Twenty-three percent of Ethiopia’s estimated 117.9 million people are aged 10–19. Young people often face major sexual and reproductive health challenges, including a lack of access to services and high levels of child marriage, early childbearing, unintended pregnancy, unsafe abortion and exposure to STIs, including HIV.
Ethiopia’s Ministry of Health has made adolescent sexual and reproductive health a major priority in recent years and is currently updating its National Adolescent and Youth Health Strategy to respond to the needs of adolescents and youth. The strategy aims to improve the overall health status of adolescents and youth, with the ultimate goal of realizing young people’s full potential in national development. In service to this goal, the Ministry of Health has instituted the provision of youth-friendly services in hospitals, health centers and partner clinics. In addition to the services offered under the strategy, One Stop Centers were established to provide holistic medical and psychological care for adolescents, as well as legal support services to survivors of gender-based violence.
The COVID-19 pandemic has presented a major threat to this progress. In April 2020, the government of Ethiopia declared a state of emergency, followed by restrictions on or prohibitions of public gatherings, border crossings and the availability and capacity of transportation services. Health facilities had to shift capacity and services to aid in the COVID-19 response, which compromised the availability of youth-friendly services, as space and staff were repurposed to COVID19 services. School closings to mitigate the spread of the virus had additional implications for adolescents’ receipt of sexual and reproductive health care, as youth often accessed such services either during school time or on their way to or from school. Finally, there also were anecdotal reports of sexual and gender-based violence following the closure of schools.
To understand how adolescent sexual and reproductive health was affected during the months following the start of the COVID-19 pandemic, this report uses service statistics data from 2019 and 2020 to analyze changes in service coverage across three main areas of adolescent sexual and reproductive health care: modern contraceptive care, pregnancy-related and childbirth care, and safe abortion care. It estimates the impact of observed service changes on the number of adolescents aged 15–19 in need of these services and the resulting impact on unintended pregnancies, unplanned births, abortions and maternal deaths, as well as the added cost to the health system from these disruptions. This report also makes the case to national stakeholders for increased resources to improve adolescent health care coverage and sexual and reproductive health outcomes.
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