Maternal Mortality Reduction In Ethiopia Faces Numerous Challenges
The maternal mortality rate has rested between 600-700/100,000, showing the persistent challenges the nation faces in securing safe maternal care1. Ethiopia has one of the lowest rates of skilled birth attendance in the world: less than 10% of women deliver with a trained nurse, midwife, or doctor. (Ethiopian Demographic and Health Survey 2011) The situation for mothers in Ethiopia has unfortunately seen little improvement over the last decade, despite other indicators of economic progress in the country – including significant improvements in under-5 mortality.
Over 80% of the Ethiopian population lives in rural areas, where infrastructure remains weak. The government has engaged in large national development projects, including bolstering the country’s road network and training over 30,000 “health extension workers,” local medical auxiliaries that assist primarily in providing ante-natal care and child health services to families in remote areas. New medical schools have cropped up around the country to improve the number of skilled health personnel, but access to quality services remains a challenge for the vast majority of Ethiopian mothers. Skilled medical personnel congregate in urban areas of the country, leaving the majority of the nation reliant on poorly-trained auxiliaries and traditional healers. Comprehensive obstetric care, including cesarean section and assisted deliveries, remain an urban luxury.
Left with few options for delivery care, mothers by and large remain at home with neighbors and relatives assisting them during labor. If a complication occurs – prolonged labor, retained placenta, post-partum hemorrhage – families attempt to take the woman to the nearest facility, but distances are so great and transport options scarce, leaving many women dead en route to care. Beyond mortality, maternal morbidity also remains a profound issue for Ethiopian women: while the exact number remains uncertain, obstetric fistula affects an estimated tens of thousands of new women each year. (Ethiopian Demographic and Health Survey 2011) In addition, unsafe abortion remains one of the primary killers of mothers, a fact which has not changed in 40 years, despite new legislation that legalizes abortion services. Because facilities are continuously out reach of Ethiopian women, the impact of national legislation and policies remains limited, and distressing mortality rates are perpetuated.