DIRE DAWA UNIVERSITY

COLLEGE OF MEDICINE AND HEALTH SCINCE

DEPARTMENT OF PSYCHIATRY
KNOWLEDGE, ATTTITUDE AND PRACTICE TO WARD MENTAL ILLNESS
AMONG COMMUNITY OF DIRE DAWA CITY ADMINISTRATION,
EAST,ETHIOPIA, ,2023 GC: CROSS SECTIONAL STUDY

BY: ID NO
KURI MOHAMMEDSAFI 1204536
ABDULEHI SEID 1104224
SENAYT MOSEWA 1201281
HANA TEFERA 1204151

ADVISORS :FUFA OLANA

: KEDIR MOHAMMED
JULY, 2023
DIRE DAWA,ETHIOPIA

DIRE DAWA UNIVERSITY

I
ACKNOWLEDGMENT

We would like to express our deepest gratitude to our advisors Mr. Fufa Olana And Mr.Kedir
Mohammed for their endless support throughout the development of this research proposal also
we would also like to thank Dire Dawa University College Of Medicine and Health Science
Department of Psychiatry for providing this opportunity to conduct proposal.

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Summary

Background: According to the American Psychiatric Association, a psychological disorder, or

mental disorder, is “a syndrome characterized by clinically significant disturbance in an
individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the

psychological, biological, or developmental processes underlying mental function.

Knowledge, attitude and practice towards mental illness (KAP) in community a are

very poor understandeds. However, there is an increasing burden of mental illness in the

community.

Objectives: To assess knowledge, attitude, and practice towards mental illness among
community Dire dawa city, Lega hare kebele, East, Ethiopia, 2023G.C.

Methods: community based cross-sectional study will be conducted from May 2023 to October
2023. DIRE DAWA University, Dire Dawa administrative city, eastern Ethiopia and systematic

random sample technique will be used to select study participant. Face to face interview with

structured and semi- structured questionnaires (that translated to afan-oromo) will be used for

data collection. Questionnaires include socio-demographic information, knowledge toward

mental illness, and attitude toward mental illness and practice toward mental illness . Data will
be entered into Epi-data version 4.6 and exported to SPSS version 25 for analysis

Work plan and Budget The study will be conducted from May, 2023 to Octobe, 2023 using a
total budget of 9270birr

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 Table of Contents

Contents Page

ACKNOWLEDGMENT..................................................................................................................I
Table of Contents............................................................................................................................II
ACRONYMS AND ABBREVATIONS.......................................................................................IV
Summary.........................................................................................................................................V
CHAPTER ONE..............................................................................................................................1
1 Introduction...................................................................................................................................1
1.1 Background................................................................................................................................1
1.2 Statement of the problem...........................................................................................2
1.3 Significance of the study............................................................................................3
CHAPTER TWO.............................................................................................................................4
2. OBJECTIVES..............................................................................................................................4
2.1 General objective........................................................................................................4
2. 2 Specific objectives.....................................................................................................4
CHAPTER THREE.........................................................................................................................5
3. Literature Review........................................................................................................................5
CHAPTER FOUR...........................................................................................................................9
4.Methodology and material............................................................................................................9
4.1. Study area and period...............................................................................................................9
4.2 Study design...............................................................................................................9
4.3 Population...................................................................................................................9
4.3.1. Source of population...............................................................................9
4.3.2. Study population.....................................................................................9
4.3.3. Study unit................................................................................................9
4.4. Inclusion and Exclusion criteria................................................................................9

III
 4.4.1. Inclusion criteria.....................................................................................9
4.4.2. Exclusion criteria..................................................................................10
4.5. Sample size determination....................................................................................10
4.6. Sampling technique and procedure.........................................................................10
4.7. Data collection tools and technique.........................................................................11
4.8. Study variable..........................................................................................................11
4.8.1. Dependent variable...............................................................................11
4.8.2. Independent variable.............................................................................11
4.9.Data quality control..................................................................................................11
4.10. Data processing and analysis.................................................................................11
4.11.Operational definition.............................................................................................12
4.12. Ethical consideration..............................................................................12
4.13. Plan for dissemination of the study........................................................12
CHAPTER FIVE...........................................................................................................................13
5. WORK PLAN AND BUDGET BREAK DOWN.....................................................................13
5.1WORK PLAN...........................................................................................................13
6.BUDGET BREAK DOWN........................................................................................................14
7. REFERENCES........................................................................................................................15
8 .ANNEX.....................................................................................................................................18

ACRONYMS AND ABBREVATIONS

IV
BMC =biomedical center

BSC= Bachelor of Science

CAMI =Community attitude toward mental illess CAMI scale

CMHI=Community Mental Health Ideology

CMUL=College of Medicine of the University of Logos
CI: Confidence Interval
DDU= DIRE DAWA University
DDCMHS=Dire Dawa College Of Medicine and Health Science
GM=Group member
KAP=Knowledge and Attitude and Practice
MDD=Major Depressive Disorder

MHKS= Mental health knowledge schedule

LMIC= low and middle-icome countries

PWMI = People With Mental Illness

SPSS=Statistical Package for the Social Sciences

SRQ= Self-Reporting Questionnaire
WHO= World Health Organization.

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VI
 CHAPTER ONE
1 Introduction
1.1 Background
Mental illness has regularly been a significant challenge and is becoming more and more
relevant in today’s fast paced world, The term mental illness, according to the World Health
Organization, is used to represent a wide range of mental and emotional disturbances that can
impact a person's thinking, feeling, decision-making, mood, everyday functioning, and capacity
to interact to others(1)(7). All parts of the world experience high rates of mental health issues,
which affect every age group, community, and level of income (52) .

Attitude is psychological tendency that is expressed by evaluating a particular entity in with

some degree of favors or disfavor (46).Attitude toward mentally ill person society can have
stereotyped views about mental ill health. Some people believe people with mental health
problem are dangerous, unpredictable and different from others, responsible for their for their
condition, hard to take to and incurable in community when in fact, they are at a higher risk of
being attacked or harming themselves than hurting other people.(44.).

Mental health knowledge includes the capacity to identify mental health problem,
understanding of risk factors and cause, professional help available, attitudes that promote
recognition, and appropriate mental health help-seeking behaviors(29).

People's attitudes and knowledge of mental health issues determine the extent to which they
interact with, support, and enable a person with mental health issues. People's attitudes and
ideas about mental illness include how they feel and express their own emotional problems and
psychological pain, as well as whether they reveal these symptoms and seek help. A person's
beliefs about what mental disease is like and how it should be treated are referred to as their
attitude toward mental illness, and these beliefs could range from acceptance to tolerance to
fear (15).

1
Personal experience with mental illness, acquaintanceship with a person who lives with a
mental illness, cultural stigma associated with mental illness, media outlets, and familiarity with
institutional practices and restrictions (such as adoption and health insurance restrictions) all
influence attitudes and beliefs about mental illness(3).

Many African societies, particularly Ethiopia, believe that mental illness is either the result of a
genetic deficiency or the product of wicked plots. Due to these unfavorable perceptions, mental
health patients are labeled as outcasts and individuals who need to be isolated (5).

