Impact of Armed Conflicts on Public Health Infrastructure and Services in Oromia, Ethiopia

Abstract

BackgroundOromia is the largest national regional state in the Ethiopian federation. It covers over a third of the country's landmass. In terms of sheer geography, Oromia is about the size of the sovereign European state of Germany. Demographically, Oromia closely matches with Poland among other European countries. Since early 2019, there are actively ongoing armed conflicts in Oromia damaging the public health infrastructure and hampering the provision of healthcare services. ObjectiveThe objective of this study is to assess and document the impacts of armed conflicts in Oromia on the public health infrastructure. MethodThe study is a quantitative review of administrative records and reports employing a qualitative analytical prism. ResultsOromia has 22 administrative zones of which 11 (50%) host 142 sites sheltering about 1.5 million Internally Displaced Persons (IDPs). A total of 1072 public healthcare facilities sustained attacks in areas of armed conflicts across Oromia. Among the 159 motor vehicles attacked (ambulances, district health office cars and motorbikes), 44% were ambulances. Only for the first two weeks of January 2023, 25,580 Severe Acute Malnutrition (SAM) cases were reported by healthcare facilities from the areas affected by armed conflicts in Oromia. In these areas, 11,740 patients with malnutrition were enrolled into the Outpatient Therapeutic Program (OTP), 1050 were put on subcutaneous infusion (SC) and seven died due to SAM only in the first two weeks of January 2023. Severe droughts that happened for five consecutive rainy seasons over the last three years have hit hard 10 administrative zones in Oromia, thereby compounding the impacts of the armed conflicts. ConclusionsArmed conflicts are damaging the public health infrastructure and hampering healthcare provisions in Oromia. Such conflicts are evicting people from their residential places thereby forcing them to live in poorly thatched out temporary shelters with clear implication for serious health crises. When compounded with natural calamities such as climate-change-driven drought, the impacts of such conflicts on public health infrastructure and the resultant constraints on provision of vital public healthcare services would be paramount. The authors recommend for further detailed studies on the sustained impacts that these armed conflicts can possibly bring on the provision of vital public health services in Oromia.

Analysing the six-year malaria trends at Metehara Health Centre in Central Ethiopia: the impact of resurgence on the 2030 elimination goals

“…Community initiatives, including expanded indoor residual spraying, rapid diagnosis, increased access to insecticide-treated nets, and enhanced awareness, may have contributed to the earlier decline. Conversely, disruptions caused by the COVID-19 pandemic, ongoing armed conflicts, and unrest may explain the sudden surge in malaria cases in 2022/23 [ 17 , 24 – 26 ]. Consistent with the current findings, a different study reported a positive correlation between malaria resurgence and armed conflict.…”

“…stephensi [ 20 ], as well as the emergence of diagnostic failures for P. falciparum [ 21 – 23 ]. Ongoing armed conflicts in different parts of Ethiopia, including Northern Ethiopia, Oromia, and Benishangul-Gumuz, coupled with population displacement due to drought, impede efforts to control and eliminate malaria [ 17 , 24 – 26 ]. Several risk factors arise in areas affected by conflict, including breakdown of health centres, displacement of large non-immune populations to endemic areas and resettlement of refugees to deteriorated environments that favour vector breeding [ 24 , 27 , 28 ].…”

A Case Series: A Mother and Daughter with a Critically Low Hemoglobin Level Resulting from Severe Anemia Secondary to Malaria

“…10 The effects of these conflicts on public health infrastructure and the resulting limitations on providing essential public healthcare services would be significant. 11 This has alarmingly led to a high number of deaths among children due to malaria and anemia. This little girl had been experiencing symptoms such as fatigue, vomiting, cough, loss of appetite, and dizziness for a week.…”

“…It is also vital to provide urgent humanitarian assistance to the affected population. 11 It is crucial to conduct a case series on low hemoglobin levels in malaria and anemia areas for several reasons. Firstly, it can provide valuable insights into the impact of these conditions on hemoglobin levels, which can aid in understanding the severity and progression of the diseases.…”