Reproductive Health and HIV/AIDS
Access to reproductive health continues to be urgent in Ethiopia . With over 60 per cent of its population under the age of 20, nearly 75 per cent of Ethiopian women marry before the age of 17. The female population accounts for half of the population, with 18.6 million in the reproductive age group. And with fertility at 5.4 children per woman, there is enormous need for comprehensive reproductive health needs.
The high fertility profile of the Ethiopian woman, and the prevailing high-risk characteristics – among teen-age women, 13 per cent have given birth to at least one child – expose women to unnecessary death: an estimated 871 maternal deaths per 100,000 live births or 25,000 maternal death occur every year.
Over 80 per cent of the maternal deaths are directly attributed to limited and inadequately skilled staff, equipment, supplies and drugs, together with an inefficient health referral system, compounded by indirect causes such as malaria, anemia and HIV/AIDS.
Implemented in all eleven regions of the country, the subprogram focuses on:
- Implementation of the regional road map for maternal mortality reduction through increased access to reproductive health services for women, men and young people, emphasizing safe motherhood, family planning, adolescent reproductive health services, and attention to the most vulnerable groups.
- Increased gender and culturally sensitive behaviour-change communication interventions to address reproductive health and sociocultural issues;
- Strengthened HIV/AIDS prevention initiatives for women, men, young people and vulnerable groups; and
- Strengthened institutional capacity for managing reproductive health programmes, with attention to ensuring reproductive health commodity security.
Use of contraceptives on a rise
Despite a rise in the use of contraceptives among sexually active men and women from 8 per cent in 2000 (DHS 2000) to 14.5 per cent in 2005, according to latest government estimates, 49 per cent of Ethiopian women are presently in need of contraceptive commodities and services. The limited access to Family Planning commodities is a direct result of: frequent stock-outs of contraceptive commodities, poorly functioning logistic management systems and insufficient numbers of skilled service providers.
The major achievements of the RH sub program
Improved technical capacity for RH service delivery including emergency obstetric care at health institutions. This is due to the various trainings provided at all levels. In 2004 alone more than one hundred health professionals were trained in adolescent reproductive health. Also trainings in contraceptive logistics system, community based RH and long term contraceptives were also provided. Trainings for RH service delivery are supplemented by production and distribution of information, education and communication materials on various issues by the Health Education Centre.
Development of a national RH strategy which is to be launched in 2005. The strategy is intended to enhance the overall efficiency of national health and development efforts by minimizing duplication and promoting the coordination of RH programs throughout the country. It expects to achieve this by identifying common areas of interest; highlighting potential synergies among stakeholders; ensuring the existence of mechanisms to guide activities; and mobilizing resources for the activities. The strategy will also help the Ministry of Health support other national development strategies, including the third iteration of the Health Sector Development Program (HSPD III), the Health Extension Package Program (HEPP), and the Millennium Development Goals (MDGs).
Conducting safe motherhood survey. Maternal and neonatal mortality in Ethiopia is among the highest in the world. Each year, over 25,000 women die from pregnancy-related complications. The survey will serve as a basis for designing effective interventions to contribute to the reduction of maternal and neonatal morbidity and mortality. The purpose of this exercise is to explore and understand the knowledge, attitudes and beliefs that influence maternal and neo-natal care-seeking behavior and practices.
Supplementing the national Making Pregnancy Safer initiative through a fund secured from the EU to improve emergency obstetric care services in four pilot regions. So far the joint initiative trained a total of 12 teams each comprised of one GP/HO, one anaesthetic nurse and one scrub nurse. In addition to the Comprehensive Emergency Obstetric Care a total of 80 health professionals from the pilot areas attended in service training in Basic Emergency Obstetric Care.
The sub-programme has contributed to the improvement of health sector
- Procurement and supply of contraceptives, medical equipment, ambulances and other vehicles both to regions and the federal ministry
- Assisting the global End Fistula Campaign by strengthening the Addis Ababa fistula hospital and its regional outreach centres
- Participating in various Sector Wide Approach Programs (SWAPs) in particular the HSDPIII where RH issues are given significant attention
- Participating in important donor group meetings such as the health, population and nutrition in order to promote RH issues among the donor community
- Assisting to higher learning institutions to train RH professionals at post graduate as well short and medium levels. In 2004 15 professional joined post graduate programs in the Addis Ababa University .
The UNFPA is coordinating and giving technical support in a youth focused HIV prevention and Sexual and Reproductive Health services which were funded by the Norwegian Agency for Development and Cooperation (NORAD) and implemented by 10 local NGOs (2002-2005). This project will be scaled up in a joint initiative between UNFPA and UNICEF through funding from the Norwegian Embassy in Ethiopia (2007-2011). The total cost of the project is estimated at USD 16.3 million.
The UNFPA is also supporting the integration of HIV/AIDS and RH in higher institutions, including the Addis Ababa and Bahir Dar Universities . This project provides VCT services to the students and staff and has installed information center and established full-time Internet connection from where students, especially girls, can access information. The project also supports and works closely with university students' anti-AIDS clubs.
Moreover, the UNFPA is leading the Prevention component of the UN Joint HIV/AIDS Programme. UNFPA has also a good experience in leading the advocacy component of UN Joint initiative on HIV/AIDS.