The attitude, the road to seeking assistance, and the prevention of stigma and prejudice
towards patients with mental health disorders are all significantly impacted by the community's
knowledge of mental health issues. It is also the cornerstone for creating community mental
health interventions based on research. One of the numerous obstacles that keep people from
receiving the appropriate therapy and force them to conceal their symptoms is the acceptance
associated with accessing mental health services (4).

Stigma, which prevents patients from seeking assistance from medical professionals and other
services offered at state, appears to be another major factor in the underutilization of mental
healthcare. Many patients with mental disorders also likely to seek treatment from traditional
healers before seeing theirs doctors. Even while mental disease affects a large number of
individuals worldwide, it is associated with a number of misconceptions and myths in contrast
to other chronic physical disorders like heart and hypertension(6).

Due to stigma, psychiatric patients are denied the compassion and understanding that have
historically been given to the continent's sickly society (7). Globally, people with mental
illnesses often feel stigmatized by unfavorable society attitudes, which influences their
decisions about getting help, getting diagnosed, and getting treatment(8).

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1.2 Statement of the problem
Mental disorder are the major burden of disease in worldwide, especially in low and middle-
income countries (LMIC) ,yet the lack of knowledge and positive attitude seen in socialite cause
global mortality and premature morbidity (4). According to WHO, urbanization's consequences
are to blame for Ethiopia's rising trend of mental health issues (7). A 2019 WHO survey found
that 970 million individuals worldwide, or 1 in every 8 people, has a mental disorder, with
anxiety and depressive disorder being the most frequent (3).

Unfortunately, in most part of the world, mental health and mental disorder are not regarded
with anything like the same importance as medical condition, but rather they have been largely
ignored or neglected (11).people perception about mental disorders if attached to knowledge,
encounter with people suffering from mental illness, media portrays, cultural stereotype and
their personal experience of mental disorder (12).

Mental health problems are more common in developed world than in developing world but
this notion has long been disputed. In Ethiopia where malnutrition and infectious disease are
very common, mental health problem are not given due attention however, in Ethiopia
population around 100 million, neuropsychiatric disorders are estimated to account for 5.8% of
the disease( 1). 12 % of Ethiopian people have suffered have suffered from mental health
problem account 12.45% of burdened of diseases in Ethiopia are from psychiatric health
problems of which 2% are sever case. The problem is aggravated by poverty, unemployment,
and the presence of another physical illness like HIV/AIDS(10).
Of all the health problems, mental illness are deficiently understand by universal in community,
such poor knowledge and negative attitude toward mental illness threaten the success of
patient care, rehabilitation, the healing processes unable to use effective treatment ,lead to
stigmatization, inhibit help seeking behavior and provide proper holistic care. Furthermore,
negative attitudes and discriminations deprive victims of human dignity and prevent social
participation. These negative experience contribute to decrease self-esteem and instill feeling
of shame guilty(13).

Population studies have usually revealed that negative stereotypical characteristics

are associated with mental disorders. First of all, people suffering from mental disorders
are considered to be unpredictable and dangerous. Secondly, they are considered to be

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irresponsible. Thirdly, they are seen as child-like and finally the fourth stereotype is of a
person who is incapable, which is associated with a self-inflicted weakness. At least the first
and fourth stereotypes have been used as explanatory variables in studies exploring social
rejection (41).
it is claimed that inadequate mental health literacy is an issue Because inadequate knowledge is
linked to treatment seeking delays, decreases in treatment seeking, and usage of subpar
treatments,. Other consequences are stigma and discrimination, limited support system, poor
quality of life and limited empowerment and advocacy (43).

The community’s mental health literacy has been found to be still unsatisfactory and needs to
be improved, in order not to hinder community support. People with mental illnesses are often
stigmatized, due to a lack of knowledge about their illness (41). Those stigmatizing beliefs about
those with mental illness (dangerous, incapable of recovering) can cause them to internalize
this beliefs and have an impacts on many area of their lives(14).

Negative attitudes against people with mental disorder and their families is a global problem
with significant clinical and public health issues(11).it was found that stigma can cause a loss of
confidence and self-efficacy in patent with mental disorder, it result of negative belief that will
never be able to recover(16) .Untreated symptoms with mental illness and negatively impact of
families affected by these for example, most people with serious and persistent mental disorder
( mental illness that affect social functioning) are jobless and live under poverty line, and may
face major barriers to obtaining decent, affordable housing, Stigma can also interfere with self-
management (2).

The factors that influencing knowledge, attitudes and practice (KAP) towards mental illness are

 Education & knowledge level: are individual have less access to mental health
information or they have lesser ability to understanding of such information as result of
their lower education (38).
 Socio-cultural factors: cultural, norms and values play a significant role in shaping kap
toward mental illness. Also cultural attitudes toward mental health, help-seeking
behaviors and stigma can differ greatly across society (47).

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  Personal experience and exposure: personal experience with mental illness, either
through personal struggles or through relationships with family or friend, can shape
KAP. For example like positive experience, such as successful treatment outcomes or
recovery, can enhance understanding while negative one such as witnessing
discrimination or inadequate treatment make KAP to mental illness worst (Error:
Reference source not found).
 Media influence : like how portrayal of mental illness in movies, TV shows and social
media can either perpetuate stereotype and stigma or promote understanding and
good attitude (45).
 Other factor are social support (46) and influence, access to resources and service (14)
and gender and age (46).

In Ethiopia in general and no enough studies in DIRE DAWA city have been done to assess the
knowledge, attitude and practice towards mental illness among community of DIRE DAWA city,
leg hare unit before. Therefore, this study was carried out to fill this research gaps

5
 1.3 Significance of the Study
Despite mental illness is a significant problem globally, especially , DIRE DAWA city
administration , Ethiopia, and it associated with inadequate knowledge ,negative attitude and
negative practices toward mental illness. As we know there is no study assessment on
knowledge, attitude, and practice towards mental illness in DIRE DAWA city administration..

Therefore: the aim of this study

1. Increasing understanding: Researching the community in DIRE DAWA city's knowledge,

attitudes, and practices around mental illness can reveal the extent of that community's
understanding and awareness of mental health..
2. Highlighting gaps or misunderstandings about mental illness that may exist in the
community, according to the study. This understanding can direct activities meant to
close these gaps, and eliminate.
3. Establishing a baseline: Researching people's knowledge, attitudes, and practices about
mental illness can create an essential foundation for comparisons and assessments in
the future. It can serve as a benchmark against which subsequent research can gauge
progress and assess the efficacy of therapies.

In summary, a study on knowledge, attitudes and practice towards mental illness among the
community in Dire Dawa city holds the potential to improve understanding reduce stigma

inform policies and services and establish a foundation for future research.

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 CHAPTER TWO
2. OBJECTIVES
2.1 General objective
· To Assess Knowledge, Attitude, and practice to Ward Mental Illness Among residents of
Lagahare kebele, Dire Dawa, East Ethiopia 2023 G.C

2. 2 Specific objectives
· To assess the knowledge of residents Lagahare kebele, Dire Dawa city
· To assess the attitude of people towards mental illness residents of residents Lagahare
kebele, Dire Dawa city
· To assess the practice of residents of residents Lagahare kebele, Dire Dawa city

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 CHAPTER THREE
3. Literature Review
Knowledge, attitude toward mental illness

Assessment of the public's knowledge and attitudes on the symptoms of schizophrenia was
done in Quebec, Canada According to a study on public knowledge and attitudes on
schizophrenia conducted in Quebec, Canada, as 36% of respondents, schizophrenia causes
feelings of comprehension deficits and 39% of respondents, suspicion deficits. 40% of
respondents thought schizophrenia could not be healed, 31% thought an employee with
schizophrenia would be fired, and 54% thought schizophrenic patients were violent and
dangerous (40).

