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

COLLEGE OF MEDICINE AND HEALTH SCINCE

I
 DEPARTMENT OF PSYCHIATRY

KNOWLEDGE, ATTTITUDE AND PRACTICE TOWARD MENTAL ILLNEs AMONG

COMMUNITY OF LAGAHARE KEBELLE, DIRE DAWA CITY , EAST,ETHIOPIA,
2023 G.C: CROSS SECTIONAL STUDY

ADVISOR: FUFA OLANA

KEDIR MOHAMMED

A PROPOSAL SUBMITTED TO DIRE DAWA UNIVERSITY COLLEGE OF

MEDICINE AND HEALTH SCIENCE, PSYCHIATRY DEPARTMENT IN PARTIAL
FULFUILMENT OF THE REQUIREMENTS FOR THE BACHELOR’S DEGREE IN
PSYCHIATRY

JULY 2023

DIRE DAWA, ETHIOPIA

II
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 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.

I
 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

II
 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

III
ACRONYMS AND ABBREVATIONS
BMC =biomedical center

BSC= Bachelor of Science

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
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.

IV
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. As per the knowledge of the investigators, studies are scarce and not

done in the study area about knowledge and attitudes of mental illness .

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 design will be conducted from May to October
2023GC. DIRE DAWA University, Dire Dawa administrative city, eastern Ethiopia. Systemic
random sampling technique will be used.
A structured questionnaire was developed from different research translated to local language(
afan-oromo). Questionnaires include socio-demographic information, knowledge toward mental
illness, attitude toward mental illness and practice toward mental illness. The collected data will
be analyzed manually, and significant associations declared at P<0.397. Finally a result was
presented by table, graphs and chart.
Work plan and Budget The study will be conducted from May to October using a total budget
of 9270birr

V
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. Numerous factors, including chronic stress, child maltreatment, drug and
alcohol abuse, chemical imbalances, and others, can contribute to mental illness. (1)( 7)

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. In past years, just 20% of adults with a diagnosable
mental disorder or a self-reported mental health problem saw a mental health professional.
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 their 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)

2
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, unempyment, 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

3
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
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 consequence 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 heath 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),

4
  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)
 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 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 hara 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.

6
 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

7
 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, According to 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 cross-sectional survey carried out in Qatar in 2009 revealed that the community had a poor
understanding of prevalent mental diseases/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 knowlged abot 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)

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 respondant belived by evil
spirits, 30.2%, then stress and trauma. 9% of respondents thought that God's wrath could be
the root of mental illness. The perception of mental illness was generally unfavorable; those
who had it were thought to be mentally handicapped, 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 were reluctant to associate socially with
someone who was mentally ill. 82.7% said they would be hesitant to talk to someone who is
mentally ill. Just a handful would be willing to keep up a friendship, and 16.9% would still be
open to the idea of getting married to them (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,
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)

9
In Malawi's institutional-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).

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)

According to a 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). 55% of participants in Dessie Town had little
information of mental illness, and 45.1 percent expressed negative opinions concerning it (13)

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 person.(28)

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

10
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 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) .

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)

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)

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)

11
CHAPTER FOUR

4. Methodology 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 boarder 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 June to July 2023
G.C
4.2 Study design
A community based cross sectional study will be conducted FROM June to July 2023 G.C
4.3 Population
All community that lives in lagahare Kebele

4.3.1. Source of population

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
Those individual who will be selected for sample.
4.4. Inclusion and Exclusion criteria
4.4.1. Inclusion criteria

12
All People who live in lagahare kebele
All people were randomly selected and agrees to participate
4.4.2. Exclusion criteria
Participants who were not in their house.
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%)

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

13
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
The questionnaire covers socio demographic factors and knowledge and attitude related to
mental illness and practice that they perform during illness Data will be collected using
structured interviewer administered questionnaire consisting of open ended questions will be
used to collect the data.. A translated Afan Oromo questionnaire will be used to collect data and
it will employed after pre-testing on 5% of other community outside but close to the study area
and corrections will be made thereafter to improve the clarity of tool. The participants will be
respond to the items on the questionnaire verbally and the data collector will record using pen.
Data will be collected by the principal investigators.
4.8. Study variable
4.8.1. Dependent variable
ü Knowledge
ü Attitude
ü Practice
Toward mental

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

14
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. 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 filled questionnaire will be checked and cleaned manually. Finally data will be exported to
SPSS version20 for analysis. A 95% confidence interval will be used to determine the strength of
association between variables. Any error identified was corrected by revision of diffetent original
questionnaire Descriptive statistics (frequencies, tables, graphs, percentages,) will be used to
characterized study subjects.
4.11. Operational definition
1. Knowledge: This refers to the understanding and awareness that individuals have
about mental illness. It includes knowledge about different types of mental illnesses,
their symptoms, causes, available treatments, and sources of support. Based on
questionnaire, knowledge toward mental illness have 17 questions. Each questions
which answered correctly have 1 point and for wrong answered 0 point.
Score description
 10-17 good knowledge
 0-9 poor knowledge
]

