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HEW - EthiopiaA new mother’s life was slipping away in a rural village in northern Ethiopia. The car that was called six hours ago still had not arrived. And the bleeding simply would not stop. A health extension worker (HEW), like Aynalem pictured on the left, arrived and gave the woman misoprostol tablets; she waited anxiously. Was the woman too close to death for the medicine to save her? And then, validating what she had learned, the bleeding that nearly took this mother away from her newborn, stopped. In a country that has the fifth highest number of maternal deaths globally, every mother counts.

In June 2010, Ethiopia took the important policy step of approving the registration of misoprostol for management of postpartum hemorrhage, enabling national distribution of the life-saving medicine in both the public and private sectors. VSI is working in partnership with the Federal Ministry of Health, social marketer DKT-Ethiopia and other stakeholders to increase access to and knowledge of misoprostol for use in controlling this life-threatening bleeding, especially among the 94% of mothers who labor at home in Ethiopia.

In addition to our efforts to reduce maternal deaths from excessive bleeding, VSI is committed to contributing to a reduction in the 32% of maternal deaths in Ethiopia resulting from complications of abortion. VSI worked in collaboration with the Tigray Health Bureau and the Bixby Center for Population, Health and Sustainability at the University of California, Berkeley in the rural northern Tigray Region to improve access to comprehensive abortion services at all levels of the health system. Read the results of this groundbreaking research.

VSI and our partners are improving women's health in Ethiopia by:

  • Training health care providers including doctors, health officers, midwives, nurses, pharmacists, health extension workers and traditional birth attendants on the effective use of misoprostol for maternal health.
  • Gaining government commitment by developing policies that will ensure women’s access to misoprostol, including revision of the guidelines for management of postpartum hemorrhage and comprehensive abortion care.
  • Research to demonstrate the feasibility of misoprostol as a safe motherhood solution throughout Ethiopia.
  • Sensitization of health workers and communities on prevention of unwanted pregnancy and unsafe abortion with support from the Anna Lalor Burdick Foundation.

Related publications and resources>

By the Numbers

Estimated Total Population

82.8 M

Lifetime Risk of Maternal Death

1 woman in 40

Maternal Mortality Ratio

470 per 100,000 live-births

Total Fertility Rate


Births Attended by Skilled Health Provider


Unmet Need for Family Planning


Source: PRB, 2011 and WHO, 2010

Registered Misoprostol Product(s): Misotac®

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