The ramification of street connectedness: Well-being and resilience among street-connected children of South-Western Ethiopia

Abstract Despite the overwhelming nature of street life, urban streets have become common residence sites for street-connected children. As these children had such a common sight, little is known about their well-being and resilience. This study applies a mixed-methods research design, an explanatory concurrent method to examine their state of survival, wellbeing, and resilience. A total of 155 street-connected children were selected using simple random sampling and purposive sampling techniques. Adapted survey scales, an interview guide, focus group discussion, and transit observation were used to collect data. Multiple regression and independent-sample t-tests were used to analyze quantitative data whereas thematic analysis was used to analyze the qualitative data. The results indicated that street-connected children had weak psychosocial well-being and affected resilience that was accounted for anxiety. Moreover, street-connected boys showed better well-being and resilience than their counterpart street-connected girls. Conclusively, street-connected children in southwestern Ethiopia had lessened psychological well-being and slow-growing resilience. Moreover, physical abuse, exploitation, mistreatment, and other basic human rights deprivations were noticed as factors lead to substance abuse that had negative impact on mental well-being.


Introduction
Street-connected life, which mainly dates back to the 1848 British revolution (Elzahne et al., 2017;Lotko et al., 2016;Poni-Gore et al., 2015) has continued to cause physical and psychological health problems. Over the last century, a growing body of evidence has reported that an increased number of street-connected children were subjected to violence and various forms of trauma that has the potential to determine their later life personality and psychological wellbeing (Abate et al., 2022;Julien, 2022).
As problem related to homelessness propagated across different countries due to various manmade and natural problems, evolution of terminologies applied to these children also become vary from place to place. Thus, together with the proliferation of street life, regardless of the variation in societal attitudes and social support status in different countries, various derogatory terms such as abandoned children, homeless children, runaway children, and street children are being applied to them in different countries across the world (Dabir, 2014). Beyond the derogatory terms used to represent these children,  reported that street connected children and those who confront them share hidden understanding that there is suffering, failure in their life and labeled as damned groups. However, study revealed children leave home in quest of what they believe to be more fulfilling way of living after realizing that they can no longer be dependent on family and kin as a means to exercise their agency (Cavazzoni et al., 2023;Cumber & Tsoka-Gwegweni, 2015).
Recounting this, terminologies like street-connected' and "children and youth in street situations" are being adopted to reduce stigmatization and negative connotations (Embleton et al., 2020). Acknowledging the contribution of all previous research conducted using these terms, the present study researchers adopted the term street-connected children as much wider and more practical that has developmental implications in that it considers a child as a social actor who is capable of developing social relationships. Besides, the technical use of the term implies children working on the street are agents who can develop emotional associations with family, community, and public space (Corcoran, 2016).
Moreover, these children experience multiple and co-existing psychosocial problems (Embleton et al., 2020;Imasiku & Banda, 2015). Further, Vostanis (2002) also confirmed that street-connected youth had depression, suicidal attempts, alcohol, consumption, drug misuse, and vulnerability to sexually transmitted diseases. Besides, Ray (2017), reported that street connected youths experience collective grief and maladaptive coping patterns that connect them to each other.
As a result, urban streets became common sites of residence where street-connected life continued to be community psychosocial health concerns. As the issue of child welfare is getting attention globally, many governmental and non-governmental organizations have been making efforts, but are unable to control street life-related ramifications. Moreover, although lessening these heightened problematic conditions of street-connected children through promoting wellbeing and resilience has a vital role in realizing positive achievements (Afek et al., 2021), little is known about psychosocial wellbeing and resilience (Maepa, 2021;Smyth & Sweetman, 2015).
Thus, transforming street-connected children's psychological well-being and state of survival for effective remediation needs researchers, policymakers, humanitarian organizations, and community attention. This study therefore, focused on untapped aspects: psychological well-being, psychosocial survival conditions, resilience and ramifications of street life having the following objectives in mind.
Thus, the first objective of this study was to identify the psychosocial well-being and resilience levels of street children in Jimma town. Second, the study looked into the effects of psychosocial survival conditions on the resilience of street-connected children. Third, it aimed at identifying gender differences in psychosocial well-being and resilience status of street-connected children.

