The Practice of Social Entrepreneurship in the Efforts

towards Solving Social Problems for the Community;

the Case of TEBITA Ambulance Pre-Hospital
Emergency Medical Service in Addis Ababa

By
Salih Bashir

Advisor
Yania Seid Mekiye (PhD)

A Thesis Submitted to the Graduate Studies of Addis Ababa University;

School of Social Work in Partial Fulfilment of the Requirements for the
Degree of Master of Arts in Social Work

ADDIS ABABA UNIVERSITY

COLLEGE OF SOCIAL SCIENCES
SCHOOL OF SOCIAL WORK

November, 2019
Addis Ababa, Ethiopia
 DECLARATION
I, the under signed, declare that this thesis is my original work in partial fulfilment of the
requirement for the degree of Master of Social Work.

I further confirm that this Thesis Work has never been presented or submitted either in part or
full to this or any other higher learning institution for the purpose of earning any degree.

All the resources and materials used in the thesis have been duly acknowledged.

Name: Salih Bashir

Signature: ________________________

Date of Submission: ________________

Place: Addis Ababa University (AAU)

College of Social Science
School of Social Work
Addis Ababa - Ethiopia
 ENDORSEMENT
This Thesis has been submitted to Addis Ababa University, College of Social Sciences,
School of Social Work Distance Learning Graduate Studies for examination with me as
university advisor.

Name: Yania Seid Mekiye (PhD)

Signature: _________________

Date: _____________________
 ADDIS ABABA UNIVERSITY
COLLEGE OF SOCIAL SCIENCE
SCHOLL OF SOCIAL WORK

The Practice of Social Entrepreneurship in the Efforts towards Solving Social

Problems for the Community; the Case of TEBITA Ambulance Pre-Hospital
Emergency Medical Service in Addis Ababa

By
Salih Bashir
Reg. No. GSD/2391/08

Advisor
Yania Seid Mekiye (PhD)

APPROVED BY BOARD OF EXAMINERS

Dean, Graduate Studies Signature, Date

Advisor Signature, Date

Internal Examiner Signature, Date

External Examiner Signature, Date

 ACKNOWLEDGEMENTS
I am very thankful to my advisor Dr. Yania Seid for her intellectual comments and
substantive inputs she has provided on my research topic selection and concept note. She has
also constructively reviewed and commented the Thesis till its final stage.
I would like to extend my special thanks to TEBITA Ambulance Prehospital Emergency
Medical Service particularly to the management for their willingness and accepting my request
to conduct the research study using the organization as one local social enterprises in Ethiopia.
Finally, I want to appreciate and be thankful for the support I have received from my family
especially my wife Elham, My Children and Son-in-law for their encouragement and inspiration
all the way through.

i
ACRONYMS
AAU Addis Ababa University
AAUSSW Addis Ababa University School of Social Work
CBO Community Based Organizations
CRGE Climate Resilience Green Economy
EMT Emergency Medical Technician
FDRE Federal Democratic Republic of Ethiopia
FGD Focused Group Discussion
GoE Government of Ethiopia
IMF International Monetary Fund
KIIs Key Informant Interview
MoLSA Ministry of Labour and Social Affairs
MoWUD Ministry of Work and Urban Development
NGOs Non-Government Organizations
NPC National Planning Commission
NASW Code of Ethics of the National Association of Social Workers
NPO Non-for-profit Organization
OECD Organization for Economic Cooperation and Development
Paramedic Emergency Paramedical Personnel
PPP Public Private Partnership
SE Social Entrepreneurs hip
SEn Social Entrepreneurs
SEr Social Entreprises
SID Social Innovation and Développent
SMEs Small and Micro Enterprises
SPP Social Protection Policy
TEBITA Ambulance Prehospital Emergency Medical Service
USAID The United States Agency for International Development
WCE World Commission on Environment

ii
ABSTRACT
Social entrepreneurship is a growing field of socio economic activity and academic interest.
Social entrepreneurs and the social oriented organizations they create have become important
actors in socio economic system; organizing resources into productive activities and creating
value for society

This study explored the practices of social entrepreneurship in the efforts towards solving
some societal problems in Ethiopia. It attempted to examine and present the benefit of
undertaking of the practice in bringing sustainable solutions for the many societal problems in
the country. Furthermore, the study also explored the nature and social service provision and
delivery as well as the innovative structure and business model of social enterprises through
modelling one pioneering local enterprise called TEBITA Ambulance Pre-Hospital Emergency
Medical Service in Addis Ababa.

During the field work of the study, thirteen study participants actively and constructively
participated at the study area. To provide answer to the basic research questions, qualitative
research method was used, and the necessary data were collected through Key Informant
Interview, Focus Group Discussion, Individual Case Studies and Systematic Observation.

The collected data were analysed employing qualitative approach of data analysis. The result
of the study indicated that despite lack of proper policy and legal framework that imposed
challenges and constraints as well as very limited attention paid for the subject matter, nature
and phenomenon of social entrepreneurship in Ethiopia, some local enterprises like TEBITA
Ambulance are really engaged in the innovative entrepreneurial practice and striving to provide
social services for their respective community to bring sustainable solutions to contribute
towards to some of the social problems prevailed across the country.

The study also found that Ethiopia really can benefit from such kind of innovative
entrepreneurial endeavours and initiatives which have the potential of job creation especially for
the marginalized that in turn also brings sustainable solutions for social development and social
change.

The study finally listed its suggestions as the need for policy and legal framework advocacy,
the creation of public private partnership between the government and the private sector to
further the socioeconomic and environmental issues and problems. In addressing the implication
towards social work, the crucial need to pay proper attention for the social entrepreneurship
concept, nature and phenomenon by both the academicians and practitioners as well as the
necessity for incorporating the discipline in all the country‟s higher education business and
social work curricula has been indicated.

Key Words: Social Entrepreneurship, Social Enterprises, Social Entrepreneurs, Social

Innovation, Social Sustainability and Development

iii
LIST OF FIGURES
Figure – 1 - Why Use Social Entrepreneurship? ......................................................................... 23
Figure – 2 - Alternative Business Model ..................................................................................... 28
Figure – 3 – The Spectrum of Social Enterprises. - Arranged by Legal Form and Revenue Source ......... 29
Table – 1 - Study Participants and Criterion of Selection .......................................................... 50

iv
 Table of Contents
Contents Page

ACKNOWLEDGEMENTS ............................................................................................................ i
ACRONYMS ................................................................................................................................. ii
ABSTRACT.................................................................................................................................. iii
LIST OF FIGURES ...................................................................................................................... iv
Table of Contents ........................................................................................................................... v
CHAPTER ONE ............................................................................................................................ 1
INTRODUCTION ......................................................................................................................... 1
1.1. Background to the Study ..................................................................................................... 1
1.2. Statement of the Problem ..................................................................................................... 6
1.3 Objective of the Study .......................................................................................................... 8
1.3.1. General Objective .......................................................................................................... 8
1.3.2. Specific Objectives ........................................................................................................ 8
1.4. Research Question of the Study .......................................................................................... 8
1.4.1. General Research Question ........................................................................................... 9
1.4.2. Specific Research Questions ......................................................................................... 9
1.5. Significance of the Study ..................................................................................................... 9
1.6. Scope of the Study ............................................................................................................. 10
1.7. Definitions of Terms .......................................................................................................... 11
1.8. Structure of the Thesis ....................................................................................................... 13
CHAPTER TWO ......................................................................................................................... 14
RELATED LITERATURE REVIEW ......................................................................................... 14
2. Introduction .............................................................................................................................. 14
2.1. Understanding Social Entrepreneurship ............................................................................ 14
2.1.1. The Meaning and Nature of Social Entrepreneurship (SE) ......................................... 16
2.1.2 Theoretical and Conceptual Frameworks ..................................................................... 20
2.1.2.1. The Social Enterprise School of thought ............................................................... 21
2.1.2.2. The Social Innovation School of Thought ............................................................. 21

v
 2.1.2.3. The Trade Off ........................................................................................................ 21
2.2. What are Social Enterprises? ............................................................................................. 23
2.2.1. Social Innovation ......................................................................................................... 25
2.2.2. The Business Model .................................................................................................... 26
2.2.3. Social Development and Sustainability ....................................................................... 30
2.3. Who are Social Entrepreneurs? ......................................................................................... 31
2.4. The Practice of Social Entrepreneurship ........................................................................... 34
2.4.1. The Global Perspective ............................................................................................... 34
2.4.2 The Practice in Africa ................................................................................................... 36
2.4.3 The Practice of Social Entrepreneurship in Ethiopia ................................................... 37
2.5. Challenges, Opportunities and System of Incubation for Social Entrepreneurship .......... 40
2.5.1. Challenges ................................................................................................................... 40
2.5.1.1. Challenges Related to Policy Making and Governance: ....................................... 42
2.5.1.2. The Need for Greater Institutional and Operational Support................................ 42
2.5.1.3. Lack of Social and Cultural Awareness and Recognition of Their Work ............ 43
2.5.2. Opportunities ............................................................................................................... 43
CHAPTER THREE ..................................................................................................................... 46
METHODOLOGY ...................................................................................................................... 46
3. Introduction .............................................................................................................................. 46
3.1. Research Paradigm ............................................................................................................ 46
3.2. Research Design ................................................................................................................ 47
3.3. Study Area ......................................................................................................................... 49
3.4. Study Participants .............................................................................................................. 49
3.5. Data Collection Tools ........................................................................................................ 51
3.5.1 Primary Data Collection Tools ..................................................................................... 51
3.5.1.1 Key Informant Interviews (KIIs) ........................................................................... 51
3.5.1.2 Focused Group Discussion (FGD) ........................................................................ 52
3.5.1.3 Individual Case Studies (ICS) ............................................................................... 53
3.5.1.4 Observation ............................................................................................................ 53

vi
 3.5.2 Secondary Data Collection Tool ................................................................................... 54
3.6 Data Collection Procedures ............................................................................................... 54
3.7 Method of Data Analysis ................................................................................................... 55
3.8 Quality Assurance ............................................................................................................. 56
3.9 Ethical Consideration ........................................................................................................ 59
CHAPTER FOUR ........................................................................................................................ 61
FINDINGS ................................................................................................................................... 61
4.1. Findings ............................................................................................................................. 61
4.1.1. General Overview of TEBITA Ambulance as one Pioneering Local Social Enterprise
in Ethiopia 62
4.1.2. The Unique Service Provision of TEBITA Ambulance and its Practical Efforts
towards Bringing Solutions to Social Problems with Service Sustainability .............. 64
4.1.3. The Challenges and Opportunities of Social Entrepreneurship as Practiced by TEBITA
Ambulance ................................................................................................................... 68
4.1.4. TEBITA‟s System of Capacity Building and Mechanisms of Incubating its Innovative
Social Entrepreneurship Practice in Ethiopia .............................................................. 71
CHAPTER FIVE ......................................................................................................................... 72
DISCUSSION .............................................................................................................................. 72
CHAPTER SIX ............................................................................................................................ 75
CONCLUSION AND IMPLICATIONS TO SOCIAL WORK .................................................. 75
6.1. Conclusion ......................................................................................................................... 75
6.2. Suggestions and Implication to Social Work .................................................................... 76
6.2.1. Clearly Defining the Phenomenon .............................................................................. 76
6.2.2. Standardization and Bench Marking ........................................................................... 76
6.2.3. Support for Pioneers and Incubators ........................................................................... 77
6.2.4. Formation of Public Private Partnership (PPP) ........................................................... 77
6.2.5. Policy and Legal Framework ....................................................................................... 78
6.2.6. Setting Up of National Social Investment Forum ....................................................... 78
6.2.7. Strengthening and Incorporating Social Entrepreneurship .......................................... 78
6.3. Questions for Debates and Future Research Initiatives and Undertakings ....................... 82

vii
REFERENCES
Appendix – I. Informed Consent
Appendix – II. Key Informant Interview Guide (Management / Program Staffs)
Appendix – III. Guiding Questions for Focused Group Discussion
Appendix – IV. Guiding Questions for Case Study
Appendix V- Checklist for Field Observation
Appendix – VI. Organizational Profile of TEBITA Ambulance Prehospital Emergency Medical
Care Service

viii
 CHAPTER ONE
INTRODUCTION
In this part of the thesis, the background to the study is provided. The research problem,
research objectives and questions, significance, scope, operational definitions and structure of the
thesis are discussed.

1.1. Background to the Study

Ethiopia is land of origins and opportunities with admiring landscape and over hundred
million as its population. Nowadays; the country is undergoing with enormous development and
growth particularly on socio-economic aspect in time of critical turning point in the political
arena. It is interesting to note that the society and the surrounding environment is constantly and
rapidly changing. With urbanization and modernization, the general community is faced with the
challenges of dealing with many problems such as poverty, food supply shortage, energy
problems, natural disaster, health care challenges, climate change, infrastructural inadequacies,
economic challenges, to mention a few (MoLSA, 2012).

Currently; the provision of social services in Ethiopia is largely remained the role of the
government with the private sector playing a peripheral role (MoLSA, 2012). However; the
government alone is unable to do so. In Ethiopia, most governmental and institutional efforts to
address societal problems are considered inadequate and with some inconsistency. To make
things worse, the situations are exacerbated and compounded by inadequate resources,
corruption, lack of political will, and conflicting political ideologies and policies. Widening
equitable distribution of wealth among the citizens of the country is creating increasing
polarization and breakdown of civil society as cited in (IMF, 2011; NPC, 2015 & MoWUD,
2006).

Stating on the importance of the environment and society as constantly and rapidly changing,
OECD (2011) and WESS (2015) in their publication discussed that most societies are dealing
with many social challenges. Both asserts that there are also social challenges that are
consequences of evolving lifestyles, social institutions and structures. All these challenges can
affect the social wellbeing of individuals. Life can only be interesting if there are tools and
1
strategies readily available for dealing with these challenges. They suggested that social
challenges at different levels, global, national or regional, require special strategies and tools for
handling them. OECD (2010) on the other hand discussed that unless adequate provision is made
on the best tools and practices for resolving these challenges and meeting people needs, the
objective of sustainable development can never be achieved. The complexities of social
challenges experienced in most nations of the world demands a more creative and innovative
approach in balancing these pressures and constraints geared towards overcoming the challenges
as well as initializing sustainable development in societies (OECD, 2011; WESS, 2013).

Ethiopia envisioned that sustainable development in the country can only be achieved if
development is pursued in the socio, economic and environmental areas in a balanced manner
and ensuring that benefits accrued are equitably shared among the citizens (UN Rio, 2012). The
main development agenda of the Ethiopian government is poverty eradication. All the countries
development policies and strategies are, therefore; geared towards this end. Economically,
Ethiopia is one of the world‟s fastest growing countries. Building on its positive recent
development, Ethiopia intends to reach middle-income economic status by 2025. (IMF, 2011).

MoWUD (2016) discussed that the social situation in Ethiopia is not different from other
developing countries. The main causes of the social calamity in the country is the widespread
and growing poverty, fuelled by recurrent drought and internal conflicts which create
displacement of people and migration to the already under serviced social provision. There are
serious problems of unemployment, underemployment, lack of access to basic social services
and various social problems that have exposed large proportion of the community to
vulnerability (MoWUD, 2016).

The issue of social development has been a growing attention in Ethiopia since it is at the
centre of the human development efforts. The overall development aspect of any community
could be best achieved through devising appropriate social development strategies based on
specific local development issues. Though, the aforesaid issue is well recognized in Ethiopia, the
social situation has been worsening mainly due to lack of the knowledge as to how to bring
meaningful and sustainable improvement and inadequate allocation of public resources to be
used for social development efforts (MoWUD, 2016).

2
 Social work is a professional activity that aims to assist people in overcoming serious
difficulties in their lives by providing care, protection or counselling or through social support,
advocacy and community development work (Rengasamy, 2011). The social work profession on
the other hand promotes social change, problem solving in human relationships and the
empowerment and liberation of people to enhance well-being. Utilizing theories of human
behaviour and social justice, social work intervenes at the point where people interact with their
environments (Hutchison, 1999). Principles of human right and social justice are fundamental to
social work (BASW, 2012). Social workers, acting as social practitioners, have the responsibility
to promote social justice in relation to society in general as well as to people with whom they
work. Challenging negative discrimination, recognizing diversity, distributing resources
equitably, challenging unjust policies and practices as well as working in solidarity are some of
the main professional undertakings of social work practitioners (Rawls, 2002).

Social entrepreneurship is believed to be a direct application of social work with its economic,
social as well as ecological impact in a society in contributing towards bringing sustainable
solutions to prevailing social problems (Vipi & Tuja, 2015). Social entrepreneurship as a concept
is an emerging discipline and gaining its popularity recently (Hand, 2016). The subject matter is
a concept with social responsibility that has not been given due proper attention in both the
academia and business circles in present Ethiopia (British Council, 2017). It addresses social
problems or needs that are unmet by private markets or governments. It furthers the causes of
sustainable development and holistic innovation motivated primarily by social benefits and
generally works with, not against, market forces (Bahari, 2016).

Shavita (2015) defined social entrepreneurship as a unique entrepreneurial skill which is

totally driven by the social problems. It promotes social innovation which is a new mode of
operation that addresses the social needs of an individual or community and thus improves
quality of life and wellbeing. Shavita (2015) and Reena (2011) argued that the social and
economic hardships of a country can be overcome through the innovation and promotion of best
practices and positive models as well as by spreading good examples of social entrepreneurship
and social responsibility.

3
 British Council (2012) reported and suggested that to make meaningful progress on the
ambitious sustainable development goals in Ethiopia; relying on government intervention,
traditional philanthropy, and development aid alone are not enough. But, it is a must to develop
innovative and financially sustainable solutions that build economic growth and deliver the
changes that the country and its people need, and hence local social enterprises can play
important roles in supporting this ambition.

In this study, the importance to discuss and study the possibility of linking the new and
emerging concept of social entrepreneurship and entrepreneurial innovation and leadership as
one determinants of social inclusion and social change for a country like Ethiopia is taken as a
crucial point. It is also believed that the practice of social entrepreneurship, particularly with
local knowledge and wisdom has a huge contribution and impact for the country in solving many
of its social problems (MoWUD, 2006). Social innovation is often the result of the creative
activities of an individual, group or community which combines exiting practice and know-how
in a new way. Social entrepreneurship sees a familiar thing from a new perspective in a
comprehensive understanding (Julkaisut, 2015).

To explore, understand and analyse the nature of social entrepreneurship and its practice and
efforts towards bringing solutions to some societal problems, the practice of a local social
enterprise called TEBITA Ambulance Prehospital Emergency Medical Service is selected and
the research study is conducted accordingly.

TEBITA Ambulance Prehospital Emergency Medical Service (TEBITA) is one of

pioneering social enterprises in Ethiopia established in 2008 and licensed by Addis Ababa Health
Bureau. TEBITA aims to provide the highest quality emergency ambulance and prehospital
medical services in the country; creates awareness on first aid and health safety procedures
through formal trainings and advocate for the development of well-organized emergency medical
services. Since its establishment, TEBITA has been dedicated in delivering the most
professional, high quality and reliable emergency medical care services to the people of Ethiopia.
The enterprise provides unique services to the public across the country as well as to
multinational companies, NGOs and many others who are working in the remote areas of the
country engaged in mining, oil exploration, railway and road construction, etc.… TEBITA

4
identifies its service users based on vulnerability to injuries and acute illness and unexpected
accident situations. The service provisions include its iconic ambulance service in different cities
and towns of the country as well as its extra ordinary efforts in reaching other vulnerable
multinational companies with its remote ambulance service program. In addition; TEBITA has
programs like assisting the implementation of the emergency preparedness and response efforts
of the country. The First Aid Training to non-health professionals to equip staffs with the
necessary skills to respond in an emergency is one service provided for the public through
TEBITA‟s paramedic training center. The peace of mind package which is available to
organizations, families and individuals is also yet another unique service of the enterprise. The
provision and staffing of emergency and medical equipment‟s, training of health and non-health
professionals, international evacuation and clinic setup are some of the characteristic and
innovative service provided by TEBITA across the country.

Moses and Olokundun (2014) in their discussion on social entrepreneurship wrote that „the
world has seen numerous social problems with the advancement of socio economic development,
modernization and urbanization. In one hand, there are strong evidences that such social
problems can be tackled and solved through innovative ideas and efforts. To solve such social
problems, efforts are carried out by governments, nongovernment organizations as well as the
private sector through the creation of social values. At global level, there are trends and practical
evidences that through the proper application of the social entrepreneurship practice, it is
possible to solve many social problems.‟

When it comes to Ethiopia, the practice of social entrepreneurship is a new and emerging
concept but with huge potential and perspectives in bringing solutions for many social problems
with significant contribution and impact towards poverty reduction. However, the conceptual and
theoretical framework as well as the practical phenomenon of social entrepreneurship is at low
level in the country and needs a lot of work to be done in this respect (British,2012; Mohammed
,2017).
The aim of this study was to attempt to contribute to the scarce knowledge base by exploring
the practice of social entrepreneurship in Ethiopia. It examined the service provision of one local
enterprise which is engaged in social entrepreneurial activities in the country. The study also

5
tried to bring understanding of how social enterprises formed and operate and contribute towards
solving social problems.

Much of existing research on social entrepreneurship is conducted in the western context,

particularly on European and American concepts and practices. These practices resulted the
literature work to be dominated in these two contexts (Kerlin, 2006; Defourny & Nyssens, 2010).
Mair and Marti (2012) discussed that while western countries typically have already established
more inclusive institutional environment in which social entrepreneurship can easily flourish, in
many developing nations however, such institutions can be either absent or weak. Furthermore;
they underlined the fact that local realities cannot be neglected when studying social
entrepreneurship in different context.

Both Mohammed (2017) and British Council (2012) indicated that while there are plenty of
research works on social entrepreneurship globally, there is a severe shortcoming within the
Ethiopian context. Due to these and other factors, the subject matter is less well understood.
Therefore; they suggested for the need to more research work, particularly on the collection of
rich qualitative and quantitative data on local practices and case studies. The limited research
work conducted on social entrepreneurship calls for more and substantial studies to contextualize
the discipline at local level. In addition, the lack of national policy and legal framework for the
discipline is also needs to be worked out (Mohammed, 2017; British Council, 2012). In this
study, it is also believed that the issue of social entrepreneurship has been given less attention by
both the academia as well as researchers so far in the country and hence there is a need to do
more.

1.2. Statement of the Problem

Worldwide, many researches have been conducted to assess and understand the concept and
phenomenon, needs, services and policies regarding social service provisions by social
enterprises. In recent times, the use of the term is gaining increased popularity in the world in
general and Ethiopia in particular (Mohammed, 2017). However; he pointed out that in present
Ethiopia, a very limited literature and research works are available and the subject matter itself is
also comparatively new in the academic circle. Among these research work is the one undertaken
by the British Council and some NGOs with some more attempts made by few individuals and

6
the government. While numerous organizations and institutions were created in the country to try
providing social service for the people, their efforts are still not enough and not up to standard
and sustainable enough (British Council, 2012). Many organizations claimed to be social
enterprises, engaging and attempting to practice social entrepreneurship and provide social
services for the Ethiopian society. Different communities in Ethiopia are provided with
education, medical care services, assistance and support, by these organization to date (British
Council, 2012).