According to a research done in 35 states, the District of Columbia, Puerto Rico, and Colombia,
62% of adults strongly believe that mental health therapy can help those with the illness lead
normal lives, but just 22.3% of respondents agreed with the statement that people are
empathetic and compassionate toward those with the illness (19).

A communti based cross-sectional survey carried out in Qatar in 2009 revealed that the
community had a poor understanding of prevalent mental DISORDER; roughly 72.5% of
respondents were unaware of these conditions. The belief that substance usage could lead to
mental illness was held by 84.7% of respondents, followed by an unpleasant experience or
shock (83%). While 38.7% thought that evil spirits were to blame for mental illness, 48%
considered that it could be the result of divine punishment. In this study, attitudes about those
with mental illnesses were investigated. Of the respondents, 40.6% thought that those with
mental illnesses were intellectually/mentally retarded. More than half (53.5%) of them believed
that people with mental illness are dangerous, 12.5% of people with mental illness consent to
sharing a room with them but a few believed that people with Mental illness can work in
conventional occupations (20).

8
According to study done in Indonesia 50% had good knowledge about mental illness and 52.46
% had positive attitudes towards mental disorder(22).Only 26.5% of respondents correctly
answer half of the questions in a Malaysian survey that evaluated respondents' mental health
knowledge, attitudes, and practices in an effort to prevent mental DISORDER. The majority of
survey participants in this study had a neutral opinion of mental health issues (25).

According to institutional based study conducted in India, western Maharashtra 2014 on

knowledge, attitude and practice among care givers of patients with schizophrenia, most of the
care givers 30% had no prior knowledge about schizophrenia. The fathers 24% and relatives
24% were the majority care givers for the patient. Care givers considered medical intervention
to be important, but they also advocated supportive intervention such as counseling and family
support. Financial problem was one of the factors that impacted negatively on the follow up of
the patient (22).

Community based Cross sectional study 87.7% of Saudi community

Community based cross sectional study that done on cape town, south Africa , one half of the r
respondent felt the case study they were presented with was not a normal response but rather
sue to stress, emotional problem, expectation too much of oneself. And many believed that
particular diagnose was not hereditary and not due to witchcraft (48).

The majority of respondents to a nationwide study in Nigeria, Sub-Saharan Africa, believed that
substance abuse might lead to mental disease (80.8%); 35% of respondent believed by evil
spirits, 30.2%, then stress and trauma. 9% of respondents thought that God's wrath. The
perception of mental illness was generally unfavorable, a nuisance to society, and 95.5% of
respondents thought they were dangerous. Only one-fourth of respondents thought that such
persons could work in ordinary employment, and less than half thought they could be treated
outside of hospitals. The majority of respondents (82.7) were reluctant to associate socially
with someone who was mentally ill (23).

According to a community-based research done in Kinondoni in 2010, very little was known
about mental illness. In fact, 61% of respondents said that such persons were dangerous,

9
unable to hold down a regular job, and had no friends. 79.6% of respondents had an
unfavorable view about people with mental illness, saying that they had no right to
employment, friendships, or integration into society (24)

In Malawi's community-based study from 2012, which included 210 participants, the majority
of individuals (95.7%) blamed mental illness on abusing alcohol and illegal drugs. This was
closely followed by mental trauma (76.1%), brain sickness (92.8%), and possession by spirits
(82.8%) (32).

Cross sectional Study conducted in Addis Ababa 78.5% of participant had negative attitude
toward mental illness and 18.5% and 37% strongly agree and agree that people with mental
illness are dangerous and 40.2% agree that mentally ill person is unpredictable (26).

A community based cross sectional study conducted in mattu south west Ethiopia about
182(28%) of study respondes reported poor kowlege of mental illness and atttuide of study
respond toward mental illness using CAMI instrument of mean of 120. And 60% reported that
unfavoreabel attitude toward mental illness (53).

According to a community based cross sectional study research conducted in Bahir Dar,
northwest Ethiopia, 48% of participants thought that biological defects were the primary cause
of mental problems, with 47% attributing it to supernatural forces and 27% to psychosocial
pressures. Only 23.1% of people said they would be willing to work with someone who had a
mental health condition, 19.1% said they would be willing to shake hands with the patient, and
only 5.2% said they would be afraid of someone who had a mental disease. The general
population views anxiety and sadness more favorably than schizophrenia (27). Community
based study about 55% of participants in Dessie Town had little information of mental illness,
and 45.1 percent expressed negative opinions concerning it (13).

The community based cross-sectional design study The study that done on gonder town,
northwest Ethiopia in 2011, 66.3% of them had good knowledge of mental illness and 87 % of
respondent had negative attitude toward mental illness and mentally ill perso.(28).

10
According to a Community based cross sectional Study that done in jimma zone almost half of
respondents had inadequate knowledge regarding mental health problem, 41 % had
respondents inadequate knowledge (29).

3.2. Practice toward Mental Illness

In a Swedish survey, 26.9 % of participant had good practice toward Mental (31), almost one-
third of respondents indicated that seeking therapy would be the best form of assistance.
Work-related interventions were favored by 15% of respondents, and just a small percentage of
respondents (1%) thought that taking medicine would be the best kind of assistance (34). In the
UK, 35% of respondents said they didn't seek any help, and 84% of those who provided input on
why they hadn't sought help cited stigmatizing beliefs as their justification (32).

In a Qatar community research, 79.9% of respondents said they would see a psychiatrist if they
were experiencing emotional distress, while just 39.1% said they would go to a healer for their
issue,39% respondent believed that mental illness can be treated with traditionally, 83 % of
respondent mental illness can be treated using psychotherapy (33) .

As community research cross sectionalstudy Only 2% of Nigerians opted to use a modern

mental health service to get assistance for mental health issues, according to a national study
there (36). When questioned about their preferred method of therapy for mental illness in a
survey conducted on Karif Village in Northern Nigeria, the majority of respondents (46%), chose
medical care. This was followed by traditional herbal medicine use (18%) and spiritual healing
(34%)(34).

Only 41% of interviewees in an additional study done in Butajira preferred contemporary

medicine for neuropsychiatric diseases, with the majority favoring medical care for epilepsy and
sleeplessness. Whereas the most frequently chosen sources of assistance for various types of
mental disorders are holy water, witchcraft, and herbalists (35).

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According to a community-based cross-sectional study conducted among residents of Gimbi
Town from May 28 to June 28, 2014, 37% have a negative view. (36). And According to a study
done in Agaro Town, treating epilepsy, schizophrenia, MDD, and GAD with contemporary
medicine is favoured by 76%, 83%, 72.4%, and 72.5% of respondents, respectively. 21% of
epilepsy patients and 19% of schizophrenia patients favored holy water (37).