2. Attitude: This refers to individuals' beliefs, opinions, and feelings towards mental
illness. Attitudes can range from positive to negative, and they can influence how people
perceive and interact with individuals who have mental health issues. Attitudes can
impact stigma, discrimination, and the willingness to seek help or support. . In this
questionnaire blow attitude towards mental illness have 21 open ended questions. for
each correct answered question 1 point and for incorrect answer question 0 point
Score description
 10-18 good attitude
 0-9 poor attitude

15
 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
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.

16
 CHAPTER FIVE
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

17
 9 Preparing final thesis Investigator

10 Final defense Investigator

6. BUDGET BREAK DOWN

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 Questionery 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

18
14 Scientific calculator 200.00 1 200.00

15 Transport (Car ) 50birr /day 5 250.00

From DDU to Lagahare

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

19
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
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)

20
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.
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

21
 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
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

8 .ANNEX

This questionnaire is adjusted from john geofrey chikomo: knowledge and

attitudes of kinodoni community toward mental illness and from
mettu university research on knowledge, attitude and practice
toward mental illness
Section 1: questions to assess socio demographic information
no questions Coding category 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

22
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. High school
d. Diploma
e. degree
6.occupation specify

23
Section 2 knowledge towards mental illness
no questions Coding category Remark
1. Have you ever heard or A, yes B, no
read about mental
illness
2. If you say yes for a. Talking alone
question 1, what b. Strange behavior
symptoms do people c. Aggression
with mental illness d. Sad feeling
exhibit? e. Sleep disturbance
f. Other(specify)…………….

3. What do you think a. Evil sprite

cause/risk factors of b. Creator will
mental illnesses c. Magic
d. Over stress
e. Poverty
f. Other(specify)…………….

4. A diagnosis of mental a. True

illness is made based on b. false
history of patient and
mental state
examination at the time
of interview
5. Mentally ill individual a. True
can have strange b. false
experience like
delusion( firm false
belief)and hallucination(

24
 perception in absence
of external stimuli)
6. Depression is choice a. True
and a sign of personal b. false
weakness
7. Lack of pleasure, a. True
hopelessness and b. false
fatigue can all
symptoms of clinical
depression
8. Being easily annoyed a. True
and unusually irritable b. false
can be an emotional
warring sign of too
much stress
9. There is only one kind a. True
of mental illness b. false
10.Do you think mental A, yes b, no
illness can be treated
11.If you say yes to a. Modern
question 5, what is b. Traditional
treatment do you c. Spiritual
think it is the best d. Others ( specify)……..

12.Mental hospital are an a. Strongly disagree

outdated means of b. Disagree
treating the mental c. Neutral
illness d. Agree
e. Strongly agree
13. If people become a. Strongly disagree
mentally ill once, they b. Disagree
will easily become ill c. Neutral
again. d. Agree

25
 e. Strongly agree
14.Do you think people A, yes b, no
who suffer from
mental illness have
many friends?
Do you think people A, yes b, no
16 with mental illness can
do a regular job?
17 16. Community members a) Strongly disagree
have nothing to fear from b) Disagree
people coming into their c) Neutral
neighbourhood to obtain d) Agree
mental health services.
e)Strongly agree

Section 3 Attitude Towards Mental Illness

no questions Coding category Remark
1. All mentally ill person are a. Strongly disagree
violent and dangerous b. Disagree
c. Neutral
d. Agree
e. Strongly agree
2. All people with mental a) Strongly disagree
illness should be feared b) Disagree
c) Neutral
d) Agree
e) Strongly agree
3. All mentally ill person are a) Strongly disagree
not clean b) Disagree
c) Neutral
d) Agree
e) Strongly agree

26
4. Even after a person with a) Strongly disagree
mental illness has been b) Disagree
treated, I would still be c) Neutral
afraid to be around them d) Agree
e) Strongly agree
5. Mental illness is punishment a) Strongly disagree
for doing wrong thing b) Disagree
c) Neutral
d) Agree
e) Strongly agree
6. You can easily tell who has a a) Strongly disagree
mental illness, by the b) Disagree
characteristics of their c) Neutral
behavior d) Agree
e) Strongly agree
7. We should not laugh at a) Strongly disagree
mentally ill, even though b) Disagree
they act strangely c) Neutral
d) Agree
e) Strongly agree
8. People are prejudiced a) Strongly disagree
toward those with mental b) Disagree
illness c) Neutral
d) Agree
e) Strongly agree
9. People with mental illness a) Strongly disagree
can hold a job b) Disagree
c) Neutral
d) Agree
e) Strongly agree
10. Would you allow your a) Strongly disagree
son/daughter to be friend b) Disagree
with a person mental illness c) Neutral
d) Agree
e) Strongly agree
11. When a spouse is mental ill, a) Strongly disagree
the law should allow for the b) Disagree