One of the values of social entrepreneurship is the promotion of social change by solving
social problems (Bryan, 2012). In Ethiopia, many problems are hindering local efforts in their
practice of social entrepreneurship and in their contribution towards solving social problems.
However; policies and legal procedures on the provision of social service that address to the
needs of the society both at micro and macro level are either limited or not exist or not properly
formulated and implemented (Mohammed, 2017; British Council, 2012).

The social service provision in Ethiopia is exclusively dependant on the government with
donors as the main source of funds; and is not sustainable enough once these donors stop funding
or withdraw due to many reasons. The lack of formal and proper policy and legitimacy for social
enterprises which really could work, if present, on social value creation is also another setback.
These policies and legitimacy could help local social enterprises to strive to bring social change
and contribute to solve societal problems in a sustainable manner in Ethiopia (Mohammed, 2017;
British Council, 2012).

Hence, this research study started with the strong belief that the low level of the practice of
social entrepreneurship particularly based on local knowledge and creativity, made the country to
be deprived of the huge contribution and impact otherwise be obtained with respect to
socioeconomic and ecological issues. Therefore, the main problem discussed in this research
study is „the low level of the practice of social entrepreneurship in Ethiopia is depriving the
country benefiting from its efforts towards solving socio-economic and environmental problems
of the society. There is a need to explore the reasons „Why the understanding and the practice of
social entrepreneurship is at low level in Ethiopia while it has huge potential contribution and
impact in social value creation and hence solve many social problems in the society?‟.

7
 Even though local enterprises like TEBITA face challenges of varying magnitude, the very
few available studies that have dealt with the practice of social entrepreneurship; the challenges
faced opportunities for social enterprises in Ethiopia, particularly in the study area reported in
this thesis, are general and scanty. Hence, this study explored and discussed the reasons for the
low level social entrepreneurial innovation and practices and the critical challenges that
specifically affects the social enterprise sector.

1.3 Objective of the Study

The objectives of the study are explained under its general and specific details as follows.

1.3.1. General Objective

The general objective of this study was „To explore the innovative social entrepreneurial
model of TEBITA Ambulance with its practical efforts towards bringing solution to some social
problems in the community and to suggest mechanisms for incubating the same in Ethiopia‟.

1.3.2. Specific Objectives

Based on the general objective of the study, the specific objectives were

1.3.2.1. To explore the innovative social entrepreneurial business model of TEBITA

Ambulance as one pioneering local social enterprise in Ethiopia
1.3.2.2. To explore the unique service provision of TEBITA Ambulance and its practical
efforts towards bringing solutions to some social problems with service sustainability
1.3.2.3. To identify the main challenges and opportunities of social entrepreneurship as
practiced by TEBITA Ambulance
1.3.2.4. To suggest mechanisms for incubating the type of innovative social entrepreneurship
practice of TEBITA Ambulance in the country.

1.4. Research Question of the Study

The research questions were explained under its major and specific details as follows

8
 1.4.1. General Research Question

The general research question was „what is the innovative social entrepreneurial model of
TEBITA Ambulance with its practical efforts towards bringing solution to some social problems
and how to incubate the same in Ethiopia?‟

1.4.2. Specific Research Questions

Based on the major research question, the specific research questions were

1.4.2.1. What is the innovative social entrepreneurial and business model of TEBITA
Ambulance as one pioneering local social enterprise in Ethiopia?

1.4.2.2. What are the unique service provisions of TEBITA Ambulance with its innovative
social entrepreneurial practice and efforts towards bringing solutions to some social
problems of the community with service sustainability?
1.4.2.3. What are the main challenges and opportunities of social entrepreneurship for
Ethiopia as practiced by TEBITA Ambulance?
1.4.2.4. What mechanisms are there to incubate the innovative social entrepreneurial practice
of TEBITA Ambulance in the country?
1.5. Significance of the Study

Despite increased interest in social entrepreneurship in Ethiopia, very little research works
have been conducted on the topic especially from the perspective of academician and
practitioners. Those researches previously conducted by Mohammed (2017) and the British
Council (2012) did not even discuss social entrepreneurship in its nature and phenomenon,
instead they tend to focus on literature review and some practices on social enterprises in the
country. Therefore; it is believed that conducting more research study on social entrepreneurship
provides the clear understanding of the concept and phenomenon at local level as well as helps to
explore the contribution and impact of its practices in solving societal problems in the country.

This study is significant in that it examined and described the practice and efforts of social
entrepreneurship towards bringing solution to societal problems in Ethiopia. Specifically, it
explored the social entrepreneurial practice of one local enterprise called TEBITA and tried to
9
understand its innovative social service provision and delivery mechanisms. By doing so, the
study aimed to understand the nature and phenomenon of social entrepreneurship and the
innovative social entrepreneurial practices of local social enterprises in the country. In addition,
the study provided significant information and evidence on the business model of social
enterprises as well as their innovative structure, practices and efforts. It is hoped that this will
help to understand the local practices of social entrepreneurship in Ethiopia and the potential
contribution it can bring in mitigating the burden of social problems to our society. Conducting
the research study also highlights the huge potential contribution of social entrepreneurship in
bringing sustainable solutions to many social problems in the country. In addition, the study
intended to bring to the attention of academicians and practitioners the very scarcity of research
works in the area and of course the need for undertakings of more research works.

The research study was conducted with the belief that its findings and results may provide
additional input for the improvements of local social entrepreneurship understandings and
practices in the efforts towards tackling social problems of the society in Ethiopia. The study
could also be considered as an additional contribution to the limited and scarce literature works
available. Furthermore; the study can be taken as an input for those who want to conduct more
studies on the practice of social entrepreneurship in the country particularly on the works and
activities of local social enterprises. The study is also significant as it suggested some practical
measures to overcome the challenges and constraints facing local social enterprises like
TEBITA, thus enabling them to play a key role in solving and mitigation of societal problems
and mainstreaming efforts of such innovative for social development and sustainability in the
country.

1.6. Scope of the Study

The scope of the study was limited in exploring the practice and efforts of social
entrepreneurship and understanding the overarching constraints and challenges as well as
opportunities in Ethiopia using qualitative research design. The innovative social entrepreneurial
model of TEBITA and its service provision and delivery were used to assess, study and
understand the current social entrepreneurship practice in the country. The efforts of TEBITA
against its innovative and sustainable social service delivery was explored. The major

10
opportunities, challenges and constraints faced by TEBITA during service delivery for its service
users were also discussed. TEBITA‟s service provision and opportunities as well as capacity
building activities and system of mechanisms for incubating its innovative social entrepreneurial
practice to others was also assessed. Collective social responsibility was given due attention in
assessing the business model of TEBITA and other similar social enterprises in their efforts and
strivings in bringing solutions to societal problems in the country.

The research study attempted to collect available literature materials and reviewed them to
conceptualize the reality in the country using TEBITA as a case study. It was however, believed
that because the concept and the practice of social entrepreneurship is a new and emerging
phenomenon for Ethiopia (Mohammed, 2017; British Council, 2012), it gives a golden
opportunity for future researchers in the subject matter to do more research on the topic as there
are still much to assess and analyse.

It is to be well noted that this research study is only indicative for the urgent need for future
research works in the area. Academicians are reminded to embark on both qualitative and
quantitative research works that are technically lacking at present. They are practically expected
to create the condition for bringing the concept of social entrepreneurship forward and sensitize
practitioners how it is exactly being practiced as well as to the public to create awareness and
understanding what benefits and contribution it might bring to them and to society. Hence, the
study was not exclusive by itself and did not attempt to generalize findings as final.

1.7. Definitions of Terms

Crowdfunding: is the practice of funding a project or venture by raising small amounts of

money from a large number of people. It is a form of crowdsourcing and alternative finance. It
has some similarities with Ethiopian traditional equb.

Local Social Enterprise: is an enterprise which is legally registered and functions in Ethiopia
and strive to work on the basic principle of social entrepreneurship like TEBITA
Paramedic: an emergency technician who is a graduate of TEBITA Ambulance whose job is
working as emergency medical service provider but who is not a doctor and help people who are
sick or injured,

11
 Practice of Local Social Enterprise: the activities of an enterprise like TEBITA Ambulance,
in Ethiopia which tries to bring innovative practices through merging the social sector with that
of the economic sector.
Public Private Partnership: the proposed partnership for the Ethiopian socioeconomic
sector between the government and the private sector to facilitate joint venture activities in the
country.
Social Business Model: is a conceptual tool which describes how a local enterprise in
Ethiopia offers social service and value to service users and its network of partners for creating
and delivering this value.
Social Entrepreneur: A person in Ethiopia who strives to use an innovative practice and
balance the social, economic and ecological aspects. He/she identifies prevailing local social
problems and uses innovative entrepreneurial skills to achieve positive changes such as
environmental protection and conservation, job creation, meeting cultural and public needs as
well as the inclusion of vulnerable members of the community.
Social Entrepreneurship: the new and innovative practices of enterprises in the socio-
economic sectors in Ethiopia which strive to bring solutions for some of societal problems in the
country.
Social innovation: creative and new way of working in the socio-economic environment of a
country like Ethiopia which has contribution and impact in bringing solution to societal
problems.
Social Problem Solving: refers to the local efforts and processes in which local social
enterprises work to find adaptive ways of coping with everyday situations that are considered
problematic in Ethiopian society.
Social Sustainability and Development: innovative activities in the socio-economic sector
which brings development in both the economic and social sector in a sustainable manner.
Societal problems: the conditions or behaviour in Ethiopian context that has negative
consequences for many people and that is generally recognized as a condition or behaviour that
needs to be addressed. Those problems in Ethiopia that negatively affect people‟s state of being
in a society.

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1.8. Structure of the Thesis

This thesis work is divided into six chapters. Chapter One contains the background, statement
of the problem, objectives and research questions of the study, significance and scope as well as
operational definition of the research study. The Second Chapter presents a review of relevant
literature, both published and unpublished. Chapter Three focuses on methodological issues; the
research paradigm, design, study area, study participants, procedures and tools of data collection
and the method of data analysis as well as quality assurance and ethical considerations. Chapter
Four concerns with the analysis of the data followed by Chapter Five, the discussions of the data
through qualitative research design. Chapter Six provides the conclusion, findings and
implication for social work based on the findings and discussion of the data.

13
 CHAPTER TWO
RELATED LITERATURE REVIEW
2. Introduction
Chapter two reviewed the relevant literature by first discussing some conceptual definitions
such as social entrepreneurship, social enterprises, social entrepreneurs, social innovation, and
social development and sustainability. In addition, an overview of the social entrepreneurial
structure and innovative business model of a typical social enterprise was provided together with
discussion of the measurement used in the definition of social enterprises. The global practice
and contribution of social entrepreneurship and its understanding in Africa is briefly presented.
Its emerging phenomenon and practices with focus to Ethiopia also explored. Finally, challenges
and opportunities of social entrepreneurship in developing countries like Ethiopia was briefly
discussed.
The study reviewed some literature works already done on the area of research in hand.
Literature review was needed to explore and understand the meaning, nature, theoretical and
conceptual framework of the practice and contribution of social entrepreneurship towards
bringing solution for societal problems so that the research could be properly articulated. The
research study tried to get available academic peer-reviews in the social science citation index
(SSCI); ERIC, PscINFO, Science Direct.com, Online Library which are interdisciplinary
databases covering leading articles and journals of social sciences. YouTube video presentations
were also used to get insights for both global and local practices of social entrepreneurship.
Articles were selected from these databases that make explicit use of one or more of the
following key terms; Social Entrepreneurship (SE), Social Enterprise (SEr), Social
Entrepreneur (SEn), Social Problems, Social Innovation, Social Development and
Sustainability. The research questions were the main domains for the research study. The
literature review is categorized into the following general themes.

2.1. Understanding Social Entrepreneurship

The emergence of social entrepreneurship is primarily associated to three reasons. First, as
Thompson (2000), Blackburn and Ram (2006) stated, the growing interest to solve social issues
has led to the continuous pursuit of effective, innovative and sustainable solutions to deal with

14
the complexity of social problems and a means to relieve modern societies from its illness such
as unemployment, inequalities in the access to health care and social services, poverty, crime,
prevention or social exclusion. Second, the rising concern on the growing range of service areas
not addressed by the public sector, but where conditions are not attractive enough for the private
sector (Darby & Jenkins, 2006). Further emphasized by Sheifer (1998) that under this
circumstance neither the government nor the private sector has the proper incentive to produce or
provide social service. Third, a growing appreciation among business or commercial
entrepreneurs and their involvement in social sector with the purpose to enhance social wealth
globally and has a way of creating community wealth (Zahra, 2008; Wallace,1999).

Neoclassical economists were with the view that self-correcting free markets have no
incentive to correct considerable economic and social harms. They continued to argue that
governmental and institutional attempts to address societal problems, compounded by inadequate
resources, lack of political will, endemic corruption, and conflicting political ideologies made the
efforts inconsistent with realities. Massive socio-economic problems defy conventional
solutions. The result as neoclassical economists concluded is increasing polarization and break
down of civil society through social disparity and economic stratification and widening wealth
gap (Paul, 2015).

Social entrepreneurship and its phenomenon and practice came as a solution to such market
failure in an economy. The practice of social entrepreneurship reduces poverty through creating
jobs, develop community trust and strengthen local networks. It makes communities self-
sufficient, self-esteem, self-worth and confident; creates market for products and services
produced locally rather than importing them. In addition, social entrepreneurship allows to retain
local wealth (Paul, 2015).

Social movements over the last twenty years have begun promoting social entrepreneurship.
Such enterprises include Ashoka Foundation, the Skoll Foundation and Schwab Foundation. Its
concept and theoretical framework came into sight in the 1980s from the work of Bill Drayton at
Ashoka Foundation which provides funding to social innovators around the world and from ED
Skloot of new Ventures that helps the non-profit organizations to explore new sources of income
(Dees, 2001). Despite the newness of the concept, the practice that employed entrepreneurial

15
capacities to ease social problems has existed for decades. Only recently social entrepreneurship
becomes a widely discussed topic and increasingly mainstreamed among policy makers, civil
society groups, businesses, financial institutions, and academics in the universities (Nicholls &
Young, 2008; Dees, 1998).

The foundation for modern social entrepreneurship was laid by the pioneers like M. Younus
who was the founder of Grameen Bank and father of micro credit who identified the stable
equilibrium for poor Bangladeshis‟ limited options for securing even the tiniest amounts of
credits (Mair & Marti, 2006). The two discussed on the foundation of social entrepreneurship
that Younus brought inspiration, creativity, direct action, courage, and fortitude to his venture.
Younus proved viability of social entrepreneurship and global network of organs replicated or
adopted his mode to other countries and cultures, firmly establishing micro credit as a worldwide
industry.

Social entrepreneurship is an emerging field that can be characterized with literature gap, lack
of consensus on definition, lack of frameworks and lack of empirical data as stated by Mair and
Marti (2006), Nicholls and Young (2008). According to Poon (2011) the emergence and
development of social entrepreneurship can be broadly categorized into two. The market-based
form of social enterprise and the hybrid-based form. The hybrid-based blends economic and
social enterprise together. A research conducted by Mohammed (2017) explains that in the last
two decades, the use of the term social entrepreneurship is gaining increased popularity in the
world in general and in Ethiopia in particular. He further suggested that there is the need to
identify crucial points that can be used to make social enterprises and the practice of social
entrepreneurship in Ethiopia more functional.

2.1.1. The Meaning and Nature of Social Entrepreneurship (SE)

Many researchers and authors tried to define the subject matter, social entrepreneurship in
many ways based on the function it is intended. Phipps and Friedrich (2012) defined it as an
emerging concept with inventive approach for dealing with complex social needs. Austin (2006),
Roberts and Woods (2005) asserted that social entrepreneurship uses entrepreneurial activity that
mainly serves a social objective. Fowler (2000) on the other hand defined it as the creation of

16
viable socioeconomic structures, relations, institutions, organizations and practices that yield and
sustain social benefits.

Others too tried to define and explain the subject matter yet in different perspectives. Social
entrepreneurship combines the resourcefulness of traditional entrepreneurship with a mission to
change society (Seelos & Mair, 2005). Mair and Marti (2006) are with the view that social
entrepreneurship is a process that catalysis social change and addresses important social needs in
a way that is not dominated by direct financial benefits for the entrepreneurs. It is also defined as
a process that includes the identification of a specific social problem and a specific solution.
Researchers like Zahra, Gedajlovic, Neubaun and Shulman (2009) discussed the social
entrepreneurship phenomenon as encompassing the activities and processes undertaken to
discover, define and exploit opportunities to enhance social wealth by creating new ventures or
managing existing organizations in an innovative manner.

Ashoka (2009), a leading association that promotes the field of social entrepreneurship
provided a definition as „any attempt at new social enterprise activity or new enterprise creation
by an individual or team of individuals with social or community goals as its base and where the
profit is reinvested in the activity or venture itself rather than returned to investors‟. Fuqua
School of Business (2013) wrote and defined social entrepreneurship as being a system of
recognizing and resourcefully pursuing opportunities to create social values and crafting
innovative approaches to addressing critical social needs. This means that it is a process by
which citizens build or transform institutions to advance solutions to social problems. The Said
School of Business (2013) similarly defined and expressed social entrepreneurship as a practice
of combining innovation, resourcefulness and opportunities to address critical social and
environmental challenges, marginalization and environmental deterioration and accompanying
loss of human dignity which are the root causes of poverty and exclusion.

Kent and Anderson (2003) on their part summarize the essence of social entrepreneurship by
stating that it is the ability to establish the relationship between social and community values
while seeking to adapt continuously to ensure social progress. In the understanding of Naya
(2009), social entrepreneurship is the use of an innovative business model that meets both social
and economic objectives contributing to labour market integration, social inclusion and
economic development. Social entrepreneurship is a process rather than an event and it is
17
described as entrepreneurial innovation. It is also a collective effort of an entire team of people
though individual social entrepreneurs play a key role in building the enterprise. Social
entrepreneurs recognize immediate social problems but also seek to understand the broader
context of an issue that crosses disciplines, fields and theories. Gaining a larger understanding of
how an issue relates to society allows social entrepreneurs to develop innovative solutions and
mobilize available resources to affect the greater global society (Baker, 2005).

Another researcher and academician called Mathew (2009) proposes a definition of

sustainable development in that a development that meets the needs of the present without
compromising the ability of future generations to meet their needs can be categorized as a social
entrepreneurship. In his book „introduction to social entrepreneurship‟, Paul (2015) explained
why to use the phenomenon of social entrepreneurship. He wrote that massive social and
economic problems defy conventional solutions. Social entrepreneurship is mission-focused, not
profit-driven that reflects its values. It fosters social and environmental innovation to solve
problems. It circumnavigates politics by taking a business approach. Social entrepreneurship
uses free market to create social values. It transforms resulting in systemic change that yields
long-term benefits. It builds, maintains, and utilizes social capital by networking for resources. It
is not bureaucratic but nimble that moves quickly and easily. It is passionate and personal to the
social entrepreneur. It is accountable to society, not to private shareholders. It facilitates
development by being equitable, enhancing social stability. Social entrepreneurs get things done
despite obstacles and inherent disadvantages by innovating and being creative (Paul, 2015).

From the above several definitions and explanations, we can understand that the term social
entrepreneurship is directly connected to the provision of social services in the efforts to tackle
and solve societal problems. It is a concept and the unique characteristics of an entrepreneurial
skill. Social entrepreneurship furthers the cause of sustainable development and holistic
innovation. A social innovation is a new mode of operation which addresses the social needs of
an individual or community and thus improves quality of life and wellbeing (Julkaisut, 2015).

Some studies describe the concept of social entrepreneurship as an extension of commercial

entrepreneurship. The main difference between the two practices are identified as what drive and
motivate their actions (Dees, 2001). Leadbeater (1997) argued that social entrepreneurship has

18
been acknowledged as a new type of entrepreneurship around the world that is based on social
wealth creation rather than the generation of economic wealth as its main objective. Prominent
researchers and Nobel Prize Winner like Younus claims that social entrepreneurial activities
have far reaching economic effects enhancing growth, reducing poverty and improving large
scale social development (Younus & Weber, 2008; Zahra; Gedajlavic; Neubaum & Shulman,
2009). Overall, social entrepreneurship hence broadly defined as a process involving the
innovative, social value creating activity that can occur within or across the non-profit business
or government sectors (Austin & Stevenson, 2006). The phenomenon is a new type of innovation
that combines profit with long-term social responsibility (Johnson, 2000).

Generally speaking; the main aim of social entrepreneurship is to further broaden social,
cultural and environmental goals. All existing definitions of the phenomenon and notion of social
entrepreneurship are based on the following characteristics as Shaw and Carter (2007) listed out.
Social entrepreneurship as addressing social problems or needs that are unmet by private market
or the government, it is motivated primarily by social benefits, it is also generally working with
not against market forces.

Social entrepreneurship is the use of the techniques by start-up companies and other
entrepreneurs to develop fund and employment solutions to social, cultural and environmental
issues. The concept may apply to a variety of organizations with different sizes, aim and believes
(Audiopedia, 2018). For-profit enterprises, social entrepreneurship typically measures
performances using business matrix like profits, revenues and increases in stock prices.
Enterprises operating under the principles of social entrepreneurship however, their goal is to
generate positive return to the society and therefore use a different matrix that attempt to further
and broaden social, cultural and environmental goals associated with the voluntary sector in
areas such as poverty alleviation, health care and community development (Audiopedia, 2018).
Social entrepreneurship is proposed as a solution to tackle social problems since it is perceived
as an innovative means to seize social opportunities or to use and combine economic and other
resources for social change (Mair & Marti, 2006).

In the 21st century, social entrepreneurship is facilitated using the internet particularly social
networking and social media websites. These enables social entrepreneurs to reach many people
who are not geographically close yet to share the same goals and encourage them to collaborate.
19
Online, learn about the issues, disseminate information about the groups events and activities and
raise funds through crowd funding‟s. Scholars and practitioners have debated that individuals
and organizations can be considered as social entrepreneurs (Meyer & Whittier, 1994). Social
entrepreneurship can be considered as social innovations. In modern society, it affects altruistic
form of entrepreneurship that focuses on the benefits of a society may rip and on the fact of
caring about the needs and happiness of other people more than our own. Simply put,
entrepreneurship becomes a social endeavour when it transforms a social capital in a way that
affects society positively. The success of social entrepreneurship depends on many factors
related with social impacts that traditional corporate business doesn‟t prioritize (Thompson,
2000).

