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Medical Abortion in Ethiopia: Policy and Practice

Medical Abortion in Ethiopia: Policy and Practice. Africa Regional Meeting on Medical Abortion Johannesburg, South Africa March 11-13rd,2009. Over View. Some Demographic Indicators The Abortion Law of Ethiopia,2005

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Medical Abortion in Ethiopia: Policy and Practice

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  1. Medical Abortion in Ethiopia: Policy and Practice Africa Regional Meeting on Medical Abortion Johannesburg, South Africa March 11-13rd,2009

  2. Over View • Some Demographic Indicators • The Abortion Law of Ethiopia,2005 • Technical & Procedural Guidelines for Safe Abortion • Current Status Of Medical Abortion • The Way Forward

  3. A. GENERAL Total population = 74 million (CSA,2007) 50% of the population under 18 years (CSA) Population growth rate = 2.6% (CSA) Primary health service coverage (MoH)≈70% Background Information on Ethiopia

  4. B. MAJOR RH ISSUES • TFR of 5.4 per woman (DHS,2005) • Low Contraceptive prevalence = 15% • High MMR ratio of 673/100,000 • 32% of maternal death is due to unsafe abortion • Unsafe abortion accounts for up to 60% of all gynecological admissions

  5. THE ABORTION LAW OF 2005 • Abortion still technically restricted but not punishable in cases of: • Rape and incest • Pregnancy endangering woman’s life and /or health • Indications of fetal abnormalities • Physically or mental deficiency • Minor :physically or psychologically unprepared to raise a child

  6. …(Continued) • MoH was mandated to issue a guideline • In the case of rape and incest, mere declaration by the woman is a sufficient condition for her to get abortion services (Article 552)

  7. TECHNICAL AND PROCEDURAL GUIDELINES FOR SAFE ABORTION SERVICES • Provides the official interpretation of the law • Details directions for health service providers and facilities: • TOP can be conducted either in public or private facility • A woman should get services within 3 working days

  8. (…Continued) All facilities with trained personnel, equipment can provide TOP up to 12 weeks TOP 13 to 28 weeks in a secondary or tertiary level Included alternative technologies like medical abortion Sanctions midlevel providers to perform MVA

  9. Medical Abortion Up to 9 completed weeks Mifspristone 200 milligrams orally, followed 36 to 48 hours later by Misoprostol 800 micrograms vaginally. Up to 7 weeks 400 ug misprostol orally

  10. Current Status of MA Drugs • Regulatory authority has included the drugs in the essential drugs list of the country • Process for registering the drugs going on since 2007 • 100,000 units of Medabon imported by DKT with pre-registration permit (2008)

  11. What has been done so far? • 42 lead trainers trained • Integrated MA in all Comprehensive Abortion Care training, since August /09 • 3,000 women received MA services in 102 (42 public + 20 MSIE clinics+40 private) facilities in 3 months • An introductory pilot study on process

  12. Preliminary Reflections Providers: Less work load Less risk of infections Women Provide privacy and less invasive Percieved less infection than surgical procedure

  13. The Way Forward: • Ensure registration of drugs/availability in Ethiopia • Complete pilot documentation study • Continue to integrate MA in all CAC trainings and services • Conduct MA stand alone trainings in selected facilities

  14. (…Continued) • Conduct targeted community/ women education on MA • Continue monitoring and supervision of services • Advocacy for the implementation of abortion care to the limits of the law with the leadership of MOH

  15. THANK YOU

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