Advocacy & Health Policy: Ethiopian Society of Obstetricians and Gynecologists Collaborates with ACOG


In March, two Fellows of the Ethiopian Society of Obstetricians and Gynecologists (ESOG), Mekdes Daba, MD, and Delayehu Bekele, MD, spent a week in the United States as part of a collaboration between ACOG and ESOG.

Dr. Daba is an assistant professor of obstetrics and gynecology at Addis Ababa University. She received her MD and MPH from Hawassa University and her specialty certificate in obstetrics and gynecology from Addis Ababa University.

Dr. Bekele is an associate professor of obstetrics and gynecology at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. He studied medicine at Gondar College of Medical Sciences and worked as a general practitioner for two years at Debub University. He did his postgraduate specialty in obstetrics and gynecology at Addis Ababa University and has an additional master’s degree in public health from the University of Gondar.

Dr. Daba and Dr. Bekele were chosen by ESOG for their leadership capabilities and interest in revitalizing the Ethiopian Journal of Reproductive Health (ERJH).

ACOG and ESOG Collaboration

The ACOG-ESOG collaboration began in 2016 and is a program in ACOG’s Office of Global Women’s Health. It is generously supported by the Center for International Reproductive Health Training (CIRHT) at the University of Michigan and includes four major components:

  • Residency Education and Programs
  • Continuing Medical Education Development
  • Certification and Accreditation Exams for Ob-Gyn Residency Programs
  • Revitalization of the ERJH

There are also smaller components of the project that include leadership development, public relations and communication strategy, and information technology.

ESOG Fellows’ Week at ACOG

During their week in the US, Dr. Daba and Dr. Bekele attended the Robert C. Cefalo National Leadership Institute in Chapel Hill, North Carolina from March 22-26. The knowledge they acquired from this meeting will help them improve their clinical practice, leadership skills, research capability, and advocacy.

The Fellows also spent a day with the staff of the Green Journal at ACOG National. This day was very encouraging for them and provided many lessons to take back from their week at ACOG.

Dr. Daba and Dr. Bekele finished up the week with a presentation to staff at ACOG National. The presentation focused on women’s health in Ethiopia and highlighted the importance of ob-gyn collaborations, such as the one between ACOG and ESOG.

Providing Women’s Health Care as an Ob-Gyn in Ethiopia

“Health care in Ethiopia has made good strides in the last decade,” said Dr. Daba. “In the last year, attention has been given to the problem of the high mortality rate.”

The maternal mortality rate in Ethiopia is 420, with 13,000 maternal deaths annually. The maternal mortality rate has decreased dramatically from 1,400 in 1990 to 420 in 2015.

Postpartum hemorrhage is a primary cause of maternal death, with 56% of maternal deaths in Ethiopia being the result of postpartum hemorrhage. Other causes include sepsis (16%), eclampsia (15%), unsafe abortion (6%), and obstructed labor (7%).

In terms of morbidity, 1% of Ethiopian women have obstetric fistula. Another factor is cervical cancer. Annually, 7,619 women are diagnosed with cervical cancer, and there are 6,081 deaths from cervical cancer each year. Cervical cancer screening is not widely practiced, and a significant number of deaths are underreported.

Severe morbidities include obstructed labor uterine rupture and vesicovaginal fistula (VVF). There are 9,000 new cases of VVF each year.

VVF has huge repercussions, not only because of the compromised health of the woman, but because the mother is often abandoned by her family and not allowed back in the house.

According to Dr. Bekele, there are three main delays in assisting mothers, especially from rural areas:

  • During home deliveries, there is often inadequate knowledge about pregnancy and the signs of complicated labor
  • Access to a health facility may be delayed due to lack of transportation, unreliable transportation, and poor roads
  • Health facilities sometimes have inadequately skilled attendants and inadequate equipment and supplies

Improving Women’s Health Care in Ethiopia

An increase in health care providers is needed to improve maternal health and lower maternal mortality and morbidity. There are 325 ob-gyns in Ethiopia for a population of 94 million, and only 23 of those ob-gyns are female. Fortunately, there are more female residents in training, with 16 current female students. 

“I am proud to be one of that small number,” said Dr. Daba, “and advocating for women’s health as a woman is a very empowering thing.”

According to Dr. Bekele, “Obstetrics has increased to more than eight medical schools. And there has been a massive expansion in a short time. And for the residency programs, there is now a standardized curriculum.”

Overall, the state of ob-gyn in Ethiopia is changing for the better—the number of fistulas is decreasing, and the number of ob-gyns is increasing. The Ethiopian government is supportive of efforts to improve the health care system, and the exchange of ideas via the ACOG-ESOG collaboration has become another part of the solution.

“Both the Leadership Institute and our day with the Green Journal staff were rewarding,” said Dr. Bekele. “We received good exposure and saw examples of how we could really get some good results.”

Dr. Daba agreed, adding, “We learned so much in just one week. We’re excited to see how things can change. We are looking forward to implementing what we learned to our programs in Ethiopia.” 

From left to right: Delayehu Bekele, MD, ESOG; Mekdes Daba, MD, ESOG; and Berhanu Taye, MD, ACOG; at the Robert C. Cefalo National Leadership Institute in Chapel Hill, North Carolina 

To Learn More

Visit the ESOG website.

See the Office of Global Women’s Health webpage to learn more about the collaboration between ACOG and ESOG.

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998