Trends in Reproductive Health indicators in Ethiopia: 2000-2014

Introduction: The Millennium Development Goals include a focus on Reproductive Health (RH) indicators which are of substantial importance in low and middle income countries. However, little has been reported of the time-trend in these indicators in Ethiopia. This study aims to describe trends in RH indicators in Ethiopia from 2000-2014. Methods: This study is a time-trend analysis of RH indicators. We used 15-years of RH indicator data sourced mainly from Federal Ministry of Health and Demographic and Health Survey. Maternal mortality ratio, antenatal care coverage, skilled birth attendance coverage, postnatal care coverage, contraceptive prevalence rate and total fertility rate were selected and analysed using numerical and graphic summaries. We used coefficient of determination (R2) for the Federal Ministry of Health facility based data to examine the variation in annual progress explained by the regression model. Confidence intervals were used in the Demographic and Health Survey data to indicate the period when significant difference was observed. Trends of indicators from both data sources were also compared. Results: During the 15-years study period, antenatal care coverage increased from 29% to 98% (R2 = 95%). It increased more rapidly than skilled birth attendance which remained low at 41% in 2014. Postnatal care coverage increased from 5% to 64% (R2 = 96%). Modern contraceptive prevalence rate among the married women improved from 6.3% (5.8%, 6.8%) to 40% (38.7%, 41.3%) within the 15-year period. Maternal mortality ratio decreased from 990 in 2000 to 420 in 2013. The total fertility rate decreased from 5.5 to 4.1 children per woman. With lowest performance in 2000, Ethiopia demonstrated better improvement compared to selected sub-Saharan African countries. Variations in the trends were observed when data from both sources were compared. Conclusions: RH service coverages have shown remarkable improvement while maternal mortality ratio, although reduced, remained high. There was a significant gap in the continuum of maternal health services.