War-Related Disruptions and Health Service Outcomes Among Internally Displaced Persons in Tigray, Ethiopia: Evidence From Adigrat City.

Abstract

Internally displaced persons (IDPs) are individuals or groups forced to leave their homes due to conflict, violence, or other coercive circumstances. This study examined the effects of armed conflict on health service availability and outcomes for IDPs residing in designated centers in Adigrat City, Tigray region, Ethiopia. From a total of 13,315 households (HHs), a stratified random sample of 373 respondents was drawn across four zones of Tigray. Key informants were selected using purposive and simple random sampling. Data were collected through direct observation, structured questionnaires, and interviews with key informants. The study focused on key indicators of health service disruption, including destruction of health facilities, access to health extension services, and treatment for chronic diseases, as well as broader health outcomes such as maternal, infant, and elderly mortality. Findings revealed severe negative consequences of war, including widespread destruction and collapse of hospitals and health centers. Regression analysis indicated that approximately 69.8% of the disruption in health service delivery and infrastructure within IDP areas was associated with the combined effects of disrupted banking services and increased crime rates resulting from the conflict. Overall, the study underscores the urgent need for coordinated postwar reconstruction, restoration of critical systems, and targeted interventions to rebuild the health sector and improve the well-being of displaced populations in Tigray.