child labour and the experiences of child labourers in the informal sector with emphasis to child domestic labour. 3. to determine the risk factors contributing to child abuse and psychiatric disorders in child labourers.

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

Results: Domestic labour, working in the streets, and in private enterprises were the three main types of child labour identified. These types of child labour were identified by 82% (n=158) key informants, who thought child labour was a social problem, mainly resulting from poverty, and associated with abuse. In the quantitative study (5-15 year old sample) 528 child labourers and 472 non-labourers were included in the study. Of the child labourers, 34% were engaged in domestic labour, 57% working in the streets, and 9% in private enterprises. Over half of the child labourers worked for more than 9 hours daily. The prevalence of child abuse was 43.9% and 17.2% among child labourers and controls, respectively (OR=3.7, 95% CI: 2.74, 5.09; p<0.001). Emotional abuse was the commonly encountered abuse compared to other types (OR=3.06, 95% CI: 2.23-4.20; p< 0.001). Child domestics and street labourers were the most vulnerable group. The prevalence of any DSM-III-R psychiatric disorder was 20.1% and 12.5% among child labourers and controls, respectively and the difference was statistically significant (OR=1.89, 95% CI: 1.34-2.67, p<0.01). Controlling for all socio-demographic factors, child labour status was the only significant factor in determining DSM-III-R diagnosis.

Discussion: In a comparable group of child labourers and controls, child labourers were found to be a high-risk group for different types of abuse and psychiatric disorders. Although parental unemployment and low maternal education were associated with child labour, the only factor that was associated with psychiatric morbidity was being a child labourer. It seems that poverty is not the only reason for child labour; hence its mere alleviation alone is unlikely to dramatically improve the risk for child labour and mental health of the children. There are many motivating reasons to be a child labourer, and likewise various positive and negative maintaining factors. Therefore, not all child labourers are prepared to stop their paid job altogether in order to become a full time student.

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

Place, publisher, year, edition, pages
Umeå: Klinisk vetenskap , 2008. , 79 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1228
Keyword [en]
child labour, child abuse, psychiatry, Ethiopia
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:umu:diva-1922ISBN: 978-91-7264-664-3 (print)OAI: oai:DiVA.org:umu-1922DiVA: diva2:142440
Public defence
2008-12-04, Sal B, 9 tr, Tandläkarhögskolan, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2008-11-18 Created: 2008-11-18 Last updated: 2009-04-20Bibliographically approved
List of papers
1. Child labour and emotional disorders in an urban district, Ethiopia: a rapid assessment on community perception of child labour
Open this publication in new window or tab >>Child labour and emotional disorders in an urban district, Ethiopia: a rapid assessment on community perception of child labour
2001 (English)In: Ethiopian journal of health development, ISSN 1021-6790, Vol. 15, no 3, 197-202 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-3641 (URN)
Available from: 2008-11-18 Created: 2008-11-18 Last updated: 2011-03-18Bibliographically approved
2. Review of child labor with emphasis on mental health
Open this publication in new window or tab >>Review of child labor with emphasis on mental health
(English)Manuscript (Other academic)
Identifiers
urn:nbn:se:umu:diva-3642 (URN)
Available from: 2008-11-18 Created: 2008-11-18 Last updated: 2010-05-28Bibliographically approved
3. Child abuse in child labor in urban district, Ethiopia
Open this publication in new window or tab >>Child abuse in child labor in urban district, Ethiopia
(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-3643 (URN)
Available from: 2008-11-18 Created: 2008-11-18 Last updated: 2017-01-30Bibliographically approved
4. The prevalence of mental health problems in Ethiopian child laborers.
Open this publication in new window or tab >>The prevalence of mental health problems in Ethiopian child laborers.
2006 (English)In: Journal of child psychology and psychiatry, ISSN 0021-9630, Vol. 47, no 9, 954-959 p.Article in journal (Refereed) Published
Keyword
Adolescent, Catchment Area (Health), Child, Child; Preschool, Cross-Sectional Studies, Demography, Employment/*statistics & numerical data, Ethiopia/epidemiology, Female, Humans, Male, Mental Disorders/diagnosis/*epidemiology/psychology, Prevalence, Questionnaires, Severity of Illness Index, Sex Factors
Identifiers
urn:nbn:se:umu:diva-13897 (URN)16930390 (PubMedID)
Available from: 2007-05-16 Created: 2007-05-16 Last updated: 2010-05-28Bibliographically approved

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