Evidence brief: Enhancing the delivery of comprehensive abortion care in humanitairan settings, Ethiopia

The ongoing war in northern Ethiopia has caused many deaths and forced millions of people to leave their homes, significantly impacting access to essential sexual reproductive healthcare. Women and girls are disproportionately impacted by the problem, lacking access to contraceptives and quality of comprehensive abortion care services.

This evidence brief presents critical insights from four context-specific research studies aimed at improving access to contraceptive counselling and safe abortion services in Ethiopia. The brief has been developed to inform a stakeholder dialogue and to guide health policy decisions that address urgent sexual and reproductive healthcare needs among internally displaced women and girls living in humanitarian settings.

The research finds that:

• There is a high rate of incomplete abortions (64%), requiring post-abortion care.
• 71% of women didn't receive care at the first facility they visited.
• Barriers to accessing services included stigma, distance, economic constraints, and lack of respectful care.
• There is a large unmet need for comprehensive abortion services with 39% of women surveyed not receiving post-abortion contraceptive counselling.
• There is a financial burden associated: 28% of women had to cover costs for medical supplies (medication) at the facility.

The brief presents a midwifery model of abortion care in humanitarian settings, which considers the main components of an enabling environment that, when combined, create conditions for midwives to provide CAC in humanitarian settings. It is recommended to further integrate the midwifery approach in humanitarian settings in Ethiopia to enhance collaborative interprofessional care that is respectful and responsive, aligns with patient preferences, and improves the overall quality of and access to CAC in humanitarian settings.