Societal and cultural norms that expose children to early alcohol use in Amhara Region rural community, Ethiopia

Background: Research on underage drinking reveals several factors that expose children to alcohol consumption, ranging from a child's personality to contextual factors. We examined societal and cultural norms that expose children to the early age of onset for alcohol use, and how community members perceive child alcohol consumption. Methods: Three focus group discussions were conducted with 36 religious leaders, elders, and locality officials; and semi-structured interviews were held with 11 women who sell alcoholic drinks near schools. Results: The findings showed nine underlying norms and assumptions that contribute to alcohol provision to minors. These norms and assumptions are mostly related to the knowledge gap regarding how alcohol harms children (and adults) and the perception of the social norms that support the drinking culture as unproblematic. Conclusion: Effective intervention and educational programs should aim at addressing the basic knowledge gap about alcoholic drinks and alcohol use disorder. In addition, challenging the harmful child-rearing practices and the feeling of resignation in life in these communities is necessary. Suggestions for short-term training and longterm educational programs are provided.