Ethiopia: Maternal and Perinatal Health Profile

Ethiopia
African Region
Maternal and Perinatal Health Profile
Department of Maternal, Newborn, Child and Adolescent Health (MCA/WHO)

Demographics and Information System
Health status indicators - Maternal and Perinatal mortality
Total population (2013) [1]
94,100,756
Maternal mortality ratio (2013) [3]
Total women aged 15-49 years (2013) [1]
22,276,033
Annual number of maternal deaths (2013) [3]
Annual number of births (2013) [1]

Sex ratio at births (2005-10) [1]
2,886,305
1.04
420
13,000
Perinatal moratlity rate (2011)[4]
46
Stillbirth rate (2009)[3]
26
Birth registration coverage [2]
6.6
Neonatal mortality rate per 1000 live births (2013) [5]
Total fertility rate (2013) [1]
4.5
Annual number of neonatal deaths (2013) [5]
Adolescent fertility rate [per 1000 woman] (2005-2010) [1]

Under five population (2013) [1]
Coverage of vital registration of deaths [2]
28
84,437
90
14,248,931
-
Sources: [1] Population Division, Department of Economic and Social Affairs, United Nations, World Population Prospects: The 2012 Revision.
[2] WHO, World Health Statistics 2014 .
[3] WHO, UNICEF, UNFPA and The World Bank estimates. Trends in maternal mortality: 1990 to 2013.
[4] Demographic Health Survey.
[5] UNICEF/WHO/The World Bank/UN Pop Div. Levels and Trends in Child Mortality. Report 2014 .
Maternal nutrition
Prevalence of anaemia among pregnant women
Night blindness (adjusted)
Iron tablets taken during pregnancy (any tablets)
Pregnancy involving risks

22
Birth interval <24 months and birth order >3
Total age <18 and birth interval <24 months
0.4
16.8
Source: Demographic Health Survey (2011)
Maternal mortality
One of the eight Millennium Development Goals (MDGs) that has made some progress, albeit slow, is MDG 5: Improve maternal
health. The two targets for assessing MDG 5 are reducing the maternal mortality ratio (MMR) by three quarters between 1990 and
2015, and achieving universal access to reproductive health by 2015.
Maternal mortality ratio (MMR): maternal mortality per 100 000 live births
Range of uncertainly on annual % change in MMR

(lower estimate)
Range of uncertainly on annual % change in MMR
(upper estimate)
Progress towards improving maternal health
MDG 5 target by 2015
-78
-6.4
-10.1
-2.4
-
350
1500
Per 100 000 LB
% change in MMR between 1990-2013

Average annual % change in MMR 1990-2013
1000
1400
1200
No Data Available
MDG5
Target, 350
990
500
740
420
0
1990 1995 2000 2005 2010 2015
Note: Consultations with countries were carried out following the development of the MMR estimates. The purposes of the consultations were primarily:
to give countries the opportunity to review the country estimates, data sources and methods; to obtain additional primary data sources that may not
have been previously reported or used; and to build mutual understanding of the strengths and weaknesses of available data and ensure broad
ownership of the results.
Source:
WHO, UNICEF, UNFPA and The World Bank estimates. Trends in maternal mortality: 1990 to 2013 .
Ethiopia
Perinatal mortality
The perinatal mortality rate expressed per 1000 pregnancies of seven or more months' duration, is used as an indicator of the
quality of antenatal and perinatal care. Perinatal deaths include pregnancy losses of at least seven months gestation (stillbirths)
and deaths to live births within the first seven days of life (early neonatal deaths).
Perinatal mortality by background characteristics
46
47
52
Previous pregnancy
interval in months
Mother's
education
Wealth
quintile
PMR
Source: Demographic Health Survey
Note: information on stillbirths and deaths to infants within the first week of life are highly susceptible to omission and misreporting.
Per 1000 births
Perinatal mortality by region

70
60
50
40
30
20
10
0
46
58
55
51
45
No Data Available
42
39.2
40.2
40.3
29.8
22.9
20
Maternal and perinatal country profile
highest
lowest
Rural
Urban
Place of
residence
2011
Early neonatal deaths rate
45
No Data Available
39+
5
0
Stillbirth rate
46
20
16.9
2005
46
Secondary
40
45
No education
46
<15
28.7
60
58
First pregnancy
46.0
71
80
Total
50
45
40
No Data Available37.0
35
30
26.9
25
20
15
10.4
10
Per 1000 births
Per 1000 births
Perinatal mortality rate (PMR): Trend
Ethiopia
Early and late neonatal deaths (proportion of death by timing)

