The ground floor of Betsegah Mother’s and Children’s Hospital was
teeming with pregnant women, who came for their
checkup appointments last Thursday. Most mothers
were chattering excitedly about their pregnancies
and swapping advice with each other, as they waited
for their names to be called.
However, for most of the women lying in the hospital rooms on the
second floor, the anticipation was over; they had
delivered their babies and were now resting, while
family and well wishers gathered around during the
lunch time visiting hours.
In one of these rooms, Zerihun Damtew was attending to his wife Tigist
Tadesse, who gave birth to a 3.5 kg baby boy on
Wednesday night. He is a teacher at a private
school, earning 3,000 Br per month, while his wife,
who works as a language and culture facilitator and
is paid on a contractual basis, brings 2,000 Br a
month on average, according to Zerihun.
This is the couple’s first born and they have prepared as best possible
for their newborn’s needs, according to Zerihun.
But a child’s needs are many, as Zerihun is finding out. He said he had
already spent 1, 500 Br buying some clothes for his
child. In addition, both parents expect the total
medical costs from the time Tigist was pregnant to
the time she will be discharged from the hospital to
reach around 10,000 Br. Tigist delivered the baby
via Cesarean section (C-section), which costs around
7,000 Br, at Betsegah, according to information from
the Hospital administration.
There is also the cost of a baby washing basin, a bed, diapers and food
to consider aside from hospital bills and clothing
“Even though I have not gone about calculating every expense in a
scientific manner, me and my wife have put our
capacity in consideration and are willing to work
hard to provide for our child, like most other
parents,” Zerihun said.
On the other hand Fetiha Temesgen, who became the mother of baby boy
Salamudin, on Tuesday last week at Zewditu memorial
hospital, says that she has not bought any clothes
nor made any preparations for her boy. Fetiha who
came from Wolkite, the rural side of the country,
considers it a taboo to buy anything for a child
before it is born.
“The child might not make it to delivery, and in such cases preparation
may cause sadness,” Fetiha, who speaks from her
experience of losing a one year-old girl previously,
Fetiha who trades vegetables on the black market while her husband
trades shoes in the same manner, claims that she
lives a hand-to-mouth existence. She does not know
what her daily income is. However, she says that
parents can raise a child with the capacity they
“I do not necessarily have to buy food or clothing from the same place
that somebody richer may shop at, however I will
provide him with basic necessities and raise my
child without spoiling him,” Fetiha says.
However much the services and products that parents use to raise a
child vary, a simple survey of the market reveals
that costs are increasing across the board.
Despite the exorbitant costs, the number of pregnant mothers and
deliveries has increased in hospitals and health
care centres over the past year. In the month of
Meskerem alone, from September 12 to October 11,
2011, 164 mothers delivered at Betsegah’s, according
to information from the hospital administration.
A rough count from the delivery register at Zewditu Memorial Hospital
reveals that during Meskerem around 327 mothers gave
birth, while the number of children delivered in the
same month the previous year was around 274.
Similarly, in the Ethiopian month of Hamle, from
July 8, 2011 to April 7, 2011, roughly 292 children
were born at Zewditu, while around 159 children were
born in the same month last year.
The cost of raising a child starts from the moment of conception when
pregnant mothers need regular medical attention.
Betsegah’s Hulagersh Gualu, a midwife of 30 years,
says a pregnant woman needs to visit a health care
centre at least four times during her pregnancy,
according to WHO convention. This is because she
needs to get blood work done, get HIV/AIDS testing
and counselling, RH blood tests and ultrasounds,
according to sister Hulageresh.
However, this is the minimum amount and most mothers come to Betsegah’s
monthly during early months of pregnancy, then every
15 days when their due date is near. A registration
card, which is valid for 10 days, costs 60 Br at
Betsegah’s. Ultrasound examinations cost 100 Br, and
laboratory fees can total up to 200 Br maximum.
These costs are only pre-delivery expenses. If a mother delivers her
baby naturally, it will cost between 1,200 to 3,000
Br, depending on medications and utilities used. If
a mother encounters complications such as mal
presentation, high BPR or multiple births and has to
have a C-section, costs can go upwards of 7,000 Br,
Usually new mothers are monitored by doctors for a couple of days at
Betsegah’s, where room costs range from 200-400 Br
depending on whether they are private or
In government hospitals the costs are less. However, there are people
that cannot even afford these costs and need to ask
for free service, which hospitals provide upon
receiving proper documentation, according to Aynalem
Mersha, an antenatal care midwife nurse at Zewditu
A card which is valid for 15 days costs five Br at Zewditu, according
to Aynalem. Delivery costs range from 50 Br for
normal delivery, 70 Br for delivery with
complications and 140 Br for C-sections, in keeping
with the price list posted on the wall of the
maternity ward corridor.
New mothers are monitored for six hours before they are sent home from
Zewditu, barring complications, according to Hanna,
a midwife nurse at Zewditu. A room in the maternity
ward costs 100 Br, 200 Br or 400 Br, depending on
whether there are wards, semi-private or private
After handling these costs, parents still have to shop for clothes for
the newborn. Like medical costs, these prices also
vary from store to store. But price increases
appear across the board.
Bezawit Abdelah, who sells baby clothes, near Betsegah hospital, says
that prices have increased by almost 100pc in the
past few years. The prices that Bezawit gives are
similar to Merkato’s, where she gets her supply
from. “Babies need wrapping blankets right after
they are born and socks and a hat, and other
clothing materials a little bit later,” Bezawit
Wrapping and holding blankets that used to cost 45 Br four years before
now sell for 230-250 Br according to Bezawit. Local
flannel wrapping blankets sell for 65 Br whereas
four years ago they used to sell for 25 Br. Costs
for socks and hats range from 8 to 15 Br, while the
cheapest outfit, which includes five pieces, costs
130 to 150 Br.
