Stronger markets, increased access to essential maternal health supplies: Policy recommendations for Ethiopia

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In the last 15 years, global efforts have nearly halved maternal mortality worldwide.1 Similarly, Ethiopia has made significant progress, and it has reduced maternal mortality by 69 percent from estimates in the 1990s.2 However, Ethiopia still has one of the highest rates of maternal deaths per year, globally.3 Additional efforts are urgently needed to continue to reduce maternal mortality in Ethiopia. This paper outlines actions that decision-makers and civil society organizations in Ethiopia can take to increase access to lifesaving maternal health products.

Maternal mortality in Ethiopia

Between 2009 and 2016, maternal mortality accounted for a quarter of all deaths among women between the ages of 15–49 in Ethiopia. During this period, the maternal mortality ratio (MMR) stood at 412 deaths per 100,000 live births.4 Recognizing the gravity of the situation, the government of Ethiopia set an ambitious target by 2020 to reduce the country’s MMR to 199 deaths per 100,000 live births, as part of Ethiopia’s five-year public health strategy, The Health Sector Transformation Plan (HSTP).2

Two leading causes of maternal death in Ethiopia include postpartum hemorrhage (PPH)— uncontrolled bleeding after childbirth—and preeclampsia/eclampsia (PP/E), a condition which causes high blood pressure and seizures during pregnancy.5 Both conditions can be addressed with effective, low-cost maternal health products: oxytocin and misoprostol to prevent and treat PPH, and magnesium sulfate to treat PE/E.

In 2012, the United Nations Commission on LifeSaving Commodities for Women and Children (UN Commission) identified these three maternal health products as lifesaving and issued a global call to action to improve access.5 However, women worldwide, including in Ethiopia, still lack reliable access to essential maternal health products. When products are available, they are sometimes of poor or unverified quality.6