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The impact of the war on the health system of Ethiopia’s Tigray region: a review – Ethiopia

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Hailay Gesesew, Kiros Berhane, Elias S Siraj, Dawd Siraj, Mulugeta Gebregziabher, Yemane Gebremariam Gebre, 7 Samuel Aregay Gebreslassie, Fasika Amdes, Azeb Gebresilassie Tesema, Amir Siraj, Maru Aregawi, Selome Hailegen Tesfayha

Abstract

The war in Ethiopia’s Tigray region that began in November 2020 and is still ongoing has caused enormous damage to the health system. This analysis provides an assessment of the health system before and during the war. Evidence of damage was compiled from November 2020 to June 2021 from various reports by the interim Tigray government, as well as international non-governmental organizations. The comparison was made with data from the pre-war calendar year. Six months after the start of the war, only 30% of hospitals, 17% of health centers, 11.5% of ambulances and none of the 712 health posts were functional. In June 2021, the population in need of emergency food assistance in Tigray rose from less than one million to over 5.2 million. While the pre-war performance of antenatal care, supervised delivery, postnatal care and immunization of children was 64%, 73%, 63% and 73%, respectively, but none of the services were was likely to be supplied during the first 90 days of the war. A conservative estimate places the number of girls and women raped in the first 5 months of the war at 10,000. These data indicate widespread destruction of livelihoods and collapse of the health system. The use of hunger and rape as a weapon of war and the targeting of health facilities are key elements of war. To avoid worsening conditions, immediate intervention is needed to deliver food and supplies and rehabilitate the health care delivery system and infrastructure.