Lemi Belay, MD, Tesfaye Hurisa, MD, Ferid Abbas, MD, Mekdes Daba, MD, MPH, Biruck Abebe, MD, Balkachew Nigatu, MD, Sarah Prager, MD, MAS
Background: To protect the gains made in sexual and reproductive health in Ethiopia over the past several decades, care for childbearing women and newborn infants needs to continue during the pandemic. The provision of safe abortion and contraceptive services remains critical. When staff and services are under extreme stress there is a real risk of increasing avoidable harm. This case study aims to determine the impact of COVID-19 on contraception and safe abortion care services at a tertiary facility in Ethiopia.
Materials and Methods: We collected data on safe abortion and contraception services from service delivery units from March through May 2020. For comparison, and due to seasonal variation in caseload throughout the year, we pulled data from March through May 2019.
Results: Deliveries and immediate postpartum family planning have decreased by 27.6% and 66.7% respectively during the pandemic compared to the same months last year. Overall, the number of clients presenting for family planning was reduced by 27%. Safe abortion services and comprehensive abortion care were reduced by 16.4% and 20.31% respectively. Likewise, family planning service utilization among safe abortion and post-abortion clients were reduced by 40.6%, and 39.7% respectively.
Conclusion and recommendations: The COVID-19 pandemic is significantly impairing safe abortion and contraception services. Both contraception and abortion services have decreased significantly following the COVID-19 pandemic. These findings underscore that the Ethiopia Federal Ministry of Health (FMOH) and their partners (donors and non-government organizations) must take swift action, including defining abortion care and contraceptive services as essential services to continue during the pandemic. Innovative methods, such as telehealth (voice or video calls), self-care interventions, and utilization of health extension workers, need to be maximized to maintain and increase access to these essential health services.