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Front view of a pharmacy with a sign in Amharic and English reading "Ethiopia Pharmacy." A mannequin is visible in the window next to the entrance. The building exterior is beige with a purple section on the side.

April 10, 2025

News | Research | Self-managed abortion with pills

Ethiopia pilot program shows private pharmacies can safely provide abortion with pills

Image: Ethiopian pharmacy exterior © 2009 Richard Lord

Study 

Frontiers | Increasing access to self-managed abortion through pharmacies: programmatic results and lessons from a pilot program in Oromia, Ethiopia

Published in Frontiers in Global Women’s Health

A pilot program by Ipas, the Ethiopian Ministry of Health, and the Oromia Health Bureau proved that private pharmacies can safely expand access to abortion with pills—making essential care more available and closer to home for women in Ethiopia.

Between December 2021 and March 2023, the program trained and supported 41 private pharmacies to offer abortion with pills and related counseling—to users both with and without prescriptions. To understand how well the model worked, implementers tracked client experiences through pharmacy records and follow-up phone calls 21 days after care.

Main takeaway 

Pharmacies are trusted, accessible, and already part of the health system. With the right support, they can significantly expand access to abortion with pills—and reduce harm caused by misinformation and stigma.

The pilot confirms that private pharmacies can be a safe, effective source of abortion with pills in Ethiopia—meeting strong demand while offering the privacy, convenience, and trusted care that people want. To scale this model, pharmacies need backing from across sectors to ensure they can offer accurate information and high-quality care.

Why it matters 

In many parts of Ethiopia, people face barriers to accessing safe, facility-based abortion care. Pharmacies, especially in urban and surrounding areas, are more accessible and often a first point of contact. The success of this pilot program shows that, with training and support, private pharmacies can safely provide abortion with pills—even without a prescription. This model could be transformative in other contexts where access to clinical abortion care is limited.

Key Findings 

    • 32 of 41 trained pharmacies provided abortion with pills to 1,457 people; 9 pharmacies withdrew due to eligibility issues, personal beliefs, or other reasons.

    • Most users (71%) were aged 20–29, and 11% were under 19. All were less than 10 weeks pregnant.

    • Nearly all (98.6%) used the recommended mifepristone-misoprostol regimen, and 99.6% followed instructions from pharmacists.

    • 98.3% had a successful abortion; only 0.8% needed further care.

    • Friends (59%) and partners (15%) were the main sources of information about the pharmacy service.

    • Most were unmarried young people, including students, unemployed individuals, and small-business owners.

    Noteworthy 

    This is one of the first documented pilots of pharmacy-based abortion with pills in Ethiopia. It demonstrates the enormous potential of pharmacies to expand access. Despite demand and proven safety, existing regulations pose challenges for pharmacy provision of abortion pills without a prescription. This gap between policy and practice highlights the need for multi-sector advocacy and reform.