In Ethiopia, liberalization of the abortion law in 2005 led to changes in abortion services. It is important to examine how levels and types of abortion care—i.e., legal abortion and treatment of abortion complications—changed over time.
Between December 2013 and May 2014, data were collected on symptoms, procedures and treatment from 5,604 women who sought abortion care at a sample of 439 public and private health facilities; the sample did not include lower-level private facilities—some of which provide abortion care—to maintain comparability with the sample from a 2008 study. These data were combined with monitoring data from 105,806 women treated in 74 nongovernmental organization facilities in 2013. Descriptive analyses were conducted and annual estimates were calculated to compare the numbers and types of abortion care services provided in 2008 and 2014.
The estimated annual number of women seeking a legal abortion in the types of facilities sampled increased from 158,000 in 2008 to 220,000 in 2014, and the estimated number presenting for postabortion care increased from 58,000 to 125,000. The proportion of abortion care provided in the public sector increased from 36% to 56% nationally. The proportion of women presenting for postabortion care who had severe complications rose from 7% to 11%, the share of all abortion procedures accounted for by medical abortion increased from 0% to 36%, and the proportion of abortion care provided by midlevel health workers increased from 48% to 83%. Most women received postabortion contraception.
Ethiopia has made substantial progress in expanding comprehensive abortion care; however, eradication of morbidity from unsafe abortion has not yet been achieved.
Yirgu Gebrehiwot is a member of the faculty of medicine, Addis Ababa University, Ethiopia. Tamara Fetters is senior advisor for research and evaluation, Ipas, Chapel Hill, NC, USA. Hailemichael Gebreselassie is senior advisor, Ipas Africa Alliance, Ipas, Chapel Hill, NC, USA. Ann Moore is a principal research scientist, and Akinrinola Bankole is director of international research—both with the Guttmacher Institute, New York. Mengistu Hailemariam is special advisor, Ministry of Health, Addis Ababa, Ethiopia. Yohannes Dibaba is senior advisor for research and evaluation, Ipas Ethiopia, Addis Ababa. Yonas Getachew is officer, Ethiopian Society of Obstetrician-Gynecologists, Addis Ababa.