Unlike traditional corporate businesses, social ventures focus on maximizing gains on social
satisfactions rather than maximizing profit gains. We need to move from success to significance.
Thinking beyond business, humanising business recognizing that people are the only source of
differentiation and value creation (Dipak & Dean, 2010).

To summarize; social entrepreneurship is understood as a tool for social responsibility and

can be regarded as a means or solution that could help alleviate or solve societal problems that
the world faces today. Hence; this research study wanted to stress that social entrepreneurship is
founded upon on social responsibility in which its main purpose is to solve societal problems and
is a best response to try to bring sustainable solution for developing countries like Ethiopia for
the many and complex prevailing as well as newly created social problems.

2.1.2 Theoretical and Conceptual Frameworks

Different schools tried to conceptualize and establish a theoretical framework of social

entrepreneurship. However; previous studies failed to establish a clear and unified definition
based on a theoretical framework for the concept (Defourny & Nyssens, 2008 & 2010).
According to Mair and Marti (2006), there is no coherent theoretical framework for the subject
matter but to frame the practice of social entrepreneurship, two school of thoughts are developed
that are critical for the growth of the field.

20
2.1.2.1.The Social Enterprise School of thought

This school of thought sets its foundation mainly by earned income strategies for non-profit
organizations that seek funding alternatives to sustain their operation and maintain
independence. One of the alternatives is to earn money through provision of goods and services
(Young & Salamon, 2002). According to Younus (2010), social businesses are related to the
mission-driven business approach that involves social business as a non-lose, non-divided
company designed to address a social objective. It is based on a business model that relies on the
provision of goods and services to very poor customers or new market segments at a very low
price in developing countries. With this respect, Younus (2010) suggested that the social
business model is expected to cover all its costs through market resources and the business is
owned by investors who do not claim dividend.

2.1.2.2. The Social Innovation School of Thought

This is the second perspective which focuses on the behaviour of social entrepreneurs where
they are considered as change agents that can replace the existing products, processes, ideas and
businesses with a new idea to bring such social enterprises with innovation that can create value
which enable them to balance the economic and social purpose (Defourny & Nyssen, 2010).

2.1.2.3. The Trade Off

Muhammed (2017) by borrowing the definition and explanation of Austin (2006) stated that
„…there should be two parts to the definition of social entrepreneurship. First, social
entrepreneurship involves creating something new, characterized by innovation rather than
simply the replication of existing enterprises or practices. Second, at least some of the objectives
of the undertaking need to be related to creating social value, sometimes referred to as SOCIAL
GOODS rather than simply creating personal and shareholder wealth‟. He discussed the
suggestion provided by Dees and Anderson (2006) on the justification for the inclusion of an
enterprise as a social enterprise. He provided the cross-fertilization, rather than competition
between the perspectives of the social innovation school and the social enterprise school will
represent the overall field of social entrepreneurship. Muhammed (2017) further discussed the
work of Dees and Emerson (2006) that advocacy work is going on by many school of thoughts

21
on the idea of mission driven business that promote broad business methods going beyond
earned income strategy. He also asserted the research work of Schumpeter (1974) by
conceptualizing social entrepreneurship as social innovation focusing on the social entrepreneurs
of individuals who tackle social problems and meet social needs in an innovative manner.
According to a recent examination by Dees and Anderson (2016) this social innovative school
focused on establishing new and better ways to address social problems to meet social needs. To
meet the social needs of the poor, innovative entrepreneurs establish either a non-profit
enterprise or a for profit enterprise (Dees & Anderson, 2016).

Bill Drayton, founder of Ashoka is considered the leading figure for the social innovation
school of thought. This school of thought on social entrepreneurship is rooted in the body of
knowledge of commercial entrepreneurship on the discovery, evaluation, and exploitation of
opportunities. In the case of social entrepreneurship, these opportunities are found in social needs
exploited by innovative means to satisfy those needs (Muhammed, 2017; Drayton, 2002).

Austin (2006) summarized the situation by saying that despite the difference in the definition
of social entrepreneurship, there is a consensus among school of thoughts and researchers that
social entrepreneurship has two parts. First, it involves creating something new which is
characterized by innovation. Second, it creates social value as well as social good rather than
creating personal and shareholder wealth. A social enterprise is a form of innovation which
combines the creation of social goods and entrepreneurship. Innovations sparks new innovations.
Social enterprises could seize the opportunity and sniff out new opportunities to create new
practice-based innovations (Thompson, 2008).

22
 Figure – 1 - Why Use Social Entrepreneurship?
Source: Introduction to Social Entrepreneurship. School of Business UAlbany SUNY New York, 2016

Summarizing from the above figure of the benefits of the use of Social Entrepreneurship and
its unique qualifications, it is mission-focused and not profit-driven that reflects its value. It is
accountable to society, not to private shareholders It fosters social and environmental innovation
to solve problems It circumnavigates (wisely avoids) politics by taking a business approach It
also facilitates development by being equitable, enhancing social stability. Social
entrepreneurship builds, maintains and utilizes social capital by networking for resources;
transforms resulting in systemic change that yield long-term benefits. It is not bureaucratic but
able to move easily and quickly (nimble) and is passionate and personal to the social
entrepreneur.

2.2. What are Social Enterprises?

Like social entrepreneurship, a social enterprise is also defined in many ways by researchers
and practitioners in the field. DTI (2002) defined it as a business primarily with social objectives
whose surpluses are principally reinvested for that purpose in the business or in the community,
rather than being driven by the need to maximize profit for shareholder and owners. Another
definition by Haugh (2006) on the other hand discussed social enterprise as a collective term for
a range of organizations that trade for a social purpose. They adopt one of a variety of different
23
legal formats but have in common the principles of pursuing business-led solutions to achieve
social aims and the reinvestment of surplus for community benefit. Here, we can derive and
understand that social enterprises are businesses which trade for a social purpose, reinvest their
surplus into their social objective and make themselves accountable for their actions rather than
simply maximizing profits for owners and shareholders. They create jobs, generate their own
revenue and deliver beneficial social impact. By utilizing the powerful benefits of trade, they
provide an innovative route beyond aid and grant to address prevailing problems. They
collaborate and engage with each other to address social problems Haugh (2006). In emphasising
on social enterprises, Baogous (2009) wrote that social enterprises are new innovations within
the non-profit organizations category. They differ from non-profit organizations in values,
strategies and norms. He explained that since the birth of non-profit organizations, they have
always tried to tackle the governmental and market failures. Whereas; social enterprises and their
purpose are to take it one step further. In doing so, they may set up for-profit and/or not for profit
organizations. And in either case, the primary objective is to create sustainable systems change.

Social enterprise and socially entrepreneurial activities emphasize hybrid models of for profit
and non-profit activities as the process of applying entrepreneurial principles to creative vision,
leadership and the will to succeed in inducing social change. They exist in space where public,
private and voluntary activities overlap. Social enterprises directly address social needs through
their products and services or through the number of disadvantaged people they employ. Socially
responsible businesses create positive social change indirectly through the practice of corporate
social responsibility (Perrini & Vurro, 2006).

Social enterprises are just like other enterprises. Their product is placed in a market and profit
is generated. However, the profit is not exclusively used to enlarge the wealth of business owners
but reinvested to increase the quality of life and wellbeing of the entire community. The success
of the business is also measured in terms of positive social and ecological impact. At times,
profit making enterprises may be established to support the social and cultural goals of the
organization. But that is not an end by itself. For example, an organization that aims to provide
housing and employment to the homeless may operate a restaurant both to raise money and
create employment for the homeless. A social enterprise might be engaged in any one or all of
value creation chain. Social entrepreneurship covers a broad spectrum of organizations starting
24
with a non-for-profit organization which does mission maximization. On the other hand, they run
for-profit organizations that maximize profit. A true social enterprise is one that is engaged in
profit maximization with social mission (PowToon, 2014).

Social enterprises are not NGOs. They try to tackle social or environmental issues. But, the
biggest difference is the revenue model. An NGO might get its fund through donations,
philanthropy and/ or grants. A social enterprise with its aim to become financially sustainable
generate income and if needed loans, capital investment, etc… (PowToon, 2014). Social
enterprises are entrepreneurial ventures their primary business is working with social objectives
whose surplus are principally reinvested for that purpose in the business or in the community
rather than being driven by the need to maximize profit for shareholders and owners (Dees &
Elias, 1998).

2.2.1. Social Innovation

Social innovations are new social practices that aim on social needs in a better way than
existing solutions. Innovation is a new idea, creative thoughts, new imaginations in the form of
device or method. Social entrepreneurship furthers the cause of sustainable development and
holistic innovation. A social innovation is a new mode of operation which addresses the social
needs of an individual or community and thus improves quality of life and well-being. It is often
the result of the creative activities of an individual, group or community that combines existing
provisions practice and know-how in a new way. In other words, a social innovation means
seeing a familiar thing from a new perspective; a new kind of comprehensive understanding
which teaches people to operate in a new way (Julkaisut, 2015).

All enterprises are social enterprises in one way or another. They create values, jobs, products
and services for the market needs. But, social enterprises create additional social and
environmental values somewhere in the value chain (Gina, 2017). The social values can be
created as further discussed by Gina (2017): - In the value chain that is sourcing product values
in the value chain in the third world and providing market access to the first world for them to
provide additional economic opportunities. In the employment stage which means employing
people who might otherwise not be able to get jobs such as disabled people. In the design part
that is by designing and providing affordable light to people in the remote rural areas who don‟t

25
have electricity. Social values are created based on the people need of energy light bulbs. In the
production or delivery stage, a company can produce and provide locally grown food which
reduces carbon emission or creating an environmental friendly product which minimizes waste
or transportation coast (disposable products). Social values can also be created to previously
underserved market like banking for the poor like what micro finance institutions do. The same
values are also created by donating a percent of the benefit/profit to a non-for-profit
organization.

Schumpeter (2014) explained that creativity and innovation offer new product or service
through developing new process or technology for producing or delivering an existing product,
service, program or project to new or previously underserved market. Creativity and innovation
uses new sources of supply of raw materials and resources, new design organization structure,
utilizing new source of labour or other production inputs. The result will be the creation of new
funding models.

2.2.2. The Business Model

A business model is a conceptual tool which describes how a company offers value to one or
several segments of customers and of the architecture of the firm and its network of partners for
creating marketing and delivering this value and relationship capital, to generate profitable and
sustainability revenue streams (Weerawardena & Mort, 2006). Social enterprises are created
based on a unique business model. Taking the issue of access to Health Care for example to
facilitate the access to Health Care. The money for an NGO might come from donors,
foundations or from the government. The NGO develops programs to provide free access to
health care for marinized communities. With a model of social enterprise, a structure (a business
enterprise) where people would pay regarding with their incomes can be created. Part of the
money (the income) would be used to cover the costs for people who otherwise could not pay for
the services provided for them. The remaining money covers the costs of the structure
(PowToon, 2014). In such unique business model, the structure (the business) is self-sustainable.
No external money in the form of donation, is needed to grow and impact more lives. Like this,
the innovative social entrepreneurial practice of enterprises can be incubated and scaled up the
changes that we want to see in the world (PowToon, 2014).

26
 Leadbeater (1997) presented a model that highlights the social enterprise playing field. The
model constitutes three big areas. The public, private and voluntary sector. The social
entrepreneurial sector is the middle intersectional meeting area of the three sectors. And it is the
sources of social entrepreneurship. Leaderbeater (1997) also commented that to be in the
intersection of the three areas are sometimes very tough for the social entrepreneur since the
resources are very scarce and the motivation are low in doing something good for the nearby
society. Younus (2008) suggested that established institutions such as government agencies, aid
agencies, charities, foundations and non-government organs should not be included as social
enterprises. This is because those enterprises have mix divide line for-profit institutions in terms
of goals and means. In other words, the justification for the exclusion of the enterprises is mainly
because for profit enterprises are not primarily funded by revenues from tax collection or
charitable aid and are thus less isolated from market dynamics.

A social enterprise is a dynamic way of doing business which uses an alternative business
model. It can transform communities and drive profound and lasting social change, social
enterprises deliver solutions that are bigger, better, bolder and fitter. Solutions are bigger because
social enterprises deliver joined-up social, environmental and economic outcome. The solutions
are better because they are community-focused and sustainable. Bolder solutions enable social
enterprises to be innovative and ambitious.

27
 Figure – 2 - Alternative Business Model
Source: http://www.4lenses.org/book/export/html/81

Hybrid Spectrum
----------------------------------------------------------------
Traditional Non-profit Social Socially Corporation Traditional
Non-profit with Income Enterprise Responsible practicing For-profit
Activities Generating Activities Business Social Activities
Activities Activities Responsibility

Mission Motive * * Profit Making Motive

Stakeholder Accountability * * Shareholder Accountability
Income Reinvested in Social Programs * * Profit redistributed to Shareholders
or Operational Costs

28
 Figure – 3 – The Spectrum of Social Enterprises. - Arranged by Legal Form and Revenue
Source

Source: Extracted from John & Elkington (2008)

SOCIAL ENTERPRISES

PHILANTHROPIC LEVERAED ENTERPRISING HYBRID MODEL SOCIAL COMMERCIAL

CHARITABLE &
NONPRonprof NONPROFIT BUSINESS BUSINESS &
NONPROFIT it Legal Entity CORPORATION
ORGANIZATION
Financially An Organization
Sustainable Nonprofit with two legal For-profit
Nonprofit entities for-profit Legal Entity For-profit
Nonprofit Legal Legal Entity Legal Entity
Entity & Non-profit or
Relaying registered under
entirely on Financially
sustainable a hybrid legal
strategic A Company
entity such as in Generates
Entirely Relies partnerships with a social
Nonprofit US & UK revenues &
on donations, for mission
grants & sustainability An Organization maximizes
Generates Reinvests 50% profits to
subsidies with a social
some income or more of its shareholders
mission, financially
making it more sustainable through revenues back
sustainable & its own generation into its core
strategic activities activities

The Different Organizational Models of Social Enterprises

Source: Extracted from John & Hartigan (2008)

Leveraged Non-profit – is one that does not have an income earning strategy but has secured
sustainable partnerships and funding to move beyond the traditional donor dependent model.
Enterprising Non-profit – is a registered nonprofit organization with a strategy for earning a
part or all its income and thus recouping a part or all its costs because they are less reliant on or
even completely independent from subsidies and grants. These types of nonprofit social
enterprises can afford greater innovation, creativity and long-term planning. Hybrid Enterprise
– combines aspects of the for-profit and nonprofit legal models, either through an innovative
legal structure such as the low-profit, limited states or the Community Interest Company(CIC) in
the United Kingdom or by using a for profit subsidiary to support the social alternatives of the

29
nonprofit. Social Business on the other hand is a registered for-profit company. Unlike
traditional for-profit business which is primarily profit driven, the social business is primary and
explicitly driven by social objectives.

Muhammed Younus, the founder of Grameen Bank defines social business as a company that
is cause-driven rather than profit-driven and that can be called a „non-loss, non-dividend
business‟. It generates revenues from its products or services but, by Younus‟s definition, all
revenues are (or 50%) fed back into the business instead of being returned to its shareholders or
investors as profit (Younus, 2010).

2.2.3. Social Development and Sustainability

Sustainable development thinking is based on the concern about inequality between people
and the vigour of ecosystem that form the basis for life. It focuses on economic, social and
ecological sustainability. It mainly addresses social change that occurs and guided on a global,
regional and local levels. Its objective is to ensure present and future generations can have the
opportunity of a good life. Sustainable development play an important role in the strategies and
developmental programmes of governments. Social sustainability is one of the focal points of
social development. Its purpose is to diminish inequality between people, to ensure that every
one‟s basic needs such as food, education, freedom of speech, etc…, are met and to create
preconditions that allow individuals to take care of their own well-being (MoFED, 2010).
Sustainable community development is when people join to develop programs for improving the
quality of life at the community level. Community development is a planned effort to produce
assets that increases the capacity of residents to improve their quality of life. These assets may
include several forms of community capital such as physical, human, social, financial and
environmental (Phillips & Pittman, 2009). By providing small loans to entrepreneurs and small
business, the Grameen Bank has empowered the poor, giving them the resources to generate
additional income and contribute towards sustainable community development (Borzaga, 2013).
On the other hand, the world commission on environment and development defines social
development as a development which meets the needs and aspirations of the present without
compromising the ability of future generations to meet their own needs (WCE, 1987).

30
2.3. Who are Social Entrepreneurs?
Dees (2001), Nandan and London (2013) defined social entrepreneurs as innovative,
opportunity oriented, resourceful, value creating as well as social change agents with a mission
to fix the system when a part of society is not properly working to solve the problem. Dees
(1994; 1998) further explained social entrepreneurs as private individuals dedicated in solving
social problems and those in need. Phipps and Friedrich (2012) wrote that social entrepreneurs
are people with a vision and spreading solutions and persuading entire societies to take new
leaps. Nandan and London (2013) argued that by taking social concern into consideration and
setting out the objective to produce social value and promote social justice, social entrepreneurs
tend to balance the economic and social goals.

A social entrepreneur is a change agent in social value by recognizing opportunities to serve

that mission (Bornstein, 2004). Bornstein sees social entrepreneurs as persons with innovative
ideas to address major problems in what business entrepreneurs are to the economy and social
change. They are creative individuals who question the status quo, exploit new opportunities,
refuse to give up, and remake the world for the better (Bornstein, 2004). Dees (1998) on his part
defined a social entrepreneur as an individual who employs a mission to create and sustain social
value by recognizing and pursuing new opportunities to support that mission and engaging in
continuous improvement acting boldly without being limited to existing resources and exhibiting
an increase sense of accountability to stakeholder.

Through many views and explanations, we will be able to understand that a social
entrepreneur as being someone who can gather a group of peoples‟ interests to a strong
commitment in a specific project. This strong commitment is based upon social values rather
than purely monetary goals (Thompson, 2002). Thompson further explained that the social
entrepreneur is equipped with similar qualities and manners that are being attached to the
business entrepreneur. However; the purpose of their work differs a lot since they are operating
in different business environments. They are active in the community and change people‟s lives
because they value social causes so much. Innovation designed to uplift societal wellbeing
supported by organizations with entrepreneurial capability is the essence of social
entrepreneurship (Nichols & Young, 2008).

31
 Leadbeater (1997) addresses different entrepreneurial skills that characterize social
entrepreneurs in general. He claims that these skills are the sources that drive the actions of the
social entrepreneur and are important for the existence of the organization. The common
entrepreneurial skills that characterize the social entrepreneur are the abilities of entrepreneurial,
innovative and transformational skills. The entrepreneurial skill deals with the ability of being
entrepreneurial in general. It refers to the way individuals undertake underutilized discarded
resources and how they identify ways of using them to satisfy unmet needs. Innovative skills
refer to the ability to create something new that is to be innovative. It could be a matter of
creating new services and products. New approaches of dealing with problems which is often
done by bringing together approaches that traditionally have been kept separate. The
transformational skill has to do with the way social entrepreneurs tend to transform the
organizations. They are involved in the neighbourhoods and communities they serve by creating
opportunities for self-development. They also recognize that economic displacement and the
globalization to some extent has been contributing to the social problems that we have today.
As discussed by Stipanicev (2016), a social entrepreneur is one that successfully balance the
economic, social and environmental goals of the enterprise. A social entrepreneur identifies
social problems and use entrepreneurial skills to achieve positive changes like environmental
protection and conservation, job creation and meeting public needs. Through the inclusion of the
most vulnerable members of the community, social entrepreneurs make changes possible and
contribute towards societal change. Social entrepreneurs achieve something larger than playing
profit through the practice of social entrepreneurship and can positively affect their own
community while maintaining steady income (Stipanicev, 2016). Brooks (2008) tried to discuss
the personality of social entrepreneurs as change agents in the social sector. In practice this
means that they adopt a mission to create and sustain social value, not just private value;
recognize and relentlessly pursue new opportunities to serve that mission; act boldly without
being limited by resources currently in hand as well as exhibit a heighted sense of accountability
to the constituencies served and for the outcomes created. Brooks (2008) also argued that the
social entrepreneur faces problems that are characterized with huge complexity. However, they
can bind these challenges into a strong vision that make it possible to change public attitudes
when it is implemented.

32
 Bill Drayton, the founder of Ashoka emphasizes in his numerous presentations and speeches
that: “Everyone is a change maker. Social entrepreneurs are critical in this change they have a
vision, and they have a big impact.” He also points out that “97% of people are afraid to see the
problem. Once when people love the idea of solving the problem, they would be more willing to
see it.” Social entrepreneurs are visionaries who see beyond the usual. They solve social
problems using synergetic approaches where the result is much higher than just the sum of
individual ideas. They have an impact because they collaborate globally by investing time and
creativity to change policies, legislation and frameworks. The most important policy objectives
results of social entrepreneurship programs and projects are: Creating new jobs; Improving the
living standards; Inventing new products and services; Activating citizens‟ participation in
decision making at all levels; Nurturing democratic processes; Integrating new comers, marginal
groups, immigrants, vulnerable groups of the population; Developing intercultural competence;
Creating wealth: Reinvestment and generation of investments; Improving the image of local
areas; Using regional resources in a creative and effective manner; Empowering people to
change their lives, to get motivated (Drayton, 2002).

Prominent individuals associated with social entrepreneurship include Pakistani actor Hamid
Khan and Bangladeshi Nobel Prize winner Muhammed and founder of Grameen Bank Younus
were the pioneers of the concept of micro credit for supporting innovations multiple developing
countries in Africa, Asia and Latina America (Ashoka, 2009). Further the definition of social
entrepreneurs by Ashoka as individuals with innovative solutions to society‟s most pressing
social problems. They are ambitious and persistent, tackling major social issues and offering new
ideas for wide-scale change. Rather than leaving societal needs to the government or business
sectors, social entrepreneurs find what is not working and solve the problem by changing the
system, spreading the solution and persuading entire societies to take new leaps (Ashoka, 2009).
Social entrepreneurs bridge the value gap over economic gap enterprises through generating a
profit while fulfilling social need. They operate outside the context of traditional corporate
businesses. They also insight broader social change through their innovations and drive
innovation through applying creativity to social problems (Ashoka, 2009).

Generally, sustainable development thinking is based on the concern about inequality

between people and the ecosystems that form the basis for life. It focuses mainly on three themes
33
economic sustainability, ecological sustainability and social and cultural sustainability. Social
development is social change that occurs and is guided on a global, regional and local level. Its
objective is to ensure that present and future generations can have a good life. It plays an
important role in the strategies and programmes of the government of a country (Julkaisut,
2015). Social impact tells the story of the impact consists of the consequences of the actions.
Social impact is the consequences of the actions organizations take to address the social needs
which are identified (Hockerts, 2006). It is also being defined further as the portion of the total
outcome that happened because of the activity of the venture about and beyond what would have
happened anyway. Financial impact reflects various financial performance of the entrepreneurial
venture such as return on equity, return on investments, operating income, profit after tax, sales
revenues and turnover (Harding, 2004).