27
 other spouse to file for c) Neutral
divorcé d) Agree
e) Strongly agree
12. People with mental illness a) Strongly disagree
should not get marriage b) Disagree
with normal person c) Neutral
d) Agree
Strongly agree
13. Those who have mental a) Strongly disagree
illness should not have b) Disagree
children c) Neutral
d) Agree
Strongly agree
14. It is best to avoid anyone a) Strongly disagree
who has mental problems b) Disagree
c) Neutral
d) Agree
Strongly agree
15. The best way to handle the a) Strongly disagree
mental ill is to keep them b) Disagree
behind locked doors c) Neutral
d) Agree
Strongly agree
16. If a mental health facility is a) Strongly disagree
set up in my street or b) Disagree
community, I will move out c) Neutral
of the community d) Agree
Strongly agree
17. Mental patients and other a) Strongly disagree
patients should not be b) Disagree
treated in the same hospital c) Neutral
d) Agree
Strongly agree

28
 18. The mentally ill are a burden a) Strongly disagree
on society b) Disagree
c) Neutral
d) Agree
Strongly agree
19. What do you think about the a. Strongly disagree
importance of mental health b. Disagree
in primary health care c. Neutral
d. Agree
e.Strongly agre
20. We have a responsibility to a) Strongly disagree
provide the best possible b) Disagree
care for the mental ill c) Neutral
d) Agree
e) Strongly agree
21. Care and support of family a) Strongly disagree
and friends can help people b) Disagree
with mental illness to get c) Neutral
rehabilitated d) Agree
e) 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
29
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
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

30
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

4. Amantaa a.Muslima

b.Ortodoksii

c.Katolikii

d.Protestaniit

e.kabiroo

5. Sadarkaa barnootaa a. Digiriijalqaba

b. Dipiloomaa

c. kabiraa--

31
Kutaa II- Hubannoo(beekumsa) waa’ee dhukkuba sammuurratti

Lakk. Gaaffilee Garee qoodamiinsaa Yaada

1. Waa’ee dhukkuba sammuu dhageessee ykn A/Eeyyee B/Lakki

dubbistee beektaa?

2. Yoo gaaffii tokkoffaaf deebii kee eeyyee A.Qofaa haasa’uu

jette,namoota dhukkuba sammuu qaban
B. Jeequmsa hirribaa
irratti mallattoolee akkamii argite?(deebii
tokkoo ol deebisuu eeyyemamaadha) C. Amala addaa

D. Qulqullina ofii eeggachuu

dadhabuu

E. Nama miidhuuf
yaaluu(arrabsuuykn rukutuun)
F.Miira gaddaa

G. Yaaddoo(cinqii) H.kan
biraa..

3. Dhukkuboota sammuuf maaltu sababa ta’uu A/Fedha rabbiiti

danda’a jettee yaadda?(Deebii tokkoo ol B/Hafuura sheexanaati
deebisuun ni eeyyama) C/Qoricha ykn araada
qabsiistota

D/Aarii
E/Hiyyummaa F/kan
biraa…………….

4.

5. Namni dhukkuba sammuu qabu tokko A. Dhugaa B. Soba

amaloota haaraa kanneen akka amantaa C .Hin beeku
jabaa waan dhugaa hin taane irratti
hundaa’e qabaachuufi utuu waan tokko isa
bira hin jiraatin akka waa argaa jiruutti kan
haasa’u amala isa godhu qabaachuu nii
danda’a.

6. .Mukaa’uun(qofaa taa’anii gadduu) filannoo

fi Mallattoo dadhabina humna
A. Dhugaa B. Soba
namummaati.
C. Hin beeku

32
7. Gammachuu dhabuun, abdiikutachuunii fi A. Dhugaa B. Soba
dadhabbiin kunneen hunduu mallattoolee
Gaddaa ta’uu nii danda’u.

8. Haala salphaan mufachuu fi yeroo tokko A. Dhugaa B. Soba

tokko aaruun mallattoo miira bay’sanii C. Hin beeku
cinqamuu ykn muddamuu agarsiisu ta’uu nii
danda’a.

9. Dhukkubni mataa gosa tokko qofaatu jira. A. Dhugaa B. Soba

10. Namni dhukkuba sammuu qabu yoomillee A. Eeyyee B.lakkii

irraa fayyuu ni danda’a jettee yaadda?

