Maternal health in Ethiopia: global and local complexities

WHO estimates that 830 women die every day due to maternal health complications. The disparities in maternal health are unevenly distributed between wealthy and poor nations. Ethiopia has one of the highest mortality rates in the world. Existing high maternal mortality rates worldwide and in Ethiopia indicate the shortcomings of maternal health interventions currently underway. Understanding the socio-cultural, economic and political factors that influence maternal health outcomes locally while simultaneously examining how global reproductive and development programs and policies shape and influence the reproductive needs and knowledge of women is important. Employing feminist and African indigenous methodologies, in this research I explore maternal health issues in Ethiopia in two of the largest regions of the nation, namely Oromia and Amhara, more specifically in Seden Sodo and Mecha districts. Using qualitative interviews and focus group discussions, I examined the various socio-cultural, political and economic factors that influence maternal health outcomes, assessing how gender, class, education, marriage and other social factors shape women's health outcomes of pregnancy and childbirth. I also explored how global and local development and reproductive health policies impact women's maternal health needs and how these needs are addressed in current implementation strategies of the Ethiopian health system. Recognizing women's social and collective existence in indigenous African communities and the new reproductive health paradigm post-ICPD, I addressed the role of men in maternal health experience. I argue that global and local development and reproductive policies and their implementation are complex. While comprehensive descriptions of national and maternal health policies on paper and gender-sensitive implementation strategies point toward the beginning of a favorable future in maternal health service provision, the global economic policies, population control ideas, modernization/development narratives that the nation employs that focus on biomedical solutions without due emphasis to socio-cultural aspects have a detrimental effect on maternal health services provision. I advocate for the need to understand and include social determinants in policies and implementation in addition to legal enforcement and biomedical solutions. I also argue for alternative perspectives on masculinities and the role of men in maternal health to improve maternal health service provision.