Participants
Participants of the study were street-connected children. A total of 155 street-connected children were selected from three localities (Mendara Kochi, Becho Bore, and Hirmata Merkato) of Jimma City, where a large number of street-connected children survived. Out of 317 teenage target children as of (Jimma Zone Women, Children, and Youth Office report, 2013E.C), 144 on-and offstreet children were selected for quantitative study using simple random sampling. For >300 target populations, at a confidence level of 95% and a margin of error of 5%, 169 is a possible sample level (Cohen et al., 2011). Accordingly, 144 participants were selected to fill out line-by-line reading (since many participants of the study cannot read it well) of the survey questionnaire with the help of a data collector. Six discussants also participated in the focus group discussion. Discussants who lived on the street for more than two years (2) without reintegrating into the family, by one's own decision or by another's, were selected to take part in the focus group discussion. The interview was conducted with five street-connected children's leaders of different teams. Within one locality, there was more than one street-connected team leader. These children select their team leader based on the length of their stay on the street (seniority) and their commitment to looking for food and other things they want when living on the street. Based on their physical growth (length in body size), children select their leaders. As a result, all street-connected children leaders were selected purposively. Three of these interviewees had more than four years of experience of living on the street, whereas two of them had more than two years. As a result, a total of 155 streetconnected children participated in the study. All participants were between 7 and 17 years of age.
The researchers dictated inclusion-exclusion criteria as follows: (1) Children less than 7 years of age were excluded from the study. (2) Children whose duration of home leaving (their families) was less than a month during data collection, because the researcher assumed these children might not forward valid information that best fitted research objectives. The inclusion-exclusion processes were carried out by child experts from the Jimma women's and children's affairs office and households of temporarily rented accommodation in order to learn more about children who had been on the street for more than a month.

Measures
Socio-demographic information was obtained by self-developed questions that address age, sex, educational level, family size, duration on the street, terms for run away, frequency of family contact and nature of street connectedness. The psychosocial wellbeing scale on the other hand, was adapted from (Ryff et al., 2010) seven-point Likert scale and change to five point's alternatives. It consisted of an 18-item scale that focused on environmental mastery, personal growth, and positive relations with others. Items to measure resilience status were adapted from Ryff and Keyes's (Ryff & Keyes, 1995) six-point purpose in life resilience scale and changed to five-point scales, ranging from strongly disagree to strongly agree. The relaiblity and validity of the adapted tools were computed (for detail see Table 1).

Procedures
After the proposal validation, tools for data collection were developed and adapted based on the intended objectives of the study. Forward-backward translation of scales from English version scales to Amharic and Afan Oromo languages was done. This is because participants of the study were from various ethnic groups; predominantly from Oromia and South Nation Nationality regions.
For the purpose of data quality assurance, orientation was given for data collectors on how to get accurate data for two days. The questionnaires were filled out by data collectors (psychologist and social worker) by reading line by line to these children. Majority of these children were contacted at the accommodation room when they turn back to home during the night. The rest were contacted at places where they were intaking various addictive substances. Reimbursement payment for food (collectively not individually), as a compensation for their time was given during data collection. Moreover, interview and focus group discussion were conducted concurrently with questionnaires. About 50-65 (57 average minutes) were spent to conduct an interview, and 80 min were spent to conduct FGD. The interview conducted was transcribed and translated. The transcribed data was labeled with previously formulated themes. Then after, data clearing was done. Questionnaires were anonymously coded. During data encoding, all negatively stated items were re-coded.

Data analysis
Quantitative data was analyzed using SPSS AMOS version 25. The P-value was set at 0.05 and all tests were non-directional. Descriptive analysis (mean and standard deviation) and multiple regression analysis were used. Regression assumptions were checked. Since the assumptions of normality of outcomes and homogeneity of variance were violated while testing gender in psychosocial wellbeing status and resilience status, Mann-Whitney U (instead of an independent t-test) was used. The coefficient of determination (R 2 ) was calculated.
For the qualitative data, themes for the data analysis were drawn from predetermined objectives and variables of the study. According to Braun and Clarke (2006), thematic analysis has its own flow. Thus, verbatim transcription of Interview and FGD data was done. Data translated was coded having the 'theory-driven' in account. The coding was done manually by working systematically through the entire data set, giving full and equal attention to each data item, and identify interesting aspects in the data items that may form the basis of repeated patterns (themes) across the data set. Different themes were colored differently. Finally the colored data were collated and matched up into one their themes. In the process of data analysis, both researchers and few professional data collectors were working together. Finally, the analyzed data was communicated with the study participants. Finally, data were thematically analyzed.