A neonatal death is defined as a death during the first 28 days of life (0-27 days). Early neonatal death refers to a death
between 0-6 days after birth. Late neonatal death refer to a death between 7-27 days after birth.
No Data Available
Late
neonatal
deaths
21%
within 24
hours
41%
Other
79%
Day 6
1% Day 5
4% Day 4 Day 3
5% 9%
Source: Demographic and Health Survey
24-48
hours
14%
48-72hours
5%
Trend of intervention coverage across continuum of care for maternal and perinatal health
100
80
No Data Available
60
40
20
0
% of women
currently using
modern
contraceptives
% of women
received ANC (at
least once)
% women who
IPT during ANC visit
received ANC 4 times
or more
2000
2005
Place of delivery - % of births delivered

Any health facility
by C-section
2011
Source: Demographic and Health Survey
% of women who
had PNC within 2
days
Ethiopia
Place of birth and type of provider
Type of postnatal care provider

- who provides the postnatal care?
Place of Births - Where are babies born?
Public
Private
hospital
hospital
No Data Available
8.7%
1.2%
Doctor/Nu
Others
0.4%
rse/Midwif
No Data
Available
e's
6.3%
Health/
Communit
y-health
workers
0.4%
No
checkup
93.3%
Home
89.7%
Intervention coverage across continuum of care by geographical areas

100%
80%
No Data Available
60%
40%
20%
0%
% of births assisted by skilled birth attendant
% of births received post-natal care within 48 h
% of births delivered by C-section
% of births in health facilities
Ethiopia
Equity across continuum of care

100
80
Percent
No Data Available
76.9
76.7
60
49.5
48.2
50.8
45.6
42.6
36.5
40
49.8
45
32.1
27.7
25.1
20
18.7
22.5
13
10
4
1.7
0
% of women
currently using
modern
contraceptive
7.2
8.1
0.5
% women who % births assisted by % of births by Creceived any ANC skilled personnel
section
by skilled provider
Poorest
Richest
Urban
9.9
4.1
2
1.5
0.1
Rural
2.7
6.7
2.8
% births in health
% of births
facilities
received postnatal
care
Total
Note:
If more than one source of ANC was mentioned, only the provider with highest qualification is conserved in this tabulation.
Utilization of services by wealth quintile

% of births in health facility
% of births assisted by skilled personnel
100
Equity gap
% of births assisted by skilled
personnel
% of birth in health facility
90
80
70
No Data Available
60
50
40
30
20
10
0
Lowest
Second
Middle
Fourth
Wealth quintile
Highest
100
Equity gap
90
80
No Data Available
70
60
50
40
30
20
10
0
Lowest Second Middle Fourth
Wealth quintile
Highest
Ethiopia
100
Equity gap
90
80
70 Data Available
No
60
50
40
30
20
10
0
Lowest Second Middle
Wealth quintile
% of mothers with postnatal checkup in <2 days of delivery

100
Equity gap
90
80
No70Data Available
60
50
40
30
20
10
0
Lowest Second Middle
% of birthts received post-natal care
Fourth
Highest
Wealth quintile
Fourth
Highest
Quality of care indicators
Reasons for not seeking medical care
Contents of ANC can be an important indicator for

accessing the quality of ANC services that pregnant
women receive in order to be prepared for
complications and any danger signs associated with
pregnancy and childbirth.
Many barriers can prevent women from seeking medical

care in general when needed. Understanding these
factors is critical to improve the accessibility and
utilization of medical care during pregnancy and childbirth.
Signs of
pregnancy
complicatio
ns
Available
No Data 100
No Data
80
60
40
20
0
Blood
sample
taken
Weight
measured
Height
measured
Urine
sample
taken
Richest
Blood
pressure
measured
Poorest
Getting
permission to go
Available
for treatment
Any of the
specified
problems
Concern there
may not be a
female provider
100
80
60
40
20
0
Getting money
for treatment
Distance to health
facility
Not wanting to go
alone
Having to take
transport
Total
Total
Ethiopia
Workforce availability
Number of nurses/ midwives/ auxilliary nurse-midwives
27,034
Number of physicians, generalists
2,935
Number of obstetricians and gynaecologists
147
Source: UNFPA, State of the World's Midwifery 2014 report (http://www.unfpa.org/sites/default/files/pub-pdf/EN_SoWMy2014_complete.pdf) .