To summarize the main characteristics of social entrepreneurs are personalities, qualities,

values and visions. Social entrepreneurs work towards more than just for profit motivates but
also by their desire to create a better world for all. Albert Einstein once said that „we cannot
solve problems using the same kind of thinking we used when we created them‟. This tells us
that today, we faced with a lot of social problems, global warming, poverty, increasing economic
inequality, famine and terrorism are some of them, and we need a new innovative way of solving
such problems in a sustainable manner (Baogous, 2009).

2.4. The Practice of Social Entrepreneurship

2.4.1. The Global Perspective
Entrepreneurship is a systematic process of applying creativity and innovation to needs and
opportunities in the market place. It involves applying focused strategies to new ideas and new
insights to create a product or service that satisfies customers‟ needs or solve their problems
(Zimmer & Scarborough, 2005). Social entrepreneurship hence stems from the concept of
entrepreneurship to imply the innovative use and combination of resources to utilize
opportunities to facilitate and address social change (Mair & Marti, 2006).

Innovative ideas and approaches are motivated by fast increase of competition and rivalry
among organization. As Weerawardena and Mort (2006) asserted, innovative ideas and
approaches are becoming crucial factors not only in for-profit organizations but also in the non-
34
for-profit organizations for the development of societies. In addition, the competitive
environment along with the increased number of the need for funds visa-vis score donations
forced non-for-profit organizations to find innovative ways that can fill the fund gap
(Muhammed, 2017).While addressing and facilitating change within the society, social
entrepreneurship activities can positively influence the economic growth and social development
of the society through reducing poverty and improving large scale economic development
(Zahra, 2009). However, this idea is challenged as mentioned in the work of Muhammed (2017)
by Nega and Schneider (2015) who stated that the influence of social entrepreneurship activity is
at micro level and it does not have great impact on poverty reduction.

Social enterprises address social and environmental problems through innovative solutions
that improve people‟s lives in communities and societies. Social entrepreneurs maximize the
social values and impact by addressing the social needs of people which are overlooked by other
institutions (McMullen, 2011). The practice of social entrepreneurship is promoted and
supported by many international organization in the world. These include the US Ashoka
Foundation, the Schwab Foundation, Aspen Network of Development Entrepreneurs (ANDE) as
well as The Skoll Foundation (SERI, 2016). Social movements like Ashoka Foundation, the
Skoll Foundation and Schwab Foundation, over the last twenty years have begun promoting
social entrepreneurship (Perrini & Vurro, 2006).

The British Council‟s global social enterprise program draws on the UK experience in social
enterprise to promote its growth around the world. In the program building the capacities in the
sector, forging international networks and supporting policy leaders to create ecosystems in
which social enterprise and social investment can thrive. The program supports positive social
changes, inclusive growth and sustainable development while building trust and creating
opportunities between the UK and other countries (British Council, 2016). Such international
organizations initiate various programs of support to promote, invest and expand the social
enterprise sector across the globe (SERI, 2016).

Social entrepreneurship is a specific type of „doing business‟ in a sustainable manner,

pursuing both social and economic wealth. Globally, the attention to social economy and social
entrepreneurship is growing with some scholars even affirming that these economic sectors are

35
the only ones that support a sustainable development of the labour market (UNWTO, 2014). The
emergency and development of social economy and social entrepreneurship exerts a powerful
impact that translates into better employment opportunities for vulnerable groups focus on
community development, better access to public and private services as well as development
incentives for small scale actors operating in various fields. At the level of society, social
enterprises provide services across the three sectors – public, private and the third sector
(NGOs). Social enterprises work together with disabled people, not for them, their aim being to
ensure disabled people feel valued as human beings. In some countries, social enterprises have
been defined as organs that deal with the employment problems of long-term jobless and
disabled people (Galliano, 2009).

2.4.2 The Practice in Africa

Both SERI (2016) and the British Council (2017) discussed that despite the support of many
countries and governments of the sector, currently no dedicated legal structure for social
enterprise exists in Africa. But there are several options available which allow for flexibility
including non-profit organizations, public benefit organisations and donor deductible status. The
African Diaspora Network provides a knowledge sharing platform for investors, social
entrepreneurs, volunteers and donors to connect and collaborate on social enterprise projects
across Africa. Similarly, the Social Enterprise Academy Africa, established in 2012 provides
learning and development for social entrepreneurs to help them increase their social impact
ensure financial sustainability and gain international recognized qualification (SERI, 2016;
British Council, 2017).
In South Africa, institutions are now beginning to incorporate the concept of social enterprise
in practical and experiential learning style courses. There is also ample evidence of local and
international partnerships between higher educational institutions and social enterprises in South
Africa that particularly focus on developing communities, creating employment opportunities
and improving access to sanitation facilities. The type of social enterprises in Africa would be
most likely to support developing a specific community, supporting vulnerable adults, children
and young people, improving health and wellbeing, addressing social exclusion, promoting
education and literacy, creating employment opportunities and contributing to international
development goals (SERI, 2016 ; British Council, 2017).

36
2.4.3 The Practice of Social Entrepreneurship in Ethiopia

According to Montero (2016) and Haugh (2007), social entrepreneurship is not about
conference, accelerators, charity and philanthropy or wealth distribution. It is about power
distribution among the poor so that they will enable themselves and they will be independent of
aid. Nega and Shneirder (2015) are with the view that social entrepreneurship in Ethiopia can
play an important role in the development of the country. It has potential for structure
transformation and poverty alleviation. It can also underline support for state led development
and democratic reforms making social entrepreneurship a useful microeconomic strategy that can
contribute in small ways to development.

For this research work, there is a significant shortage in finding evidence-based study articles
on the practice of social entrepreneurship in Ethiopia. The only few research materials and
articles available are those prepared by the British Council (2010, 2016, 2017), Muhammed
(2017), Reach for Change (2013), Ministry of Urban Construction and Development (2013),
Ethio-Canada Cooperation as well as Micro and Small Enterprises (2014). Therefore, to explore
and understand the level of awareness and practice of social entrepreneurship in the country,
these very few and limited research studies are reviewed here under.

Wearawardena and Mort (2006) stated that the use of the term social entrepreneurship is
gaining popularity in the world in general. And in Ethiopia, some awareness is created in specific
(British Council, 2010). The concept of social entrepreneurship is rarely discussed in Ethiopia
even though the practice of delivering social values to the population has been around for years.
Only in recent years the concept is making some significant development and getting more
interest from social entrepreneurs (Mohammed, 2017). In the 2017 publication of the British
Council that describes the general situation needed to accelerate the development of the sector, it
was estimated that numerous social enterprises are operating in the country; mostly in the areas
of education, poverty, rural development, and environmental sustainability, employment for the
marginalized and at risk. The publication highlighted that social enterprises domain in Ethiopia
has been largely driven by isolated communities in a specific geographic region or a theme.

The study conducted by the British Council (2017) states that in Ethiopia, there is no distinct
legal form or registration process for social enterprises. Besides; most of the social enterprises in

37
Ethiopia are registered as Micro and Small Enterprises (MSEs) followed by sole
entrepreneurship, cooperatives, partnership, and charity respectively. The main problem for the
country is that the practice does not get proper attention even though it is very useful in solving
many social and other problems of the country. Another major barrier reported in the study was
lack of access to capital and financial institutions while obtaining grant fund (British Council,
2017). Given the absence of legal form for social enterprise, social entrepreneurs in Ethiopia
need to be careful to not confuse the very essence of the social enterprises. In addition; there is a
very limited research work on social enterprises in Ethiopia that can tell us about the practices,
challenges, and opportunities of social enterprises (British Council, 2017). Nevertheless; there is
a common recognition among key stakeholders that social enterprise has the potential to solve
many social challenges by utilizing the best of for-profit and non-profit sectors which also
underlines the „hybrid‟ approach currently being practiced in the country (British Council, 2012).
The publication further discussed the need for integrated efforts from various agencies to
increase level of awareness on social enterprises and the practice of supporting the community
with various social entrepreneurship activities. There is also a need to educate the public and the
community on the importance and potential of the social enterprise sector in promoting
nationally sustainable social economic development.

Another article by British Council (2016) presented an analysis of the current context,
regulatory framework challenges and opportunities social enterprises face in Ethiopia. The report
confirmed the presence of social entrepreneurial activities in the country and the growing nature
of the social enterprise. The survey also aimed at providing a summary of the current size and
scale of the social enterprise sector in Ethiopia. It found out that social enterprise activities in the
country is mainly practiced in four sectors namely service, business development and enterprise
support, agriculture, fishery and retail businesses. In addition, it was suggested that the result of
the survey is expected to serve as a baseline to allow actions to access progress and identify
possible intervention to support the growth of the sector. Finally, the main recommendation for
this report concluded by addressing the need for an improved information and understanding of
the social enterprise sector, enhancing the capacity of social enterprise institutions and
practitioners including social entrepreneurs, CSO Leaders, intermediaries and educators and
increasing the awareness and capacity of government official and policy influences. The survey

38
also confirmed the existence of limited research on social entrepreneurship activities and social
enterprises in Ethiopia.

Most other existing researches that are relevant to social enterprise in Ethiopia focus on Micro
and Small Enterprise Development. The Ethiopian Ministry of Urban Development and
Construction and Ethio-Canada Cooperation Office commissioned a 2015 survey on urban micro
and small enterprises in Ethiopia with the aim of better understanding the role, status and
challenges of MSEs in the country. Both reports concluded by confirming on the limited
research-based evidence for the sector and the need to provide a deeper understanding of the
opportunities and challenges of MSEs in Ethiopia.

A mapping of social entrepreneurship practices and social enterprises in Ethiopia was

conducted by an organization called Reach for Change in 2013. The result revealed that there are
enormous social needs in Ethiopia and both existing and aspiring social entrepreneurs seek to use
innovation for social good (Reach, 2013). Another very good attempt of a literature review
available is a research conducted by Mohammed (2017) asserts that the use of the term social
entrepreneurship is gaining some understandings and awareness in Ethiopia in recent time.

Mohammed justified his motivation for conducting the literature review by stating the social
injustice in developing countries is because of income gap, absence of unified definition for
social entrepreneurship and the legitimacy issue of social enterprise. Accordingly, he reviewed
the literature to reveal the debatable issues regarding definition, legitimization and school of
thoughts under the social entrepreneurship construct and to forward future direction in Ethiopia.
The review study focuses on briefly discussing the definition and concept of social
entrepreneurship, school of thoughts as well as on legal form of social entrepreneurship in the
country. In trying to present the practice of social entrepreneurship in Ethiopia, Mohammed
however, only presented the type of social enterprises operating in the country and due to lack of
legitimacy, he claimed that the social enterprises are not really considered as social enterprises.
Mohammed further explained in his research study that there is the need to identify crucial points
that can be used to make social enterprises and the practice of social entrepreneurship in Ethiopia
more functional.

39
 The British Council (2012) suggested that in present Ethiopia, it is difficult to differentiate
social enterprises from business enterprises because there is no separate legal form for social
enterprises. The establishment of Ethiopian Social Entrepreneurship Forum (ESEF) in September
2016, seeking to drive forward a sector with the potential to transform lives across the country,
the idea of planning to bring together, innovators, entrepreneurs, investors and actors from
government, business and NGOs who will join forces to empower social entrepreneurs to create
lasting positive change initiated (British Council, 2016).

Havertkort briefly discussing on social entrepreneurial practices in Ethiopia wrote that it is

well common for individual entrepreneurs to set up a business as a social enterprise in the
country. However; there are some well-established social enterprises that offer products and
services alongside employment and training of disadvantaged young boys and girls and they
have made a real impact in society over the years (Haverkort, 2016).

2.5. Challenges, Opportunities and System of Incubation for Social Entrepreneurship

2.5.1. Challenges
The British Council (2012) discussed that the practice of social entrepreneurship is most
applicable in nations which have developmental issues. Ethiopia, as one developing country, has
its own social challenges and such social developmental issues. The country has developed
different social and social related policies to address the pressing social problems in the country.
The most directed policy was the National Social Policy issued in May 1994 which was revised
and renamed as Developmental Social Welfare Policy issued in 1996 by MoLSA (2012). The
development of social policies of the country justified the need for the policy by accepting social
problems as by-products of misguided public polices by previous regimes (MoLSA,1996).

The overarching objective of social protection policy is „creating an enabling environment in

which Ethiopian citizens have equitable access to all social protection services that will enhance
their growth and development‟ (MoLSA, 1996; MoWUD, 2006).

Social entrepreneurship has the capacity to solve major social inequalities which are
prevailing in a country (IRJET, 2018). Further discussing the issue, IRJET asserted that social
entrepreneurship has a wider scope than economic entrepreneurship. It focuses on the deprived

40
or weak section of a society. It sees social benefits as primary while profits as secondary. It
addresses social problems and helps in meeting these problems by capitalizing the local
resources and applying entrepreneurial principles which can minimize the impacts of the social
problems. The social innovation in social entrepreneurship focuses upon the social problems.
Some challenges of social entrepreneurship are the problem of creativity, the problem of
arranging finance, shortage of talented/ dedicated workforce, the problem of setting and
communicating value objective, the problem of elevating the individual, lack of unethical
framework, the commercial assumption, lack of evidence-based analysis, lack of planning and
appropriate structure (Roberts, 2005).
Based on institutional theory, organizations gain legitimacy by aligning with social rules,
norms, and values which allow them to status and access to resources (Meyer & Rowan, 1977).
Social enterprises are hybrid organizations that entertain conflicting social welfare and
commercial logics (Battilana & Dorado, 2010; Battilanna, 2012). A Social welfare logic focuses
on improving the welfare of society whereas a commercial logic stresses profit, efficiency and
operational effectiveness. Each logic is represented and supported by distinct institutional
structures. Social welfare logic is associated with philanthropic actors and a non-profit legal
form. A commercial logic relies on earned revenues and a for-profit legal form (Battilana, 2012).
Many social enterprises find it difficult to balance the business and social mission and they tend
to shift to priorities their business venture over their social mission (Grimes, 2010; Mohammed,
2017). The field of micro finance illustrates this tendency as several prominent organizations
have drifted away from their initial social mission in search of increased revenues (Marshland &
Rossman, 999; Younus, 2010).
The major challenge for social enterprises is to sustain commitments to both social welfare
and commercial logics. Legitimacy for an enterprise is very important and it is a challenge in a
country like Ethiopia. In USA, UK and Italy there is a new legal form for social enterprises. In
Ethiopia, however; there is no legal form in which social enterprises get licenced. Capital debt or
equity, grant funding, suitable premises, support and advisory services, cash flows and
managerial skills are the main challenges and barriers. Hence policy and law makers in Ethiopia
need to consider the special feature of social enterprises and it is better if they revise the existing
legal forms of organizations (British Council, 2017). In the conclusion remark, Bornstein (2007)

41
wrote that „mission driven businesses that improve the lives of the poor and generate a profit has
become a national phenomenon in developing countries‟.
Quoting the word of Eric Schwarz in DTI (2002), „the best social entrepreneurs have great
results. Government is looking at ways to get results at low costs. Social entrepreneurs can help
them achieve this. They can test new ideas and innovations, and partner with government to
bring successful ones to scale up.‟ Integrating the profit and social value in a single organization
is the challenging task among many practitioners that has now become the priority of social
enterprises. The legal boundary limits non-for-profit organizations (NPOs) from realizing profit
due to their social mission. NPOs are legally limited from participating in other organization
forms and hence cannot distribute profit to investors/shareholders (British Council, 2017).
In its 2009 publication, Ashoka listed the many challenges social entrepreneurs face to cluster
in three broad categories

2.5.1.1. Challenges Related to Policy Making and Governance: Because most social
enterprises are registered as non-for-profit organizations, social entrepreneurs find themselves
struggling with restrictive regulatory environments and bureaucratic procedures that often limit
their ability to become sustainable or to scale up. In addition, several social entrepreneurs note
that they lack knowledge of current laws and how to positively use the provisions of these laws,
for instance, to create income-generations activities for sustainability.

2.5.1.2. The Need for Greater Institutional and Operational Support: The growth of social
entrepreneurship is limited due to a gap in access to finance and investments geared toward the
sector. Many social entrepreneurs rely on funding from international donors and note the
difficulty of securing funds for their core operations and activities from these donors. Because
funding tends to focus on short-term projects, financing the sectors ability to engage in long-term
planning, develop self-sufficiency and achieve larger impact is limited access to other sources of
financing such as repayable commercial loans from banks remain a limited option for non-profit
social enterprises. To enable social entrepreneurs to flourish, wide-ranging collaborations with
the private sector and a more evolved support sector are needed. However, social entrepreneurs
have limited access to technical support that is management consulting services, financial and
business planning, legal counselling impact evaluation and marketing and training.

42
2.5.1.3. Lack of Social and Cultural Awareness and Recognition of Their Work: Social
entrepreneurship is neither widely recognized nor understood as a concept in many parts of the
world particularly in the third world. Academic institutions have yet to capitalize on this growing
field of study and to integrate its ideas, impact and potential in their work. Furthermore, local
media has not played a role in showing its existing success. Educational systems and social
norms in most developing countries create an environment that often discourages innovation and
dissuades/persuades young people from acting assertively and creativity on the challenges they
face.

Defoury and Nyssens (2008) discussed the legitimacy of social enterprises to minimize the
legal complexity of social enterprises by mentioning the practice in Europe and America. They
list several legal forms that have appeared like Social Cooperatives in Italy, the Community
Interest Company in the UK, the Social Purpose Company in Belgium.

2.5.2. Opportunities

Schwab (2010) explained the opportunities and future perspective for social enterprises and
discussed on the role of critical institutions as shaping the social enterprise sectors that play a
defining role. The media represents a powerful tool for bringing attention to the efforts of social
entrepreneurs and social enterprises profiling them as role models and helping to encourage more
entrepreneurial mindsets and behaviours. Online media platforms have emerged as a critical
component in introducing and sharing the concept of social entrepreneurship with a wider
audience. Equally important is the influence of religious beliefs and institutions. Religion is a
driving force for values and attitudes among young people and thus in how they choose to
interact with their communities and conceive their civic roles. Furthermore, many faith-based
organs in country can lead the way in innovating solutions to development needs on the
grassroots level.
On the role of the government as Schwab (2010) wrote that in any country, the impact of
social entrepreneurship is strongly influenced by the stance of the local or national government
including how and to what degree governments engage with home-grown social entrepreneurs
and enterprise. Government might adopt a „Do No Harm‟ approach removing barriers and
allowing social enterprises to grow on the more positive side. They might encourage social

43
enterprises to take an active role in addressing social problems. In analysing the array of rapidly
developing innovative practices being tested by governments around the world. It is apparent that
they can affect the growth and development of social entrepreneurship in three main areas.
Creating and enforcing the appropriate regulatory framework (policy and legitimacy) for the
functioning of social enterprises; rewarding successful social enterprises and social entrepreneurs
through recognition, procurement and partnership; and developing and supporting the broader
ecosystem for social enterprise comprising the government, the corporate sector, the investor, the
intermediaries, the international donors and the education system (Schwab, 2010).
The British Council (2017) highlighted the opportunities for social entrepreneurship in
Ethiopia and discussed that the sector has the potential to attract new customers, investment and
new products and services. It expands into new geographic areas, increase sales with existing
customers as well as the possibility of merges of enterprises. The survey by the Council also
estimated that there are close to 55,000 social enterprises operating in Ethiopia and their number
is expected to grow. Many social enterprises in Ethiopia exist to create employment
opportunities, selling products and services, improving a community, improving health and well-
being addressing financial exclusion and supporting other social enterprises. A typical social
enterprises ecosystem in Ethiopia comprises Reach for Change Development Forum, East Africa
Social Enterprises, Ice Addis, Ethiopia Social Entrepreneurs Forum as well as Micro and Small
Enterprises (British Council, 2016; 2017).
To conclude and summarising reviews on the literature , recognizing that there are no
standard definitions of social enterprises and any definition vary from country to country and
context, a working definition used in this study is one provided by Ashoka (2009) which states
that an attempt at new social enterprise activity or new enterprise creation by an individual or
team of individuals with social or community goals as its base and where the profit is reinvested
in the activity or venture itself rather than returned to investors. The rationale for the limited
growth and development of social enterprises in Ethiopia can be seen with respect to the lack of
recognition given to them in terms of innovation and job creation.
The social entrepreneurship sector is believed to play instrumental role in bringing innovative
solutions for many societal problems in the country by successfully capitalizing on innovative
entrepreneurs. Entrepreneurial innovation and job creation in the socioeconomic environment

44
were used as proxy measures of the existence and practical contribution and sustainability of
social enterprises while exploring and discussing the nature and phenomenon of local social
entrepreneurship for this research study (British Council, 2016).

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 CHAPTER THREE

METHODOLOGY

3. Introduction

In the preceding chapter, the study provided a discussion of conceptual definitions such as
social entrepreneurship, social enterprise, social entrepreneurs, social innovations and the
business structure and model. The practice of local social enterprises in Ethiopia with their
prevailing challenges, constraints and opportunities was also discussed. The parameters used for
the analysis to justify local enterprises as practicing social entrepreneurship towards bringing
solution for social problems also presented. This chapter provides a discussion of the type of
research conducted, the data collection procedure and tools for data analysis, the collected data in
the study, quality assurance and ethical considerations.

Jane and Lewis (2003) asserted that research methodology needs to match the study subject
and context of the study. Hence, this part of the study details the research methods used.
Accordingly; it explains the research paradigm, the study design, description of the study area,
study participants, data collection tools and procedures. In addition; data analysis methods,
quality assurance and ethical consideration are also discussed in the section.

3.1. Research Paradigm

The study employed the assumption of social constructivism as its research paradigm.
Creswell (2007) discussed the assumptions of social constructivism in that individuals seeking
understanding the world in which they live and work. He explained that individuals develop
subjective meanings of their experiences directed toward certain objectives or things. These
meanings are varied and multiple, leading the researcher to look for the complexity of views
inductively rather than narrowing meanings into a few categories or ideas. Social constructivists
view knowledge and truth as created by the interactions of individuals within a society
(Andrews, 2012). Hence, as the phenomenon of the practice of social entrepreneurship is vast
and complex, the research study attempts to get as much broader views as possible from study
participants. Unstructured and open-ended guiding questions are used to get more and more
information from participants.

46
 Bulmer (1982) explained that social research is at its most useful when theoretical insights
and social investigation are mutually enhancing such that the collection of evidence is informed
by theory and interpreted in the light of it. Subjective meanings are not simply imprinted on
individuals, rather are formed through interaction with others and through historical and cultural
norms that operate in individuals‟ lives (Creswell, 2007).
In terms of ontological position on what is possible to know about the world, Harmmerssel
(1992) stated that the social world does exist independently of individual subjective
understanding. But it is only accessible to us via the respondents‟ interpretations which may then
be further interpreted by the researcher. Participants‟ different point of view yield different types
of understanding. But this does not negate the existence of the reality. The diversity of
perspectives thus adds richness to the understanding of the various ways in which reality has
been experienced (Harmmerssel, 1992). The meanings others have about social entrepreneurship
is believed to help the research study to make sense of and interpretation of its phenomenon and
practice.

