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

Abstract

Background Oromia is the largestnational 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 otherEuropean countries. Since early 2019, there areactively ongoing armed conflictsin Oromiadamagingthe public health infrastructure and hampering the provision of healthcare services. Objective The objectiveof this study isto assess and document the impacts of armed conflicts in Oromia on the public health infrastructure. Method The study is a quantitative review of administrative records and reports employing aqualitativeanalytical prism. Results Oromia has 22 administrative zones of which 11 (50%) host142 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 carsand 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 byarmed conflictsin 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 inOromia, therebycompounding the impacts of the armed conflicts. Conclusions Armed conflictsare damagingthe public health infrastructureand hampering healthcare provisionsin Oromia. Suchconflictsare evictingpeople from theirresidentialplaces thereby forcing themto live in poorly thatched out temporary shelterswith clearimplicationfor serious health crises. When compounded with natural calamities such as climate-change-driven drought, the impacts ofsuch conflictson public healthinfrastructure 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.