Family Planning and HIV in Ethiopia


Ethiopia - home to Africa's second largest population and one of the fastest growing economies in the world - is often mischaracterized as a land of poverty and famine.
While these aspects of life are true in Ethiopia today - 80% of the country's population continues to live primarily subsistence lifestyles in rural areas - they are only part of the picture, and overlook the rapid industrial, economic and social growth that are quickly making Ethiopia a regional leader.

In the context of and parallel to this rapid growth and change, Ethiopia has made considerable progress decreasing the total fertility rate (TFR), increasing family planning (FP) and controlling HIV/AIDS, activities that make up the majority of DKT Ethiopia's work.

Family Planning in Ethiopia

Ethiopia has experienced a significant decrease in TFR as well as a corresponding increase in contraceptive prevalence rate (CPR) over the past 15 years. In 2000, Ethiopia's TFR was 6.3 and CPR 4%. By 2014, TFR had decreased to 4.1 and the national CPR was 42%.
These remarkable achievements put Ethiopia at the forefront as a global population leader, as highlighted in this article. Ethiopia, along with Kenya, received the Excellence in Leadership for Family Planning (EXCELL) Award at the 2016 International Conference on Family Planning (here), further evidence of the country's success increasing family planning.
Ethiopia's FP landscape is split between rural and urban areas, with rural areas experiencing much higher TFR and lower CPR. For example, in 2014, TFR was 4.5 and CPR 39% in rural areas compared to 2.2 and 59.6%, respectively, in urban areas.
DKT Ethiopia has historically focused its work in urban areas, where market mechanisms and population size is sufficient to sustain social marketing distribution. However, in light of the rural/urban FP divide, DKT Ethiopia has branched out to rural areas through programs like the Rural Social Marketing or Lekie Project which deliver high-quality FP commodities and promotion on market days in rural areas across the country. (See Lekie Project.)

HIV in Ethiopia

Unlike the generalized pandemics of south and eastern Africa, Ethiopia's HIV-problem is one of low overall prevalence - an estimated 1.2% of the population is HIV-positive (0.8% of males and 1.6% of females) - with geographic and demographic pockets of high-prevalence. For example, over 6% of the population in Gambella and 5% in Addis Ababa is HIV-positive and HIV-prevalence is nearly six times as high in urban as rural areas.
The country continues to prioritize condoms as a key preventive technology in efforts to control the epidemic. For example, by 2020, the Health Sector Transformation Plan (HSTP), the guiding health sector document for the country, calls for the rate of condom use at last sexual activity with a non-regular partner to increase to 80% from the current 33.7%.
As the leading supplier of condoms to the private sector in the country and the largest distributor of condoms historically outside of the Government, this leaves DKT Ethiopia with a prominent role in helping Ethiopia continue to manage and make strides against the epidemic in the country.