11. Eeyyee yoo jatte gaaffii 10ffaaf haala kamiin A. Kan ammayyaa
fayyuu danda’a jettee yaadda?
B. Kan aadaa

C. Kan amantaa

D. Kan biraa (ibsi)

12. Manni yaalaa sammuu dhukkuba sammuu A. Tasumaa itti waliin galu
yaaluuf kan yeroon itti dabre jattee
B. Itti waliin galu
yaaddaa?
C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

13. Namoonni yeroo tokko yoonifi dhukkuba A. Tasumaa itti waliin galu
sammuutiin qabaman salphatti deebi'anii
B. Itti waliin galu
dhukkubsachuu danda’u.
C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

14. Namoonni dhukkuba sammuu qaban hiriyaa A. Eeyyee B. Lakkii

baay'ee qaban jattee yaaddaa?

15. Namoonni dhukkuba sammuu qaban hojii A. Eeyyee B. Lakkii

isaanii guyyaa guyyaa hoojjachuu ni
danda’an jattee yaaddaa?

16. Miseensi hawaasaa namoota gara naannoo A. Tasumaa itti waliin galu
isaanìi tajaajila fayyaa sammuu argachuuf
B. Itti waliin galu
dhufan sodaachuu hin qaban.

33
 C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

Kutaa III-Ilaalcha waa’ee dhukkuba sammuurrattii.

Lakk Gaaffilee Garee qoodamiinsaa Yaada

1. Namoonni dhukkuba sammuu qaban A. Tasumaa itti waliin galu

hundinuu kan balaa uumanii fi hamoodha.
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

2. Namoonni dhukkuba sammuu qaban A. Tasumaa itti waliin galu

hundinuu sodaatamuu qabu.
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

3. Namoonni dhukkuba sammuu qaban A. Tasumaa itti waliin galu

qulqulluu miti.
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

4. Eega dhukkuba sammuu irraa fayyan illness A. Tasumaa itti waliin galu
indoor isaan jiraatan jiraachuu niin sodaadha
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

5. Dhukkubni sammuu adabbii wants badaa A. Tasumaa itti waliin galu

hoojjachuu ti.
B. Itti waliin galu

34
 C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

6. Dhukkubsattoota sammuu salphatti amala A. Tasumaa itti waliin galu

isaanii ilaallee himuu ni dandeenya.
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

7. Dhkkubsattoota sammuutti kofaluu hin A. Tasumaa itti waliin galu

qabnu .
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

8. Namoonni dhukkuba sammuu qaban hojii A. Tasumaa itti waliin galu

qabaachuu ni danda'an.
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

9. Ilma kee ykn intala kee nama dhukkuba A. Tasumaa itti waliin galu
sammuu qabu waliin hiriyaa akka taatu ni
B. Itti waliin galu
hayyamtaa?
C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

10. Namoonni dhukkuba sammuu qaban A. Tasumaa itti waliin galu

namoota normal wajjiin bultii ijaarrachuu hin
B. Itti waliin galu
qaban.
C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

35
11. Namoonni dhukkuba sammuu qaban ilmaan A. Tasumaa itti waliin galu
godhachuu hin qaban.
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

12. Dhukkuba sammuu qabaachuun safuu dha. A. Tasumaa itti waliin galu

B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

13. Karaa filatamaan itti namoota dhukkuba A. Tasumaa itti waliin galu
sammuu qaban to;achhuu dandeenyu,
B. Itti waliin galu
keessa tokko , mana cufame keessa keenyee
achitti isaan eeguudha. C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

14. Yoo dhaabbanni fayyaa sammuu ganda A. Tasumaa itti waliin galu
kiyyatti baname nan baha gara ganda biraa.
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

15. Namoonni dhukkuba sammuu qabaniifi A. Tasumaa itti waliin galu

dhukkubsattoonni biraa iddoo tokkotti
B. Itti waliin galu
yaalamuu hin qaban.
C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

16. Namoonni dhukkuba sammuu qaban A. Tasumaa itti waliin galu

hawaasarratti dhiibbaa (ba’aa)dha.
B. Itti waliin galu

C. Hin beeku

36
 D. Ittiin walii gala

E. Sirrittiin itti walii gala

17. Hawaasni dirqama dhukkubsataa sammuutiif A. Tasumaa itti waliin galu

gargaarsa gochuu qabu.
B. Itti waliin galu

C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

18. Gargaarsi maatiifi hiriyaa dhukkubsataan A. Tasumaa itti waliin galu

sammuu dhukkuba isaarraa akka fayyuu
B. Itti waliin galu
keesatti gahee qaba.
C. Hin beeku

D. Ittiin walii gala

E. Sirrittiin itti walii gala

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?

37
 C. Sheeka

4. Dhukkubsataa sammuutiif A. Qoricha

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

5.

38