Benefits of Meeting the Contraceptive Needs of Ethiopian Women

Author(s)

Aparna Sundaram
,
Michael Vlassoff
, ,
Lisa Remez
and
Yirgu Gebrehiwot

The ability to practice contraception is essential to protecting Ethiopian women’s health and enables them to plan the size and timing of their families. Yet low levels of contraceptive use have led to high levels of unintended pregnancy in Ethiopia, a problem for which women and society pay dearly—in women’s lives, family well-being and public funds.

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Key Points

Key Points

• As of 2008, an estimated 41% of all pregnancies in Ethiopia were unintended. Unintended pregnancy is lowest in Somali (9%) and highest in Addis Ababa (72%), where motivation to have small families is strongest.

• More than seven in 10 women who want to avoid pregnancy either do not practice contraception or use a relatively ineffective traditional method. These women can be said to have an unmet need for modern contraception.

• Meeting just half of this unmet need would result in 754,000 fewer unintended pregnancies each year, leading to 178,000 fewer unsafe abortions and 3,300 fewer maternal deaths.

• If all unmet need for modern methods were satisfied, maternal mortality would drop by almost one-third from current levels, and unplanned births and unsafe abortions would decline by 89–92%.

• Investing in contraceptive commodities and services to fulfill all unmet need among women wanting to avoid pregnancy would result in a net annual savings of US$34 million (314 million Ethiopian birr) over what would otherwise be spent on medical costs associated with unintended pregnancies and their consequences.

• Expanding contraceptive services confers substantial benefits on women, their families and society. All stakeholders, including the Ethiopian government and the private sector, should increase their investment in modern contraceptive services. Particular attention should be paid to reducing inequalities in access.

*According to the Ministry of Health,
the proportion of deliveries assisted by
a skilled health professional in 2008 was
20% (source: Ministry of Health, Health
and Health Related Indicators, Addis
Ababa: Planning and Programming
Division, Ministry of Health, 2008). This
discrepancy is likely due to differences
in methodology; our estimate is based
on EDHS data on deliveries attended by
trained health professionals (defined as
doctors, nurses and midwives only).
†The 2005 EDHS cites a maternal
mortality ratio of 673 maternal deaths
per 100,000 live births. We use the
WHO estimate for uniformity with other
projects in this series and because it
has been adjusted for underreporting
and misclassification of maternal deaths

*Ten percent of all intended pregnancies end in miscarriages, and the proportion of all pregnancies (both intended and unintended) that result in miscarriage is 16%. To calculate this overall proportion, we used a model-based approach based on clinical studies, whereby miscarriages (which include any spontaneous fetal losses, including stillbirths) are estimated to be 20% of births plus 10% of induced abortions.

*We arrive at this figure by adding to the current proportion using a modern method (29.3%), half of the proportion using no method (34.2%) and half the proportion using traditional methods (1.2%), for a total of 64.7%.
*Using an estimated 2008 exchange
rate of 9.24 birr per US$1 (source:
National Bank of Ethiopia, National
Bank Report 2007-2008, Addis Ababa:
National Bank of Ethiopia, 2009).