Overview of maternal health in Ethiopia
Ethiopia made a striding change in maternal death over the last decades, the MMR decreased from 871 per 100,000 in 2000 to 401 per 100,000 in 2017 , this is death of about 12,000 mothers every year. Direct obstetric complications account for 85% of the deaths. The long-term conditions disable women following delivery-related complications, such as fistula, uterine prolapsed, chronic pelvic pain, depression and exhaustion. Fistula is especially common in Ethiopia, primarily due to the frequency of adolescent pregnancy combined with neglected prolonged labor. High maternal mortality rates are also directly related to high neonatal mortality rate of 29/1,000 live births. This reflects the difficult state of the mother at the time of birth. The main cause of neonatal deaths include prematurity, asphyxia and sepsis.
Among the direct causes of maternal deaths, reports from evidence showed that abortion related deaths are on decline while bleeding during and after child deaths are causes most of the deaths. Such a decline in maternal death achieved by collaborative effort of the Ministry of Health, partner organizations, bilateral organizations and joint effort of the community and other stakeholders. The achievement is a result of increasing uptake of skilled delivery service with an increment from 8% in 2000 to 49% in 2016 as seen in the most recent mini-EDHS. Preventing every unwanted pregnancy by using modern family planning, using skilled delivery service for every delivery and access to emergency obstetrics and newborn care for every complication markedly reduces maternal death. The ministry of health expand the recommended services including quality antenatal care, postnatal care and comprehensive abortion care that is being delivered through the three tier health system.
Maternal Health programs
- Quality and equitable antenatal care 1st & 4th services
- Quality and evidence based labor and delivery service
- Postnatal care 24hr stay
- Emergency obstetric and newborn care
- Maternal and perinatal death surveillance and response system
- Obstetric and gynecologic problems referral and network system
- Prevention and management of obstetric fistula and pelvic organ prolapse
- Expansion of maternity waiting homes at each public health facilities
Maternal Health initiatives
- Access and quality of Antenatal Care
- Strengthen skilled birth attendance at health facilities
- Improved postpartum health care coverage
- Improved C/S service coverage
- Reduced the number of stillbirths
- Implementation of catchment based mentorship
- Strengthen maternal health commodities and blood supply to reduce maternal mortality
- Increased treatment services to Fistula and Uterine prolapse
- Strengthening safe abortion services
Guidelines
- National technical guidance for maternal and perinatal death surveillance and response
- Implementation guide for 24 hours postnatal care and stay
- Technical and procedural guidelines for safe abortion services
- Catchment based clinical mentoring for reproductive, maternal, and new-born health services