Ethical Considerations
Ethical consideration issues were carefully taken into account. Universal as well as contextual regulations and norms were thoroughly applied. After critical evaluation and comments on the research protocol, an Institutional Review Board (IRB) of Jimma University College of Education and Behavioral Sciences provided ethical clearance for the researchers. Permission to access the children was also obtained from the Jimma Town Women, Youth, and Children's Affairs Office. The consent form that described the purpose of the study, and the risks and benefits of participating in the study was debriefed for study participants. Consent for publication was also received. The confidentiality of information to be obtained from the participants was cared for by assigning identification numbers.

Socio-demographic information
Socio-demographic characteristics of the study address age, sex, educational level, family size, duration on the street, terms of run away, frequency of family contact and nature of street connectedness (For detail see Table 2).

Survival Conditions of Street-connected children
The survival condition of street children is characterized by various psychological, social, economic, and identity dilemmas. Psychosocial conditions, which were seen from the difficulty perspective, indicated that street-connected children had a reasonable level of anxiety (M = 3.145, SD = 1.21), which is remarkably problematic (For details, see Table 3).

Survival conditions related to basic social services
Basic social services are services that are necessary for these children to get as human beings. These services were food, clothes, and shelter, and education and treatment as a human being.

Housing
Housing problem is one of the most challenging problems for homeless and street children. The overwhelming state of housing was reported by participants of the study.
Thus, one of the street children's team leaders reported that: Do you see us? Our home is on a street. The street-side ditch-the waterways you see-is where we surrender when faced with difficulties and feel powerless. Except for this place, we have no place to surrender ourselves freely.
Another interviewee also reported the seasonal difficulty of living a life of street connectedness.
Even, during the rainy season, this ditch also changes its face like a human being. During the rainy season, we had no place to sleep because at midnight the flood suddenly comes and makes all that we have wet, and sometimes when it comes in power it flows over us.
A result from the focus group discussion also revealed that street children were getting challenged in their everyday life. Situations are upside-down regarding getting food, accommodation, and sleeping.

Food
We get food mostly from restaurants and inns mostly by paying money. If the amount of money we have is modest, we prefer to buy leftover food "bulle" when we get hungry in the morning and at night. We prefer bulle since it has variety of food items in one. Besides, one bulle is plenty for one team. This bulle used to cost 10-15 birr from hotels, restaurants, and inns. We also pay 6-10 (ETB) individually per night to sleep. When we have no money, we sleep in a ditch-a waterway found on the right and left side of the street-because the policeman and high-building custodians hit us if we go to sleep on the verandah.
Result from observation also indicates that in each day, street-connected children move in groups. Majority of them move in group of 2-3individuals whereas very few groups ramble in a group of five and above. In the team, all team members act freely with no inappropriate dominance one over the other. Moreover, since they had common sight, money gained by one of the member is considered as money gained by the contribution of all of the members. So that they eat together, sniff glue together and move to hunt money for survival together.

Social support conditions and maltreatment
Qualitative data also confirmed that street-connected children had significantly lower mental wellbeing as a result of physical abuse and coercion from adults, social ignorance, and disregard for them, an abusive style they experience in their everyday life trajectory.
One of the focus group discussants dictated that: This indicates street-connected children were experiencing inappropriate treatment from people. As a result, they are forced to sniff the glue as a coping mechanism. They reported that it gives them power, distracts them from their worries, and helps them forget what bad people did to them. Both street boys and street girls abuse drugs, especially sniffing glue.
One of the street children's leaders stated that: . . . . . . .Yeah, we sniff glue. Whenever we sniff it, we get high; it takes away all our worries. It is good. It is the only thing we put our hope in, like when relatives come to make condolences to a man in a mourning state.
The interview results also revealed that street children in South western Ethiopia are subjected to a wide range of violations of their rights, including being denied payment for the personal belongings of passengers materials they carry; being subjected to physical abuse, especially at the evening; and being snatched away or forced to hand over the money they earn working and begging on the street during the day to street adults and gangsters. As the study comes across, if street children do not submit money they get by working or begging on the street to street adults and gangsters at night, those adults and gangsters cut off the children's bodies (face and hands) by surgical blade and put them under coercive force.

