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Ethiopia: pregnancy and HIV and STIs

In Ethiopia the 2024-25 Demographic and Health Survey recorded 141 maternal deaths per 100,000 live births, skilled antenatal care for 78% of mothers but births in a health facility for 89% of urban and only 49% of rural mothers, and a pregnancy rate of 10% among girls aged 15 to 19; the Labour Proclamation grants 30 days of prenatal and 90 days of postnatal leave and bars dismissal until four months after confinement. Proclamation No. 276/2002 set up a national HIV/AIDS council that includes leaders of associations of people living with HIV, and HIV/AIDS status is a prohibited ground of discrimination at work.

Illustration: Health: pregnancy, STIs and care
Location map — Ethiopia
Ethiopia. Simplified location map — Natural Earth data, public domain.

Pregnancy

The Key Indicators Report of the 2024-25 Ethiopia Demographic and Health Survey (fieldwork 1 August 2024 to 14 April 2025, 805 clusters, 22,540 households) puts the maternal mortality ratio at 141 deaths per 100,000 live births in the seven years before the survey, with a confidence interval of 87 to 195 and a lifetime risk of maternal death of 0.006; only 49 maternal deaths were recorded, so the report asks for caution. A maternal death is one during pregnancy or childbirth or within 42 days afterwards, accidents and violence excluded. For comparison with earlier surveys the report also gives a pregnancy-related mortality ratio, counting any death within two months of the end of a pregnancy: 169 per 100,000 live births, against 412 in the 2016 survey, 676 in 2011 and 871 in 2000.

Of women with a live birth in the two years before the 2024-25 survey, 78% received antenatal care from a skilled provider (doctor, nurse, midwife, health officer or health extension worker), 53% made four or more visits and 69% took iron supplements; 64% of births were assisted by a skilled provider and 61% took place in a health facility, and 36% of mothers had a postnatal check within two days. Skilled assistance at delivery has risen from 12% in 2011. The gaps are wide: 89.4% of births in urban areas took place in a facility against 49.4% in rural areas; skilled antenatal care reached 98.2% of mothers in Addis Ababa and 35.1% in Somali region, where only 34.2% of births were in a facility and 9.4% of mothers had a postnatal check, against 68.1% in Addis Ababa.

Ten per cent of girls aged 15 to 19 (10.2%) had ever been pregnant, 8.1% had had a live birth and 2.4% were pregnant at the time of the survey. The share rose from 1.5% at age 15 to 24.7% at age 19, and was 24.3% among girls with no education against 5.5% with secondary education, 21.3% in the poorest wealth quintile against 4.2% in the richest, and, by region, from 2.1% in Addis Ababa to 13.7% in Oromia and 23.3% in Afar. The survey measured 53 births per 1,000 women aged 15 to 19 and a total fertility rate of 4.4 children per woman.

The Constitution guarantees women's right to maternity leave with full pay, which the law may extend to prenatal leave with full pay (Art. 35(5)), and to family planning education, information and capacity to prevent harm from pregnancy and childbirth (Art. 35(9)). The Labour Proclamation No. 1156/2019 adds specific protections: a pregnant worker is entitled to paid leave for medical examinations connected with the pregnancy, on presenting a medical certificate if asked (Art. 88(1)); she may not be assigned to night work between 10 p.m. and 6 a.m. or to overtime (Art. 87(4)); she must be moved to other work if a physician ascertains that her job is hazardous to her health or to the fetus (Art. 87(5)); and her contract may not be terminated during pregnancy and until four months after confinement (Art. 87(6)), save for the causes in Arts. 27 and 29(3) that are unrelated to pregnancy and delivery (Art. 87(7)).

Leave is 30 consecutive days of paid prenatal leave and 90 consecutive days of postnatal leave (Art. 88(3)); where the birth comes before the end of the prenatal period, the 90 days of postnatal leave start immediately, and where it comes later the worker is entitled to additional leave until confinement (Art. 88(4)). A father is entitled to three consecutive days of paternity leave with full pay (Art. 81(2)). The World Bank's 2024 review records that Ethiopian law provides at least 14 weeks of paid maternity leave, but that the benefit is not paid solely by the government.

Key points

Maternal mortality ratio141 per 100,000 live births, interval 87 to 195, seven years before the 2024-25 survey (49 deaths recorded)
Pregnancy-related mortality ratio169 per 100,000 live births in 2024-25; 412 in 2016; 676 in 2011; 871 in 2000
Antenatal careSkilled provider 78%; four or more visits 53%; iron supplements 69%
BirthsAssisted by a skilled provider 64%; in a health facility 61% (urban 89.4%, rural 49.4%)
Postnatal check within two days36% of mothers (Addis Ababa 68.1%, Somali 9.4%)
Girls aged 15 to 19 ever pregnant10.2% (no education 24.3%; secondary 5.5%; Addis Ababa 2.1%; Oromia 13.7%)
Maternity leave30 consecutive days prenatal and 90 consecutive days postnatal, paid (Labour Proclamation Art. 88(3))
DismissalProhibited during pregnancy and until four months after confinement (Art. 87(6))
Night work and overtimeProhibited for a pregnant woman, 10 p.m. to 6 a.m. (Art. 87(4))