This outfit used to cost 45 to 50 Br, according to Bezawit. Other
outfits in Mercato can range from 250 to 300 Br.
Shoes cost 60 to 120 Br and locally made diaper
t-shirts cost 12 Br in shops and boutiques around
Pricier boutiques and shops in malls sell wrapping and holding blankets
from 350 to 550 Br. Tiny shoes can sell for up to
400 Br and small pants and t-shirts cost 250 and 170
Br respectively. These boutiques say their products
come from the United States, the United Kingdom (UK)
or the United Arab Emirates (UAE) and prices are
affected by the current foreign exchange rate.
But more than clothing expenses, new parents say they are most affected
by the cost of diapers and food. Usually people
bring clothes for newborn babies in different sizes
which can last up to a year, Fetiha told Fortune.
Fetiha also has a sister in Qatar, who provided her
clothes for the first daughter before she died. If
they have children with similar gender parents are
also likely to cloth babies with hand-me down
Most parents use cloth diapers that are reusable. One ready-made diaper
with four corners, made from Debela, a thick cotton
material, sells for 11 Br in Merkato. Prices are
cheaper in Lideta, where diapers with three corners
cost 2.50 Br a piece in cooperative shops.
Lemlem Shumye, who has been selling small clothing items on the streets
of Merkato since the King’s time, remembers when the
11 Br diapers used to sell for three Br. These
diapers are cost-friendly aside from expenses
incurred for soap and water to wash them.
Disposable diapers on the other hand, which are available in
supermarkets and stores, are a pricier option but
save time and energy. In supermarkets the small
eight-piece disposable diapers sell for 48 Br and
large 32-piece disposable diapers sell for 110 Br.
Disposable diapers bought in bulk ranging from 48
pieces to 64 pieces sell for 216 and 319 Br,
respectively. One disposable diaper can be used for
four hours and most mothers say that small babies
use up to four diapers a day, while kids a year old
and above use fewer.
When it comes to feeding their babies, mothers are advised to feed
breast milk to their babies exclusively for six
months. However, most mothers may be employees and
can only have maternity leave for 2-3 months.
Increasingly therefore mothers rely on formula milk
to feed their babies.
Currently in supermarkets, formula milk brands like Infacare, Promil,
Mother’s Milk, and S-26, at 400gm per volume, sell
for prices ranging from 122 to 152 Br. Instant
cereals like Cerelac and the local Cerefam, which
can be supplementary food after six months, sell for
40 Br and 18 Br respectively at supermarkets.
Some mothers like Fetiha, however, plan to prepare porridge material
out of mixed ground cereals containing 15 or so
cereal varieties called mitin and use cow’s milk
which can be purchased by the litre daily and can
cost up to 360 to 400 Br a month. The price for such
homemade ground cereals is also increasing. Barley,
a major ingredient in the mixes, now sells for 17 Br
Despite all these basic and necessary costs, the birth rate in the
country is increasing. The current crude birth rate
in Ethiopia is 34.5 births per 1000 population
according to the Ethiopian Demographic and Health
Survey 2011 preliminary report. However other data
from the CIA world factbook 2011 estimates the birth
rate to be 43 births per 1000 population. Ethiopia
ranks at number six in the birth rate list according
to the factbook, preceded by five other African
Hulageresh and Aynalem, the nurses at Betsegah and Zewditu
respectively, would like to see more done in the
area of family-planning and maternal health.
Hulageresh, who has worked for five years at
Betsega’s and 25 years rotating through government
hospitals, says that more attention needs to be
given especially to homeless mothers, who often use
their kids for begging on the streets.
Aynalem says she encounters a lot of homeless mothers who have had
unplanned pregnancies come to Zewditu. “We try to
teach them as much as we can to care for their child
when they are pregnant and also give them training
for family planning, but in most cases it is to no
avail,” she told Fortune.
“Our focus should not be on the number of children we have but our
capability of raising children that will be active
citizens,” Hulageresh explains.
The total population of Ethiopia is 80.4 million according to the 2010
population projection of the Central Statistics
Agency (CSA); however CIA estimates that in 2011 the
population has reached 90 million people. The
fertility rate is five children born to every woman
according to the 2010 Ethiopian Demographic and
Health Survey preliminary report.
Meanwhile the maternal mortality rate is 600 deaths per 100,000 live
births and infant mortality is 77.12 deaths of 1000
live births, according to the Ethiopian Demographic
and Health Survey preliminary report.
Ethiopia will have to reduce the maternal mortality
rate to 267 per 100,000 live births and the child
mortality rate to 31 deaths per 1000 live births in
order to meet the millennium development goals
according to Ministry of Finance and Economic
Development, indicating that a lot should be done.
CIA world fact book 2011 which estimates the
maternal mortality rate to be 470 deaths per 100,000
live births, ranks Ethiopia at number 29 for
maternal mortality rate and number 17 for infant
mortality rates respectively.
Expenses and mortality rates, however, fade into the background for
parents like Fetiha and Zerihun who are revelling in
the experience of having newborns. As Zerihun tries
to explain to Fortune how he plans to care for his
child, his mother-in-law Negatua Tsegay, who has 20
children and grandchildren combined, interjects
repeatedly the age-old saying, “My child, it does
not matter how expensive raising a child gets, Lij
Tsega new; a child is a gift.”