According to cross sectional community based Study that done on Dessie town about 95 % of
responders’ perforce modern medical and 409 religious treatment and 40.9% from traditional
treatment (38). According to the result of study conducted in Bahir Dar the most preferred
place that persons turn to seek help were holy water (89%) and modern medicine was
preferred by only 30% of respondents . (39)

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CHAPTER FOUR

4. Method and material

4.1. Study area and period

The study will be conducted among residents of Dire Dawa city, Lagahare kebele, Eastern
Ethiopia.
Dire Dawa is found in eastern Ethiopia near the border with Somalia dire dawa is approximately
515 km away from Addis Ababa and 63 km from Harar.
Dire Dawa has 2 Woredas (administrative divisions) and 23 Kebeles (subdivisions). The climatic
condition of Dire Dawa is classified as a hot semi-arid climate. Its characterized by hot
temperatures throughout the year, with average highs ranging from 27 to36 degree Celsius and
lows around 16-23 degree Celsius .the city also experiences a dry season from November to
February and a wet season from March to October. It’s a major hub for many ethnic groups in
Ethiopia, especially the Oromo and Somali. The city covers an area of about 1,213km2 with total
population of the 760,963 in 2023.
This Study will be conducted on all Dire Dawa City Lagahare residents from May to October
2023 G.C

4.2 Study design

A community based cross sectional study will be conducted from May to October 2023 G.C

4.3 Population
All community that lives in lagahare Kebele

4.3.1. Source of population

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All residents of Lagahare Kebele , Dire Dawa city, East Ethiopia.

4.3.2. Study population

All selected residents in the kebele will be used as study population for this study.

4.3.3. Study unit

Households will be selected for sample.

4.4. Inclusion and Exclusion criteria

4.4.1. Inclusion criteria
 All People who live in lagahare kebele
 All people were randomly selected and agrees to participate

4.4.2. Exclusion criteria

 Householder where eligible respondent were not available at their houses
 All people who are under 18 of age
 People who has serious illness

4.5. Sample size determination

Maximum estimate sample size had to be taken from the results of a previous study done on
dessie town Knowledge, attitude & practice towards mental illness among community but
since there is known result of “p value” 39.7%(0.397) will be used to calculate the maximum
estimate sample size.
Single population proportion formula was determined sample size at 95% CI and 5%
marginal error:
The sample size is calculated by using the single population formula

n= (Zα/2)2 P (1-p)
d2
Where:
P = prevalence point under consideration that took from kAP of community (59%).
d= degree of precision (assumed to be 5%)

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 
z
(Zα/2) 2 = denotes the value of stand reed normal variable that corresponds to be 95%
confidence levels (1.96).

Then calculating the sample size

n= (Zα/2)2 P (1-p) = (1.96)20.397(1-0.397) = 368
d2 (0.05)2
We add the 5%, of 288 for non-respondent rate it became 386
since study population is greater than 4830 it’s finite

4.6. Sampling technique and procedure

Systematic random sampling method will be employed to select respondents and the first
respondent will be selected by lottery method, then every K th resident will be selected with
interval of : i.e. Kj =Nj/nj
Where Kj=sampling interval
Nj= total number of respondents
nj=number of sample

4.7. Data collection tools and technique

Structured and semi- structured questionnaires will be used for data collection with face to face
interview that going to be translated from English to local language( afan Oromo) to make it
simple and understandable then to English to check it consistency. The questionnaires contains
4 part such as socio demographic , knowledge toward mental illness from Mental Health
Knowledge Schedule(MAKS), attitude toward mental illness from Community Attitude to mental
illness inventory (CAMI) and practice toward mental illness and practice toward mental illness
are adjust from mettu university self-reporting questionnaire . The participants will be
responding to the items on the questionnaire verbally and the data collector will record using
pen. Data will be collected by the principal investigators. The questionnaire will employed after
pre-testing on 5% of other community outside. Then appropriate modification will be made after
analyzing the pre-test resulte.
4.8. Study variable
4.8.1. Dependent variable
ü Knowledge
ü Attitude

15
 ü Practice
ü Mental illness

4.8.2. Independent variable

ü Age
ü Sex
ü Level of education
ü religion
ü Ethnicity
ü Marital status
ü Residential area
ü Monthly income
ü Friends with mental illness
ü Perceived level of social support

4.9. Data quality control

To assure the data quality great emphasis is given in designing data collection instrument. For its
simplicity the questionnaire will be pre-tested prior to the actual data collection on 5%, followed
by modification. And questionnaire has been translated to local language ( afan oromo) the
collected data will be reviewed and checked for completeness before data entry; the incomplete
data will be discarded.

4.10. Data processing and analysis

The data collected will be checked for its completeness, consistency and accuracy and then its
will be analysis. Data will be coded, entered into EPI-DATA version 4.6 then exported to SPSS
version 25 for further analysis simple descriptive statistics such as frequency, mean, .median and
percentage are going to be use to summarize the results. Frequency is going to be used to check
for missed variable and errors. Any error identified was corrected by revision of different

16
original questionnaire Descriptive statistics (frequencies, tables, graphs, percentages,) will be
used to characterized study subjects.. .

4.11. Operational definition

1. The mental health knowledge schedule (MAKS) is 12 item scale comprised domains
of relevant evidence-based knowledge in relation to stigma toward mental illness.
The coding of the items uses an ordinal scale (1–5). The total score is calculated by
adding the points earned for each of the 12 items. Items with which the respondent
strongly agrees receive 5 points; responses with which the respondent strongly
disagrees receive 1. Greater knowledge is reflected in higher total scores correct
(51).
2. Community Attitude to mental illness inventory (CAMI) Is a forty- item was
developed by 2 researcher at Canadian university and was used to investigate the
public attitude toward the mentally ill people. CAMI is divided in 4 attitude
categories where originalyl each category contains of 10 statements. The four
attitude categories are Authoritarianism, Benevolence, Social Restrictiveness and
Community Mental Health Ideology (49).
§ Authoritarianism measured by Statements like "the mentally ill must be
institutionalized" and "the mentally ill are not to blame for their problems”. This
category tests the participants' understanding of mental illness as a disease, how
it affects those who have it, how it progresses, and how those who are ill should
be treated. A high mean value here denotes knowledge of the causes of mental
illness and a compassionate understanding of how to best care for those who are
ill (49).
§ Benevolence looked into Claims such as “mentally ill have long been the targets
of mockery". A high mean value in this category suggest to paternalistic and
sympathetic view of mentally ill (49,50)l.
§ Social restrictiveness looks into a claim like "Mentally ill are a danger to
themselves and to others" whether those with mental illnesses are perceived as
being dangerous to society (50). A high mean value in this category denotes a
favorable social attitude toward those who suffer from mental illness (49).
§ Community Mental Health Ideology look into such "It is scary to think that
mentally ill people live in common neighborhoods". A high mean vale in this
category Refers to the community's acceptance of mental health services and
patients who are mentally ill (50).
3. Practice: This refers to the behaviors and actions of individuals concerning mental
illness. It includes actions such as seeking professional help, providing support to
someone with a mental health issue, promoting mental health awareness, and engaging

17
 in self-care practices to maintain good mental health. It includes questionnaire with 6
open ended questions. for each correct responds 1 point and for incorrect responds 0
point.
Score description
 3-6 good practice
 0-2 poor practice

4.12. Institutional Ethical clearance

The study will be conducted after getting official permission from dire dawa university, CMHS<
department of psychiatry and approval letter from lagahare kebele 08 administration. The
respondent will be informed about the aim of the study. Confidentiality and privacy of the
respondents will be maintained by using anonyms. Finally verbal consent will be obtained from
the subjects included in the study immediately before the interview verbal consent will obtained
from each participant before under taking the interview.
4.13. Plan for dissemination of the study the studying finding will be disseminated to Dire
Dawa city health office, and DDU department of psychiatry.

