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“They come when you build it”: the impact of introducing a model abortion clinic on safe abortion care access expansion in Ethiopia

Abraham Fessehaye Sium(1), Abrham Getachew(2), Lemi B. Tolu(3), Sarah Prager(4),


(1) Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
(2) School of Public Health: Department of HSM, HP, RH, & Nutrition, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
(3) Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
(4) Division of complex family planning, Department of Obstetrics and Gynecology, University of Washington (UW), Medicine, Seatle, USA
Corresponding Author

Abstract


Current strong evidence supports that making abortion legal, safe, and accessible significantly reduces unsafe abortion-related maternal morbidity and mortality. We conducted a decade-long (2009 – 2019) trend-analysis study of safe abortion care and post abortion care services in relation to introduction of a new abortion clinic at St. Paul’s Hospital in Ethiopia. There were 9491 total abortions (6449 post-abortion care cases and 3042 safe abortion cases) during the study period (between September 2009 to August 2019). Following the opening of a model abortion clinic, access to safe abortion care significantly increased, and post-abortion care abortion service dominance was replaced by safe abortion care. Before the introduction of the clinic in 2016, only 1 in 3 abortions were safe abortions, the rest being post-abortion care cases. During the years 2017-2018 and 2018-2019, safe abortion care increased to 6 in 10 and 7 in 10 of all comprehensive abortion care provided, respectively. This “They come when you build it” effect on the trends of safe abortion - a paradigm shift of post-abortion care into safe abortion care - can be implemented in other Sub-Saharan settings.

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