Ethiopia

“Culture in simple terms is behavior and beliefs that are learned and shared” (Skolnik, 2020b). Individuals should have a basic understanding of just how culture can dramatically affect one’s health. An individual’s culture according to Skolnik (2020b) influences practices of health both harmful and beneficial, views on cleanliness, opinions of illness and what illness is, when to seek care, and different thoughts pertaining to practicing medicine. Culture also plays a key role in gender norms and what is considered socially acceptable within a given group.

In Ethiopia men are typically tasked with doing more labor-intensive duties, such as working in the fields with crops, construction, and trading goods (Nag, 2018). Women in Ethiopia preform household duties and raise children (Nag, 2018). The makeup of the family is typically patriarchal in nature, unless an individual lives in a more urban area where gender roles are not as prominent (Nag, 2018). Typically, the oldest male will lead the household if anything happens to the father who is in control and makes decisions (Nag, 2018). If any inheritance is to be had it will favor the males in the family, leaving the females with little to none (Nag, 2018).

One cultural practice that has been made illegal in Ethiopia since 2004 but is still be practiced in more rural parts is female genital mutilation of FGM (UNICEF, 2020c). FGM is categorized into four types, type one being the least severe with partial or total removal of the clitoral glans and/or prepuce of clitoral hood extending to the most severe which is type four and can involve any harmful procedure to genital area (World Health Organization, 2020b). According to UNICEF (2020a), 65% of women have experienced FGM and 47% of adolescent girls ages 15-19 have undergone FGM. Some risk factors for undergoing FGM are living in a rural area, being less educated, and/or identifying as Muslim (UNICEF, 2020a). The practice is still performed by some due to it being considered the norm, it is believed that it prepares a young girl for marriage, religious reasons, enforces socially acceptable sexual behavior of females by decreasing sex drive, and increases likelihood of marriage (World Health Organization 2020b). FGM has no health benefits only problems, which include issues with urination, cysts, infections, tissue swelling, fevers, bleeding, shock, death, complications with childbirth, an increased risk of newborn death, and psychological problems (World Health Organization, 2020b).

Another harmful cultural practice involves child marriage in Ethiopia. The average age for marriage for a female in 2011 was 16.5 (Marshall et al., 2016). The government is making great strides in attempting to end childhood marriage by 2025 and has set a legal age limit of 18 for marriage (Marshall et al., 2016). Arranged marriages are not uncommon in rural Ethiopia, with the exchange of a dowry for a young woman’s hand in marriage, if a young man cannot afford the dowry then there have been instances where the woman/girl is kidnapped and raped so that the family will allow the marriage, this is known as marriage by abduction (Marshall et al., 2016). Even an educated woman still marries at a relatively young age with the average being 23.8 years old (Marshall et al., 2016). An astonishing four out of five women are married before the age of 15 if they are uneducated and live in a rural area (Marshall et al., 2016). If a female is married before the age of 15 then she is more likely to die from pregnancy related issues (Marshall et al., 2016). There is also an increased risk of sexually transmitted diseases and HIV due to most married couples having unprotected sex with their spouse, and most young females’ spouses are older males (Marshall et al., 2016). The main reason for the continued incidence of childhood marriage is because it is considered the social norm and for monetary reasons related to the dowry received by families for their daughter (Marshall et al., 2016).