Following Health Ministry Directive

Number of Ethiopian Women in Israel Given Depo-Provera Drops by Some 40%

Knesset Labor, Welfare and Health Committee asks attorney general to probe use of Depo-Provera in Israel's Ethiopian community.

Health Ministry director general Ronni Gamzu on Wednesday said that since January, when he instructed Israel four main HMOs not to automatically administer Depo-Provera to Ethiopian women who request a contraceptive, such treatments have dropped 30 to 40 percent.

Gamzu made his remarks to the Knesset Labor, Welfare and Health Committee. The Health Ministry stressed that the figures Gamzu presented Wednesday are preliminary data submitted by the HMOs at the ministry’s request, and the ministry is still reviewing them.

Nevertheless, while there’s still no evidence of any deliberate attempt to suppress the Ethiopian birthrate, the figures do strengthen the claim that until now, Ethiopian women were given the shots without any explanation of either the side effects or alternative contraceptive methods.

The drug’s possible side effects include irregular bleeding, headaches, dizziness, stomach pains, weight change, anxiety and depression.

Gamzu said that in light of the data, the ministry is considering taking the unusual step of requiring women to sign a consent form before receiving the shots, to help ensure that they first receive the requisite explanations. Currently, consent forms are required only for invasive procedures.

Several MKs voiced suspicions that the shots were given in a deliberate attempt to lower the Ethiopian birthrate, in light of Central Bureau of Statistics data cited in the Knesset research center’s report. This data showed that among women who immigrated from Ethiopia between 2000 and 2010 − i.e., those most likely to have been given Depo-Provera − fertility rates were 38.2 percent lower than the average Israeli fertility rate in 2010 and 40 percent lower than the average rate among women who immigrated from Ethiopia in the 1990s.

MK Orly Levi-Abekasis (Likud Beiteinu), who also organized a letter co-signed by several other MKs to urge Shapira to investigate the matter, said she was deeply disturbed by the data.

“It’s known that these shots should be avoided whenever possible; they’re the last resort,” she said during Wednesday's hearing. “Why weren’t alternatives presented to these women? Why did they continue giving the shots without examining the patients’ medical files from previous years, when they were still in Ethiopia? Why is the rate of those receiving the shots among women of Ethiopian origin so much higher than among other Israeli women?”

Data from two of the four HMOs, which was compiled by the Knesset research center at the request of Levi-Abekasis, show that until then, Depo-Provera treatments had been on the rise. At Meuhedet, the number of women receiving the shots rose by a factor of 7.2 between 1998 and 2012, from 56 to 407, with a 62 percent increase recorded from 2010 to 2011 alone. At Leumit, the number rose from just one in 2008 to 521 in 2012.

Clalit and Maccabi, the two largest HMOs, declined to provide data, citing a class-action suit against them on the issue − though that suit also targets Meuhedet. But according to a 2009 study by the feminist organization Isha L’Isha, there was a significant rise in the number of Ethiopian women receiving Depo-Provera at those HMOs as well in 2000-2009.

At the conclusion of Wednesday's hearing, the committee asked State Comptroller Joseph Shapira to investigate the use of Depo-Provera in Ethiopian women. Health Minister Yael German, who attended the hearing, also proposed that a parliamentary committee of inquiry be established on the matter.

Coincidentally, the Tel Aviv District Court held a hearing Wednesday on the class-action suit against Clalit, Maccabi and Meuhedet, filed by three Ethiopian women who claim they were given Depo-Provera without appropriate explanations of the side effects. The next hearing in the case will be held in November.

Members of the Falashmura community in Ethiopia in 2013, waiting to immigrate to Israel
Anshel Pfeffer