Ethiopia Makes Strides in Family Planning

Masimba Biriwasha

Unsafe abortion is the second leading cause of death in Ethiopia. So the Ministry of Health's announcement that it will provide family planning services to 8.5 million women across the country is particularly welcome.

In Ethiopia, women use herbs, poison, wire or coat-hangers to end unwanted pregnancies.

Unsafe abortions are the second leading cause of death for women, after tuberculosis. Though abortion is illegal in Ethiopia, studies indicate that abortion is widespread and generally performed by untrained persons.

According to Planned Parenthood, Ethiopia has among the highest fertility and maternal death rates in the world. Approximately 1 out of every 7 women die from pregnancy- or abortion-related complications.

Given such shocking statistics, the recent announcement by the Ethiopia's Ministry of Health to provide family planning services to 8.5 million women across the country during the next Ethiopian year is highly laudable. If fully implemented, the plan will definitely have a positive ripple effect across the Ethiopian society.

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Political will is a key ingredient to improve the reproductive health status of women, particularly in countries where long-held traditions and customs put women at high risk.

"Traditionally, women in Ethiopia have been consigned to strict societal roles, based on cooking, raising children, and a muted voice in decisions affecting them," says the World Bank.

"Most women have accepted tradition without question, subjecting themselves and their daughters to genital mutilation, early marriage, milk tooth extraction, and domestic abuse."

With increased government efforts to expand family planning services, more women will be reached, in the process saving lives and giving women and their families greater hope. But with political will there must be a willingness to also improve the health infrastructure and distribution systems.

Although family planning tools are available in Ethiopia, access to them has been a major hindrance for the majority of the women. Planned Parenthood states that only 13% of Ethiopian women – and only 4% in rural areas – use modern contraception. This is despite the fact that studies show that approximately 60% of the women in the country approve family planning.

Undoubtedly, improved access to family planning and other reproductive health services in the country could significantly combat the incidence of maternal mortality and improve the state of women. Comprehensive, high-quality sexual reproductive services can help to prevent the unnecessary deaths of women in the country.

The Global Gag Rule which restricts funding for family planning reinstated in 2001 by President George Bush has been a major factor blamed for the restriction of women's access to contraceptives in Ethiopia.

"The gag rule restricts the simplest ways to improve the status of women: funding birth control supplies so they can avoid unintended pregnancies and care for children they already have," said Dian Harrison, President and CEO of Planned Parenthood Golden Gate.

In an October 2007 report, Population Action International also points out the Global Gag rule, abstinence only education, and the anti-prostitution pledge as harmful policies that undermine women's access to information and healthcare in countries such as Ethiopia.

Fortunately Ethiopia has seen the light and will implement initiatives that will benefit its women. In order to increase the uptake, Ethiopia's Ministry of Health plans to create accessible, affordable and comprehensive coverage of family planning services for women.

More importantly, 600 health professionals will be trained to train nurses currently working at health facilities specifically carry out family planning for women. If the expanded access to family planning services in Ethiopia is to improve the status of women, it must be culturally appropriate, with particular attention to marginalized communities across the country.

In addition, the Ethiopian government needs to adequately finance the process both in the short and long term so that access to the family planning services is neither compromised nor cut mid-way. There must be a commitment to make access to services that improve the status of women as much a part of national life as breathing air.

Having said that, mechanisms must be put in place to monitor both the costs and the quality of services provided.

Indeed, the Ethiopian government can become a model for many countries around the world if it follows through on the plan to improve women's lives.

However, the US must show leadership by revoking the Global Gag rule which only serves to worsen the situation of already marginalized women in poorer parts of the world. According to Planned Parenthood, the resulting lack of U.S. funds has restricted the contraceptive supply, which means that abortion is also very common.

For any society to live up to its potential, its women need to have access to comprehensive information and healthcare that can help them to make responsible choices.

More than anything else, the Ethiopia government needs to implement policies that promote the liberation of women from traditional, economic, legal and cultural fetters.

"Female education and empowerment are critical determinants of fertility, and providing girls with access to education is likely to reduce the fertility rate," states Kristen P. Patterson in a paper titled Integrating Population, Health, and Environment in Ethiopia.

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