New estimates published by the Guttmacher Institute reveal critical gaps in sexual and reproductive health services for women of reproductive age in Ethiopia. The data, published in two fact sheets, examine current needs for contraceptive services and maternal and newborn health care among women of reproductive age (15–49), as well as specifically among adolescent women aged 15–19 in Ethiopia. They also estimate the cost of fully meeting these needs. The research shows that investing jointly in modern contraception and maternal and newborn health care is essential to improving women’s health and well-being.

Ensuring access to and provision of contraceptive services is a crucial element of fulfilling people’s right to make autonomous decisions about whether and when to have a child. Yet the data show that 4.5 million women in Ethiopia, including 284,000 adolescent women, have an unmet need for modern contraception; that is, they are married or sexually active and do not want a child for at least two years, but are not using a modern contraceptive method.

“Ninety percent of all adolescent unintended pregnancies in Ethiopia occur among young women with an unmet need for modern contraception,” said Yordanos Wolde of Talent Youth Association. “Young people need more tailored and non-stigmatizing services to meet our needs.”

In recent years, the Ethiopian government set targets for increasing the use of interventions that reduce maternal and neonatal mortality and committed to making contraceptives available to all who want them. The government’s efforts include strengthening adolescent- and youth-friendly services and improving access to contraception for adolescents.

Yet the authors of the study found that few of the 323,000 adolescent women who give birth each year receive the essential components of maternal and newborn health care recommended by the World Health Organization and the Ethiopian Ministry of Health. For example, only one in 10 adolescents give birth in a health facility.

Taking a coordinated approach to the provision of sexual and reproductive health services would yield immense health benefits for all women of reproductive age. If full provision of modern contraception were combined with adequate care for all pregnant women and their newborns, maternal deaths would drop by 81% per year and newborn deaths would drop by 85% per year.

“Comprehensive strategies for sexual and reproductive health care are vital for improving the well-being of women and their families,” says Taylor Riley, research associate at the Guttmacher Institute and coinvestigator of the new estimates. “Fulfilling the need for modern contraception together with high-quality maternal and newborn health care services should be prioritized.”

Investing in meeting the need for both modern contraception and maternal and newborn health care would also cost less compared with focusing on maternal and newborn health care alone. This is because the cost of preventing an unintended pregnancy through use of modern contraception is far lower than the cost of providing care for an unintended pregnancy. In fact, fully meeting the need for maternal and newborn health care in conjunction with fulfilling the modern contraceptive needs of women in Ethiopia would save approximately US$261 million annually compared with the cost of meeting the need for maternal and newborn health care alone. This dual investment translates to a cost of $12.81 per person per year.

The authors recommend improving access to and provision of comprehensive sexual and reproductive health care services, especially for vulnerable groups, such as pastoral communities. This should include strengthening the quality of adolescent and youth-centered health services and school-based programs, especially for more marginalized groups, such as adolescents with disabilities and those with less education or lower socioeconomic status. Implementing health worker trainings focused on ensuring the provision of quality and respectful sexual and reproductive health services would help enhance health outcomes for women of all ages in Ethiopia.