This thesis aimed to gain a deeper understanding of the lives of women experiencing homelessness and the services and policies designed to meet their mental health and well-being needs by exploring lived experiences and multiple perspectives of both women of reproductive age and individuals providing homeless-focused mental health and psychosocial services in Addis Ababa, Ethiopia.

For Paper I, a photovoice study, women experiencing homelessness (n=9) were provided with cameras and asked to photograph their lives on the streets and discuss the images. Data from the photographs, interviews, and discussions were co-analysed with the women, and reflexive thematic analysis was also performed. Findings revealed that homeless women were deprived of basic needs, struggled with addiction, humiliated, and treated as social pariahs. Further, many children on the streets struggled with adversity from an early age, being subjected to violence and exploitation.

Based on in-depth interviews with 19 women who experienced homelessness, Paper II showed how the common threads of abuse, micro-level relational factors, and housing issues shaped women’s trajectories through homelessness. The reflexive thematic analysis identified four main themes: trauma from childhood abuse, sexual violence, barriers to leaving street living, and sources of hope. The findings highlighted how re-traumatisation on the streets fuels these adverse traumatic experiences. However, although they faced personal, economic, and normative barriers, some women highlighted their resilience, willingness to seek support, and reliance on their strength and faith.

Papers III and IV recruited participants from government and non-government organisations. The findings of the inductive thematic analysis in Paper III demonstrated that contradictory beliefs and practices, problem−solution incompatibility, and mismatched resources all hindered the provision of psychosocial services to women experiencing homelessness.

The data collected for Paper IV were analysed using Shiffman and Smith’s political prioritisation framework. The results indicated gaps in actors’ power, how homelessness is portrayed in varying political contexts, and other issues of this topic (including lack of reliable indicators, effective interventions, and sufficient information on the problem’s severity). Overall, the thesis identified that interventions targeting individual-level vulnerabilities to systemic-level challenges are needed to address the multifaceted aspects of women’s homelessness.