By Koffi Kouame, UNFPA Country Representative

The last thirty years have been marked by significant progress in women’s health. Globally, maternal death rates have fallen by 34 per cent since 2000, and unintended pregnancies by 20 per cent since 1990. In Ethiopia, in the last thirty years, maternal death rates have fallen by 79% from 1,250 in 1990 to 267 per 100,000 live births by 2020. Although this decline is commendable, as per the 2020 estimate, Ethiopia is still among the top ten countries with the highest sum of maternal deaths. A lot of work remains ahead.

But as we push forward, we must ask who is still being left behind. 

Women, girls, young people with disabilities, migrants, and people living with HIV continue to experience discrimination and exclusion when they seek sexual and reproductive health care. Too many communities are still facing high rates of maternal mortality, unintended pregnancy, and ill health. Gender inequalities and harmful practices also continue to violate the rights of women and girls. Conflicts and natural disasters are exacerbating existing vulnerabilities, disproportionately impacting the most marginalized communities.

As a result, progress is slowing, and in some cases, it has stalled completely. Since 2016, the world has made zero progress in saving women from preventable deaths in pregnancy and childbirth. One in four women cannot make her own health-care decisions. Nearly 1 in 10 are unable to choose whether to use contraception. A woman in a country with a fragile health system is 130 times more likely to die from pregnancy and childbirth complications than a woman in a country with easy access to emergency obstetric care. 

These statistics highlight the inequalities inherent in our sexual and reproductive health systems, both at the global and national levels.

The path forward is clear: As we observe the 30th anniversary of the landmark International Conference on Population and Development, we must prioritize reaching those furthest from access to health care, dismantle barriers to reproductive rights, and empower women to make autonomous decisions about their bodies and futures. These are not problems that can be solved with one-size-fits-all approaches. Instead, it’s time for us to empower women and girls to craft and implement tailored, innovative solutions that work for their communities. 

We must not lose the momentum we have built in the last 30 years through collective action and dedicated investment. In the coming decades, let us measure progress, not by the gains afforded to those easiest to reach, but by the ability to lift-up everyone, especially those left furthest behind.

We need to redouble our efforts to achieve comprehensive, universal, and inclusive health care grounded in human rights. It is time to commit to intensify our efforts for the full, effective, and accelerated implementation and funding of the ICPD Programme of Action.

This is a joint journey in which the Government of Ethiopia, civil society, the private sector, and communities must work together. UNFPA in Ethiopia remains steadfast in its commitment to be a supportive partner, providing technical, financial and advocacy support to tackle inequalities and accelerate progress.

Let us forge a stronger partnership to ensure that every individual, everywhere, has the right, the power, and the agency to decide their own bodies and their own future.

This message is published by UNFPA, the United Nations Population Fund, in connection with the launch of the State of World Population 2024 in Ethiopia.