3.2. Research Design

This research study aims to explore and analyse the practice of social entrepreneurship
towards its efforts in solving societal problems. The selected approach is qualitative. Alston and
Bowles (2003), Creswell (2007) stated that qualitative method enables to further the knowledge
of the situation during seeking to describe social reality. Qualitative research approach is used
when a problem or an issue needs to be explored and analysed. It is better to explore a problem
rather than to use predetermined information from other research studies. Qualitative method is
used to address research questions that require explanation or understanding of social
phenomenon and its context like the theoretical and conceptual framework of social
entrepreneurship.
Exploratory case study research design is used to see what effects the practice of social
entrepreneurship has in solving social problems. Kreuger and Neuman (2006) highlighted that
exploratory studies are used in situations where little is known or written about a certain issue.
They stated that exploratory research answers „what‟ questions „whose‟ aims are to become
familiar with basic facts, setting, and concern about an issue. Since there is little study available
on social entrepreneurship in the context of Ethiopia, the choice of qualitative research approach
47
and the use of exploratory study is needed to explore the local practice and efforts of social
entrepreneurship.

Dezin and Lincoln (2000) explained that a qualitative researcher studies thing in their natural
settings, attempting to make sense of or interpret phenomena in terms of the meanings people
bring to them. This idea is also supported by Bryman (1988). Bryman is with the believe that the
way in which people study, understand and interpret their social reality is one of the central
motives of qualitative research. Hence; the objective of this research study is to explore and
understanding the practice of social entrepreneurship and its efforts in solving underlying social
problems of a community.
Several authors like Denzin and Loncoln (1998), Marshall and Rossman (1999) argued that if
the main purpose of the research is concerned with exploring to understand the nature and
context of the subject matter, then qualitative evidence is needed. Therefore, qualitative approach
will be the best approach needed to address a research question. One of the main reasons for
conducting a qualitative study is that the study is exploratory. This usually means that not much
has been written about the topic being studied, and the researcher seeks to listen to participate
and build an understanding based on what is heard.

Ritchie and Lewis (2003) discussed that qualitative research is also used when the subject
matter, here the practice and efforts of social entrepreneurship, a newly developing social
phenomena to be clear and understood with respect to its nature and issue, but where
measurement of its extent is not of interest. Creswell (2007) stated that qualitative approach
enables to further our knowledge of the situation when seeking to describe social reality.
Qualitative research is conducted when a problem or an issue needs to be explored. This idea is
also shared by Alston and Bowles (2003).
A good qualitative research study design is one which has a clearly defined purpose in which
there is a coherence between the research questions and the methods or approaches proposed
that generate data which is valid and reliable (Bechhofer & Paterson, 2000). As explained by
Bryman (2001) a case study is strongly associated with qualitative research. Several cases are
selected and used to explore the phenomena of social entrepreneurship and the contribution in
solving social problems. According to Kreuger and Neuman (2014) qualitative research design

48
enables to understand the details and interpret the social world of research participants by
learning about their experience perspectives and histories.
This research study was designed to be qualitative study to gain an in-depth understanding of
the subject matter of the practice of social entrepreneurship particularly with local enterprises.
The study will also have attempted to assess the social, economic and environmental contribution
of the social services of TEBITA Ambulance. Creswell (2007) explained that the process of
research involves emerging questions and procedures, collecting data in the participants setting,
analysing the data inductively, building from to general themes and making interpretations of the
meaning of the data. Hence, qualitative research is the strategy of inquiry used in this study for
exploring and understanding the meaning and phenomenon of social entrepreneurship in
Ethiopia.

3.3. Study Area

Qualitative studies are almost invariably confined to a small number of geographical

community or reorganizational location. This is partly because of the research conducted is
known and for reasons of resources and efficiency (Jane & Lewis, 2003). The data collection and
study area of the research was TEBITA Ambulance Pre-Hospital Emergency Medical Service
premises. The enterprise is located in Yeka Sub City; Woreda 7; House. No. 668 on Haile
Gebreselasie Road; Behind Axum Hotel in Addis Ababa. TEBITA is strategically located at the
centre of Addis Ababa.

3.4. Study Participants

The participants of this research study were the management and selected employees of
TEBITA Ambulance as well as some willing service users (clients and subscribers) of the
enterprise. The management of TEBITA were requested to discuss organizational philosophy
and strategy and the business model. Those employees who are directly responsible for different
programs and activities related with service provisions were consulted and asked to give
information on their respective field of service provision and delivery. In addition; several
service users of TEBITA were also invited to sit for individual case studies and discussions to
explain on the type of services they received and the reason for choosing TEBITA as their
service provider and with respect to their satisfaction on service delivery. To complement the
49
 above data collection procedure, a systematic field observation was also done so that a general
understanding of TEBITA was comprehend.

The criteria for selection of study participant was based on some pre-identified selection
points. The two members of the management of TEBITA were selected because of their
resourcefulness in the organization. Both have all the knowledge and understandings of TEBITA
from its inceptions till the present. The seven employees from TEBITA‟s operational and support
departments were actively participated in the FGDs. They were selected due to their direct
responsibility and involvement of the entire pre-hospital emergency medical service provision
and delivery. Four service users were also met and requested to sit for discussion in the
individual case study sessions. One service user called subscriber and another three services
users called clients of TEBITA provided their understanding of the enterprise and their
satisfaction on the emergency ambulance and medical services. They were selected because they
have got the enterprise‟s service and benefited from it.

Table – 1 - Study Participants and Criterion of Selection

No. Participant Participated in Sex Criteria for Selection
1. General Manger KII M Knowledge on organizational structure and
Business Model
2. CEO & Founder KII M Knowledge on organizational inception and
Business Model
3. HR Head FGD F Knowledge on organizational Structure and HR
4. Head of Ambulance Dispatch FGD F Knowledge on Ambulance Dispatch and Operation
5. Logistic & Maintenance FGD M Knowledge on Ambulance Dispatch and Operation
Coordinator
6. Paramedic Training in FGD M Knowledge on Training of Paramedics
Charge
7. Finance & Administration FGD F Knowledge on Finance and Social Responsibility
Head Fund
8. Emergency Medical FGD F Knowledge on Emergency Medical Service
Technicians Nurse Provision
9. Emergency Medical FGD M Knowledge on Emergency Medical Service
Technicians Nurse Provision
10. Service Subscriber ICS M Knowledge on service used
11. Service user # 1 ICS M Knowledge on service used
12. Service user # 2 ICS F Knowledge on service used
13. Service user # 3 ICS M Knowledge on service used

50
 3.5. Data Collection Tools

For triangulation purpose, this research study employed a variety of data gathering tools. Both
primary and secondary data collection methods were used. Primary data are original in nature
and directly related to the issues under study. They are more relevant to the topic of the research
and improve the degree of accuracy of the research study. Moreover; primary data are current,
and they can better give a realistic view about the topic under consideration (Maxwell, 2008).
In-depth interview with key informants, focus group discussions with employees who
directly work in organizational service provision and operation as well as case studies with
service users were used as tools to obtain primary data. Besides, journals, articles, dissemination
materials and video presentation related to the study and TEBITA were also being reviewed to
gather secondary data. A combination of different primary data collection methods was used for
this study to ensure the validity of data collected. The study uses triangulation of sources and
methods. These includes Key Informant Interview (KII), Focus Group Discussions (FGD),
Individual Case Studies (ICS) and Systematic Observation.
The study used qualitative data, both primary and secondary, collected from the study site.
Miles and Humberman (1994) and Silverman (1993) explained that qualitative data deals with
phenomenon that relate to qualities or types. It is based on information expressed in words,
descriptions, accounts and on the opinions and feelings of the people. The primary data were
collected using the data collection procedures and techniques described in the following sections.

3.5.1 Primary Data Collection Tools

For this research study and during the field work of data collection, primary data was
collected through Key Information Interviews (KIIs), Focused Group Discussion (FGD),
Individual Case Studies (ICS) as well as Observation.

3.5.1.1 Key Informant Interviews (KIIs)

According to Mikkelsen (2005), Key Informant Interview aimed at obtaining special

knowledge and understandings of an issue. The information usually generated from key
informants is of complementary nature. KII was used to explore the concept of social
entrepreneurship and the nature of the innovative social entrepreneurial business model of

51
TEBITA. Key Informant Interview is a two-way method which permits an exchange of ideas and
information. Interviewing is fundamentally a process of social interaction (Bechhofer &
Paterson, 2000). In the study, two members of the management of TEBITA were contacted as
key informants and requested to discuss all about the enterprise to further enrich the data
collected through other tools. To conduct KII, open ended guiding questions based on the
specific objectives of the study was prepared and used.

3.5.1.2 Focused Group Discussion (FGD)

Most of the time as Kitchin and Tale (2000) explained, in many qualitative studies one-to-
one interviews are supplemented by FGD consists of a group of six to twelve individuals
discussing a topic under a guidance of a moderator who promotes interaction and directs the
conversation. FGD has been proven instruments to illustrate and explore the inter-subjective
dynamics of thoughts, speech and understanding of the members of a group (Pratt, 2001). The
researcher of this study moderated and facilitated the entire FGD and took care of the note taking
work. Through FGD information on issues like context, the practice of social entrepreneurship
by TEBITA, the contribution and impact of the service provision, the business model were
collected. The FGD was conducted with a group of crucial employees of TEBITA who are
directly responsible for service provisions across different programs and activities of the
organization. The use of FGD was important to gather data about the issue that would not
possible by using other methods in terms of attitudes, feelings, beliefs, experiences and realities
of group participants. It helped the study to triangulate data collection through other methods
(Suhonen, 2009). Moreover; FGD is a group perspective and shared understanding of
participants about the issue (Maxwell, 2008). The FGD was guided by questions prepared based
on the specific objectives of the study.

A focus group discussion is a type of group interview that concentrates on an in-depth

discussion of a particular theme or topic. In most cases, the group is made up of people who have
experience or knowledge about the subject of the study or who have a particular interest in it
(Kothari, 2004). The interviewer‟s job is a delicate balancing act and he or she should be seen
more as a moderator of the resulting discussion than as a dominant question; one who prompts
the discussion without unduly influencing its direction. Moreover, the moderator should provide

52
a suitable introduction and conclusion to the sessions, providing information about the research
and what is to be done with the data (Kothari, 2004).

3.5.1.3 Individual Case Studies (ICS)

Case studies were used to explore the contribution of the innovative nature of social
enterprises towards bringing sustainable solution for the community. Some service users of
TEBITA were contacted and interviewed using guiding questions and asked how to do they
came to know TEBITA and its service as well as their satisfaction on the service provision of the
enterprise. All information obtained from each case were documented using field notes during
the field work.

3.5.1.4 Observation

Observation becomes a scientific tool and a method of primary data collection when it serves
a formulated research purpose and is systemically planned, recorded and subjected to checks and
controls to ensure the validity and reliability of the data (Nicolas, 2008). When using this tool,
the researcher should keep in mind what things should be observed, how the observations should
be recorded and how the accuracy of the observation can be ensured (Holloway & Wheeler,
1996).
Systematic observation is a qualitative collection tool that was employed and applied during
the field work to understand the overall situations of the innovative entrepreneurial nature and
strategies of the service provision by TEBITA. Systematic observation method of data collection
was used to see the real contribution of the different programs and service provisions of the
enterprise in tackling the prehospital emergency societal problems of the community
(Morse,1991). Moreover; during observation, all the data collected through other methods were
evaluated and verified. Therefore; observation guideline was prepared to collect and document
field observations. During the field observation, field notes were taken to further analyse the
conformity or deviation of data collected through other methods and to understand the day-to-
day activities and service provisions of TEBITA with respect to the study community.

Observation is a checklist consisting points to look for the behaviour of members of the
setting. According to Bryman (2012), a kind of non-participant observation designed to be used

53
to describe a situation in which the observer observes but does not participate in what is going in
the social setting. Structured observation is usually based in the non-participants setting
(Bryman, 2001).

3.5.2 Secondary Data Collection Tool

Secondary data collection was done through literature reviews on social entrepreneurship as
well as visiting TEBITA‟s archive. Broachers, reading materials and publication from the virtual
environment was extensively used.

3.6 Data Collection Procedures

The research study utilized both primary and secondary information accessed from various
sources. The primary data was collected mainly through KIIs, FGD and Individual Case Studies
which, according to Kitchin and Tate (2000) allows a research to produce a rich and varied data
set in a less formal setting with more detailed examination of experiences, feelings or opinions.
In addition; systematic observation and referring and reviewing TEBITA‟s Resource Centre was
also extensively employed to further substantiate the data gathered from primary sources. In
addition to primary data collection sources, relevant secondary data sources like books, academic
journals, electronic soft copies, YouTube video materials and presentations, related conceptual
and theoretical framework and different research studies, locally written and presented
documents were consulted and used. This helped to identify the research gaps with respect to the
secondary data analysis, the research consulted several broachers and promotional materials on
TEBITA to grasp and understand the core organizational philosophy, business model and service
provision as well as its performance in the socioeconomic sector (Tebita, 2008-2019).

Multiple forms of data collection tools were used and considerable time in the natural setting
gathering information is spent. Conducting Key Informant Interview, Focus Group Discussion
and Observation were only possible through a field work organized at the main office of
TEBITA. Individual Case Studies with clients and subscribers of TEBITA prehospital
emergency medical care services were conducted by directly contacting and going to each
respective individual‟s home office or inviting them to TEBITA‟s premises. Precaution was
taken not to make the study disruptive so that KII and participants in the FGD are consulted to

54
provide convenient time for their participation without affecting their normal duties and
responsibilities.

3.7 Method of Data Analysis

Analysis of data involves several closely related operations. These are performed with the
purpose of summarising the data and organizing them in such a way that they answer the
research objectives of the study and estimate the values of the unknown parameters of the
population (Sharma, 1983; Silverman, 1993). Data analysis is studying the organized material to
discover inherent facts. Analysis of data is a challenging and exhaustive stage of qualitative
research process. It requires a mix of creativity and systematic use of methods (Ritchie & Lewis,
2001).

After the field work was completed, collected data were recorded and transcribed manually.
The transcribed raw data was categorized into different pre-determined themes based on the
research objectives. Analysis was done thoroughly considering the practice and contribution of
social entrepreneurship. To portray the multi-faceted effect and nature of the context in which
TEBITA operates, unique informative and demonstrative statements by study participants were
included in the thesis work as quotes to substantiate what has been commented and discussed
before.

Qualitative raw data come in various forms. Most commonly, they comprise of verbatim
transcripts interviews and observational notes. Whatever form they take, the material is likely to
be highly rich in detailed but intertwined in content. For this reason, organizing to manage the
data are essential. Hence, the study identifies the initial theme or concept; labelling or Tagging
the data; sorting the data by theme or concept and summarising or synthesising the data which
involves framework, indexing and chanting (Ritchie & Lewis, 2003).

Raw data in the form of text and field notes were collected through several visits to the study
area and contacting study participants. Then, the raw data were organized and prepared for
analysis. All collected and organized data were thoroughly read, comprehended and thematised
by the researcher. Several themes were inductively constructed and interrelated. Finally, the
meaning of each theme that ensures the occurrence of the information were interpreted. In this

55
study, the data analysis was based on the data collected and compiled from primary sources and
supplemented by secondary sources. In addition, the ideas, opinions and explanations from
TEBITA‟s management and other concerned staffs through KII and FGD discussions were
analysed using descriptive narrations. The analysis of the interview data began soon after during
the data collection to focus on the research questions and on the study paradigm. Guided by the
research questions, each interview transcription was checked for consistency. Lists of key issues
were prepared and the findings were organized according to these. All collected data were
organized, summarized based on guiding research questions and based on relevance to the study
objectives. After summarization and categorization of data based on research questions and
specific objectives, it was analysed through triangulation of the various data sources to maximize
the trust worthiness of the study findings by giving due attention to observed non-verbal
expressions of the study participants. Hence; during the analysis process, all data obtained
though different data collection tools were interpreted and presented in a proper and meaningful
way. Besides; relevant conceptual and theoretical frameworks of social entrepreneurship in the
literature review was critically reviewed to strengthen and support the findings of the study.

3.8 Quality Assurance

A good research is clearly defined with coherence between research questions and method
which will generate valid and reliable data that can be achieved with the available resources. But
social research always involves an element of the known and hence qualitative research offers
the advantage of flexibility (Bechhofer & Paterson, 2000).

Validity concerns the soundness, legitimacy and relevance of a research idea or theory and its
investigation (Kitchin & Tale, 2000). Reliability on the other hand is „the repeatability or
consistency of a finding‟. Being a qualitative study, this research is mainly interested in validity.
The salience of validity over reliability in qualitative inquiries is well recognized as well. To
mention one among others, for instance Silverman (1994) cited in Kitchin and Tale (2000) and
stressed the importance of validity in qualitative research when he wrote that qualitative research
has to be more than „telling convincing stories‟ and rigorous in nature so that its conclusions can
be accepted more definitely. It is shown in the introductory part of this research report that the
purpose of the research study is to explore the practice of social entrepreneurship and the effects

56
it brings in solving social problems of the community. This may not be easily replicated in other
similar studies as to be reliable.
A qualitative research must establish credibility, dependability, transferability and
confirmability which are its aspects of trustworthiness. Credibility is the first aspect or criterion
that must be established. It is seen as the most important aspect or criterion in establishing
trustworthiness. Because credibility essentially asks the researcher to clearly link the research
study‟s findings with reality to demonstrate the truth of the research study‟s findings. Credibility
has the most techniques available to establish it like triangulation and member checking.
Triangulation involves using multiple methods, data sources and observation to gain a more
complete understanding of the phenomena. It is a way of assuming the validity of research using
a variety of methods to collect data on the same topic. Triangulation and member checks help
establish credibility and contribute to trust worthiness. Triangulation asks almost the same
research questions of different study participants and collects data from different sources through
different methods to answer the same question whereas members checks occur when the
researcher asks participants to review the data collected by the interviewer and the researcher‟s
interpretations of that data. Participants generally appreciate the member check process because
it gives them a chance to verify their statements and fill in any gaps from earlier interviewers.
Credibility involves establishing that the results of qualitative research are credible or believable
from the perspective of the participant in the research. Since the purpose of qualitative research
is to describe or understand the phenomena of interest from the participant‟s eyes, the
participants are the only ones who can legitimately judge the credibility of the results (Yvonna,
1985).
Transferability refers to the degree to which the results of qualitative research can be
generalized or transferred to other contexts or settings. From a qualitative perspective
transferability is primarily the responsibility of the one doing the generalizing. The qualitative
researcher can enhance transferability by doing a thorough job of describing the research context
and the assumptions that were central to the research. Transferability refers to the degree to
which the results of qualitative research can be generalized or transferred to other contexts or
settings. From a qualitative perspective, transferability is primarily the responsibility of the one

57
doing the generalizing. Transferability is established by providing readers with evidence that the
research study‟s findings could be applicable to other contexts, situations times and populations.
Research study provided the evidences of the practice and contribution of social
entrepreneurships in Ethiopia that it could be applicable. Taking TEBITA as a case study, the
study avoided generalizability which is basically a small group of people is representative of the
larger population instead, trended to transferability which allows the option of applying results to
outside contexts. Conformability in qualitative research can be conducted to replicate earlier
work and when that is the goal, it is important for the data categories to be made internally
consistent stated by Yuonna & Egon (1985). Qualitative research tends to assume that each
researcher brings a unique perspective to the study. Confirmability refers to the degree to which
the results could be confirmed or corroborated. However, this research study has found no other
similar study in the same topic in Ethiopia.
Dependability is the quality of being trustworthy and reliable. It is a value showing the
reliability to others because of integrating truthfulness of information to be trusted in which
reliable or confidence may be placed (Glaster, 1967). To achieve dependability, the research
study tried to avoid mistakes and limit damage to get easily able to be depended and accountable.
As the research study employed a qualitative research, the study work tried to be dependable as
the stability of data over time and over conditions. The dependability of the study can be
compared to reliability and data and relevant supporting documents can be scrutinized by
external reviewer. It is essentially concerned with whether we would obtain the same results if
we could observe the same thing twice. But we cannot be measuring two different things to
estimate reliability. Qualitative researchers construct various hypothetical motion to try to get
around this fact. It emphasises the need for the researcher to account for the ever-chanting
context within which research occurs. The researcher is responsible for describing the changes
that occur in the setting and how these changes affected the way the research approached the
study.
Efforts have been made throughout the entire research process to ensure that the findings are
repetitive of the concrete reality with the facts on the grounds. On the other hand, for meeting
validity, credibility, transferability, conformability and dependability the research uses different
combinations of data gathering tools. In line with this, Alain (2010) described that one way of

58
ensuring validity in qualitative research is triangulation which means confirming results by
consulting multiple and varied sources. In ensuring internal validity, data were collected through
multiple sources to include interviews and observation. The information collected serves as a
check throughout the analysis process.

3.9 Ethical Consideration

Any research study raises ethical consideration, and this will have a resonance in qualitative
research studies (Jane & Lewis, 2003). All research study participants involved were
appropriately informed about the purpose of the study and their willingness and consent were
secured before the start of KII, FGD and Individual Case Study Interview sessions. This means
providing them with information about the purpose of the study that was to explore and
understand the programs and service provision of TEBITA Ambulance in bringing tangible
benefit for service users with their clear satisfaction. And how the data will be used, in this case
only for educational purpose. What kind of participation required from them was also discussed.
How much time participants should spend and in what way their participation would benefit the
research study to understand the social service and contribution of TEBITA was clarified to each
participant.

As discussed by Holloway and Wheeler (1996) informed consent of participants be based on

the understanding that participation is voluntary. Consent to approach potential participants
(selected service users and concerned staffs) first was sought from the organization as it is the
service provider and employer. In protecting the right to privacy of the participants, the
researcher and facilitator maintained the confidentiality and identity of each participant. In all
cases, names were kept confidential and therefore a collective name such as „study participant‟
was used.
Defined by Jane and Lewis (2003), anonymity means the identity of those taking part not
being known outside the research work area. While confidentiality on the other hand means
avoiding the attribution of comments, in reports or presentations of research finding to
participation. Hence; in the research study, direct attribution to comments and indirect attribution
to a collection of characteristics that might identify the participants were avoided. It was believed
that there will be no harm for participants in taking part as the selected topic for the study was on

59
the practice of social entrepreneurship which is not sensitive. In addition; attempt was made to
make sure that the study was carried out as per the code of ethics of social work that is …
(NASW, 2008). A letter of support from school of social work was presented to TEBITA
Administration and management before the commencement of the field work and data collection
process. During data collection activities, participants were communicated as they have the full
right to stop the interviewer at any time if they did not understand what the interviewer was
asking or if they did not feel comfortable, they might also skip questions. In other words, the
issue of willingness and the right to privacy were secured.

