The implementation of safe abortion services in Ethiopia

Abstract

In 2005, a new criminal code was established to align Ethiopia's laws with its new Constitution. Following a period of intense activism and debate, abortion remained criminalized, but several significant exceptions were made, allowing for the expansion and integration of services within the public health system. The passage of the law and the establishment of technical guidelines each served as essential steps in determining the extent to which services were implemented. The integration of safe abortion services expanded the scope of practice for multiple cadres of healthcare providers, including emergency surgical officers, nurses, and health extension workers. The political will of the Ministry of Health, the research produced by the Ethiopian Society of Obstetricians and Gynecologists, and the expertise of nongovernmental organizations were essential to the implementation of services.

The role of nurses and midwives in the provision of abortion care: A scoping review

“…The routine nursing and midwifery tasks described in the articles were pregnancy diagnosis and options counselling (Levi et al, 2009), pharmacological and nonpharmacological pain relief (Lindström, Wulff, Dahlgren, & Lalos, 2011), administration of anti‐D, and antibiotic prophylaxis (Cappiello, Beal, & Simmonds, 2011), handling the products of conception (Andersson, Gemzell‐Danielsson, & Christensson, 2014; Mauri, Ceriotti, Soldi, & Guerrini Contini, 2015; Michalik et al, 2019; Mizuno, 2011; Nicholson, Slade, & Fletcher, 2010), gestational dating, bimanual examination (Averbach, Puri, Blum, & Rocca, 2018) screening for domestic violence, postabortion contraception care (Purcell, Cameron, Lawton, Glasier, & Harden, 2016), referrals (Grace, 2016), health education (Cappiello et al, 2011; Halldén, Lundgren, & Christensson, 2011), counselling (Hulme‐Chambers et al, 2018), prescription of abortion drugs (Simmonds, Beal, & Eagen‐Torkko, 2017), administration of abortion drugs, manual vacuum aspiration abortions (MVA) (Berer, 2009; Bridgman‐Packer & Kidanemariam, 2018; Paul, Gemzell‐Danielsson, Kiggundu, Namugenyi, & Klingberg‐Allvin, 2014), postabortion phone counselling (Dawson, Bateson, Estoesta, & Sullivan, 2016), peer education (Puri, Regmi, Tamang, & Shrestha, 2014; Puri, Tamang, Shrestha, & Joshi, 2015), care of or referral for postabortion complications (Hulme‐Chambers et al, 2018; Yegon et al, 2019), screening and treatment of sexually transmitted infections and human immunovirus (Yegon et al, 2019) and management of postabortion complications (Cleeve et al, 2019; Paul et al, 2014; Yarnall et al, 2009; Yegon et al, 2019). These tasks were not ubiquitous.…”

Magnitude and Determinants of the Late Request for Safe Abortion Care Among Women Seeking Abortion Care at a Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study

“…[10][11][12][13][14][15][16][17][18][19] In Ethiopia, the liberalization of the abortion law in 2005 and the establishment of technical guidelines have served as essential step in determining the practice of safe abortion services. 7,20 However, eradication of morbidity from unsafe abortion has not yet been achieved. 8 Access to second-trimester abortions is severely limited and only 9-10% of all facilities have a provider who can perform this service.…”

Necessary but not sufficient: a scoping review of legal accountability for sexual and reproductive health in low-income and middle-income countries

“…Strategies that emphasised the morbidity, mortality and other undesirable outcomes associated with VAW, FGM/C and unsafe abortion illuminated a clear pathway for legal accountability. 27 28 37 57 61 148 On the other hand, some authors pointed out that a narrow public health framing could weaken commitment to the broader social determinants of SRH, such as gender equity and human rights. 149 …”