SUBSTANCE ABUSE AMONG UNDERGRADUATE STUDENTS AT A UNIVERSITY IN ETHIOPIA ...

296 Pages·2017·2.4 MB·English

SUBSTANCE ABUSE AMONG UNDERGRADUATE STUDENTS AT A
UNIVERSITY IN ETHIOPIA
by
TEKA TESFAY ASGEDOM
Submitted in accordance with the requirements
for the degree of
DOCTOR OF LITERATURE AND PHILOSOPHY
in the subject
HEALTH STUDIES

at the

UNIVERSITY OF SOUTH AFRICA
SUPERVISOR: PROF AH MAVHANDU MUDZUSI
CO-SUPERVISOR: PROF JH ROOS
JULY 2017
DEDICATION

To my mother Fotyen Zenebe who lived no more than two decades when she
passed away due to untreated illness when I was just 4 years old. Mom, your kid has
grown by the help of God. May you rest in peace!
To my wife Mihret Debebe who survived an accidental sub-dural hematoma at the
mid of the course of this study.

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Student Number: 46529705
DECLARATION
I declare that SUBSTANCE ABUSE AMONG UNDERGRADUATE STUDENTS AT
A UNIVERSITY IN ETHIOPIA is my own work and that all sources that I have used
or quoted have been appropriately acknowledged by means of complete references.
This work has not been submitted before for any other degree at any other
institution.

Signature: Date: 25 June 2017

Full name: Teka Tesfay Asgedom

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ACKNOWLEDGEMENTS
This work would not have been completed without the unlimited support and
encouragement provided by my supervisor Professor AH Mavhandu-Mudzusi and
Co-supervisor Professor JH Roos. I therefore immensely thank them for igniting my
potential to work and complete my studies, while providing me with their endless
support throughout the course of my studies. I also wish to extend my heartfelt
thanks to the following people for their unwavering support during the course of my
studies:
 Ms Tsige Abera for courteous cooperation to all my inquiries.
 University of South Africa (UNISA) staff at Akaka learning centre for their
cooperation to my inquiries.
 UNISA library staff at Akaka learning centre (especially Ms Yemisrach and
Mr. Addisalem Desta) for their unwavering assistance with my inquiries.
 Mr Said, Academic Vice President of the target University for his cooperation
and support during my research studies.
 Dr Shide Hassen, Medical Director at target Hospital, for his cooperation and
support during my research studies.
 Mr Tedros Siyum and Sr Ababa Birhanu, staff members at the target Hospital,
for their assistance during the qualitative data collection.
 The study respondents and participants for their time and full cooperation
throughout this study.
 The target University for granting me permission to collect data.
 The peer reviewers for reviewing and forwarding valuable inputs during the
process of guidelines developed.
 The target University Office of Registrar staff members (Ms Tsige, Ms Hiwot)
for their cooperation with required access to data.
 Mr Melkamu Tebeje for his assistance in statistical analysis.
 My wife Mihiret Debebe for all her personal and emotional support throughout
the course of this study.
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 UNISA for providing me postgraduate bursary.
 The target Hospital for granting me permission to collect data.
 Mr Sipho Ndlovu for critical reading and editing this study.

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SUBSTANCE ABUSE AMONG UNDERGRADUATE STUDENTS AT A
UNIVERSITY IN ETHIOPIA
STUDENT NUMBER: 46529705
STUDENT: TEKA TESFAY ASGEDOM
DEGREE: DOCTOR OF LITERATURE AND PHILOSOPHY
DEPARTMENT: HEALTH STUDIES, UNIVERSITY OF SOUTH AFRICA
SUPERVISOR: PROF AH MAVHANDU- MUDZUSI
CO-SUPERVISOR: PROF JH ROOS
ABSTRACT
This convergent parallel mixed methods study based on Social Ecological Model
investigated substance abuse among undergraduate university students at one of
the universities in Ethiopia. For quantitative strand of study, data was collected from
422 randomly selected undergraduate students. Data were analysed using
Statistical Package for Social Sciences version 17. For qualitative strand, face-to-
face interviews were conducted with 17 purposefully selected participants directly
involved with students abusing substances. The findings revealed that factors at
individual, interpersonal, institutional, community and societal levels affect substance
abuse among university students. The study also uncovered loopholes in the
policies, guidelines, and programme implementations in the prevention, control, and
management of substance abuse at the university. Based on the findings, the
researcher developed guidelines based on the findings of the study, the critical
literature review, and the inputs from the experts who reviewed the guidelines. The
researcher assumes that implementation of the guidelines will reduce substance use
and substance abuse among university students.
Key terms: Addictive substance, Perception, Substance Abuse, Substance use,
Undergraduate Students,