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 CHAPTER FOUR

FINDINGS
This chapter addresses results of the study findings.

4.1. Findings

In total thirteen study participants were participated for this study during the field work.
Specifically, two in the key informant interview (KII), seven in the focus group discussion
(FGD), and four in the individual case studies (ICS) alongside the systematic observation
conducted. In the KII, the general manager of TEBITA Ambulance, who has been working in
the organization since its inception, actively and repeated participated and provided the
necessary information during and after the interview session. The founder, owner and CEO of
TEBITA also contributed through virtual environment and enriched the information needed. The
two personnel in management position participated in the KII and explained and discussed the
inception, establishment, organizational philosophy, the innovative social entrepreneurial
structure and its business model of TEBITA. In the FGD, seven study participants who are
responsible for different operational and support sectors and departments of TEBITA
participated and discussed in detail the unique service provision and delivery of the organization
and how TEBITA plans to contribute towards bringing solutions to prevailing social problems in
the prehospital emergency with service sustainability through its innovative social
entrepreneurial practice. They include the HR head, the head of ambulance dispatch, the logistic
and maintenance coordinator, the paramedic training centre in charge, the finance and
administration head as well as two representatives of emergency medical technician (EMT). To
explore the practice and contribution and impact of TEBITA‟s service provision and delivery,
three service users called clients from the 24/7 public category and one service user from the
service subscriber group were also participated in the individual cases study interview.
Organizations exist for a variety of resources. Some pursue profits, while others promote the
general social welfare. Regardless of its purpose or mission, any organization must be properly
aligned with its environment if it is to be effective. However; there are disperse views on how
this alignment should be achieved and how an organization can legitimately pursue and then use
revenues or profits. Some companies aggressively seek to maximize their profits, grow at any

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cost, and focus on nothing but what is best for the company. Others take a much different
approach to business and activity work for the betterment of society, even when it means less
profit for the owners. Clearly, the environmental context of business today is changing in
unprecedented ways. Social responsibility is the set of obligations an organization must protect
and enhance the social context in which it functions (Ricky, 2016).
The findings of the research study are presented in the following four themes in line with the
research questions.

4.1.1. General Overview of TEBITA Ambulance as one Pioneering Local Social Enterprise
in Ethiopia

As regard to the general overview of TEBITA Ambulance Prehospital Emergency Medical

Service, first-hand information was received from the general manager of this institution and
summarized as follows. TEBITA is a private enterprise which strives to operate on the principle
of social entrepreneurship. The enterprise is conceived by the current CEO who is also the owner
and founder. The CEO was an Anastacia in Tikur Anbassa Referral Hospital. He started thinking
on how to tackle the problem of handling pre-hospital emergency accidents occurring across the
country, like traffic accident victims. He and his colleagues pushed the idea of how to handle this
social problem which needs a significant attention by all stockholders. Victims of traffic
accidents and other emergencies which need prehospital medical care service reach hospital after
they are severely injured lost a lot of blood and with other complication. Despite, hospitals and
medical personnel working hard to save the life of victims who arrive in very critical condition, a
lot of lives lost due to the lack of proper treatment and handling of victims at prehospital settings
of the accident. This was the huge gap in the medical health service in Ethiopia particularly in
Addis Ababa which was identified by him as critical social problem affecting a significant
number of the population that needs immediate attention.
In his personal efforts to bring sustainable solution to this and other serious social problems
which needs a prehospital emergency medical service, the CEO and his friends started thinking
how to bring sustainable solution for the victims as well as the society. TEBITA Ambulance was
conceived as the result. while trying to justify his iconic idea, the CEO visited several countries
tried to get their experience on the so-called emergency medical care service. He got concrete
evidences that prehospital emergency medical care services are determinantal to save lives in a
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country. Finally, the CEO decided to contribute his part as a citizen of the country and embarked
on the long journey. He worked hard to realize his vision. He stated generating money first by
selling his own house. Later, he got the golden opportunity to participate in a business award
competition and through his participation managed to secure a fund which was enough to buy
new and better standard ambulances.

TEBITA Ambulance started as a private prehospital emergency medical service in 2008 after
receiving licenses from Addis Ababa City Administration Health Bureau. It has achieved ISO
certification in quality management systems. Since its establishment, TEBITA Ambulance has
been dedicated to delivering the most professional, high quality and reliable emergency care
services to the people of Ethiopia, multinational companies, non-governmental organizations,
and many others. TEBITA means a drop in the Amharic language, the founder started striving to
drop his own contribution in the efforts towards tackling one of this critical social problem of the
country and promoted his idea and motivated other to do the same. „Drop Your Own Effort as a
Citizen of the Country to Contribute in Tackling the Emergency Medical Problems of Ethiopia
and hence Bring Sustainable Solution for the Victims/ Patients as well as for the Community‟
was the motto to establish TEBITA.

The CEO then started the long way of the challenging legal process and securing finance. He
sold his house to purchase three used ambulance cars. To take off, he and his friends used their
private houses to be used as its office. Later, rented a small office. He also evidenced that
TEBITA Ambulance was striving to work on the principle of social entrepreneurship and
provides a pre-hospital emergency medical care service. TEBITA was structured and organized
itself as a social enterprise with a cross subsidizing business model. Cross subsidizing was an
innovative business model employed by TEBITA which provides subsidized services for the
majority public 24/7 emergency ambulance service users. The service provided to big companies
helped TEBITA to cross subsidizes the 24/7 service for the public. As narrated by the
management, TEBITA is a private enterprise and needs to be paid. But payment is its second
priority. The priority for TEBITA is to save live. TEBITA does not compromise somebody‟s life
due to payment issue. TEBITA strongly believes that by doing good for the community, it can do
good for itself in turn. TEBITA pursues contacts and agreements with international companies
(like mining and oil exploration companies) to provide emergency transport for employees

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located in harsh, rural settings. TEBITA also partnered with AMREF‟s Flying Doctors in
Nairobi, International SOS, and Africa Assist to facilitate internal evacuations, and works to
provide other premium services that will attract international clients. The revenue generated from
these partnerships allows TEBITA to continue to serve low-income clients (the 24/7).
Entrepreneurship is the process of planning, organizing, operating and assuming the risk of a
business venture. And, an entrepreneur, in turn is someone who engages in entrepreneurship. The
entrepreneur starts new business which may be owned by himself or a small group of individuals
and has services or products that are meaningfully influence the environment (Ricky, 2016).
Continuing the discussion, Ricky (2016) social enterprises on the other hand is particularly
characterized by the practice and contribution of the enterprise measured in terms of its effects
on key aspects of socioeconomic system including job creation and innovation. Enterprises are
important sources of new jobs. Entrepreneurial business success more than business size and
accounts for most new job creation.

From the above evidence based analysis and looking through the social entrepreneurial lens,
the organizational effective business strategy in place and innovative business structure and
model in hand as well as the overall performance of its entrepreneurial practices and contribution
for the general public since its establishment in 2008, we can safely conclude that TEBITA is
really striving and practicing as one local social enterprise in Ethiopia with visible contribution
towards bringing solutions towards a significant social problem of emergency medical care
service. In addition, the enterprise has proved its real social contribution in job creation initiative
for marginalized youth group through its in-house trainings as paramedic emergency technicians
to serve the enterprise as well as other public organizations including the government emergency
health systems.

4.1.2. The Unique Service Provision of TEBITA Ambulance and its Practical Efforts
towards Bringing Solutions to Social Problems with Service Sustainability

With pertaining to the unique provision of TEBITA, besides data gathered from the
management and other staffs, the information obtained from document analysis presented as
follows. Currently, TEBITA has become one of the pioneering local social enterprise in Ethiopia
aims to provide the highest quality emergency ambulance care and pre-hospital medical services

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and create awareness on first aid and health safety through formal trainings, and advocate for the
development of well-organized emergency medical services management.
TEBITA‟s general manager explained that generally, health care is public provision, private
good. Therefore, some service in the health industry needs collaboration of the public and private
enterprise. Otherwise, the free rider cost will fall on the shoulder of that service provider‟s
enterprise. Emergency ambulance service is among this service. The remedy is third party must
be there to compensate for the free rider service users particularly for low income segment of the
community. For this reason, the government is the major stakeholder to finance while the private
sector is responsible to provide quality service with acceptable response time. To start with,
TEBITA provided First Aid Training, which is a pure private good, to finance its prehospital
ambulance service for the public. Later, TEBITA with its remote ambulance service sub program
continues providing its service for multinational and local companies which are working in
remote areas of the country. TEBITA considers the remote ambulance service as a take-off for its
innovative social service in the country.
Currently, ambulance services are provided by many actors in Ethiopia. The Ethiopian Red
Cross Society, the Fire bridged, the government‟s making pregnancy safer woreda level program
as well as many individual private medical centers and hospital have their own system and
format of ambulance service across the country. All ambulance services provided in the country
are mostly at hospital care and rehabilitation care level. As clarified by the general manger, the
type of ambulance service provision by TEBITA is unique. TEBITA‟s ambulance service is an
emergency medical care service created by an innovative thinking in which instead of waiting
victims and patients at hospitals and/ medical centers, it is much better to reach them at the point
of emergency that is at the pre-hospital care level. In addition, TEBITA believes that first aid and
other emergency medical services should be provided at the scene of accidents to save more life
before it is getting late.
The findings of key informant and focus group discussions stated that the enterprise created
an emergency call system service with 8035 which is a very important and crucial system in an
emergency medical service. It advocates for one call system and syncretized across the county
for whatever problem the public face. The call system is supported and controlled by a GPS
system. Subscribers and service users make calls either with the short number 8035 and/ or other

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direct number 0911225464/0911641609 with the 24/7 standby dispatch center and inform
TEBITA what program they have and where and when. Clients make call and request for
ambulance dispatch for their emergencies. TEBITA‟s ambulances are unique because all basic
lifesaving (BLS) and advanced lifesaving (ALS) cares are equipped with oxygen and all the
necessary life support supplies and par medic emergency care personnel with them. The dispatch
center prioritizes emergency on the road and patients in house. Patients in hospitals are second
priority for TEBITA. Mass accidents in the city or across the country get completely free access
from TEBITA. Responding on such mass accidents and calamities is exclusively considered by
TEBITA as it cores social responsibility as one local enterprise in Ethiopia. After responding to
emergencies and saves precious lives of the public, TEBITA demands appropriate payment from
service users/ clients. For those who are unable to pay the partial or full payment of the bill for
the service are requested to provide a copy of their ID so that this will be settled with TEBITA‟s
corporate responsibility budget.
The findings of the discussions also provide the information that TEBITA is different from
other ambulance providers in which its ambulances are equipped with Basic & Advanced Life
Support Ambulance medical service, transportation ambulance service as well as special need
people ambulance service. All ambulances have ventilation, intensive care unit, oxygen and
some medical personnel who exactly knows what to do (EMT). TEBITA, to fiancé and subsidize
its public service which is most of the ambulance service provision, it created corporate social
responsibility budget (CSRB) and donation fund. The idea for creating CSRB is just to subsidize
the 24/7 public service users which TEBITA stands for and will continue to provide its service
and discharge its responsibility as one social enterprise in the country. CSRB as well as the
system of cross subsidizing are sustaining the business of TEBITA and make it resilient.
In addition, TEBITA assists in implementing emergency preparedness and response. The first
aid training to non-health professionals to equip staffs with the necessary skills to respond in an
emergency is another service provided for the public. The peace of mind package which is
available to organizations, families and individuals is another unique service by TEBITA. Unlike
the Ethiopian Red Cross Society which provides its ambulance service for free, TEBITA charges
a subsidized amount of money from its service users to stay in the business and to make its
services sustainable. TEBITA believes that for emergency service providers letting them to

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operate with a specified budget is a mistake. Instead they should be allowed to be paid exactly
what they have spent. Budgeting will limit their operation and make them out of the business.
The enterprise also believes that those who can pay should pay for the service they have received
and those who cannot should get a subsidized service. TEBITA‟s focus and priority is to save
life not to collect money. Money collection and generating revenue comes at second priority for
TEBITA. TEBITA strongly believes that through its innovative medical service, it is supporting
the Ethiopian government in its effort to tackle the health problem of the country. Hence, the
government should give proper attention towards the work and efforts of TEBITA. TEBITA
ambulance service uses ado payment system in which Birr 20 per one km for basic life service
(BLS) ambulance and Birr 30 per one km for advanced ambulance service (ALS). This payment
rate continues since TEBITA started its operation which is much cheaper that what a private taxi
is changing per km.
Currently, the enterprise provides training on first aid for non-health professionals, basic and
advanced life support trainings for in service personals and paramedic pre-hospital emergency
medical care service for selected and competent students. TEBITA is the leading Pre-hospital
Emergency provider in Ethiopia. Paramedic personnel/ emergency medical technicians (EMT)
after receiving proper training on level - 3 (primary/basic lifesaving emergency training) and
level four (advanced emergency lifesaving training) can manage trauma emergencies, medical
emergencies as well as OB/GYN emergencies in all circumstances. In its effort to create and
strengthen the public private partnership in the country, TEBITA has designed and worked out
the curriculum and the project proposal, in collaboration with Kotebe University College, for
such paramedic pre-hospital emergency medical care service training for all those who are in
need in the country. The proposal is submitted to ministry of health and it is awaiting its
approval.
From all discussions and systematic observation on the work and services of the enterprise,
the following findings can be safely stated. It prioritizes the 24/7 public emergency medical care
service across the country with BLS & ALS ambulances and EMT (house pickups, emergencies
with oxygen users, delivery service, traffic accidents, ICU service, special care patients and
emergencies, etc…). TEBITA‟s ambulances use calculated speed limits. They drive fast to reach
and respond for emergencies but slow down after picking the patients or victim of accidents. It

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provides a highly subsidized emergency medical care service. Provides peace of mind service
with multi national and local companies (like Heineken, Foot Ball federation, embassy occasions
etc…). Event emergency medical care service (like providing escorting for the Ethio -American
Military Training and Drills, African Union Meetings, International Conferences, the Prime
Minister and President of Europe visits to Ethiopia, Asia and other events across the country). It
recruits, trains and creates employment opportunities for disadvantaged and vulnerable youth
section of the community. It tries to create a public private partnership with the ministry of
health through advocacy in the policy and legal procedure shift so that the service of pre-hospital
ambulance medical care service is sustainable in the country. It creates a kind of business entity
in the form of income generating scheme while it uses majority of the revenue to finance its own
operation and subsidize its 24/7 public service users.
Thus, from the above findings of the data it is possible to conclude that TEBITA employed an
innovative and unique social service as emergency medical care across different section of the
Ethiopian society paying focus on the majority of 24/7 ambulance users/clients. It wisely applied
the cross-subsidizing business model to finance the service provision and delivery of the
emergency medical care for the majority through properly challenging the social responsibility
fund and redirecting the revenues obtained from its few service subscribers.

4.1.3. The Challenges and Opportunities of Social Entrepreneurship as Practiced by

TEBITA Ambulance

Data obtained from focus group discussion as well as key informant discussions with the
management as regard to challenges and opportunities of TEBITA Ambulance summarised as
follows. TEBITA is performing well in the new and less understood of the social
entrepreneurship phenomenon. Through its eleven years of restless service delivery, it has
encountered many challenges and constraints which restrict its rapid growth and service delivery.
The biggest challenge is the nature of the service. Health care, the emergency health care is one
basic human right of all people. Earlier, it was stated as public provision; private good in nature.
That makes the service and its provision more challenging. The third party must be there to
compensate the costs incurred by the service provide so that it only focuses on the delivery and
quality of the service it provides for service users. Currently TEBITA and all its service
provision including parking its more than fifteen ambulance cares is housed in a rented building
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with very limited court yard. This prevents the proper parking of its ambulance cars ready for
emergency take off. In addition, the increasing payment of the house rent is another challenge
which threatened its philosophy of subsidizing the public. All the dispatch centre, the main
office, the training centre as well as maintenance are all packed in one building which should not
be the case for an emergency medical service provider
The solution for the above challenges according to the participants, TEBITA is requesting the
government to provide a convenient site/ place in which it could build its own state of the art
emergency medical care centre. For unavailability of medical supplies in the domestic market
compromise the service delivery and the solution suggested by the same are make available
emergency drugs and medical supplies at all time in the domestic market; ambulance service
means using movable cares with all medical supplies and personnel spare parts, maintenance and
other logistical constraints are also challenge.
As discussed by the research study participants, TEBITA advocates that there should be a
health insurance scheme in Ethiopia. Such scheme allows TEBITA and others to do their
professional work and focus on its service provision. The government will do the regulatory
work. TEBITA does not want to be involved in collecting money from service users. The
government, through the health insurance scheme, should pay TEBITA. It strongly believes that
what is to be done in the emergency medical care service is that of the duties and responsibilities
of the government. Any service or good needs the production/ or service provisions, distribution
and regulations from the stage of production until it reaches to end users. The government
cannot do all together. If this happens, the issue of efficiency and cost effectiveness will be
compromised. Through Public Private Partnership (PPP), outsourcing the service
production/provision and distribution to others like TEBITA and focus only on the regulatory
part makes the government more efficient and cost effective. The government through creating a
proper public private partnership should give the right work to the right enterprise i.e. TEBITA is
the right enterprise in Ethiopia to work on pre-hospital emergency medical care ambulance
service and the government should provide the fund and payment for TEBITA for its extra
ordinary service for the public and of course for the country. TEBITA really wants to focus on its
professional service provision.

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 Participants who participated in the focus group discussions listed the following challenges
that TEBITA institution faces and suggested possible solution to the problems as follows. Lack
of understanding and attention on the part of the community and the government for the nature
and phenomenon of social entrepreneurship in the country. Academicians and practitioners
should do more efforts to make social entrepreneurship understood by all. Lack of clear policy
on social entrepreneurship is another constraint. Clear policy on social entrepreneurship should
be integrated with the social policy of Ethiopia. The lack of legalisation (legal bases) and
confusion in categorizing and registering social enterprise or as NGOs or charity organizations is
also a challenge in the country. The legal base to distinguish the unique and innovative business
model of social enterprise from other forms of organization should be legislated. The findings of
the study also stated that the non-availability of the public health insurance scheme and pubic
private partnership is also a challenge. Public Health Insurance Scheme and PPP should be
created in the country. The government of Ethiopia should do its own analysis and select those
sectors and enterprises which are more beneficial for the society and the country and engage in
PPP.
The discussion with the management provided that to run a health provision with pre-budget
system, TEBITA believes that health system needs to be paid what exactly it has spent because
the small amount of the corporate responsibility budget available to subsidize the public 24/7
compromising the service provision. More and more local companies and enterprises should be
involved and discharge their social corporate responsibilities to help minimize the social
problems in the country. Problem with working Capital. Getting loans from banks is very
difficult as banks consider social enterprises like TEBITA are not profitable enough to repay
their loans.
The study uncovered many challenges facing local social enterprises in the study area. These
were the results of several factors including scarcity of capital because of the reluctance of
formal financial institutions to cater for the sector, lack of business premises and infrastructure
and constraints related to policy and legal institutional linkages.
From this data it is possible to conclude that despite all the challenges and constraints faced
and the lack of legitimacy for enterprises to register themselves as a full-fledged local enterprise
exclusively working on social innovation, job creation for the marginalized and stay socially

70
sustainable, TEBITA is striving to be one best model social enterprise in the country and is
leading the sector. TEBITA, through its active participation and even presiding the Social
Entrepreneurs Forum Ethiopia, is making a deference.

4.1.4. TEBITA’s System of Capacity Building and Mechanisms of Incubating its Innovative
Social Entrepreneurship Practice in Ethiopia

Through document analysis made as well as the findings of the KII, FGD and ICS as
regarding to TEBITA Ambulance‟s system of capacity building and mechanisms of incubation
summarised as follows. TEBITA made a tripartite agreement with Ministry of Health and Kotebe
Metropolitan University to promote PPP to train up to 5000 para medical trainees recruited
across the country for the next several years. Partnering with East Africa Emergency Service for
capacity building and exchange of professionals. With the support of the British Council,
actively participate in the formation of Social Enterprise Ethiopia Forum (SEEF) and promotion
of social enterprises in Ethiopia. TEBITA presides the forum and advocate the cause of social
entrepreneurship in the country. Thinks big to establish air ambulance service and extends its
operation in the regions in Ethiopia; started small with only three ground ambulance cars and
limited staffs and service provisions; acts now with its innovative social entrepreneurial business
model and with all its potentials and available resources despite all the challenges and constraints
it is facing.

From the findings of the above, it is possible to conclude that TEBITA is also able to spread
the innovative idea of social entrepreneurship and incubate the business model for the benefit of
the majority across the country. TEBITA is actively engaged in peer capacity building activities
and even has prepared a strategy and a project proposal on the bases of public private partnership
and proposed the same for the Ethiopian government.

Currently, TEBIA seams fully controlling the prehospital emergency medical service in the
country and has huge number of beneficiaries. In addition, there are no real competitors for
TEBITA which operate on the same business model and purpose. However; as the concept of
social entrepreneurship is speeding and gaining momentum, it is clear that the enterprise
definitely will be challenged by some competitors hence needs to be prepared and be resilient.

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 CHAPTER FIVE
DISCUSSION
Social entrepreneurship can be reasonably explained using criteria instead of a definition. It
has a broader social conceptualization or meaning. It is societal. This means that social
entrepreneurship is not limited to target groups. According to British Council (2013), social
entrepreneurship in Ethiopia has increasingly involved with issues of community.

The purpose of social enterprise is the maximization of social output, not profit. The societal
goals of social enterprises don‟t exclude making income. They are not charitable institutions.
They have sustainable business models and earn income from selling their products or delivering
services. TEBITA, as an enterprise also has the plan to extend its services to other regions and
east African Countries through Air Ambulance Services by opening dispatch centers to reach
patients and people in need of emergency services as quickly as possible and contributing in the
region.

In general, the social entrepreneurship environment in Ethiopia can be defined as one in its
early stage. Social entrepreneurs created significant role to the society by creating employment,
empowerment of youth, women and marginalized groups. They also work for social and
environmental impact as well as a profitable organization. However, even if their contributions
to solve social problem are large, their existence and work are not well appreciated. Social
entrepreneurs faced many challenges through social, economic and legal factors like lack of
awareness, the community and culture are not supportive, weak distribution channel, lower
access to low interest credit, un stimulating tax system, constraints to initial capital, high labor
cost, lack of working area influenced negatively (British Council, 2013).

Furthermore, social entrepreneurs are suffering from regulatory aspects like no explicit legal
framework for social entrepreneurs/enterprises in Ethiopia, un-conductive government policies,
unfavorable political climate and unaccommodating bureaucratic environment of government
offices. Though these challenges exit there are some successful examples of social
entrepreneurial ventures in the country.

