Result area 2 – SRHR - Ethiopia

A growing number of people have access to anti-retroviral drugs, contraceptives and other
commodities required for good sexual and reproductive health

Question 2a: To what extent do more people have
access to anti-retroviral drugs, contraceptives and
other commodities required for good sexual and
reproductive health?

The Government of Ethiopia has employed more than 17.000 Health Extension Workers and
trained them to provide a.o. long-term modern contraceptive methods. Percentage of married
women between 15-49 years old using any method of contraception increased in 5 years from
14% to 28.6%. This increase is especially due to increased use of injectables. Family Planning
methods are free of charge in public and most NGO facilities.
Supply of reproductive health commodities is improving but remains highly dependent on donor
agencies. The unmet need of contraceptives declined but remains high (25%), especially among
young people.
The number of public and private health facilities providing HIV Counselling, Testing services and
treatment increased in 2011. Prevention from Mother To Child Transmission services increased
to 1.445 centres, though only 24% of pregnant HIV-positive women receive Anti Retro Viral
therapy. This is due to low Ante Natal Care attendance (42%) and low institutional deliveries
(10%).
The HIV/AIDS control programme remains highly dependent from external funding, especially the
United States and Global Fund to fight AIDS, TB and Malaria.
Objective
Indicators
Baseline (2011) (2015)
Result (2012) Result (2013) Result (2014) Source
Contraceptive Prevalence Rate - married women 15-49 28.6%
66%
DHS 2011
(MDG indicator 5.3)
Unmet need for family planning (per age group, where All: 25.3%
All : 10%
DHS 2011
available and relevant)
Urban: 15%
(MDG indicator 5.6)
Rural: 27,.5%
Proportion of population with advanced HIV infection
Adults : 86
Adult : 95
Federal
(according to CD4) with access to antiretroviral drugs
Children: 20
Children: 90
HIV/aids
(MDG indicator 6.5)
(CD4 < 200)
(CD4< 200)
Reports
Question 2b: With which results has your programme NL supported the purchase of contraceptives through the Protection of Basic Services -health
contributed to a greater choice in and sufficient
facility (up to 2012) and through the MDG Performance fund of the MOH (since mid-2012) and
availability of contraceptives/medicines?
through DKT (a social marketing agency of contraceptives). This has contributed significantly to
increased availability of contraceptives and condoms both in the public and the private sector.
DKT has registered 2 new products (female condom, lubricant) aiming at a reduction in HIV
transmission in high-risk populations.
The number of clients in clinics supported by Family Guidance Association of Ethiopia (FGAE) and
Marie Stopes International Ethiopia (MSIE) is sharply increasing. The NL embassy contributed
60% to DKT's , 35% to FGAE's and most of MSIE's programmes. Other donors include Irish Aid,
DFID and the Packard Foundation.
Objective
Result
Indicators
Baseline (2011) (2015)
Result (2012)
(2013)
Result (2014) Source
Type of new, user-friendly products / medicines on the
market for improved sexual and reproductive health
Number of couples protected by various
contraceptives (Couple Year Protection)
Question 2c: With which results has your programme
contributed to addressing sociocultural barriers
preventing women from using contraceptives?

Assessment of results achieved across the entire
result area, Dutch contribution
A. Results achieved better than planned
B.

Results achieved as planned

C.

Results achieved poorer than planned

D.

Results achieved much poorer than planned

2 – lubricant
female condom

DKT (2012)

DKT : 2.8 m
DKT :10.4 m
Project /
MSIE: 0.6 m
MSIE: 1.0 m
HSDP reports
MOH: 7.4 m
MOH:15.5 m
According to DHS 2011: 29% of women don't get health care as they don't have permission from
their husbands to go to a health facility. For 53% of the women the chance that there is no
female health worker forms a barrier. The government has therefore employed thousands of
women in community health centres. In Afar Region the embassy provided support to efforts to
dispel socio-cultural barriers to Family Planning through community meetings and focussed
information programmes.
Private sector providers are less judgemental and show less stigma. Hence, support to private
sector services of MSIE, FGAE, DKT supported by the NL embassy contributes to reduced social
and cultural barriers to SRH services for women, youth and sexual minorities. In all programmes
(DKT, FGAE, MSIE) efforts are made to increase men's understanding of SRHR issues. FGAE also
raised awareness of religious and traditional leaders on SRHR issues.
B
Reasons for results achieved:
Due to the high priority (GOE and partners) for SRH and HIV/AIDS control, good progress is made
in access to reproductive healthcare and HIV/AIDS control services. Remaining challenge is
especially to reach young people and the rural population. More remains to be done to integrate
HIV/AIDS control in the regular provision of SRH services especially Prevention of Mother to Child
Transmission.

Implications for planning
1) The embassy will continue to emphasize importance of increased access to an integrated package of SRHR services and hiv/aids control by a variety of
service providers (public, private, NGO's, informal.
2) More efforts need to be made to promote local ownership and funding of SRH and HIV/AIDS control programmes, also through health care financing
reforms i.e. Social Health Insurance, Community Based Insurance and contracting out of services.
3) Marie Stopes International’s initiative to provide SRHR services as part of workplace policies of private companies will be encouraged in collaboration
the Agriculture and Private Sector Development programmes.