CHAPTER FIVE

18
 5. WORK PLAN AND BUDGET BREAK DOWN
5.1WORK PLAN
Table 1: Shows work plan for proposal development and final thesis on assessment of
knowledge and attitude towards mental illness in Dire Dawa city lagahare kebele residents
Ser. Activities Responsible May June July October
No personnel

1 Title selection Advisor

2 Proposal development Investigator

3 Preparing questionnaire Investigato

r
4 Obtaining ethical clearance DDU

5 Proposal submission & Investigator

approval & Advisor
6 Data collection Investigator

7 Data entering & analysis Investigator

8 Preparing draft thesis Investigator

9 Preparing final thesis Investigator

10 Final defense Investigator

6. BUDGET BREAK DOWN

19
 Table 2: Total budget breakdown for accomplishment of the research project knowledge,
attitude and practice toward mental illness among lagahare kebele residents. Dire Dawa, Eastern
Ethiopia 2023 G.C

No Budget categories Unit cost Multiplying factor Total cost

1 Repairing computer 1500 1 1500

2 Questioner duplication paper 25cont/quest 8page x 386 3091

3 Binder 180 2 360

4 Printing paper ( pack) 500.00 1 500.00

5 Pen 15.00 2 30.00

6 Pencil 10.00 2 20.00

7 Eraser 10.00 4 40.00

8 Share per 2.00 2 4.00

9 flipchart paper 5.00 5 25.00

10 Marker 30.00 2 60.00

11 Printing and binding 3birr/page 40page x 10birr 400.00

12 Rural 25.00 2 50.00

13 Note book 60.00 4 240.00

14 Scientific calculator 200.00 1 200.00

15 Transport (Car ) 50birr /day 5 250.00

From DDU to Lagahare

20
16 Data collector 500birr/day 5 2500

17 Total 9270

7. REFERENCES

1. WHO mentalhealth: a state well-being.on http://www.who.int/factifiles/mental_health?

accessed 30 july 2019
2. attitudes toward mental illness: resualt from thebehaviotal risk factor survellance
system. Atlanta(GA); CENTER for disease control and prevention; 2012 6pdf
3. Bagchi A et al. Int j Community Med public health.2020 mar;7(3):1078-1083
4. Who mental health: mental disorders . on Http://www.who.int news_room? fact-sheet/
mental disorder/ accessed 8 june 2022
5. African journal of psychiatry. JULY 2011 9 pdf
6. Hitches, L(2008) aa why is mental health nursing unpopular. Nursing times. net accessed
at December 19 2011.
7. Ahmed et al. int j mental health syst (2019) 13;5 1 pdf
8. albarqi m, almaqhawi a. knowledge and attitude toward mental illness amoungthe
population at king faisal university, Saudi Arabia.fam med prim care rev 2022 12 pdf
9. BMY GH BLOGS, mental health crisis torn country .October 28 2022
10. assessment of KAP of nurse toward mental health problems Amare d et al Ethiop J
health Sci . July 2005
11. amrutha ravi; 04 February 2020
12. Afr L psychiatry 2011; 14: 225-235
13. Birikie and anbesaw BMC psychiatry 2021

21
14. Bifftu et al BMC psychiatry 2014 ,:259
15. American journal of humanities and social science research 2021
16. Amrutha ravi KAP among anganwadi worker of rural and semi urban area of jharhand
seat india : a comparative study 2021
17. mental illness: result from the behavioral risk factor surveillances system. Atlanta (GA)
; center for disease control and prevention; 2012
18. (trends in cognitive science January 2012, vol, 16 No.1)
19. . Attitudes toward mental illness: result from the behavioral risk factor surveillances
system. Atlanta (GA) ; center for disease control and prevention; 2012
20. ). Suhaila G, Abdulbari, Tuna Epidemiological Survey Of Knowlefge, Attitude And
Health Literacy Concerning Mental Illness In National Community Sample: A Global
Burden2009
21. . Irma m, ingka tisya garnisa, rono k witriani w; psychology research and behabavor
management 2020, 845-854
22. ). Mahadeo, amol d,shivaji h pawar knowledge, attitudes and practices among
cargivers of patients with schizophrenia in western meharashtra. May 2014
23. british journal of psychiatry 2005 communty study of knowledge of and attitude to
mental illness in Nigeria
24. john geofrey chikomo: knowledge and attitudes of kinodoni community toward
mental illness.
25. crabb et al BMC public health; attitudes toward mental illness in malawi: a cross-
sectional survey)
26. ahmed , hailu merga, and fessahaye a; knowledge, attitude and practice toward
mental illness service provision and associated factor amonghelath extension
professional in adis ababa (2019) 13;5
27. .minale tareke PLOS ONE 2020 common mental illness amond epilepsy patient in bahir
dar city
28. haregewoin , equlinet m and haddis s: public knowledge and attitude toward mental
illness and mental challenging people in gonder town 2011.

22
29. tesfaye Y, et al BMJ open 2022
30. john geofrey chikomo: knowledge and attitudes of kinodoni community toward
mental illnes
31. Illness Carla Abi Doumit; Knowledge Attitude And Behaviors Toward Patens With
Mental Illness,
32. Keziban S And Barbara M; Identifying Barriers To Mental Health Help-Seeking Among
Young Adults In Uk October 2016
33. ) Suhaila G, Abdulbari, Tuna Epidemiological Survey Of Knowlefge, Attitude And
Health Literacy Concerning Mental Illness In National Community Sample: A Global
Burden2009 (28) .
34. Mohammed Kabir, Zubeir I. Isa M And Muktar H
35. Atalay A, Derege K ; How Are Mental Disorder Seen And Where Is Help Sought In
Rural Ethioia Community 1999
36. . Misael B, Jemal E, Tadesssew A, Zegeye Y And Asres Community Perception Toward
Mental Illness Among Resident Of Gimbi Town, Western Ethiopia 2016
37. Yonas Shiferaw Tamirat How Are Mental Health Problems Perceived By A Community
In Agaro Town jun 2004
38. . Mengesha Birkie And Tamrat Anbesaw Of Knowlefge, Attitude And Associated
Factors To Wards Mental Illness Among Resident Of Dessie Town, Northes Ethiopia
2021
39. Minale Tareke PLOS ONE 2020 Common Mental Illness Amond Epilepsy Patient In
Bahir Dar City
40. Emmanulel S. jean c carol j and Lane: people perception in QUEbec Canadian medical
asspication journal 2001
41. Job T.B. van ‘t Veer, Herro F. Kraan, …Jacqueline M. Modde, Determinants that shape
public attitudes towards the mentally ill, 2006
42. Esa Aromaa Attitudes Towards People with Mental Disorders in a
General Population in Finland 2011
43. mamo. D.c addressing patient need; the role of mental health literacy 2007

