Situational analysis- accessibility of Reproductive Health Care

The 2007/2008 human development report showed Ethiopia as the 169th country on gender related development index. Extreme gender imbalances together with poorly structured financial and legal management system and scarcity of skilled human resources have curbed the process of increasing the accessibility of RH care. Abortion is prohibited by law except for special cases and only few proportions of people access post-abortion care services. Unsafe abortion is estimated to be the second cause of maternal mortality.

Reproductive Health partners provide to the country nearly 65 million USD/year. This is much lower compared to the 300 million obtained for HIV. The government then allocates few amount of matching fund for every micro activity in reproductive health in the regional states. Despite a strong commitment from all actors the Contraceptive Prevalence Rate is 14% with recent studies indicating it as doubled. The institutional delivery rate is 16.4% and postnatal coverage is 19% and Maternal Mortality Ratio is 673/100,000. Among the sexually transmitted infections excluding HIV; women accounted for 2/3rd of the total infected according to the national health indicators. There are estimated 100,000 women suffering from obstetric fistula.

Policies as national directives do not often get to touch the grassroots. Laws and regulations are overlooked by the traditional law and rules of societies that existed for centuries.

All health and development interventions should be designed to address equity in access that is tuned to the local context. Advocacy to increase utilization of services and service expansion should be done simultaneously.