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Introduction: Homelessness among women of reproductive age is a globalproblem. Several unique gender-based issues affect homeless women’s wellbeing, including reproductive health issues, their homelessness experiences,and a high rate of sexual violence. In this study, we aimed to describe women’sexperiences of street homelessness in their own terms and their suggestions toaddress their unmet needs.Methods: This photovoice study draws on photos, focus group discussions, andsemi-structured interviews. We conducted the study in collaboration with womenin their reproductive years experiencing homelessness (n = 9). A total of 80 photoswere taken, and 40 were chosen to be discussed in interviews and further focusgroup discussions. The participating women selected photographs, explained theirsignificance, and codified them based on how they related to their lives. Data fromthese discussions were then analysed using a reflexive thematic approach.Results: Four themes were developed from the data: (a) deprivation of basicneeds; (b) experiencing dependency, shame, and seclusion while dealingwith the burden of street life; (c) the vulnerability and neglect of children; and(d) being resilient to harsh conditions. In this study, women’s street life wascharacterised by numerous unfavourable aspects, including unmet needs,human rights violations, social exclusions, substance use, and child protectionissues. Participants provided suggestions for change and confirmed their beliefthat adequate housing represents one of the most urgent unmet basic needsof people experiencing homelessness. They also emphasised the critical needfor employment opportunities, non-discriminatory provision of social support,treatment programs for substance misuse, and legal and social protection.Conclusion: This study contributes to understanding how women experiencinghomelessness describe and articulate their living circumstances and whatthey perceive needs to be addressed. Based on participants’ proposal forchange, comprehensive services are needed to address women’s multifacetedissues. However, the mitigation strategies and long-term effects of women’shomelessness require further research.

Background: Studies show that women’s trajectories through homelessness are shaped by gendered individual susceptibility, dysfunctional family dynamics, and social norms, as well as high rates of violence. Although women’s homelessness, specifically that of single mothers, often has a significant impact on the lives of women and their children, there is a dearth of research on this area in Ethiopia. Therefore, the purpose of this study was to explore homeless women’s early life experiences, their trajectories through homelessness, and the challenges inherent in community reintegration, as they perceive them. 

Method: We conducted a qualitative study in December 2023 using semi-structured interviews. We purposively selected homeless women of reproductive age from the beneficiaries of a local civil society in Addis Ababa, Ethiopia (n = 19). 

Results: ‘Childhood trauma from abuse’, ‘Sexual violence’, ‘Barriers to leaving street living, and ‘Sources of hope’ were four themes identified from the data. Despite differences in the reasons for homelessness and the routes that led the women to the streets, most of them experienced abuse, neglect, and exploitation in their early years of life. Rather than giving them a window into healing from their childhood trauma, the street further exposed women to sexual abuse, addiction, and underserved justice. Although there were personal, economic, and normative impediments, some women highlighted how they accepted the situation, looked for support, and relied on their strength and faith. 

Conclusions: The findings highlight how the trajectories through homelessness were shaped by abuse as the common thread in the lived experiences of homeless women in Addis Ababa, Ethiopia. Given the highly gendered and traumatic nature of their situation, our results call for action to address the need for contextualizing tailored and gender-responsive, multi-level trauma-focused domestic violence and sexual violence interventions and rehabilitation services, as well as reintegration mechanism for homeless women of reproductive age.

Background: Mental health conditions are among the health issues associated with homelessness, and providing mental healthcare to people experiencing homelessness is challenging. Despite the pressing issue of homelessness in Addis Ababa, Ethiopia, there is scant research on how service providers address women's mental health and psychosocial needs. Therefore, we explored service providers' and programme coordinators' perceptions and experiences regarding mental healthcare and psychosocial services delivery to women experiencing street homelessness in the city.

Methods: We conducted a descriptive qualitative study with selected healthcare and social support providers and programme coordinators. The study involved 34 participants from governmental and non-governmental organisations in Addis Ababa, Ethiopia. Data were analysed using an inductive thematic approach.

Results: Four themes were derived from the analysis. The first of these was "divergent intentions and actions". While service providers and programme coordinators showed empathy and compassion, they also objectified and blamed people for their own homelessness. They also expressed opposing views on mental health stigma and compassion for these people. The second theme addressed "problem-solution incompatibility", which focused on the daily challenges of women experiencing homelessness and the types of services participants prioritised. Service providers and programme coordinators proposed non-comprehensive support despite the situation's complexity. The participants did not emphasise the significance of gender-sensitive and trauma-informed care for women experiencing street homelessness in the third theme, "the lack of gendered and trauma-informed care despite an acknowledgement that women face unique challenges". The fourth theme, "mismatched resources," indicated structural and systemic barriers to providing services to homeless women.

Conclusions:Conflicting attitudes and practices exist at the individual, organisational, and systemic levels, making it challenging to provide mental healthcare and psychosocial services to women experiencing homelessness. An integrated, gender-sensitive, and trauma-informed approach is necessary to assist women experiencing homelessness.

Introduction: Globally, homelessness is a growing concern, and homeless women of reproductive age are particularly vulnerable to adverse physical, mental, and reproductive health conditions, including violence. Although Ethiopia has many homeless individuals, the topic has received little attention in the policy arena. Therefore, we aimed to understand the reason for the lack of attention, with particular emphasis on women of reproductive age.

Methods: This is a qualitative study; 34 participants from governmental and non-governmental organisations responsible for addressing homeless individuals' needs participated in in-depth interviews. A deductive analysis of the interview materials was applied using Shiffman and Smith's political prioritisation framework.

Results: Several factors contributed to the underrepresentation of homeless women's health and well-being needs in the policy context. Although many governmental and non-governmental organisations contributed to the homeless-focused programme, there was little collaboration and no unifying leadership. Moreover, there was insufficient advocacy and mobilisation to pressure national leaders. Concerning ideas, there was no consensus regarding the definition of and solution to homeless women's health and social protection issues. Regarding political contexts and issue characteristics, a lack of a well-established structure, a paucity of information on the number of homeless women and the severity of their health situations relative to other problems, and the lack of clear indicators prevented this issue from gaining political priority.

Conclusions: To prioritise the health and well-being of homeless women, the government should form a unifying collaboration and a governance structure that addresses the unmet needs of these women. It is imperative to divide responsibilities and explicitly include homeless people and services targeted for them in the national health and social protection implementation documents. Further, generating consensus on framing the problems and solutions and establishing indicators for assessing the situation is vital.