23
44. mental health foundation stigma and discrimination 4 october 2021 ) (tesfaye et al
BMC psychal 2021
45. . Dilip k, pradeep k, amool r and samrat s; knowledge and attitude toward mental
illness of key informate and general population ; 2011
46. Baatrice Ewalds-kvist et al nord J psychiatry
47. Suneet k, chintan M and devendra K Sharma ; the soiocultural factors and patterns of
help-seeking among patient with mental illness inj sub-himalayan region 2018
48. Hugo CJ, BOshoff DEL,Traut a zungu-dirway N, Stein DJ. Community attitude toward
and knowledge of mental illness south Africa 2003
49. Sandra Frykman,Julia Angbrant Attitudes Towards Mental Illness A Comparative
Sample Study of Sweden contra India
50. David t, smith c attitude of mental health professional toward mental illness 2010
51. Carla abi doumit knowledge, attitude and behaviors toward patint with mentalillness
cross sectional study sep 2019
52. WHO. mhGAP Mental Health Gap Action Programme Scaling up care for mental,
neurological, and substance use disorders. Switzerland (2015).
53. Mohammedamin Hajure Jarso; Knowledge, attitude, and its correlates of the
community toward mental illness in Mattu, Southwest November 2022

24
8 .ANNEX
This questionnaire have 4 sections such as socio demographic, kowleged toward mental
illness( it adjusted from MENTAL HEALTH KNOWLEDGE SCHEDULE ), attitude toward
mental illness ( adjusted from Community Attitudes towards Mental Illness- CAMI
scale) and practice toward mental illness (adjusted from mettu unvercity )
Section 1: questions to assess socio demographic information
no questions Coding catagory Remark
1.How old are you a. 18-24
b. 25-35
c. 35-50
d. 50+
2.What is your gender a. Male
b. female
3.Marital status a. Single
b. Married
c. Divorced
d. Widow
4.religion a. Muslim
b. Orthodox
c. Catholic
d. Protestant
e. other
5.What is your education level a. No formal education
b. Primary school
c. Higth school
d. Dipoloma
e. degree
25
 6.occupation specify

SECTION 2 MENTAL HEALTH KNOWLEDGE SCHEDULE

Section 2.1: For each of statements 1– 6 below, respond by ticking one box only.
Mental health problems here refer,
no questions Coding catagory Remark
1.Most people with mental health a. Strongly disagree
problems want to have paid b. Disagree
employment. c. Neutral
d. Agree
e. Strongly agree
2.If a friend had a mental health a. Strongly disagree
problem, I know what advice to give b. Disagree
them to get professional help. c. Neutral
d. Agree
e. Strongly agree
3.Medication can be an effective a. Strongly disagree
treatment for people with mental b. Disagree
health problems. c. Neutral
d. Agree
e. Strongly agree
4.Psychotherapy (e.g. talking therapy a. Strongly disagree
or counseling) can be an effective b. Disagree
treatment for people with mental c. Neutral
health problems. d. Agree
e. Strongly agree
5.People with severe mental health a. Strongly disagree
problems can fully recover. b. Disagree
c. Neutral
d. Agree
e. Strongly agree
6.Most people with mental health a. Strongly disagree
problems go to a healthcare b. Disagree
professional to get help. c. Neutral
d. Agree

26
 e. Strongly agree

Section 2.2: say whether individual think each condition is a type of mental
illness by circling one of given choice.
no questions Coding catagory Remark
7.Depression f. Strongly disagree
g. Disagree
h. Neutral
i. Agree
j. Strongly agree
8.stress f. Strongly disagree
g. Disagree
h. Neutral
i. Agree
j. Strongly agree
9.schizophrenia f. Strongly disagree
g. Disagree
h. Neutral
i. Agree
j. Strongly agree
10.Bipolar disorder f. Strongly disagree
g. Disagree
h. Neutral
i. Agree
j. Strongly agree
11.Drug addiction f. Strongly disagree
g. Disagree
h. Neutral
i. Agree
j. Strongly agree
12.grief f. Strongly disagree
g. Disagree
h. Neutral
i. Agree
j. Strongly agree

27
Section 3 community attitude toward mental illess CAMI scale

Section 3 Community Attitudes towards Mental Illness- CAMI scale

no questions Coding category Remark
1. As soon as a person shows signs a. Strongly disagree
of mental disturbance, he should b. Disagree
be hospitalized. c. Neutral
d. Agree
e. Strongly agree
2. The mentally ill should be a. Strongly disagree
isolated from the rest of the b. Disagree
community c. Neutral
d. Agree
e. Strongly agree
3. The best therapy for many a. Strongly disagree
mental patients is to be part of a b. Disagree
normal community. c. Neutral
d. Agree
e. Strongly agree
4. The mentally ill are a burden on a. Strongly disagree
society. b. Disagree
c. Neutral
d. Agree
Strongly agree
5. There is something about the a. Strongly disagree
mentally ill that makes it easy to b. Disagree
tell them from normal people. c. Neutral
d. Agree
e. Strongly agree
6. The mentally ill have for too long a. Strongly disagree
been the subject of ridicule. b. Disagree
c. Neutral
d. Agree
e. Stongly agree
7. Locating mental health facilities a. Strongly disagree
in a residential area downgrades b. Disagree

28
 the Neighborhood. c. Neutral
d. Agree
e. Strongly agree
8. The mentally ill are far less of a a. Strongly disagree
danger than most people b. Disagree
suppose. c. Neutral
d. Agree
Strongly agree
9. A woman would be foolish to a. Strongly disagree
marry a man who has suffered b. Disagree
from mental illness, even though c. Neutral
he seems fully recovered. d. Agree
Strongly agree
10.As far as possible mental health a. Strongly disagree
services should be provided b. Disagree
through community based c. Neutral
facilities. d. Agree
Strongly agree
11.Less emphasis should be placed a. Strongly disagree
on protecting the public from b. Disagree
the mentally ill. c. Neutral
d. Agree
Strongly agree
12.No one has the right to exclude a. Strongly disagree
the mentally ill from their b. Disagree
neighborhoods. c. Neutral
d. Agree
Strongly agree
13.Having mental patients living a. Strongly disagree
within residential b. Disagree
neighborhoods’ might be good c. Neutral
therapy, but the risks to d. Agree
residents are too great. Strongly agree
14.We need to adopt a far more a. Strongly disagree
tolerant attitude toward the b. Disagree
mentally ill in our society. c. Neutral
d. Agree

29
 Strongly agree
15.I would not want to live next a. Strongly disagree
door to someone who has been b. Disagree
mentally ill. c. Neutral
d. Agree
Strongly agree
16.Residents should accept the a. Strongly disagree
location of mental health b. Disagree
facilities in their neighborhoods c. Neutral
to serve the needs of the local d. Agree
community. Strongly agree
17. The mentally ill should not be a. Strongly disagree
treated as outcasts of society. b. Disagree
c. Neutral
d. Agree
Strongly agree
18. There are sufficient existing a. Strongly disagree
services for the mentally ill. b. Disagree
c. Neutral
d. Agree
Strongly agree
19. Mental patients should be a. Strongly disagree
encouraged to assume the b. Disagree
responsibilities of normal life. c. Neutral
d. Agree
Strongly agree
20. The best way to handle the a. Strongly disagree
mentally ill is to keep them b. Disagree
behind locked doors. c. Neutral
d. Agree
Strongly agree
21. Our mental hospitals seem more a. Strongly disagree
like prisons than like places b. Disagree
where the mentally ill can be c. Neutral
cared for. d. Agree
Strongly agree
22. Anyone with a history of mental a. Strongly disagree

