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Maternal mortality, abortion services and stigma: Providers' experiences and attitudes in Addis Ababa, Ethiopia

Sarah Jane Holcombe, The Regents of the University of California - School of Public Health, 2011

Project abstract

Women in Addis Ababa, the capital of Ethiopia, have very low fertility, but also low levels of contraceptive use and very high maternal mortality (EDHS : Ethiopian Demographic and Health Survey 2005). Several researchers surmise that abortion may in part account for some of these phenomena (Kinfu 2000; Sibanda et. al. 2003).

However, the majority of these abortions are unsafe (Singh et. al. 2010) and maternal mortality levels remain very high despite slight recent declines, even after the 2005 liberalization of abortion law, which greatly streamlined access. In this context, an understanding of the historical availability of abortion and attention to what formally trained providers can do to expand the availability of safe abortion and reduce maternal mortality are critical.

This research aims to increase understanding of provider attitudes toward abortion generally and to provision of abortion in particular, including any associated stigma. The three main research questions are:

  1. How have abortion incidence and the availability of abortion care in Addis Ababa evolved between 1970 and 2011?
  2. What are trained providers' attitudes towards women's decisions to have an abortion, and toward their own and colleagues' provision of abortion care?
  3. What socio-demographic, legal understanding or training factors are associated with variation in the attitudes of formally trained providers toward abortion and abortion provision in Ethiopia?

These research findings can provide empirical data to inform efforts to recruit and train abortion providers in Ethiopia, increasing women's access to safe abortion and potentially reducing maternal mortality.

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