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TABLE OF CONTENTS
DEDICATION i
DECLARATION ii
ACKNOWLEDGEMENTS iii

ABSTRACT v

CHAPTER 1
ORIENTATION TO THE STUDY
1.1 INTRODUCTION 1
1.2 BACKGROUND INFORMATION ABOUT
THE RESEARCH PROBLEM 2
1.2.1 The source of the research problem 2
1.2.2 Background to the research problem 3
1.3 STATEMENT OF THE RESEARCH PROBLEM 4
1.4 RESEARCH PURPOSE 5
1.5 RESEARCH OBJECTIVES 5
1.6 Research questions 6
1.7 THEORETICAL FRAMEWORK OF THE STUDY 6
1.8 DEFINITIONS OF KEY CONCEPTS 7
1.9 OPERATIONAL DEFINITIONS OF KEY CONCEPTS 8
1.10 RESEARCH METHODOLOGY 8
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1.10.1 The research approach 9
1.10.2 Research design 9
1.10.3 Research Procedures 9
1.10.3.1 Data collection procedures 9
1.10.3.2 Data analysis procedures 10
1.10.3.3 Data and design quality 10
1.11 ETHICAL CONSIDERATIONS 10
1.12 SIGNIFICANCE OF THE STUDY 11
1.13 SCOPE OF THE STUDY 11
1.14 STRUCTURE OF THE THESIS 11
1.15 CONCLUSION 12

CHAPTER 2
LITERATURE REVIEW
2.1 INTRODUCTION 13
2.2 SCOPE OF THE LITERATURE REVIEW 13
2.3 SEARCH STRATEGY 14
2.3.1 Inclusion criteria 14
2.3.2 Exclusion criteria 15
2.4 APPRAISALS OF IDENTIFIED STUDIES 15
2.4.1 Social Ecological Model 16
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2.4.1.1 Dimensions at intrapersonal level 17
2.4.1.1.1 Determinant factors at intrapersonal level 17
2.4.1.1.2 Consequences of substance abuse at intrapersonal level 23
2.4.1.1.3 Interventions at intrapersonal level 26
2.4.1.2 Dimensions at interpersonal level 29
2.4.1.2.1 Factors related to interpersonal relations 30
2.4.1.2.2 Interventions at interpersonal level 33
2.4.1.4 Dimensions at institutional level 34
2.4.1.4.1 Factors at institutional level 34
2.4.1.4.2 Consequences of substance abuse at institutional level 38
2.4.1.4.3 Interventions at institution level 39
2.4.1.3 Dimensions at community level 44
2.4.1.3.1 Determinant factors at community level 44
2.4.1.3.2 Interventions at community level 45
2.4.1.5 Dimensions at society level 46
2.4.1.5.1 Factors that determine substance abuse at society level 46
2.4.1.5.2 Economic and social consequences of
substance abuse on the society 47
2.4.1.5.3 Interventions at societal level 48
2.5 SUMMARY 55
2.6 CONCLUSION 56
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CHAPTER 3
RESEARCH DESIGN AND METHOD
3.1 INTRODUCTION 57
3.2 PHASE 1: SITUATIONAL ANALYSIS 57
3.2.1 Research paradigm
3.2.2 Research approach 58
3.2.3 Research design 59
3.2.4 Part 1: Quantitative strand of the study 59
3.2.4.1 The research site 59
3.2.4.2 Population 60
3.2.4.3 Sampling and sample size 61
3.2.4.5 Inclusion and exclusion criteria
for selecting respondents 62
3.2.4.6 Data collection 62
3.2.4.6.1 Development of the instrument 63
3.2.4.6.2 Piloting the data collection instrument 64
3.2.4.6.3 Recruitment of respondents 65
3.2.4.6.4 Administering the data collection instrument 66
3.2.4.6.5 Data management and analysis 68

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