Despite rapid economic growth over the past few years, Ethiopia remains one of the poorest countries in the world, with around 80 percent of the population relying on agriculture for its livelihood.
Ethiopia consistently ranks near the bottom of indices that measure poverty reduction, health, and education. Its involvement in conflicts with neighboring countries, as well as internal political tensions, has compounded already-widespread poverty and ill health. In addition, its reproductive health indicators remain some of the worst in the world.
By the time the typical Ethiopian woman has reached the age of 18, she is likely to be married, has had or will soon have the first of her five children, and is managing most of the household chores. She has not gone to school since the fifth grade, yet she likely makes some money for her family by selling produce at the market. She is not using contraception, but like many of her neighbors, wants to be. She is lucky to have survived the births of her children, given the one in 14 chance she has of dying from pregnancy or childbirth. In addition to her own children, she may be caring for other children who have been orphaned by AIDS.
The Ethiopian government has made some strides to improve the health of women and their families. It has adopted the World Health Organization's Safe Motherhood Initiative, and in 2005 it decriminalized abortion in an effort to reduce death and disability resulting from illegal, unsafe abortion.
However, significant challenges remain.
The total annual government health spending averages just $5 per person, and with 84 percent of the population living in rural areas, access to health facilities is severely limited. As a result, only 10 percent of women in Ethiopia give birth in the presence of a skilled birth attendant, and unsafe abortions persist due to women's fear of social and religious disapproval, inability to access safe abortion services, and a lack of medical providers offering services.
PPFA in Ethiopia
The work of Planned Parenthood Federation of America (PPFA) in Ethiopia focuses on reducing maternal death and disability by preventing unintended pregnancies and increasing the availability of affordable, safe abortion services. Despite the decriminalization of abortion, many medical providers are not offering services due to discomfort, lack of knowledge about the law, or lack of skills.
There is a great need to build local capacity to ensure that when unintended pregnancies occur, women have access to abortion services that are safe and affordable. PPFA is one of the few organizations that are meeting this need by equipping nongovernmental organizations with the skills, capacity, and funding they need to offer safe abortion and other reproductive health services, contraceptives, and education.
Our newest partner, Mary Joy Aid Through Development, is a well-established Ethiopian organization that implements integrated urban development programs to aid communities in need. Although this organization has long offered primary health services to the communities it serves, it lacked the capacity to offer reproductive health services until it partnered with PPFA. With PPFA's support, Mary Joy Aid Through Development is training clinic and community-based medical providers, procuring equipment and supplies, and establishing a network for providers to share expertise and experiences.
In addition to medical services, this project also supports a network of "peer health promoters" — trained youth and adults who spread health messages and distribute contraceptives in their communities. In one innovative model, "mother-to-mother" peer promoters educate and distribute contraceptives to other women in their communities through women's savings and credit cooperatives and during the traditional "coffee ceremony" — an important daily ritual in which people get together to socialize and share a cup of Ethiopia's specially brewed coffee. Peer promoters attend these gatherings and provide short talks on reproductive health issues of interest to the women in attendance and refer them for specific services.
View photos from a recent PPFA trip to Ethiopia and see some of our work on the ground!