The revised guideline is working document on the techniques and procedures
that must be observed in providing safe termination of pregnancy as permitted
by the penal code of FDRE (May ,2005).
The revised guideline has incorporated the latest evidence in abortion care
and has made it context specific relevant to FDRE and make sure all relevant
policy documents, standards and guidelines are seamlessly integrated to make a
Technical and Procedural Guideline for Abortion Care Services in Ethiopia
Third Edition 15
coherent document.
The aim of this guideline is to ensure that women in Ethiopia considering safe
termination of pregnancy have access to services of high standard and quality.
The guideline is meant to ensure that women obtain standard, consistent,
comprehensive abortion care regardless of the level of care of the health
institution or the qualification of the service provider.
The guideline is for health managers, program coordinators and health care
providers – Gynecologists, General Practitioners, health officers , IESO
and midwives, nurses and health extension workers. This guideline will be
implemented in all health institutions recognized and registered by MOH.

Since liberalization of the Ethiopian abortion law, there have been significant improvements in the availability and utilization of facility-based abortion services in the country. However, nearly half of abortions still take place outside of health facilities, where the quality of procedures remains unknown. Abortion stigma is one reason that unsafe abortion persists. This study aims to evaluate the effect of community interventions conducted from 2016 to 2019 on the level and manifestation of abortion stigma and knowledge in a community in Oromia region, Ethiopia.

Adolescence and youth are times of major growth and change that can place young people at elevated risk of poor sexual and reproductive health (SRH) outcomes, particularly when they are living away from home for the first time. Understanding the barriers that young people face when accessing SRH services and information is imperative for addressing their SRH needs; our study explored this topic among university students in Ethiopia. Specifically, we explore university students’ SRH experiences, access to services, and preferred sources of information.

Ethiopia has made significant improvements to sexual and reproductive health (SRH) in recent decades, yet the COVID-19 pandemic brought new challenges to SRH service delivery. In the early months of the pandemic, health facility and health management information system data showed reductions in SRH service utilization, however more evidence is needed on ongoing SRH impacts to inform policy and program decision-making. Our study aimed to assess the impacts of COVID-19 on SRH service utilization and access from the perspective of providers, clients, and stakeholders in Addis Ababa and Amhara Regional State.

Patient satisfaction is a measure of the extent to which a patient is content with the health care received from health care providers. It has been recognized as one of the most vital indicators of quality. Hence, it has been studied and measured extensively as part of service quality and as a standalone construct. In spite of this, there has been limited or no studies in Ethiopia that describe factors of abortion care contributed to women’s satisfaction.

This study aimed to identifying the underlying factors that contribute to patient satisfaction with comprehensive abortion care and at exploring relationships between total satisfaction scores and socio-demographic and care-related variables in Addis Ababa, Ethiopia.

To determine how many times Ipas manual vacuum aspiration (MVA) instruments are reused, for what reasons, when the instruments are replaced and/or discarded, and what the barriers are to replacing them.

Despite progress in assuring provision of safe abortion, substantial disparities remain in quality of abortion care around the world. However, no consistent, valid, reliable method exists to routinely measure quality in abortion care across facility and out-of-facility settings, impeding learning and improvement. To address this need, the Abortion Service Quality Initiative developed the first global standard for measuring quality of abortion care in low-income and middle-income countries.

Maternal mortality from unsafe abortions has significantly decreased in Ethiopia since the reform of the abortion law in 2005 (CITE), due in large part to the development of national safe abortion guidelines, integration of comprehensive abortion care (CAC) in public health facilities, training of mid-level providers in abortion care, and the expansion of medication abortion (MA).

Ethiopia has made remarkable progress in expanding access to and provision of comprehensive abortion care. However, complications due to unsafe abortion still contributes to a significant proportion of maternal mortality in the country. As efforts to increase accessibility, availability, acceptability, and quality of comprehensive abortion care continue, evaluating service quality is critical. This study assesses the quality of comprehensive abortion care in public health facilities, from clients’ perspectives, in four regions of Ethiopia to examine how person-centered care differs based on facility and service characteristics.

Despite having one of the more liberal abortion laws in Africa, approximately half of abortions in Ethiopia continue to take place outside of health facilities. Use of medication abortion (MA) has increased dramatically however there remains a lack of data on women’s experiences using MA, including both those who received MA in a facility setting, and those who took MA without clinical supervision (i.e. had a self-managed abortion). Our study aimed to explore women’s experiences using MA in Oromia, Ethiopia.

Ipas is a non-profit making, nongovernmental organization that works around the world including Ethiopia to increase women’s ability to exercise their sexual and reproductive rights, especially the right to safe abortion and contraception. In more than 20 countries in Africa, Asia, and Latin America, Ipas works in partnership with diverse stakeholders to carry out different interventions. Ipas is planning to re-envision its strategies and needed opinions and feedbacks from its partners.