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 Social entrepreneurship is an approach by startup companies and entrepreneurs, in which
they develop, fund and implement solutions to social, cultural, or environmental issues. This
concept may be applied to a wide range of organizations, which vary in size, aims, and
beliefs. For-profit entrepreneurs typically measure performance using business metrics
like profit, revenues and increases in stock prices. Social entrepreneurs however, are either non-
profits, or they blend for-profit goals with generating a positive „return to society‟. Therefore,
they must use different metrics. Social entrepreneurship typically attempts to further broad
social, cultural, and environmental goals often associated with the voluntary sector in areas such
as poverty alleviation, health care and community development. At times profit-making social
enterprises may be established to support the social or cultural goals of the organization but not
as an end in itself.

Globally, there is a belief and trend that the best way to empower developing countries and
tackle their massive societal problems is through incubation of private social enterprises and job
creation, not charity. The research field work has found that TEBITA is the first private sector
ambulance company in Ethiopia. It works in collaboration with EAES (East Africa Emergency
Service) to transform Ethiopia‟s health industry. The enterprise is making enormous changes to
the health care industry in the country. It is a known fact that Ethiopia is one of the countries
with the highest rate of car accidents and deaths which necessitates prehospital emergency
medical service in the world (MoLSA, 2016). TEBITA is revolutionizing the industry by
addressing the service gap that between the scene of an accident and the hospital and minimizing
death rates and other consequences in the process.

Every paramedic at TEBITA has the know-how for life-saving equipment, in addition to the
emergency services to clients. TEBITA also gives services to elderly citizens travelling to
hospitals regularly. TEBITA Ambulances transport them to and from hospitals and other medical
centers in a safe and guaranteed way. Such services were not available before the coming of
TEBITA hence the new and innovative service is positively impacting individuals and the
community needing the service. This is changing the entire picture of the industry. Currently,
TEBITA is in the process of extending its iconic paramedic trained technicians placement in
other organs like government and the fire bridge ambulance, etc.….

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 Pre-hospital care should comprise basic strategies with proven effectiveness, such as
accessible and rapid transportation and the deployment of personnel with basic life-support
skills. Social entrepreneurship, social enterprises and social innovation in the working group‟s
mandate. Social entrepreneurship is understood as a type of enterprise with the following three
characteristics. It is targeted at a social objective where there is an unmet welfare need. It
contributes innovative solutions to these challenges. It is driven by the social results, but also
by a business model that can make the enterprise viable and sustainable.

The following challenges are the main challenges identified during the field work. Lack of
access to funding and inadequate or non-existent support structures. To deal with these
challenges, participants pointed to the need for better funding options from both government and
other sources. Regulations and their implementation. Attention was drawn to the challenges
linked to public procurement regulations and their implementation. They highlighted the need for
changes in these regulations and greater emphasis on quality, social responsibility and social
value. Lack of awareness of social entrepreneurship and social innovation. Participants pointed
to a lack of awareness in society in general and among public authorities. To deal with these
challenges, they mentioned a wide range of initiatives, including research and education, analysis
and exchange of experiences with good examples, and information campaigns. Attitude, culture
and organization in government.

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 CHAPTER SIX
CONCLUSION AND IMPLICATIONS TO SOCIAL WORK
This chapter summarized and concluded the general findings of the study and made
recommendations to policy makers, researchers in the academician circles as well as
practitioners or social entrepreneurs in the social entrepreneurship sector. The analysis and
discussions of the data allowed for conclusions and suggestions to be made. The findings of the
study have important implications for appropriate actions to be considered for social work
discipline.

6.1. Conclusion
From the obtained results, the following conclusions have been made. TEBITA is really
practicing social entrepreneurial activities and striving to be one important local social enterprise
in Ethiopia with visible contribution towards bringing solutions towards a significant social
problem in the country namely prehospital emergency medical service. In addition, the enterprise
has proved its real social contribution in job creation initiative for marginalized youth group
through its in-house training as paramedic emergency technicians to serve the enterprise as well
as other public organizations including the government emergency health systems. It employed
an innovative and unique social service as emergency medical care across different section of the
Ethiopian society paying attention on the majority of the 24/7 ambulance service users/clients.
The enterprise wisely applied the cross-subsidizing business model to finance the service
provision and delivery of the emergency medical care service for the majority through properly
channeling the social responsibility fund and redirecting the revenues obtained from its few
service subscribers.

Despite all the challenges and constraints faced and the lack of legitimacy for enterprises to
register themselves as a full-fledged local enterprise that exclusively working on social
innovation, job creation for the marginalized and stay socially sustainable, TEBITA is striving to
be a best model social enterprise in the country and is leading the sector. TEBITA, through its
active participation and even presiding the Social Entrepreneurs Forum Ethiopia, is making a
difference.it also actively participating and largely contributing in the consecutive Social
Enterprise World Forum with the last forum held in Addis Ababa in October 2019. TEBITA is

75
also capable to spread innovative ideas of social entrepreneurship and incubate the business
model for the benefit of the majority across the country. It is actively engaged in peer capacity
building activities and even has prepared a strategy and a comprehensive project proposal based
on public private partnership and proposed the same for the Ethiopian government.

6.2. Suggestions and Implication to Social Work

From the obtained results the following suggestions have been made: -

6.2.1. Clearly Defining the Phenomenon

There is a strong potential for social entrepreneurship to bring sustainable solution for many
societal problems, through its practice and contribution, in Ethiopia. However; neither the
concept nor the term has been fully and clearly understood. Academicians should take the lead
actor and provide a clear and workable definition with clarifications on important terminologies
for the new concept and they should also try to integrate it in social work, social science and
business education and curricula. Students of social science and social work must dare to embark
on more and more evidence-based research works as social entrepreneurship and the practical
phenomenon is believed to be one direct practical aspect of the social work profession. Measures
to create awareness towards social entrepreneurship that is to disseminate the understanding that
it has a social output. Through the local broadcast and the print media concerning the impact of
social enterprises for communities, the environment and society. So that the current low level of
awareness and understanding in Ethiopia. The few social enterprises that are really practicing
social entrepreneurship should focus greater attention to their business models to ensure their
sustainability.

6.2.2. Standardization and Bench Marking

There is the need to standardize and bench marking for measuring social and environmental
returns and impacts for local innovative social entrepreneurship practices by enterprises in
Ethiopia. Currently, many social investors like TEBITA are searching for new ways to evaluate
their financial and social returnees in a clear, standardized and transparent fashion. Increased
access to measurement tools and services allow to evaluate the effectiveness of interventions like
TEBITA‟s emergency medical care service. TEBITA is striving to build social returns on its
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investment that measure the social, environmental and economic costs and benefits. In addition,
policy makers, social enterprises and other stockholders should actively engage in seeking new
ways to measure projects or interventions that have positive impacts to achieve both qualitative
and quantitative results.

6.2.3. Support for Pioneers and Incubators

Supporting innovative start-ups is critical for evaluating their chances of success and
sustainability. Incubators like that of TEBITA, can provide subsidized services such as social
business planning, management and leadership mentoring, etc.… for social enterprises start-ups.
They should be provided strong with support from the government and could be taken as role
model for incubating the practice of social entrepreneurship in Ethiopia. Because of its service
for larger community, contribution towards bringing sustainable solutions for many societal
problems as well as its crucial play to impact socioeconomic outstanding issues, local social
enterprises like that of TEBITA needs to be provided with the necessary support and assistance
by the government. The challenges and constraints which render their innovative entrepreneurial
efforts should get proper consideration and quick actions. To bring significant contribution and
impact on the socioeconomic arena and hence poverty reduction, social enterprises in Ethiopia
should work in collaboration to each other through the social enterprise forum and with that of
the government in PPP model. This will further increase their social contribution and impact on
both at micro as well as macro level. Worldwide experiences prove that the business incubator as
a successful mechanism for nurturing of social enterprise business start-ups. The main objectives
of incubation are to transit developing enterprise societies into knowledge-based societies.
Appropriate business incubation mechanism minimizes the high level of the failures of business
start-ups in the social entrepreneurship sector.

6.2.4. Formation of Public Private Partnership (PPP)

Public Private Partnership refers to forms of cooperation between public authorities and the
private sector which aim to ensure the financing, construction, renovation, management,
operation and/or maintenance of infrastructure and/or the provision of service. It involves some
form of risk sharing between the public and private sector in the provision of an infrastructure or
service. The PPP has two forms-contractual and/or institutional (USAID,2012). PPP should be
77
promoted in the country so that individual private social enterprises can directly work with the
government structure. The ongoing debate should get its final and the PPP should be soon
realized in Ethiopia.

6.2.5. Policy and Legal Framework

Introducing legal policy and frameworks to encourage the establishment of social investment
funds, policy dialogue should aim to produce introducing legal structure for social
entrepreneurship in Ethiopia. This needs in-depth discussions and analysis on the country‟s
current social policy and legitimacy as well as identifications of areas of modifications and
amendments on outstanding issues. Doing so in turn will create more conducive environments
for PPP more innovative social investments.

There is a clear need to have a policy on social entrepreneurship for Ethiopia. Law makers in
Ethiopia need to consider and investigate the special feature, characteristics and business model
of social enterprises. There is also the need for revising existing legal forms of organizations, as
there is no workable legal framework for the many social enterprises to fit in which are operating
across the country.

6.2.6. Setting Up of National Social Investment Forum

Socially responsible corporations can be important role models for social enterprises. They
can also be major players in promoting a fair and competitive environment for social enterprises
development and growth. This further can be integrated and work together with Ethiopian
Enterprise Forum. Forming such a forum brings together social investors, philanthropists and
venture capitalists with small scale social enterprises in a common platform. This can serve the
purpose of matching demand with supply means demand for channeling smaller investments
with a supply of sustainable, innovative efforts on the ground. The forum can also provide
opportunities for cross-country learning of experiences and awareness raising.

6.2.7. Strengthening and Incorporating Social Entrepreneurship

Strengthening and incorporating the phenomenon and concept of the social entrepreneurship
in the country‟s education system and curricula is paramount. Promoting educational initiatives

78
related to social innovation and civic engagement can bring more opportunities for community
services and skills building, it can also provide needed support for emerging social enterprises.
Social entrepreneurship can be integrated into educational course curricula across a number of
disciplines and subjects helping students develop the necessary skill setups to succeed in both the
business and social sphere.

Finally, to highlight the importance of development and promotion of social entrepreneurship

in Ethiopia, further suggestions are stated as follows. The field of social entrepreneurship is vast,
covers diverse and interesting topics and areas with many unresolved issues that can attract the
interest of academicians that calls for more research works. Future research works, and
undertakings could investigate more deeply the potential of the social entrepreneurship sector in
bringing real solutions to mitigate outstanding socioeconomic issues and problems both at micro
and macro level in Ethiopia. From policy perspectives, some practical and outstanding debates
that are going with respect to the formation and legalizing of the Public Private Partnership in
Ethiopia should quickly get solution and enter in to practice for the betterment and development
of the social entrepreneurship sector.

With respect to Social Work study, higher educational institutes and universities should be
encouraged to incorporate and integrate the social entrepreneurship as part of their practical
project works to complete the theoretical classroom studies. They must start conducting research
studies on social entrepreneurship with its Undergraduate and Graduate Area of Concentration so
that the discipline could be integrated in the higher educational curricula and given as part of
social work studies and research endeavors.

Today‟s social problems demand the attention of the world‟s brightest minds and
entrepreneurs. To prepare future innovations, the institutions that nurture tomorrow‟s leaders
(our universities) are equipped students with the skills they need to effect meaningful change.
The social entrepreneurship programs and the respective concentrations and courses will
empower students to join the next generation of thought-leaders who change the society hence
the world. Such courses and research endeavors help students to bring their innovative ideas for
social good to fruition and success. Such programs provide students with an understanding of
how to use business skills and market knowledge to create social solutions. The specific courses

79
also help students to focus on a wide range of topics as well as flexibility to focus on a specific
industry within the social sector. Students may dedicate their studies to environmental
sustainability, health, economic opportunity or education. Such programs also allow students to
approach their area of interest as they see fit through either a nonprofit leadership or social
enterprise/business approach (SEWF, 2018).

The work of social entrepreneurs Bill Drayton Founder of Ashoka, in its publication
„Innovators for the Public,‟ stated that „Whenever society is stuck or has an opportunity to seize
a new opportunity, it needs an entrepreneur to see the opportunity and then to turn that vision
into a realistic idea and then a reality and then, indeed, the new pattern all across society. We
need such entrepreneurial leadership at least as much in education and human rights as we
do in communications and hotels.’

Students can learn how social policy and institutions have the power to impact society.
Students can also learn how to look at the root causes of social issues and think critically about
how they can create sustainable, scalable business solutions to the social and justice challenges
of our world. Such programs can also help create life changing experiences for socially minded
entrepreneurs. Through a multidisciplinary approach, students can acquire the tools they need to
launch their own enterprise or achieve success at an existing organization. Tailored and specific
course helps students to use their business degree to solve societal problems. Students also learn
that real change must begin from within both on an individual and a community level.

In line with international experience, a Center for the Development and Advancement of
Social Entrepreneurship in the School of Social Work can be created and provide the following
Undergraduate and Graduate Concentration Courses in the respective programs Social Work Vs
Social Entrepreneurship; Social Entrepreneurship Vs Social Responsibility and Impact ;Social
entrepreneurship Vs Social Policy and Practice /Nonprofit Leadership; Social entrepreneurships
Vs Social Welfare, Nonprofits, Social Enterprises and Public Sector Social entrepreneurship;
Social entrepreneurship Vs Social Impact Strategy; Social entrepreneurship Vs Social Innovation
and Design and Development; Social entrepreneurship Vs Performance and Social Change and
Change by Design; Social entrepreneurship Vs Leading as a Social Entrepreneur; Social
entrepreneurship Vs Impact and Advanced Social entrepreneurship; Social entrepreneurship Vs

80
Global Social entrepreneurship or Managing Social Enterprises or Urban Poverty and Economic
Development; Social entrepreneurship Vs Public Management and Social Innovation; Social
entrepreneurship Vs Environmental Sustainability, Health, Economic Opportunity or Education;
Social entrepreneurship Vs Corporate Social Responsibility, Energy and Clean Technology and
Social Sector Leadership; Social entrepreneurship Vs Philanthropy, Cross Cultural Perspective,
Topics in Nonprofit Management, Global Poverty; Social entrepreneurship Vs Public Economics
for Business Leaders; Social entrepreneurship Vs Leading Mission-Driven Enterprises; Social
entrepreneurship Vs Public Policy and Social Impact Law; Social entrepreneurship Vs Nonprofit
Finance, Fundraising and Development; Social entrepreneurship Vs Nonprofit Incubators and
Societal Solutions; Social entrepreneurship Vs Crowd funding; Social entrepreneurship Vs
Culture, Society and Entrepreneurship in Developing Economies; Social Entrepreneurship Vs
Social Responsibility through Eco-Enterprise; Social entrepreneurship Vs 21st Century
entrepreneurship, Business and Social entrepreneurship; Social entrepreneurship vs Business
Solutions for the Developing World, Learning through Service, Integrated Reporting for Socially
Responsible Strategies and Geographies of Global Change; Social entrepreneurship Vs Socially
Minded entrepreneurship; Social entrepreneurship Vs Innovation for the Underserved
Communities; Social entrepreneurship Vs Design and Policy for Humanitarian Impact; Social
entrepreneurship Vs Social Innovation Incubator; Social entrepreneurship Vs Sustainability,
GLOBASE, Business Leadership/Social Outreach, the Nonprofit & Voluntary Sector, Fund
development for Nonprofits; Social entrepreneurship Vs Investing in Impact Ventures and
Social entrepreneurship Vs Design, Develop and Deliver.

Such programs and concentration course can be supported by Core Courses, Elective Field
Interests and practices, Internship and Professional Development trainings, Management
Sequence and Consultancy Projects, Systemic Perspectives, Analytical Capabilities,
Experimentation in Design, Implementation and Impact Assessment, Problem-Solving
Activities, and Interaction with Social Enterprise World Forum as well as Ethiopia Social
Entrepreneurs Forum.

81
6.3. Questions for Debates and Future Research Initiatives and Undertakings

Does the practice of local social entrepreneurship have its impact on micro economic level or
it has also significance at macro level, at socio economic sector on poverty alienation and social
change?

What type of legal forms of social enterprises is feasible for Ethiopia that is compatible with
the country‟s current development and economic reforms?

How Public Private Partnership can solve the current challenges and between private
enterprises and the government sector for rapid development and sustainability in the
socioeconomic arena in Ethiopia?

82
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Source. Introduction to Social Entrepreneurship. School of Business UAlbany – SUNY New York, 2016

Figures – 2 - Alternative Business Model

Source. http://www.4lenses.org/book/export/html/81

Figures – 3 - The Spectrum of Social Enterprises. - Arranged by Legal Form and Revenue
Source
Source. John & Elkington (2008)

TEBITA online Material

TEBITA Ambulance Crowdfunding – Matchboxology

Private Equilties Showing Interest in Ethiopia‟s Growing Economy – CGTN Africa
New Life: Urgent Care (Tebita Ambulance Service) – ebstv worldwide
TEBITA Ambulance – Kibret Abebe – capacity4dev
Tebita Ambulance Services – Abinet Asefa
„Let‟s be part of the solution‟ Mr. Kibret Abebe, founder of Tebita Ambulance Service –
Ethiopian Embassy in Brussels
What is New: Coverage on TEBITA Ambulance – One Ethiopia
Appendix – I. Informed Consent
Confidentiality and Anonymity: the information that will be collected from this research
project will be kept confidential and anonymous. Right to refuse or withdraw, participants have
the full right to refuse from participating in this research if not wish to participate. Participants
will have also the full right to withdraw from the project at any time they wish to do so without
losing any of their rights.
I am a master Student of Addis Ababa University; College of Social Sciences; School of
Social Work. This consent form is prepared for the main aim to explain for study participants
that the collection of data through several data collection methods is solemnly for educational
study. The findings and results of the research study is used as a partial fulfilment for a Master
Thesis work in MA Social Work Distance Leaning Study.
Incentive: participation in this study work will not bring any incentives. However, the
willingness to contribute is vital and appreciated. Participants may not get direct benefit, but
their participation can contribute to the knowledge gap resulting from the limited research on SE
in the country.
Risks/ Discomfort: By participating in this research project, participants may spend some of
their time (about 60 – 90 minutes). However; comparing with its potential benefit, it is not too
much. Participation will have a great contribution in the overall improvement and efforts to
understand the current practices of SE in the country and to helps to suggest mechanisms for
scaling up the practice and experience. There is no risk at all in participating in this research
study.
Name of Facilitator: Salih Bashir
Name of Participating Organization: TEBITA Ambulance Pre hospital Emergency Medical
Service
Name of Sponsor: Self sponsored
Appendix – II. Key Informant Interview Guide (Management / Program Staffs)
General Introduction:
The purpose of this interview is to collect data about the general understanding of the practice
of social entrepreneurship taking the organizational structure and philosophy as well as the
business model of TEBITA Ambulance. Participants are expected to provide information on how
TEBITA as one pioneering social enterprise in Ethiopia structured and organized to provide its
innovative services in the crucial emergency medical service for its service users and clients.
The Interview Guide is prepared only for educational study for the final Thesis Work in the
Master of Arts study in the School of Social Work at AAU. Therefore; as a key informant
participating in this interview, you are requested to participate and provide available information
which helps the research study in understanding how TEBITA is working, practice and
contribute as one social enterprise in Ethiopia. During and after your participation in the
interview, all information provided and discussed will be kept confidential, protected and valued.
Thank You in advance for your participation and time
Part – I. Questions Related on Profile of Key Informant
1. Position & Responsibility in TEBITA _________________________________________
2. Age _____________ Sex _______________
3. Educational Background& Qualification:
4. Year of Service:
5. Contact Details
6. Place of Interview:
7. Date of Interview:
8. Starting Time:
9. Finishing Time:
10. Name of Interviewer/Facilitator:
Part – II. Questions Related to Basic Information on TEBITA
1. Who is TEBITA Ambulance? _____________________________________________
2. When TEBITA was established? ___________________________________________
3. How was TEBITA conceived & established? _________________________________
4. Who was the founder? ___________________________________________________
5. What was the basic motive to establish TEBITA? ______________________________
6. What looks like the organizational structure of TEBITA? ________________________
7. Information on Organizational Philosophy, Vision & Mission of TEBITA______________
8. What leadership & Management Style TEBITA has?
9. TEBITA‟s capacity in its service provisions
1. Staffs
1. At management level ____________________________
2. Employees at program level _________________________
3. Employees at service provisions _____________________
4. Support staffs & subordinates _______________________
5. Volunteers ______________________________________
2. Number of Ambulance & type _______________________________
3. Training facility __________________________________________
4. Other
Part – III. Questions Related to Programs, and Services Provision and Trends of TEBITA
1. What are the Major Program and Service Provisions of TEBITA?
2. Who are TEBITA‟s Service Users & Clients?
3. How TEBITA is providing its service (the strategy)?
4. Would you please explain what is exactly mean by Tier Pricing and Cross Subsidizing?
5. What is TEBITA‟s Social Business Model? ____________________________________
6. Do you really consider TEBITA a Social Enterprise? How? _______________________
7. How TEBITA addresses the Social, Economic and Environmental Issues and tries to Solve
Problems of its Service Users?
8. How TEBITA is fulfilling its social responsibility through its Innovative Social Enterprise?
What is the logic for this? What Contribution and Impact has TEBITA at Nationally?
______________________________________________________________
9. How TEBITA‟s Performance & Achievements Are Measured? ____________________
10. What Challenges TEBITA is Encountering during its Service Provision?
11. What is TEBITA‟s Future Plan and Perspective? ________________________________
12. Does TEBITA have System of Capacity Building and Experience Sharing Program?
13. How TEBITA works to Incubate and Spread its Innovative Social Entrepreneurial
Reputation in Ethiopia?
14. How does TEBITA ensures the sustainability of its program and services? As well as its
own existence?
15. What Measures and Coping Mechanisms TEBITA must stay resilient? ______________
16. Any other point you want to add _____________________________________________
17. Do you have any question to forward? ________________________________________
Thank You Very Much for Your Time
Appendix – III. Guiding Questions for Focused Group Discussion
General Introduction:
The purpose of this group discussion is to collect data about the specific activities and service
provision of TEBITA to its Service Users/Clients. Participants in this group are selected among
staffs based on their professional work and contribution in TEBITA as they are the main service
provider with direct contact and interaction with Service Users. Participants are expected to
provide information on how social service program of TEBITA is implemented and different
activities and service are directly provided to Service users. Details on Service Users/Clients are
discussed. TEBITA‟s performance and best practices as well as challenges of service provision
are also discussed in the FGD. The discussion guide is prepared only for educational study for
the final Thesis Work in the Master of Arts study in the School of Social Work at AAU.
Therefore; as a participant in the FGD, you are kindly requested to participate and provide
available information which helps the research study in understanding how TEBITA‟s social
service is provided, for whom. the participant is also expected to discuss what best practices are
there for TEBITA and challenges during service provision During and after your participation in
the interview, all information provided and discussed will be kept confidential, protected and
valued.
Thank You in advance for your participation and time
Part – I. Questions Related on Basic Information of FGD Participants
1. Number of FGD Participant _______________________________________
2. Male: ____________ Female:
3. Educational Background & Qualification:
4. Years of Service:
5. Positions & responsibility
6. Place of Interview:
7. Date of Interview:
8. Starting Time:
9. Finishing Time:
10. Name of Interviewer/Facilitator:
Part – II. Questions Related to Information Programs and Service Provisions
11. What are the Major Program and Service Provisions of TEBITA?
12. Who are TEBITA‟s Service Users & Clients?
13. How TEBITA is providing its service (the strategy)?
14. How many departments/sections are there in TEBITA?
15. In which department do you work?
16. How do you provide the service in your own department/section?
18. What is 24/7 service mean?
20. How do you contact Service Users/Clients?
21. How the service users directly reach TEBITA? What is the call service (8035)?
22. What other methods are there to reach TEBITA?
23. Is there a membership system for service users?
Part – III. Questions Related to Capacity, Performance & Challenges of TEBITA
24. On average, how many service users are benefited from TEBITA
1. Per day_______ 2. Per month _________ 3. Annually
____________________
25. How many staffs are there who directly work with service users?
26. How many Ambulance are there? What is the condition of the Ambulances?
27. What makes TEBITA‟s Ambulance service unique?
28. What looks like the work relationship between the management and staffs?
29. What are the major constraints for you during service provisions?
30. How do you try to solve such problems of service delivery?
31. Is there operational procedures & standards for TEBITA‟s service delivery?
32. What is TEBITA‟s system of service dissemination and promotion?
33. Do you get on job trainings that may help you increase your capacity and quality of service
delivery and update yourselves?
34. Any Other Business (AoB)

35. Do you have any Question __________________________________?

Thank You Very Much for Your Time

 Appendix – IV. Guiding Questions for Case Study
General Introduction:

The purpose of this Individual Interview Questions is to collect data about the specific service
provision of TEBITA to its Service Users/Clients. Participants are expected to provide information
on what type of service is provided for them, When? How? In addition; they are asked what made
them choose TEBITA as their service provider? Their satisfaction level is also discussed. Do they
recommend TEBITA for others? Why? The Interview Guide is prepared only for educational study
for the final Thesis Work in the Master of Arts study in the School of Social Work at AAU.
Therefore; as a participant in the Case Study, you are kindly requested to participate and provide
available information which helps the research study in understanding the service provisions of
TEBITA for its Service Users/Clients. During and after your participation in the interview, all
information provided and discussed will be kept confidential, protected and valued.

