Geographical distribution of the health crisis of the war in the Tigray region of Ethiopia – Ethiopia
Mulugeta Gebregziabher, Fasika Amdeselassie, Reiye Esayas, Zerihun Abebe, Hannah Silvia, Abeba A Teklehaimanot, Jeffrey E Korte, John L Pearce, James J Cochran
Correspondence to Mulugeta Gebregziabher; [email protected]
War destroys health facilities and displaces health workers. It has a devastating impact on the health of the population, especially among vulnerable populations. We assess the geographical distribution of the impact of war on health care delivery by comparing the pre-November 2020 and November-June 2021 status of health facilities in the Tigray region of Ethiopia. Data was collected from February 2021 to June 2021, during an active civil war and imposed communications blackout in Tigray. Primary data was collected and verified by multiple sources. The data includes information on health facility type, geocoding, and health facility status (fully functional (FF), partially functional (PF), non-functional, no communication). Only 3.6% of all health facilities (n=1007), 13.5% of all hospitals and health centers (n=266), and none of the health posts (n=741), are functional. Destruction varies by geographic location; only 3.3% in the West, 3.3% in the South-East, 6.5% in the North-West, 8% in the Center, 14.6% in the South, 16% in the East and 78.6% in Mekelle are FF. Only 9.7% of health centers, 43.8% of general hospitals and 21.7% of primary hospitals are FF. None of the health facilities are functioning at pre-war levels, even when classified as FF or PF due to lack of electricity and water or essential appliances looted or destroyed, as they continue to function. The Tigray war clearly had a direct and devastating impact on the delivery of health care. The restoration of destroyed health facilities must be a priority for the international community.
What do we already know about this?
Previous research has shown the deleterious effects of war on health and health care delivery. Due to limited communication and reporting, the extent of the direct impact on health care delivery from the war in Tigray has not been well characterized at a granular level, including its geographic distribution.
What does this study bring?
In this study, we conducted a granular assessment of the functional status of all health facilities in Tigray. The comparison between the pre-November 2020 and November-June 2021 condition of each health facility revealed the extent and severity of the devastation and their geographical differences.
How might this study affect research, practice or policy?
The catastrophic impacts of war on health and health care delivery should make war a priority agenda in health policy making. This prioritization can lead to improved research and strategies to prevent war and mitigate its negative impacts.