In practice

  • Ask the employer for paid time off for antenatal examinations and bring a medical certificate if requested (Labour Proclamation Art. 88(1)).
  • Tell the employer in writing as soon as the pregnancy is known so that the rules on night work, overtime and transfer from hazardous work apply (Art. 87(4) and (5)); the physician's certificate is what triggers the transfer under Art. 87(5).
  • Plan the 30 days of prenatal and 90 days of postnatal leave from the expected date; if the child is born early, the postnatal 90 days start from the birth (Art. 88(4)).
  • If the employer ends the contract during pregnancy or within four months after confinement, cite Art. 87(6) in writing, since the prohibition covers that whole period, and complain to the Ethiopian Human Rights Commission (toll-free 7307) if rights are denied.

Cost and coverage

Maternity leave is paid, but the World Bank's 2024 review records that leave benefits for mothers are not paid solely by the government, so the employer bears part of the cost.

Recent changes

The Demographic and Health Survey 2024-25 Key Indicators Report, published in January 2026, is the source of the maternal mortality ratio of 141 per 100,000 live births, based on the WHO-style definition of deaths within 42 days; its authors point out that earlier surveys used a two-month window, which is why the pregnancy-related ratio of 169 is the figure comparable with 2016.

Where to go

  • Public health facilities, where skilled providers include doctors, nurses, midwives, health officers and health extension workers.
  • The employer, for leave, transfer and protection from dismissal under Arts. 87 and 88 of the Labour Proclamation.
  • Ethiopian Human Rights Commission, toll-free 7307, report@ehrc.org.

Worth knowing

Art. 88(3) of the Labour Proclamation speaks of 30 and 90 consecutive days of leave, while Art. 88(4) speaks of 30 and 90 working days; the English text of the two sub-articles is not consistent, so the length of leave should be confirmed with the employer in writing.

Frequently asked questions

How many women die in pregnancy and childbirth in Ethiopia?

The 2024-25 Demographic and Health Survey estimates 141 maternal deaths per 100,000 live births for the seven years before the survey, with a confidence interval of 87 to 195, based on 49 recorded deaths.

How much maternity leave does an employee have?

Under Art. 88(3) of Labour Proclamation No. 1156/2019, 30 consecutive days of paid prenatal leave and 90 consecutive days of postnatal leave.

Can a pregnant employee be dismissed in Ethiopia?

Not for reasons related to pregnancy: Art. 87(6) prohibits terminating the contract of a woman during her pregnancy and until four months after confinement, with an exception for the causes in Arts. 27 and 29(3) that are unrelated to pregnancy and delivery (Art. 87(7)).

Sources

The general article: Pregnancy · Compare with another country

HIV and AIDS

The sources opened for this page show no standalone HIV statute. Proclamation No. 276/2002 created the National HIV/AIDS Prevention and Control Council and the HIV/AIDS Prevention and Control Office, and the Labour Proclamation No. 1156/2019 defines discrimination to include distinction on the basis of HIV/AIDS status (Art. 2(15)), makes it unlawful for an employer to discriminate between workers on that ground (Art. 14(1)(f)), exempts the HIV test from medical examinations that a worker must undergo when the employer requires them (Art. 14(2)(e)) and from those the employer must arrange at his expense for new and hazardous-work employees (Art. 92(5), which adds 'unless the country has an obligation of international treaty'), and gives severance pay to a worker who terminates his contract on his own initiative because of HIV/AIDS (Art. 39(1)(i)). The Criminal Code punishes intentionally spreading or transmitting a communicable human disease with rigorous imprisonment up to ten years, rising to twenty years, or life or death in grave cases, where the disease can cause grave injury or death or an epidemic is transmitted (Art. 514(1) and (2)); it does not name HIV. Where a rape transmits a communicable disease the relevant provisions apply concurrently (Art. 620(4)), and transmitting a venereal disease that the offender knows he has aggravates the sexual offences (Art. 628(b)).

Proclamation No. 276/2002, published on 11 June 2002, provides that the National HIV/AIDS Prevention and Control Council is presided over by the President of the Republic and includes, among its members, leaders of associations of persons living with HIV (Art. 4(20)). Its objectives include creating conditions in which people living with HIV and orphans obtain health, psychological and counselling services and 'ensure the full protection of their rights' (Art. 5(3)); the Office is the executive organ. These are the provisions as printed in 2002.

The 2017-2018 Ethiopia Population-based HIV Impact Assessment (EPHIA), led by the Federal Ministry of Health and the Ethiopian Public Health Institute and covering urban Ethiopia only because earlier studies found prevalence below one per cent in rural areas, measured prevalence among adults aged 15 to 64 at 3.0% (4.1% of women and 1.9% of men), about 380,000 adults, and 0.3% among children under 15. Prevalence ranged from 0.8% in urban Somali region to 5.7% in Gambella, and at ages 30 to 34 it was 6.1% among women against 0.9% among men. Viral load suppression among urban adults living with HIV was 70.1%, and annual incidence 0.06%, about 7,000 new cases a year; the December 2018 summary sheet describes its findings as preliminary.