Psychological circumstances of street-connected children
A significant degree of anxiety and depression knocks their conscience to look for future life options and growth zones.

One of the interviewees reported that:
Day by day, shame, guilt, and worry about life are not far from us. We perceive and also realize that people hate us, even if they have children like us.

Psychosocial states and resilience in street-connected children
Multiple regression results indicated anxiety is moderately and positively accounted for streetconnected children's resilience status at b=. 573, t (117) = 8.948, p˂.001. Furthermore, at R 2 =.423, F (137) = 70.86, p.001, the anxiety they experience while living on the street accounted for 42.3% of the variation in resilience status (details explained in Table 4 below).    Figure 1 indicates that anxiety accounted for resilience of street connected children. As they experience anxiety, puropse in life resilience increase. However, other basic social services were not found significant predictors (for detail see figure 1).
As the graph indicates, as basic social services and social care and support provided for these children decrease, resilience decreases. On the other hand, anxiety and depression increase, and street-connected children tend to turn back, join their family, or look for the safest zone of life. The graph has been supported by the multiple regression analysis, as it has been stipulated in Table 4.

The psychosocial well-being and resilience in street children
A Mann-Whitney U test was used to examine the extent of the difference in psychosocial wellbeing and resilience status between male and female street-connected children (the assumption of an independent t-test was violated, as it was equivalent to an independent sample t-test).

Gender disparities in well-being and resilience
Well-being and resilience in street connected children Table 5 indicates the psychosocial well-being and resilience in street connected children. The result revealed that there is no difference in psychosocial wellbeing based on gender. However, street connected children had a growing resilience (see table 5 for the detail).
A Mann-Whitney U test revealed no significant difference in the extent of psychological wellbeing in street-connected boys and girls (median = 71) than for females (median = 69.5). U = 349.001, p = .010. However, there was a greater difference in the extent of resilience between genders in boys (median = 71) than in girls (median = 57.5). U = 349.001, p.010. However, the effect size is small (r = .423).

Discussion
Many studies found that street children had mental health problems regardless of their nature (Crombach et al., 2014;Savarkar & Das, 2019). For instance, Hills et al. (2016) stated that even though these children are resilient, sometimes they have suicidal behaviour, unprotected sex, and other risk behaviours that highly affect their psychosocial wellbeing. The current study has similarities with previous studies in that living on the street had a negative impact on street children's mental health.
Another study reported that there was an apparent lack of organized health and social services for street-connected children that affected their resilience status (Ayub et al., 2015). Similarly, Myburgh et al. (2015) reported that street-connected children had sadness, fear, anxiety, misery, despair, hopelessness, helplessness, and suicidal ideation, which in turn led to drug abuse and criminal activities as coping mechanisms (Myburgh et al., 2015). We did not replicate the previously reported findings but our results also suggest that street-connected children in South West Ethiopia have experienced stressful life conditions. A similar conclusion was reached by Hills et al. (2016) regarding the lived experience of street children in South Africa, in which street-connected children had high rates of substance abuse, especially sniffing glue, physical abuse, and stigma experience due to their state of homelessness Moreover, when comparing the qualitative findings of our study to those of older studies like (Ayenew et al., 2020;Bah, 2018;Nasir & Siddiqui, 2017;Sofiya & Galata, 2019), it must be pointed out that street-connected children were aggressively consuming substance abuse, particularly glue-sniffing (commonly known as "Mastish"), which has an addictive chemical component. Gosa (2017)also found that glue sniffing has both immediate and long-term negative health consequences. So, to lessen the problem, Gigengack (2013), suggested the development of interventions such as product modification, treatment, identifying diversionary activities, and harm reduction depends on understanding inhalant use as a social practice. The present study also suggested to promote community wide understanding and intervention of the drug supply as well as proper use.
Moreover, street-connected children experienced complicated traumas, maltreatment, psychological, physical, and sexual abuse, and labor exploitation. This result has synergy with a study conducted by Sisay (2017) that confirmed child labor exploitation has become an excessive problem in the study area. These multifaceted factors greatly reduce the resilience of these children. Street children faced particular anxiety (Derivois et al., 2018).
Looking into the well-being and resilience of street-connected children attracts the attention of researchers, since well-being and resilience are assumed to be an important way to change the future of street children. In this regard, even though there is a lack of evidence that asserts gender differences in well-being and resilience, Maepa (2021), Asante (2015, and Sun and Stewart (2007), suggest street children, in general, are less resilient than non-street children. Moreover, study findings on gender variation in resilience among street-connected children reported that streetconnected boys are more resilient than their female counterparts (Berhanu et al., 2019). However, Hays (2018) found that girls were more resilient than boys in adversity. For example, girls are more likely than boys to survive famines and epidemics. Contrary to the findings of Hays (2018) and Kaiser and Sinanan (2019), we did not find street-connected girls are more resilient than streetconnected boys. In a different context, a study conducted by Sun and Stewart (n.d) on in-school children concluded girls were better than boys in communication, empathy, help-seeking, and goals for the future and aspirations as indicators of resilience. This gender difference in different contexts could be attributed to socio-cultural variables. Thus, understanding well-being and resilience in street children and gender differences deserves further investigation.