Ethiopia made a significant progress in addressing maternal death over the last decades. The maternal mortality rate decreased from 871 per 100,000 in 2000 to 401 per 100,000 in 2017.1,Direct obstetric complications account for 85% of the deaths.2 Evidence indicates that unsafe abortion accounted for 10% of avoidable maternal deaths.3 Ipas Ethiopia node is among the leading players in Ethiopia’s journey towards ensuring access to quality comprehensive abortion care and contraceptive services. Over the past two decades, Ipas in collaboration with the MoH and other partners become a leader in expanding safe abortion services creating conducive environment for women and young girls to have access to SRH information and services. It has implemented wide arrays of programs including training of health workforce on comprehensive abortion care and contraceptive service provision; enhancing the capacity of health program managers on program coordination and support; expanding quality CAC and CC services at health facilities, equipping health facilities with essential supplies, and provision of support for minor renovations; advocacy and community engagement. In this document, the contribution of Ipas Ethiopia node in terms of expanding comprehensive abortion care and comprehensive contraception information and services in Ethiopia is presented.

Drought is a major threat to human security, and it can have a particularly devastating impact on women and girls. When drought strikes, families are forced to make difficult choices about how to allocate scarce resources. This can lead to increased stress and conflict within families, which can make women and girls more vulnerable to violence. Ethiopia is one of the most drought-prone countries in the world. In recent years, the country has experienced a series of severe droughts, which have had a devastating impact on the population. Drought can have an impact on women's reproductive and fertility decisions and behavior because it makes it difficult to access health care due to disrupted transportation and communication networks and causes economic hardships. Hence, drought can lead to increased rates of unwanted pregnancy, unsafe abortion, and maternal morbidity and mortality. Drought can also exacerbate gender inequalities adding workload and financial hardship to the women making it difficult for them to participate in education and employment and leaving them at increased risk of SGBV. Therefore, this study aimed to explore the impacts of drought on SGBV services utilization and care delivery and the preparedness, mitigation and responses to address its effect in drought-affected areas.

Ipas has played a significant role in the expansion of access to comprehensive abortion and contraceptive care services in Ethiopia. After long years of providing capacity building training to service health professionals, conducting post-training follow-up and support, and equipping the health facilities with essential supplies and commodities as well as minor renovations, Ipas has devised and implemented a strategy to graduate the matured and seasoned health care facilities. This study was designed to assess the provision of Comprehensive Abortion Care and Comprehensive Contraceptive services in graduated public health facilities.

Unsafe abortion is a major public health problem globally contributing to significant proportion of maternal mortality in developing countries. Each year an estimated 36 million to 53 million abortions are performed worldwide. Of this, around 20 million are considered unsafe. In Ethiopia 382,000 induced abortions occurred in 2008 and abortion rate was 23 per 1,000 women in reproductive age. The unfavorable attitude of health care providers is one of the challenges to making the services accessible and available to women and girls. The study provides inputs on issues that need to be addressed with regard to the unfavorable attitude of health care providers rendering the safe abortion services and helps to inform the magnitude of unfavorable attitudes towards abortion among health care providers, associated factors, resistance of providers and the stigma associated with providing the services.

It is estimated that one in three women will experience sexual or physical violence in their lifetime. According to the 2016 Ethiopian Demographic and Health Survey report, sexual violence was reported to be 10%, but recent studies show a prevalence of over 40%. Despite the increase in prevalence, the reporting and care seeking behavior continues to be poor. It has been reported that Sexual and Gender Based Violence (SGBV) increases during conflict and the period following them, as it is used as a war tactic. During such times, the tendency to report and seek care is thought to decrease even more due to insecurity, displacement and the inability of the health system and other services to address these situations. Therefore, the study aimed to understand the existing gaps in disclosure and formal reporting of SGBV or sexual exploitation, barriers for care seeking and sexual and reproductive health (SRH)-SGBV care delivery to survivors exposed to violence during conflict or forced displacement from conflict. The finding provides evidence on how to offer, integrate and deliver comprehensive sexual and reproductive health care in humanitarian settings.

This toolkit is a resource for trainers, program managers and technical advisors who organize or facilitate training events and advocacy workshops in the field of sexual and reproductive health and, specifically, for increased access to safe abortion care. It is designed to provide experienced facilitators with the background information, materials, instructions and tips necessary to effectively facilitate abortion values clarification and attitude transformation (VCAT) interventions. There are also activities and materials to conduct a workshop to help experienced trainers increase their skills in facilitating abortion VCAT training events

Ethiopia has one of the highest maternal mortality ratios in the world (420 per 100,000 live births in 2013), and unsafe abortion continues to be one of the major causes. To reduce deaths and disabilities from unsafe abortion, Ethiopia liberalized its abortion law in 2005 to allow safe abortion under certain conditions. This study aimed to measure how availability and utilization of safe abortion services has changed in the last decade in Ethiopia.

The main objective of this research is to gather feedbacks/opinions from key actors of the abortion and contraception ecosystem and use them to inform Ipas’s strategic planning exercise.

Unsafe abortion has been one of the main causes of maternal death in Ethiopia. Recognizing this, the abortion law was revised in 2005 and legal induced abortion has been permitted for specific indications. As a result, comprehensive abortion care (CAC) with different implementing guidelines has been expanded to reduce unsafe abortion in the country.