Thank You in advance for your participation and time

Part – I. Questions Related with the Profile of Case Study Participants
1. Real Name_______________________ Pseudo Name ____________________
2. Age _________________ Sex ________________ other ___________________
3. Contact Details
4. Palace of Interview: ____________________________________________________
5. Date of Interview: ______________________________________________________
6. Starting Time: __________________________ Finishing Time: __________________
7. Name of Interviewer: ____________________________________________________
Part – II. Questions Related with Service Provision
8. Type of Service used. what type of service you get from TEBITA? ___________
9. When & How service is provided ______________________________________
10. Is that your first time to get service from TEBITA? ______________________________
11. How much does it cost you for the service? Was it fair in your sense?
12. What makes you choose TEBITA for the service? Ambulance service is also provided by
the Red Cross & other private hospitals and medical center. why TEBITA?
_________________
13. Could you explain your satisfaction level? Were you satisfied by the service you get from
TEBITA?
14. Will you continue to use the service of TEBITA? Do you recommend TEBITA for
others? Why?
15. What is your opinion on the establishment of more organizations like TEBITA which
works on the principle of social entrepreneurship in the country?
16. What is your suggestion contributions and Impacts it will bring in tackling and reducing
the many social problems in the country?
Appendix V- Checklist for Field Observation

1. Observing on TEBITA‟s Office and Premises Arrangements

2. Study TEBITA‟s Organogram, Organizational Structure & the Business Model
3. Observation on Number and Qualification of Staffs and Employees
4. Observation and Understand the Management and leadership style
5. Observation on Number & Qualities of Ambulance and the Service
6. Observation on Training Facility & Training Provisions
7. Observation on Service Users and Clients List
8. Observation on Type & Quality of Programs, Activities and Services
9. Observation on System of Service Provision & Coordination
10. Observation on Quick Wins
11. Observation on Challenges in the Service Provision
12. Observation on the Practice Social Entrepreneurship & Contribution of towards tackling
problems of its Clients
13. AoB
 VI. Organizational Profile of TEBITA Ambulance Prehospital Emergency Medical Care
Service

Enterprise Name: TEBITA AMBULANCE PREHOSPITAL EMERGENCY MEDIACAL

SERVICE (PLC)

TEBITA Ambulance aims to provide the highest quality emergency ambulance care and pre-
hospital services, create awareness on first aid and health safety through formal trainings, and
advocate for the development of well-organized emergency medical services management.

The organization is licensed by the Addis Ababa Health Bureau and has achieved ISO
9001:2008 certification in quality management systems.
Core Values
C: Commitment to save life and provide the highest quality service
A: Always be compassionate
R: Respect and dignity for our fellow man
E: Enhance and improve the emergency medical field
THE SERVICES
Since its establishment, TEBITA Ambulance has been dedicated to delivering the most
professional, high quality and reliable emergency care services to the people of Ethiopia,
multinational companies, non-governmental organizations, and many others. TEBITA has
received several awards from the Government of Ethiopia, foreign governments and
development organizations for its role in bringing about life saving services to Ethiopia. The
company is licensed by the Addis Ababa Health Bureau to provide emergency medical services
and offers certified trainings on first aid and health safety.

Remote Ambulance Services

Multi-national and local companies who are working in remote areas and are involved in
mineral mining, oil exploration, rail and road construction, etc. are vulnerable to injuries and
acute illness.
The Team
Ato. Kibret Abebe: is a professional anesthetist with over 25 years‟ experience. Mr. Abebe,
established TEBITA Ambulance after witnessing the poor conditions of victims of traffic
accidents and other emergency medical patients when they arrived at local Addis Ababa
hospitals. Very few patients arrived via ambulance, while the majority traveled by public
transportation. In a country where the rate of traffic accidents per capita is among the highest in
the world, Mr. Abebe saw the need to improve patient transportation and pre-hospital care. He
proposed the concept to the Ministry of Health, helped craft the government regulatory standards
for the industry, and received the first ambulance license for TEBITA Ambulance in 2008. Six
years later, TEBITA remains the only licensed for-profit ambulance and pre-hospital trauma care
business in the country.
Ato. Yitages Mengistu: as a comprehensive registered nurse, Mr. Mengistu worked in the
operating rooms Tikur Anbessa Hospital for 15 years, the biggest and tertiary hospital in
Ethiopia's capital of Addis Ababa. He also served as the executive director of the Ethiopia
Midwives Association. Mr. Mengistu holds a Master of Science in Resource and Environment
Economics, and has taught different courses at colleges and universities, including biostatistics,
health economics, and principles of economics and operating room technique. Mr. Mengistu
joined TEBITA Ambulance as the Operations Manager because he too understands Ethiopia's
need for top quality pre-hospital and emergency care. His life's passion is to save lives and assist
those in need.
Picture – 1 – TEBITA Ambulance – Dial 8035 to Save Life
Picture – 2 - TEBITA Ambulance Prehospital Emergency Medical Care Service Staffs
Picture – 3 – TEBITA Ambulance Emergency Medical Technicians
Picture – 4 - TEBITA Emergency Medical Technicians Trained as Paramedics

Benefits :
1. 24/7 equipped ambulances at your project site reduce needless death or medical complications
due to airway obstruction, cardiac arrest, bleeding, etc.
2. Assist in implementing emergency preparedness and response and fulfill your occupation‟s
safety and health standards at national and international levels.
3. Integrate TEBITA‟s ambulance service with the appropriate the health facility for
definitive care.
4. TEBITA‟s availability helps reduce disabilities after traumatic injuries (e.g.: spinal injuries
and bone fractures).
5. TEBITA‟s Remote Ambulance Service reduces your organization‟s health care work burden,
and therefore increases your overall work efficiency.
Training Non-Health Professionals
First aid training to non-health professionals. TEBITA provides a 1 to 3-day course on
location or at its training facility to equip staffs with the necessary first aid skills to properly
respond in an emergency.

Benefits:
1. Reduce immediate deaths and medical complications due to cardiac arrest, airway obstruction
and bleeding that occur in the workplace.
2. Increase your organization‟s emergency preparedness.
3. Increase your staff‟s work quality and fulfill your organization‟s health and safety standards.
Provision of Emergency Equipment
Interested in purchasing first aid kits for you and your staff? Participate in one of TEBITA
Ambulance‟s first aid trainings to receive a 20% discount.

Training Health Professionals

Basic, advanced life support and CPD training for health professionals. TEBITA provides a 1
to 5-day course to train health professionals about emergency care techniques in the context of
Ethiopia

Benefits:
1. It is a requirement to renew your first aid license every 5 years.
2. It increases the overall emergency service efficiency at your health facility.
3. It reduces death rates due to poor handling in the emergency service department.
Medical Equipment
First aid kits that provide standard medical equipment for your medical emergency needs.
Benefits :
1. Obtain first aid kits or replacement medical equipment for expired or used items for a nominal
price.
2. For those who have taken a TEBITA emergency response training, a 20% price reduction will
be given to participants who require a first aid kit.
Peace of Mind Ambulance Services
The Peace of Mind package is available to organizations, families and individuals. It is
standard and fully equipped ambulances for advanced life support management with well-
experienced emergency professionals. Sleep well at night knowing the Peace of Mind services
ensure fast and reliable response times to meet the emergency needs of your key personnel living
in and around Addis Ababa, Ethiopia.
Benefits Package for Ambulance Membership
Our reliability and accessibility.
1. Our dispatch availability at different points in the city.
2. In certain situations, we will waive the out of pocket service expenses and will work with
your insurance company to process your medical bills.
3. Free consultation for health-related problems.
4. Members can receive a 20% discount on them at home oxygen supply or on other services.
5. Evacuation from any corner of the country to Addis Ababa.
6. Assisted evacuation from Ethiopia to abroad with ground ambulances and planes, if the need
arises.
7. Commit ment to Local Citizen
8. TEBITA is committed to local citizens by providing annual basic first aid and CPR trainings
for schools and organizations, as well as community outreach and prevention programs,
including Heart Healthy Communities and Car Seat Safety, as well as providing public
service announcements.
Remote Ambulance Services
Each ambulance is fitted with state of the art equipment to meet the requirements of the client.
Our remote ambulance services come with a highly professional crew, including a first aid
trained driver and an emergency trained nurse.
Staffing
We will staff your project with proper emergency medical personnel to ensure the highest
quality care for your employees. TEBITA specializes in:
 Emergency medical doctors
 Specialized emergency nurses
 Critical care medical Professional
 First and trained general staff
 Other specialists as needed from Ethiopia or abroad
International Evacuation
Through partnerships, we will ensure the proper evacuation systems and protocols are in
place to evacuate your personnel, when necessary, to the international location of your choice.
Clinic Set Up
Need a temporary clinic at the site of your project or camp? Based on your unique
requirements, we can provide the equipment and facility to meet your project‟s needs.
CLIENTS: TEBITA has transported more than 30,000 patients in Ethiopia and provided
specialized services to a variety of diplomatic missions, non-governmental organizations,
hospitals, multinational companies, construction companies, banks and hotels. The company has
evacuated patients from across Ethiopia. TEBITA has facilitated more than 500 international
evacuations. Specific clients include UNWFP, Oil Libya, The British Council, Heineken
Brewery, Tullow Oil and Total Oil, among others.

PARTNER
In May 2015, TEBITA Ambulance formed a working partnership with East Africa
Emergency Services, LTD (EAES), an Ethiopian and American joint venture. EAES works with
providers of emergency medical services and training in East Africa, to ensure that international
and domestic clients have access to reliable, high-quality emergency care. EAES offers business
development, procurement and administrative support to TEBITA Ambulance. EAES seeks to
help medical service companies, like TEBITA Ambulance, operate more efficiently and to free
them up to focus on their core functions, primarily caring for patients in crisis. In meeting this
need, TEBITA Ambulance and EAES aim to improve the quality and scope of emergency
services for thousands across East Africa and create jobs in the local Ethiopian economy.
Together, TEBTITA Ambulance and EAES are working to establish the first trauma center and
air ambulance system in Ethiopia.

Tebita Ambulance and Pre-Hospital Emergency Medical Services

Ethiopia is home to over 80 million people, 80 percent of whom live in rural areas without proper
roads or nearby hospitals. Ethiopia also has high rates of maternal and infant mortality, with 1 in 27
women dying in pregnancy. The country‟s highly fragmented emergency medical transport system
means a complicated pregnancy can easily become a life-threatening situation for a woman trying to
reach a hospital. While the Addis Ababa Red Cross has 10 ambulances, their budget limits them to
running only four per day, which are staffed by minimally-trained volunteers. The Ministry of Health
is working to expand the country‟s ambulance fleet, but there are few trained emergency medical
staff. With few options, Ethiopia‟s pregnant women often resort to using taxis, motorbikes, or
bicycles to reach a hospital in an emergency. In rural areas, transport options are further limited to
mules, horses, or being carried by neighbours and relatives. The HANSHEP Health Enterprise Fund,
implemented by the SHOPS project, selected Tebita Ambulance and Pre-Hospital Emergency
Medical Services to receive a grant to expand the first private ambulance fleet in Ethiopia to fill this
unmet need.
THE BUSINESS MODEL

Tebita offers professionally staffed, well-equipped, door-to door ambulance services. With this level
of service Tebita keeps patients stable while transporting them to one of four different hospitals. With
the slogan, “Dial 8035 to save lives,” Tabita‟s four-digit telephone number makes access to
ambulance services fast and easy for those in an emergency. Many Ethiopians in need of emergency
services cannot afford typical ambulance rates, which are often high due to substantial maintenance
and fuel costs. However, Tebita finds limiting services to high-income patients to be unacceptable.
Thus, the company is working to perfect a tiered-pricing and cross-subsidization model for their
services. To subsidize services for the poor, Tebita pursues contracts with international organizations
and multi-national companies. For instance, Tebita holds contracts with mining companies to provide
emergency transport for employees located in harsh, rural settings. Tebita also partners with
AMREF‟s Flying Doctors in Nairobi, International SOS, and Africa Assist to facilitate international
evacuations, and works to provide other premium services that will attract

Tabita‟s ambulance team is prepared to serve Ethiopia

Grantee at a Glance

• Vision: Serve as a comprehensive, internationally-accredited emergency medical service hub in

East Africa Innovation type: Ethiopia‟s first private ambulance and emergency medical
service provider

• Health focus: Maternal and child health

• Target population: Men, women, and children in need of emergency care

• Country: Ethiopia
international clients. The revenue from these partnerships allows Tebita to continue to serve low-
income clients. To complement their emergency transport services, Tebita is starting a home-based
nursing care service to reduce the burden on hospitals with limited bed space. The company also
offers first aid and paramedic training and sells well-equipped first aid kits. In the future, Tebita
expects to launch the country‟s first paramedic training centre.

BUILDING A STRONG BUSINESS

The HANSHEP Health Enterprise Fund is supporting Tebita to expand its existing emergency
response capabilities through complementary activities, including expanding to a network of multiple
dispatch centres with a larger ambulance fleet, training additional paramedics, creating first aid
awareness videos in three major local languages (Amharic, Oromifa, and Tigregna), and developing a
home-based nursing service.

SHOPS sponsored a team of MBA students to conduct a costing exercise and market analysis of
cross subsidization within Tabita‟s existing offerings. This support helped Tebita better understand its
underlying cost structure, segment the market, and select locations for the new dispatch centres.
SHOPS also provided support to improve Tabita‟s technology platforms. At a Health Enterprise Fund
event, Tabita‟s founder, Kibret Abebe, learned of impact investing organization, Acumen, and was
selected as Acumen‟s first East Africa Fellow from Ethiopia. In addition to leading to an executive
MBA in leadership, this fellowship will connect Abebe with onward investors and other social
entrepreneurs for training and networking. Tebita has also networked with the other fund grantees
during technical assistance activities, most notably, Telemed Medical Services. As a result,
Tebita is partnering with Telemed to offer seamless ambulance service to Telemed‟s call
centre customers when they require emergency assistance.
THE IMPACT
We are ambitious, and we know we will grow, and if you give us the chance we will do
it.” - Kibret

Tuffa, General Manager, Tebita

With support from the Health Enterprise Fund, Tebita provided emergency transport to over
1,800 patients in just one year. Approximately 20 percent of ambulance patients used the
services for maternal and child health emergencies, including pregnancy complications and
neonatal pre-hospital care. Tebita has also provided first aid and health safety training for
more than 25,000 trainees, and produced a video on first aid principles, which includes 12
topics related to first aid management. This program aired on Ethiopian television to teach
the public about basic life support. Tebita has also signed a contract with a popular radio
station to broadcast first aid programming once a week for the coming year. The number of
patients served by Tabita‟s ambulances grew by more than 50 percent within the first year of
the Health Enterprise Fund, and growth should continue. Tebita expands its fleet and
improves support services.
 Social entrepreneur who saves lives in Ethiopia aims to win minds in Europe

Social entrepreneur who saves lives in Ethiopia aims to win minds in Europe

At the European Development Days, Kibret Abebe Tuffa will make a powerful case for the
role that social enterprise can play in support of the Sustainable Development Goals. Kbret
Abebe Tuffa sold his only home to launch Tebita. Today, the Ethiopian social enterprise has
11 ambulances, 63 employees and as provided ambulance services to more than
40,000 clients. Photograph: Tebita Ambulance Pre-Hospital Emergency Medical Service.
Kibret Abebe Tuffa is the founder and owner of Tebita Ambulance Pre-Hospital Emergency
Medical Service, a social enterprise that developed the first private ambulance service in
Ethiopia. While working for 17 years as a nurse anesthetist at the largest teaching and referral
hospital in Addis Ababa, Kibret handled numerous emergency cases and saw first-hand how
many lives were unnecessarily lost due to lack of ambulance services. In a country with some of
the world‟s deadliest roads, the absence of critical life-saving support was for him a daily
tragedy. He asked his colleagues: “How can we wait for a victim to come to us without any life
saving measure rather than going out to assist him or her?”. So in 2008, Kibret sold his house to
acquire three old ambulances, the necessary license and launched Tebita Ambulance. He did so
against the advice of nearly all of his peers and relatives who questioned the impact he could
deliver and argued that ambulance service was the responsibility of government or the Red
Cross. His response was, “I prefer to start challenging this problem rather than sit and complain
about it.”

From the outset, Kibret wanted Tebita to generate income so that it would be financially
self-sustainable, not aid dependent, but it took time to find the right formula. “When we
started, we knew nothing about any practical business model,” says Kibret, who credits a one-
year training program on business strategy offered by SIDA, Sweden‟s international
development agency, with helping him to develop a successful social enterprise. He has since
developed a business model based on cross-subsidization. Tebita offers high quality, ISO-
certified ambulance service, remote medical assistance and emergency aid training to
multinationals, diplomatic missions, foreign NGOs and expatriates. Surplus income from those
activities to subsidises the cost of a local 24/7 ambulance service in Addis Ababa and in
surrounding provinces. As a result, Tebita can offer ambulance service to the public for an
average of $15-20 (£10£13), even though the actual cost is $51 (£35).

Kibret began with a team of two employees and for the first five years he continued working
as a hospital anesthetist to help pay his staff. Today, Tebita has 11 ambulances and 63 employees
and has opened Ethiopia‟s first emergency and paramedical training center. It has launched a
motorcycle service to send first aid responders quickly through Addis Ababa‟s snarled traffic to
provide support before its ambulance can arrive. And it has provided ambulance services to more
than 40,000 clients and emergency training to more than 25,000 trainees. In addition, Tebita
provides emergency medical services to Ethiopia‟s national football team and Kibret himself
travels with the squad offering his services pro bono. In 2014, Tebita received a grant and
technical assistance from USAID and DfID through their joint Health Enterprise Fund which,
says Kibret, helped Tebita to scale up and enhance its strategic planning and financial
forecasting. In 2015, he also became an Acumen Fellow which offered him the opportunity to
participate in a one-year leadership program. Tebita faces several challenges, chief among which
is access to finance. They generate a healthy financial surplus, but local banks are hesitant to
provide loans, citing a lack of collateral. A US impact investor has conducted due diligence and
would like to offer financing to Tebita, but current investment regulations in Ethiopia prevent
foreign investors from participating directly in the emergency medical services sector. Another
challenge is Tebita‟s fragile supply chain. Their current business license only allows them to
import ambulances, not medical supplies, which are not available locally. So Kibret wants to
apply for an import license and start manufacturing emergency medical supplies locally. Despite
these hurdles, Kibret says, “We are very committed individuals who have a very clear vision to
change the emergency medical service system of our country and even East Africa.”

Advertisement

For Kibret, launching Tebita Ambulance was about more than saving lives. It was also about
changing mindsets. Tebita is an Amharic word meaning „” drop” and Kibret chose it to inspire
others to consider their own “drop” of contribution to humanity. He believes that by encouraging
people, especially the young, to reflect on how they can become active agents of change, he can
inspire them to develop solutions to the problems they face. This is one of the messages Kibret
will bring to the European Development Days, Europe‟s leading forum on international
development, where he will be on a panel alongside speakers form the British Council, World
Bank and European Commission, that will examine the role that social enterprises, social
investment and responsible business can play in achieving progress on the Sustainable
Development Goals. Another message he will deliver is that, “without responsible private sector
involvement, tackling social problems is like clapping with one hand.”

The debate “Achieving the Sustainable Development Goals: How can we make business more
social?” will be hosted by the British Council in partnership with the World Bank as part of the
European Development Days 2016. The debate will be held in Brussels on 16 June. Kibret has
also been invited to share insights during a Roundtable on Social Enterprise in Africa held by
the European Parliament.
http://www.theguardian.com/british-council-partner-zone/2016/jun/08/social-entrepreneur-
who-saves-livesin-ethiopia-aims-to-win-minds-in-europe-european-development-days
CONTACT

TEBITA Ambulance Pre-Hospital Emergency Medical Service

Addis Ababa, Ethiopia

+251-11-661-6342 / +251-91-122-5464

Head Office:
+251-11-662-2225

Training Center :
+251-11-868-4868 / +251-11-868-1323 / +251-11-868-1324