The Reporter, an Ethiopian newspaper, reported on 26 July 2025 that prevalence among adults aged 15 to 49 had fallen to 0.7% according to 2023 data from the US Centers for Disease Control and Prevention, that the Ethiopian Public Health Institute projected nearly 600,000 people living with HIV in 2024, and, citing an official of the Ministry of Health's HIV office, that prevalence was 3.3% in Addis Ababa and 3.2% in Gambella.

The 2024-25 Demographic and Health Survey measured testing and knowledge: 49% of women and 43% of men aged 15 to 49 had ever been tested and received their result, 18% of women and 12% of men had been tested in the past twelve months, and 26% of young women and 30% of young men aged 15 to 24 had comprehensive knowledge of HIV prevention. Among people who had intercourse in the past year with a partner who was neither spouse nor lived with them, 21% of women and 33% of men used a condom the last time; 1% of women and 3% of men reported two or more partners in the past twelve months.

Key points

National coordination bodyCouncil presided over by the President, with leaders of associations of people living with HIV (Proclamation No. 276/2002 Art. 4)
Discrimination on HIV/AIDS statusIncluded in the definition of discrimination; unlawful for an employer (Labour Proclamation Arts. 2(15) and 14(1)(f))
HIV test in required medical examinationsExcluded (Arts. 14(2)(e) and 92(5))
Severance payDue to a worker who terminates on his own initiative because of HIV/AIDS (Art. 39(1)(i))
Spreading a communicable diseaseRigorous imprisonment up to 10 years; up to 20 years or life in grave cases (Criminal Code Art. 514)
Urban adult prevalence, ages 15 to 64 (EPHIA 2017-2018)3.0%: women 4.1%, men 1.9%; about 380,000 adults
Viral load suppression, urban adults living with HIV70.1% (preliminary summary sheet)
Ever tested (EDHS 2024-25, ages 15 to 49)Women 49%, men 43%; in the last 12 months women 18%, men 12%
Adult prevalence reported in July 20250.7% at ages 15 to 49 (2023, CDC), nearly 600,000 people living with HIV (EPHI projection for 2024)

In practice

  • If you are asked to take an HIV test as part of a pre-employment or periodic medical examination, point to Art. 14(2)(e) and Art. 92(5) of the Labour Proclamation, which except the HIV test from the examinations that a worker must undergo or the employer must arrange.
  • Where a worker is forced to leave because of HIV/AIDS, the Labour Proclamation gives severance pay to a worker who has completed probation, is not eligible for a pension and terminates on his own initiative because of HIV/AIDS (Art. 39(1)(i)).
  • After a sexual assault, seek care at a hospital or one-stop centre: the centre in Dessie, inaugurated in November 2022, treats HIV, sexually transmitted infections and hepatitis B as part of the clinical management of rape.
  • Complain to the Ethiopian Human Rights Commission (toll-free 7307) about discrimination by an authority or institution; it can receive any complaint of a human rights violation except one pending before a court or a legislative body (Proclamation No. 210/2000, Art. 7).

Recent changes

The most recent survey figures opened for this page are the Demographic and Health Survey 2024-25 Key Indicators Report (January 2026), which gives testing and knowledge indicators but not HIV prevalence, and a July 2025 newspaper report of 0.7% adult prevalence attributed to 2023 CDC data.

Where to go

  • Health facilities, for testing and care, and one-stop centres after sexual violence (for example in Dessie).
  • Ethiopian Human Rights Commission, toll-free 7307, report@ehrc.org, for complaints of discrimination.
  • Federal HIV/AIDS Prevention and Control Office and National Council created by Proclamation No. 276/2002 (coordination, not individual complaints).

Worth knowing

The Labour Proclamation protects workers covered by its scope; the sources opened do not show a stand-alone Ethiopian statute on HIV confidentiality or testing, so the rights to confidentiality and consent rest on general constitutional guarantees such as Art. 26 (privacy) and Art. 16 (protection against bodily harm).

Frequently asked questions

Can an employer require an HIV test in Ethiopia?

The Labour Proclamation excepts the HIV test from the medical examinations a worker must undergo when required by law or the employer (Art. 14(2)(e)), and from those the employer must arrange for new and hazardous-work employees (Art. 92(5), subject to a reference to international treaty obligations); discrimination on HIV/AIDS status is unlawful (Art. 14(1)(f)).

How common is HIV in Ethiopia?

The 2017-2018 population-based assessment found 3.0% prevalence among urban adults aged 15 to 64; The Reporter cited an adult (15 to 49) rate of 0.7% from 2023 CDC data and nearly 600,000 people living with HIV in a 2024 projection.

Who coordinates the national HIV response?

The National HIV/AIDS Prevention and Control Council and the HIV/AIDS Prevention and Control Office created by Proclamation No. 276/2002; the 2002 text puts the President of the Republic in the chair of the Council.

Sources

The general article: HIV and AIDS

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Text prepared with artificial intelligence, reviewed and checked by the AffectionPlus team (method and sources: About). This content does not replace medical or legal advice. Spotted an error? Write to us.

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