30
 problems should be excluded b. Disagree
from taking public office. c. Neutral
d. Agree
Strongly agree
23. Locating mental health services a. Strongly disagree
in residential neighborhoods’ b. Disagree
does not endanger local c. Neutral
residents. d. Agree
Strongly agree
24. Mental hospitals are an a. Strongly disagree
outdated means of treating the b. Disagree
mentally ill. c. Neutral
d. Agree
Strongly agree
25. The mentally ill should not be a. Strongly disagree
denied their individual rights. b. Disagree
c. Neutral
d. Agree
Strongly agree
26. One of the main causes of a. Strongly disagree
mental illness is a lack of self- b. Disagree
discipline and willpower c. Neutral
d. Agree
Strongly agree
27. We have the responsibility to a. Strongly disagree
provide the best possible care b. Disagree
for the mentally ill. c. Neutral
d. Agree
Strongly agree
28. Residents have nothing to fear a. Strongly disagree
from people coming into their b. Disagree
neighborhoods to obtain mental c. Neutral
health services. d. Agree
Strongly agree
29. Virtually anyone can become a. Strongly disagree
mentally ill. b. Disagree
c. Neutral

31
 d. Agree
Strongly agree
30. It is best to avoid anyone who a. Strongly disagree
has mental problems. b. Disagree
c. Neutral
d. Agree
Strongly agree
31. Most women who were once a. Strongly disagree
patients in a mental hospital can b. Disagree
be trusted as babysitters. c. Neutral
d. Agree
Strongly agree
32. It is frightening to think of a. Strongly disagree
people with mental problems b. Disagree
living in residential c. Neutral
Neighborhoods’. d. Agree
Strongly agree

Section 4; Practice Toward Mental Illness

no questions Coding catagory Remark
1. Do you have any training in a) Yes
psychiatry or treatment of b) no
mental illness
2. If say yes, what type of a) Modern
training have you received b) Traditional
on mental health c) spitual
3. Where do you take someone a) Mental hospital
who is mentally ill b) Shakh or
c) Traditional healer
4. Which modern treatment a) Medication
you think best for those with b) Talking therapy
mentally ill c) Surgical
5. Vary effective and safe drugs a) Strongly disagree
are available to treat mental b) Disagree
illness c) Neutral
d) Agree

32
 E)Strongly agree
6. The best therapy for many a) Strongly disagree
mental patient is to be part b) Disagree
of a normal community c) Neutral
d) Agree
E)Strongly agree

OROMIC VERSION of QUESTIONNERIES

Kutaa-I;Gaaffilee haala jiruufi jireenyaan wal qabatan.

Lakk. Gaaffilee Garee qoodamiinsaa Yaada

1. Umrii a .18-24

b. 25-35

c. 35-50

d. 50+

2. Saala a. Dhiira

b. Dhalaa

3. Haala gaa’elaa a. Ka hin fuune/heerumne

b. Ka fuudhe/heerumte

c. Kan wal hiike/hiikte

d. Ka gargar bahan

e. Kan irraa du’e/duute

33
4. Amantaa a.Muslima

b.Ortodoksii

c.Katolikii

d.Protestaniit

e.kabiroo

5. Sadarkaa barnootaa a. Digiriijalqaba

b. Dipiloomaa

c. kabiraa--

34
 Kutaa-2.1; Tokkoon tokkoon hima 1– 6 armaan gadiitiif, filannoo tokko qofa
naannessuudhaan deebii kenni. Rakkoo fayyaa sammuu asitti ref
Lakk. Gaaffilee Garee qoodamiinsaa Yaada

1. Namoonni rakkoo fayyaa A. Tasumaa itti waliin galu

sammuu qaban baay’een isaanii
hojii kaffaltii qabu qabaachuu B. Itti waliin galu
barbaadu. C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

2. Hiriyaan koo tokko rakkoo fayyaa A. Tasumaa itti waliin galu

sammuu yoo qabaate gargaarsa
ogeessaa argachuuf gorsa B. Itti waliin galu
akkamii akka isaaniif kennu nan C. Hin beeku
beeka
D. Ittiin walii gala

E. Sirrittiin itti walii gala

3. Qorichi namoota rakkoo fayyaa A. Tasumaa itti waliin galu

sammuu qabaniif yaala bu’a
qabeessa ta’uu danda’a. B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

4. Yaaliin sammuu (fkn yaala A. Tasumaa itti waliin galu

haasa’uu ykn gorsa) namoota
rakkoo fayyaa sammuu qabaniif B. Itti waliin galu
yaala bu’a qabeessa ta’uu C. Hin beeku
danda’a
D. Ittiin walii gala

E. Sirrittiin itti walii gala

5. Namoonni rakkoo fayyaa A. Tasumaa itti waliin galu

sammuu cimaa qaban
guutummaatti fayyuu danda'u. B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

Namoonni rakkoo fayyaa A. Tasumaa itti waliin galu

sammuu qaban baay’een
B. Itti waliin galu
isaanii gargaarsa argachuuf
gara ogeessa fayyaa deemu. C. Hin beeku
35
D. Ittiin walii gala

E. Sirrittiin itti walii gala

 Kutaa-.2.2; Filannoo 5 keessaa tokko qofa naannessuudhaan tokkoon tokkoon haalaa gosa
dhukkuba sammuuti jettanii yaaddu jedhi

Lakk. Gaaffilee Garee qoodamiinsaa Yaada

1. Mukuu hamaa A. Tasumaa itti waliin galu

B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

2. Cinqii A. Tasumaa itti waliin galu

B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

3. Dhibee Iskiizoofreeniyaa A. Tasumaa itti waliin galu

B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

4. dhibee baay’ee nama dhiphisu A. Tasumaa itti waliin galu

(bipolar disorder).
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

5. Araada qoricha sammuu A. Tasumaa itti waliin galu

hadoochu
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

36
 6. Gadda A. Tasumaa itti waliin galu

B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

Section 3 Community Attitudes towards Mental Illness- CAMI scale

no questions Coding category Remark
1. Namni tokko akkuma mallattoo A. Tasumaa itti waliin galu
jeequmsa sammuu agarsiise B. Itti waliin galu
hospitaala ciisuu qaba. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
2. Dhukkubsataan sammuu hawaasa A. Tasumaa itti waliin galu
hafe irraa adda baafamuu qaba B. Itti waliin galu
C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala

3. Dhukkubsattoota sammuu A. Tasumaa itti waliin galu

hedduudhaaf yaaliin hundarra B. Itti waliin galu
gaariin qaama hawaasa idilee C. Hin beeku
ta’uudha. D. Ittiin walii gala
E. Sirrittiin itti walii gala
4. Dhukkubni sammuu akkuma A. Tasumaa itti waliin galu
dhukkuba kamiiyyuu dhukkuba. B. Itti waliin galu
C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
5. Dhukkubsattoonni sammuu hawaasa A. Tasumaa itti waliin galu
irratti ba’aa ta’aniiru. B. Itti waliin galu
C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
6. Dhukkubsattoonni sammuu balaa A. Tasumaa itti waliin galu
namoonni baay’een yaadan caalaa B. Itti waliin galu
baay’ee xiqqaadha. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
7. Dhukkubsattoota sammuu A. Tasumaa itti waliin galu

