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Problem Statement: Mortality from AIDS has been increasing at an alarming rate in Ethiopia, especially in urban centers, to the great detriment of households and communities. The epidemic causes stress or even collapse of social institutions performing valued community functions. One such institution threatened by the HIV/AIDS epidemic is the iddir, a form of indigenous social insurance whose main function is to help members during bereavement.
Results: The historical review suggests that iddirs were developed by migrants to Addis Ababa in the early part of the twentieth century and spread rapidly from the time of the Italian occupation, with increasing use of currency, formalization, diffusion, and transformation from mono- to polyethnic voluntary organizations. The review considers the relationships of iddirs with the state during three successive regimes, noting that despite considerable potential for partnership, iddirs have tended not to become involved with development activities such as education and healthcare services or community development, fearing state interference. The surveys showed that while none of the iddir leaders had heard of an iddir going bankrupt due to increased mortality and payment overload, all the study iddirs reported decreases in their deposits in recent years. Mortality increase in the younger population was the perceived reason for these financial constraints. Strategies used to cope with the increased mortality problem include increasing membership contributions and premiums and renting out equipment.