11 December 2016

Ethiopia: Comprehensive Abortion Care to Decline Maternal Death

Induced abortion or the deliberate termination of pregnancy is one of the most controversial issues in legal discourse. As a legal issue, abortion is usually discussed in light of the principles of criminal law. Depending on circumstances, however, abortion can also be discussed from the standpoint of constitutional law.

In the former case, the issue usually takes the form of criminalizing or decriminalizing the act, while in the latter, the issue becomes whether a pregnant woman has a constitutional right to terminate her pregnancy. The issue thus usually involves the competing arguments in favour of the "right" of the fetus to be brought onto life (i.e. personhood) vis-à-vis the right of the mother to abortion based on her interests and choice.

In May 2005, Ethiopia's new Criminal Code came into effect. The government revised the code to permit abortion for an expanded range of indications. These include: when the pregnancy results from rape or incest; when the health or life of the woman and the fetus are in danger; in cases of fetal abnormalities; for women with physical or mental disabilities; and for minors who are physically or psychologically unprepared to raise a child.

The revised law also notes that poverty and other social factors may be grounds for reducing the criminal penalty for abortion. In addition, the revised code stipulates that the woman's word is all that is needed to justify pregnancy termination in cases of rape and incest. Unsafe abortion is one of the leading causes of maternal morbidity and mortality in Ethiopia. Nearly one third of pregnancy related deaths are caused by the complications of unsafe abortion.

In 2005, the Ethiopian parliament enacted one of Africa's most progressive abortion laws. A year later, the Ethiopian Ministry of Health released guidelines for safe abortion services, making major progress towards implementing revision of the country's abortion law. The government in collaboration with partners immediately started rolling out as per the provision of services according to the law by training service providers, building the capacity of health facilities, Health State Minister Dr. Kebede said.

" More women are now accessing comprehensive abortion care services and the proportion of safe abortion cases increase from none to 80 per cent. Moreover, the contribution of safe abortion to maternal death decreased from 32 per cent in 2005 to less than 10 per cent currently."

Dr. Kebede Worku further said recognizing unbearable fall of unsafe abortion, the fact that it is one of preventable causes, the government has taken courageous position in the historic revision of the penal code in 2005. It was at this time the abortion law was made relatively more liberal than it was before.

According to the state minister, prior to 2005, the abortion law was restrictive and only applicable to save woman's life when she is engrave to death. By contrast, since 2005 the amended penal code expanded the condition in which a woman can access abortion for reasons including rape and incest or if the woman is with mental and physical disability, if it is needed to save woman's life or physical health or if she is not physically or mentally prepared for that.

More recently, the Africa regional conference on abortion has taken place here. Participants of the conference were commended Ethiopians' effort in reducing unsafe abortion devising and implementing viable policies and strategies.

African Union Commissioner for Social Affairs Dr. Sidiki Kaloko also said the continent has shown very firm commitment to include women right in the various continental policy documents. After the adoption of these charters, most African member states have been able to facilitate programmes towards the care or the reduction of maternal mortality and reproductive health as a whole, he added.

The commission continues to play an important role in women sexual and reproductive health, he said. The issue has come to the limelight following agenda 2063. This would mean in accordance with Maputo Plan of Action, to support the removal of legal, regulatory and policy barriers limiting women, men and the youth especially adolescence access to sexual and reproductive health, commodities, programmes and services, the commissioner stressed.

"Look at the progress here in Ethiopia, thanks to strong collaboration of stakeholders, we were able to come together in early 2000 for law reform and to increase access to safe and legal abortion as well as contraceptive care. Evidences show, it has a profound effect in women health and maternal mortality in Ethiopia. The African Union needs to recognize Ethiopia's experience in maternal health best practice,"Ipas CEO John Hetherington said.

"We have also seen how this evidence has strengthened abortion policy reforms and improve abortion services in a number of African countries. If we have to achieve our goal of eliminating unsafe abortion, we must map the best way forward." Ipas Ethiopia Country Director Saba Kidanemariam said. Over 250 researchers, policy makers, advocates, health care providers, youths, journalists and donors are attending the meeting.

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