37
 namoota idilee irraa salphaatti B. Itti waliin galu
adda baasuun wanti nama godhu C. Hin beeku
jira. D. Ittiin walii gala
E. Sirrittiin itti walii gala
8. Dhukkubsattoonni sammuu yeroo A. Tasumaa itti waliin galu
dheeraaf qoosaa ta'aniiru. B. Itti waliin galu
C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
9. Dubartiin tokko dhiira dhukkuba A. Tasumaa itti waliin galu
sammuutiin rakkate guutummaatti B. Itti waliin galu
fayye fakkaatus fuudhuun C. Hin beeku
gowwummaa ta’a. D. Ittiin walii gala
E. Sirrittiin itti walii gala
10. Hanga danda’ametti tajaajilli fayyaa A. Tasumaa itti waliin galu
sammuu karaa dhaabbilee hawaasa B. Itti waliin galu
bu’uura godhateen kennamuu qaba. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
11. Ummata dhukkubsattoota sammuu A. Tasumaa itti waliin galu
irraa eeguu irratti xiyyeeffannaan B. Itti waliin galu
xiqqaan kennamuu qaba. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
12. Namni kamiyyuu dhibee sammuu A. Tasumaa itti waliin galu
ollaa isaa keessaa baasuuf mirga hin B. Itti waliin galu
qabu. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
13. Dhukkubsattoota sammuu A. Tasumaa itti waliin galu
naannoo mana jireenyaa keessa B. Itti waliin galu
jiraatan qabaachuun yaala gaarii C. Hin beeku
ta’uu danda’a, garuu balaan D. Ittiin walii gala
jiraattota irratti dhufu garmalee E. Sirrittiin itti walii gala
guddaadha.

14. Hawaasa keenya keessatti A. Tasumaa itti waliin galu

dhukkubsattoota sammuuf ilaalcha B. Itti waliin galu
kana caalaa wal danda’uu C. Hin beeku
qabaachuu qabna. D. Ittiin walii gala
E. Sirrittiin itti walii gala
15. Nama dhukkuba sammuu qabu itti A. Tasumaa itti waliin galu
aanee jiraachuu hin barbaadu. B. Itti waliin galu
C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala

38
16. Jiraattonni fedhii hawaasa naannoo A. Tasumaa itti waliin galu
tajaajiluuf bakka dhaabbileen fayyaa B. Itti waliin galu
sammuu naannoo isaanii jiran C. Hin beeku
fudhachuu qabu. D. Ittiin walii gala
E. Sirrittiin itti walii gala
17. Dhukkubsataan sammuu akka nama A. Tasumaa itti waliin galu
hawaasa keessaa baafameetti B. Itti waliin galu
ilaalamuu hin qabu. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
18. Dhukkubsattoota sammuuf tajaajilli jiru A. Tasumaa itti waliin galu
gahaadha B. Itti waliin galu
C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
19. Dhukkubsattoonni sammuu itti A. Tasumaa itti waliin galu
gaafatamummaa jireenya idilee akka B. Itti waliin galu
fudhatan jajjabeeffamuu qabu. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
20. Dhukkubsattoota sammuu to’achuuf A. Tasumaa itti waliin galu
karaan hundarra gaariin balbala B. Itti waliin galu
cufame duuba kaa’uudha. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
21. Hospitaalonni sammuu keenya bakka A. Tasumaa itti waliin galu
dhukkubsattoonni sammuu B. Itti waliin galu
kunuunfamuu danda'an caalaa mana C. Hin beeku
hidhaa fakkaatu. D. Ittiin walii gala
E. Sirrittiin itti walii gala
22. Namni seenaa rakkoo sammuu qabu A. Tasumaa itti waliin galu
kamiyyuu aangoo mootummaa B. Itti waliin galu
fudhachuu irraa hambifamuu qaba. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
23. . Tajaajila fayyaa sammuu naannoo A. Tasumaa itti waliin galu
mana jireenyaa keessatti argachuun B. Itti waliin galu
jiraattota naannoo balaadhaaf hin C. Hin beeku
saaxilu. D. Ittiin walii gala
E. Sirrittiin itti walii gala
24. Hospitaalonni sammuu mala yeroon A. Tasumaa itti waliin galu
isaa darbee dhukkubsattoota sammuu B. Itti waliin galu
yaaluuf gargaaranidha. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
25. Dhukkubsattoonni sammuu A. Tasumaa itti waliin galu
mararfannaan keenya hin malu. B. Itti waliin galu

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 C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
26. Dhukkubsattoonni sammuu mirga A. Tasumaa itti waliin galu
dhuunfaa isaanii dhorkamuu hin B. Itti waliin galu
qaban. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
27. Sababoota dhibee sammuu keessaa A. Tasumaa itti waliin galu
inni guddaan tokko of-danda’uu fi B. Itti waliin galu
humna fedhii dhabuudha C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
28. Dhukkubsattoota sammuuf kunuunsa A. Tasumaa itti waliin galu
hundarra gaarii ta’e kennuudhaaf itti B. Itti waliin galu
gaafatamummaa qabna. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
29. Jiraattonni namoota tajaajila fayyaa A. Tasumaa itti waliin galu
sammuu argachuuf gara naannoo B. Itti waliin galu
isaaniitti dhufan irraa waan sodaatan C. Hin beeku
hin qaban. D. Ittiin walii gala
E. Sirrittiin itti walii gala
30. Namni kamiyyuu jechuun ni A. Tasumaa itti waliin galu
danda’ama sammuudhaan B. Itti waliin galu
dhukkubsachuu danda’a. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
31. Nama rakkoo sammuu qabu A. Tasumaa itti waliin galu
kamiyyuu irraa fagaachuun B. Itti waliin galu
gaariidha. C. Hin beeku
D. Ittiin walii gala
E. Sirrittiin itti walii gala
32. Dubartoonni yeroo tokko A. Tasumaa itti waliin galu
dhukkubsattoota hospitaala B. Itti waliin galu
sammuu turan irra caalaan isaanii C. Hin beeku
akka daa'ima kunuunsitootaatti D. Ittiin walii gala
amanamuu danda'u. E. Sirrittiin itti walii gala

33. Namoota rakkoo sammuu qaban A. Tasumaa itti waliin galu

naannoo mana jireenyaa keessa B. Itti waliin galu
jiraatan yaaduun nama C. Hin beeku
sodaachisa. D. Ittiin walii gala
E. Sirrittiin itti walii gala

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Kutaa IV-Bartee(shaakala) waa’ee dhukkuba sammuurratti.

Lak. Gaaffilee Garee qoodamiinsaa Yaada

1. Ogummaa wal’aansa A. Eeyyee B. lakkii

sammuu irratti Leenjii yeroo
gabaabaa fudhattee
beektaa?

2. Waa’ee fayyaa Sammuu A. Kan ammayyaa

irratti Leenjii akkamii
B. Kan aadaa
fudhatte ?
C. Kan amantaa

3. Nama dhukkuba Sammuu A. Mana yaala dhukkuba sammuu

dhukkubsatu tokko eessatti
B. Yaala aadaa ykn
geessita?
C. Sheeka

4. Dhukkubsataa sammuutiif A. Qoricha

qoricha ammayyaa isa kamtu
B.Teeraapii
bareedaa dha jattee yaadda?
C.Baqaqsanii yaaluu

5.

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