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Presentation given Spring 2012 at Emory University as part of GH 542 "Evidence-based Strategic Planning" which used Ethiopia as a case study on public health and development issues and solutions
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Fertility, Family Planning, and Abortion in Oromia
Melissa ReichwageGH 542
February 29, 2012
MaNHEP Formative Research Report
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Fertility
• Fertility rate = 6.2 children per woman
• Women marry and give birth at a young age, have children close together, and have polygynous marriages
Fertility and Family Planning in Ethiopia: A New Look at Data from the 2005 Ethiopia Demographic and Health Survey
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Unmet Need for Family Planning
• The unmet need for family planning is at 41.5% in Oromia
• Over 75% of married women report that they either want no more children or would like to wait at least 2 years before having their next child
• The ideal number of children wanted, if they could choose, is 4.5 for women and 5.2 for men
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Current Contraceptive Use• 13.6% of married women in Oromia use modern
contraception– Injectables are the most popular method– Four-fifths of women obtain their method from the public
sector• 87% of married women have heard of at least one
modern method of contraception• Reasons for not using a family planning method:– Want as many children as possible (18%)– Religious prohibition (14%)– Knowing no method to use (9%)– Health concerns about the methods (10%)
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Fertility IntentionsVary with the age of women, socioeconomic status, number of living children, place of residence, education, child mortality, expectation about child survival conditions, preferences for a single sex (usually male), and exposure to media.
Fertility and Family Planning in Ethiopia: A New Look at Data from the 2005 Ethiopia Demographic and Health Survey
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Ethiopia Abortion Law• Since 2005, abortion is permitted only when
“the pregnancy results from rape or incest, when continuation of pregnancy endangers the health or life of the woman or the fetus, in cases of fetal impairment, for women with physical or mental disabilities, for minors who are physically or psychologically unprepared to raise a child and in cases of grave or imminent danger that can only be averted through immediate pregnancy termination.”
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Ethiopia Abortion Estimates
• An estimated 382,000 abortions occurred in 2008
• Of these, only an estimated 103,000 women obtained legal abortions in health facilities
• Unsafe abortion accounts for over 30% of maternal deaths
MaNHEP Formative Research Report
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Current Government Actions• The fertility rate has declined from
6.4 in 1990 to 5.4 in 2005, however change has slowed
• Government set goal to reduce fertility rate from 5.4 to 4 by 2010
• Increase number of Health Extension Workers (13,487 in Oromia as of 2010)
• Medical abortion products are being considered for official registration and government approval
http://www.pbase.com/bmcmorrow/image/108961028
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Conclusion• There are low rates of family
planning and high rates of unintended pregnancy
• The growing gap between actual fertility and women’s average preferred family size suggests that the abortion rate will likely increase in the next few years if modern contraceptive use does not increase sharply
• Abortion access is very low for rural women, leading to higher rates of maternal mortality from abortion
MaNHEP Formative Research Report
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Works Cited• Dibaba, Yohannes. "Factors Influencing Women's Intention to Limit Child Bearing in Oromia,
Ethiopia." Ethiopian Journal of Health and Development (2009): 28-33. Print. • Ethiopia. Federal Ministry of Health. Health Extension Program in Ethiopia. Addis Ababa, 2007.
Print. • Ethiopia. Federal Ministry of Health. Planning and Programming Department. Health Sector
Strategic Plan. 2005. Print. • Ko, I.S., M.A. You, E.S. Kim, T.W. Lee, S. Kim, Y.M. Kim, J.J. Nam, and H.K. Lee. "Family Planning
Practice and Related Factors of Married Women in Ethiopia." International Nursing Review (2012): 377-82. Print.
• Sibley L. and A. Abebe. “Maternal and Newborn Heath in Ethiopia Partnership Dataset.” (2012). Oromiya, Ethiopia.
• Singh, Susheeia, Tamara Fetters, Haiiemichaei Gebreseiassie, Ahmed Abdella, Yirgu Gebrehiwot, Solomon Kumbi, and Suzette Audam. "The Estimated Incidence of Induced Abortion In Ethiopia, 2008." International Perspectives on Sexual and Reproductive Health (2010): 16-25. Print.
• USAID, and Government of Ethiopia. Fertility and Family Planning in Ethiopia: A New Look at Data from the 2005 Ethiopia Demographic and Health Survey. Rep. 2005. Print.
• USAID, and Health Policy Initiative. The Cost of Family Planning in Ethiopia. Issue brief. 2010. Print. • WHO Regional Office for Africa. WHO Country Cooperation Strategy 2008-2011: Ethiopia.
Publication. Brazzaville: WHO, 2009. Print.
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