Implications
Growing evidence that focused on trauma asserted that childhood trauma is either a simple or complex event that results in harm, injury, or death (Tobin, 2016). In this regard, simple trauma is either a man-made or a natural stressor that happens on one occasion and affects individuals' well-being, whereas complex trauma includes repeatedly ongoing threats of violation between a child and another person (Tobin, 2016). In terms of practical experience, bodies of evidence show that the scope and extent of trauma experience among children is increasing in the community, at school, in a prison setting, and in medical systems; and this has a long-lasting and devastating effect on daily functioning (Evans et al., 2018). Street-connected children are susceptible and developmentally at risk of abuse, exploitation, and trauma that have long-lasting deleterious effects (Cumber et al., 2017).
As the study reported, due to on-street abuse and neglect, interrelated domains of development like physical, social, psychological-emotional, and behavioral aspects are inevitably affected. Further, Dugal et al. (2016) determined that early childhood interpersonal trauma such as psychological, physical, and sexual abuse, psychological and physical neglect, and witnessing inter-parental violence results in enduring and adverse effects on adult psychorelational functioning. Therefore, as the present study suggested, interventions to boost psychosocial wellbeing and resilience need to be tested considering the complex and long-lasting effects of the nature of street-connected life. To avert its long-lasting effect, Prather and Golden (2009) suggested the integration of attachment theory with cognitive-behavioural and trauma-based therapy plays a great role.
Furthermore, unlike street-connected children in rehabilitation centres, where a responsible body of professionals' works to change their problematic behaviour and protect them from abuse and exploitation, street children who have recently worked and/or lived on the street are discovered victims, and the community takes no consistent care and responsibilities to protect them (Tyler & Melander, 2015). Moreover, a recent approach to resilience building values a multisystem model of resilience in which resilience comes out of an interaction between intra-personal assets, the community in which an individual is located, and other micro and macro-level factors (Rodriguez & Dobler, 2021). However, the trauma of the present study revealed direct and indirect abuses and neglect directed at street children, which manifested in the form of physical and verbal abuse, being perceived as disobedient children, exploitation, and a weak sense of belonging, guidance, and addictive drug abuse as a means of survival and coping with the daily stressors. Thus, adapting and strengthening the multi-systemic resilience model would be more feasible.

Limitations
Despite the contribution, this study didn't address the level of stress, depression, anxiety as well as other physical and reproductive health problems. The study also didn't considered the wellbeing's and resilience's of children whose duration of running away was less than a month during data collection. Despite the recounted limitations, the present study is noteworthy.

Conclusion
Urban streets are becoming a common alternative site of residence in the eyes of street connected-children. Ramification associated with street life imposes devastating effects on streetconnected children and treet-connected children encounter seriously affected psychosocial wellbeing. They also had poor social adjustment and environmental mastery that further affected their positive self-perception and growth. On the other hand, anxiety significantly accounted for variation in purpose in life-oriented resilience. The study also concluded that street-connected children show a significant but growing level of resilience in which boys have a better mental view and purpose in life than their counterparts living in the street. Finally, the number of street-connected children was experiencing increased inhumanity, violence against human rights, and coercion by youths, physical abuse, sexual exploitation, and substance abuse (khat, hashish, glue, and gasoline sniffing). Thus, researchers suggest work on well-being and resilience has paramount advantages.