1
These figures do not necessarily reflect the number of practicing midwives or the ICM definition of a midwife.
Health system and policy indicators

Health system and policy indicators
Does the national policy/policy statement indicate the minimum ANC visits during the normal pregnancy?
If yes, how many visits
Yes
4
Is there a national policy or policy statement on the right of every woman to have access to skilled care at
childbirth?
Yes
Is there a national policy on discharge of mother and the baby after normal cildbirth at facility?
Yes
Is there a policy recommending postnatal follow up visit/review by a trained provider for mother and newborn?
Yes
Maternal deaths review

No
Does national policy require all maternal deaths to be notified within 24h to a central authority?
What year was the policy adopted?
2013
Yes
Does the national policy require all maternal deaths to be reviewed?

If yes, what year was the policy adopted?
2013
Is there a facility maternal death review (audit) process in place?
Yes
Is there a community maternal death review (audit) process in place?
Yes
No
Is there a national panel (committee) to review maternal deaths in place?

How often does the panel meet?
No
Is there a subnational panel (committee) to review maternal deaths in place?
Stillbirths
No
Is there a policy that requires all stillbirths (fresh or macerated) to be reviewed?

3--
Is there a facility stillbirth review (audit) process in place?
Neonatal deaths
No
Is there a policy that requires all neonatal deaths (0-28 days) to be reviewed?
Is there a facility neonatal deaths review (audit) process in place?
Is there a community neonatal death review (audit) process in place?
Essential drugs list for maternal and newborn health

Does national Essential Drugs List include the following drugs indicated for use during pregnancy, childbirth?
Magnesium Sulphate
Yes
Yes
Oxytocin
Source: WHO: Global maternal newborn, child and adolescent health policy indicator database (2014) based on key informant surveys in 2009-10, 2011
& 2013-14

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Ethiopia

Maternal and Perinatal Health Profile

Department of Maternal, Newborn, Child and Adolescent Health (MCA/WHO)

Health status indicators - Maternal and Perinatal mortality

Total population (2013) [1]

Maternal mortality ratio (2013) [3]

Total women aged 15-49 years (2013) [1]

Annual number of maternal deaths (2013) [3]

Annual number of births (2013) [1]

Perinatal moratlity rate (2011)[4]

Stillbirth rate (2009)[3]

Birth registration coverage [2]

Neonatal mortality rate per 1000 live births (2013) [5]

Total fertility rate (2013) [1]

Annual number of neonatal deaths (2013) [5]

Adolescent fertility rate [per 1000 woman] (2005-2010) [1]

Pregnancy involving risks

Birth interval <24 months and birth order >3

Total age <18 and birth interval <24 months

Source: Demographic Health Survey (2011)

Range of uncertainly on annual % change in MMR

% change in MMR between 1990-2013

Perinatal mortality by background characteristics

Source: Demographic Health Survey

Source: Demographic Health Survey (2011)

Per 1000 births

Perinatal mortality by region

Source: Demographic Health Survey (2011)

Maternal and perinatal country profile

Per 1000 births

Per 1000 births

Perinatal mortality rate (PMR): Trend

Early and late neonatal deaths (proportion of death by timing)

Source: Demographic and Health Survey

Source: Demographic Health Survey (2011)

Place of delivery - % of births delivered

Source: Demographic and Health Survey

Maternal and perinatal country profile

Place of birth and type of provider

Type of postnatal care provider

Place of Births - Where are babies born?

Source: Demographic Health Survey (2011)

Source: Demographic Health Survey (2011)

Intervention coverage across continuum of care by geographical areas

% of births assisted by skilled birth attendant

% of births received post-natal care within 48 h

% of births delivered by C-section

% of births in health facilities

Source: Demographic Health Survey (2011)

Maternal and perinatal country profile

Equity across continuum of care

Utilization of services by wealth quintile

% of births assisted by skilled personnel

% of birth in health facility

Source: Demographic Health Survey (2011)

Source: Demographic Health Survey (2011)

Maternal and perinatal country profile

% of mothers with postnatal checkup in <2 days of delivery