Special Journal Supplement Reflects on Sexual and Reproductive Health in Ethiopia Over the Past Two Decades

A special supplement of BMC’s Reproductive Health journal, guest edited by researchers at Mathematica and Addis Continental Institute of Public Health, explores sexual and reproductive health (SRH) achievements, challenges, and learnings in Ethiopia over the past two decades. Coinciding with the launch of FP2030—a global partnership centered on family planning (FP)—the supplement reflects on progress toward meeting the country’s FP and SRH goals and provides insights to accelerate the achievement of Ethiopia’s Sustainable Development Goals, which include a universal health coverage target.

Published with support from the David and Lucile Packard Foundation, the supplement features 16 research articles and commentaries representing contributions from 70 researchers, practitioners, and policymakers engaged in FP and reproductive health (RH) work in Ethiopia. The guest editors included diverse perspectives, types of evidence, and insights on Ethiopia’s RH context and the way forward, focusing on three main issue areas: (1) FP and contraceptive use, (2) adolescent and youth SRH, and (3) abortion.

The supplement covers two decades of substantial progress on RH and FP. Six times more women were using a modern contraceptive method in 2019 than in 2000 (41 versus 7 percent). The health and well-being of adolescents and youth, particularly girls, is improving as girls today are marrying and bearing children later and using contraceptives at higher rates than girls 20 years ago. In addition, the liberalization of Ethiopia’s abortion law in 2005 has contributed to a decline in maternal mortality.

This supplement explores these gains and their drivers in more detail and identifies some remaining challenges around RH and FP. The articles provide insight into the scope and size of enduring geographic disparities, with urban areas having higher contraceptive use and better RH indicators than rural areas. Across all three issue areas, the authors explore how stigma, gender inequality, and individual and community misconceptions around FP and RH limit women’s agency to make personal decisions about how many children they want and when.

Together, these articles can inform agenda setting for FP, RH, and adolescents in Ethiopia. A launch event for this supplement, held in Addis Ababa on June 14, 2022, provided the opportunity for nearly 250 participants from federal and state-level government, non-governmental and civil society organizations, and donor agencies—along with health care practitioners and academics—to reflect on progress and catalyze momentum and renewed commitments to address Ethiopia’s outstanding SRH needs. In her speech, Ethiopia’s Minister of Health, Dr. Lia Tadesse Gebremedhin, referenced this energy and commitment by saying:

“As we celebrate this achievement of the past 2 decades, my call is to use this to build on the gains and use the evidence to design better interventions, to address the gaps that we still have like the unmet need which is still high in our country, but also to focus on building a resilient system that can respond to emergencies and humanitarian situations.”

The Minister of Health’s research advisory council, which also participated in the event, will play an important role in guiding the SRH agenda, and has committed to using the supplement’s findings to inform future SRH and FP research priorities and ensure continued progress in the decades to come.