Contraceptive Use in Ethiopia Doubles Twice in Ten Years
"[It's] incredible. It's a significant accomplishment for Ethiopia and shows that investments in family planning pay off. Unmet need for family planning has declined, as have maternal mortality and total fertility rates." - Pathfinder Country Representative Mengistu Asnake
Twenty years ago, few women in Ethiopia were using family planning. In 1990, the contraceptive prevalence rate was a mere 3 percent and rose to only 8 percent in 2000, with modern contraception use accounting for 6 percent. This low use of family planning led to high fertility rates and one of the highest rates of maternal mortality in the world.
However, a renewed commitment from the government of Ethiopia, along with a new model of distributing both information and contraceptives, has made a dramatic difference. Newly released, preliminary data from the 2011 Ethiopian Demographic and Health Survey (DHS) show that the contraceptive prevalence rate has increased to 29 percent a 96 percent increase over the previous, 2005 survey figures.
"Ethiopia is one of only a few countries in the world to begin with a contraceptive prevalence rate above 10 percent and see a doubling within five years," Dr. Mengistu Asnake, Pathfinder's Deputy Country Representative in Ethiopia, said. "To go from 8 percent in 2000 to 15 percent in 2005 and then on to 29 percent last year is incredible. It's a significant accomplishment for Ethiopia and shows that investments in family planning pay off. Unmet need for family planning has declined, as have maternal mortality and total fertility rates."
This change is a reflection of strong leadership from the government of Ethiopia. Six years ago, the Ethiopian government began a bold initiative to improve health services by training and deploying more than 34,000 rural health extension workers. This community outreach model, combined with the Ethiopian Federal Ministry of Health's skillful mobilization of community, government, and donor resources to construct 15,000 health posts in rural villages, has increased access to preventative education and health services, including family planning.
Through the USAID-funded Integrated Family Health Program, Pathfinder has worked to expand access to Implanon, a one-rod implant that provides three years of contraception. The implant has become increasingly popular, particularly in rural, hard-to-reach areas where health clinics are scarce or hard to reach.With generous financial support from USAID and other donors, including CDC, the David and Lucile Packard Foundation, the Swedish International Development Agencyand others, Pathfinder International is pleased to have contributed to expanding access to quality reproductive health and family planning services in Ethiopia.
Through the USAID-funded Integrated Family Health Program, managed by Pathfinder International in partnership with John Snow, Inc., and a local NGO, the Consortium of Reproductive Health Associations, Pathfinder has worked closely with the government of Ethiopia to expand access to Implanon, one of the most popular forms of contraception. Implanon is a one-rod implant that provides three years of contraception. The implant has become increasingly popular, particularly in rural, hard-to-reach areas where health clinics are scarce or hard to reach. The Integrated Family Health Program has focused on improving community-based distribution of Implanon, through the government's health extension workers, since 2009. Prior to 2009, both the Integrated Family Health Program and the Pathfinder-led Reproductive Health and Family Planning Project, funded by USAID and supported by the Packard Foundation, as well as other donors, had implemented practical training and support to the health extension workers, enabling them to provide family planning counseling and services, including injectable contraceptives. The health extension workers also distributed contraceptive pills and condoms for dual protection.
"What we've seen is truly incredible," Pathfinder's President Daniel E. Pellegrom said. "Conservative estimates for Implanon distribution through the Integrated Family Health Program show that the project has provided nearly 400,000 implants. Our team's data indicates that this contributed to as much as 69 percent of the shift in implant use documented in the 2011 DHS."
This success suggests that providing injectable contraceptives and Implanon through government health extension workers, who are able to effectively reach rural populations in need of contraceptive counseling and services, is a strong step in the right direction to addressing unmet need and improving contraceptive prevalence throughout Ethiopia.
"While further studies are underway, we are seeing that Ethiopian women are increasingly having more say in decisions about whether and when to have children, and how to plan their fertility," Tilahun Giday, Pathfinder's Country Representative in Ethiopia said. "We applaud the government's bold measures to address women's health. These changes are already having an impact on women's lives today. Our hope is that this will provide a continuing, positive trend for the women we serve, their families, and their communities."
Focus Area: Sexual and Reproductive Health and Rights, Contraception & Family Planning
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Supported by Pathfinder International, the MacArthur Foundation, and the Packard Foundation, the Health of the People and Environment in the Lake Victoria Basin initiative, or HoPE-LVB, has employed the PHE model to address food insecurity, weak health infrastructure, environmental degradation, high maternal and infant mortality, and inadequate water, sanitation, and hygiene.