RESUMO
The war and siege in Tigray led millions to displace internally. More than three-fourths of the health facilities were either destroyed or not functional as the equipment and other resources were stolen. Furthermore, the remaining functioning health facilities were flooded beyond their capacity, resulting in many patients received treatment late, and ending with complications including life loss. Mekelle City is one of the largest towns with many internally displaced people from different areas of Tigray. To provide services for the most vulnerable populations, 11 IDP clinics were opened for internally displaced people and the surrounding host community in Mekelle. A total of 6732 patients received clinical services, of which 3465 were males. The age of the patients was in ranged of 24 days to 95 years. A total of 364 patients were emergency cases and 428 outbreaks were seen. A total of 722 patients with chronic illnesses received follow-up services, the most common being hypertension (112), diabetes (79), and asthma (70). Overall, 1198 investigations were done and 1339 were referred to higher-level healthcare facilities. Upper respiratory infection (n = 976), acute gastroenteritis (n = 667), and pneumonia (n = 612) were the most common disease conditions in IDP clinics. Antibiotics were the most commonly prescribed medication for 2468 patients, followed by anti-pain/pyretic (1402). This community engagement showed us that, it is possible to continue healthcare services when health facilities get collapsed during crisis owing to the relocation and mobilization of available resources.
RESUMO
BACK GROUND: HIV/AIDS remained among the common public health problems in developing country. Despite the extensive delivery of ART and improved coverage of the service access, still, man-made problems like war have negatively influenced the utilization of antiretroviral treatment services. The war in Tigray Region in the northern Ethiopia broke out in November 2020 and thereby has brought about an extreme damage on most of the infrastructure in Tigray, including the health institutions. The purpose of this study is, therefore, to assess and report the trend of HIV service provision across the war affected rural health facilities in Tigray. METHODS: The study was conducted in 33 rural health facilities during the active war in Tigray. A facility based retrospective cross-sectional study design was conducted among health facilities from July 03 to August 05, 2021. RESULT: A total of 33 health facilities from 25 rural districts were included in the HIV service delivery assessment. A total of 3274 and 3298 HIV patients were seen during pre-war period in September and October 2020, respectively. The number of follow-up patients during the war period in January remained to be only 847(25%) which is significantly reduced with a P value<0.001. A similar trend was observed during the subsequent months until May. The trend of follow-up patients on ART significantly declined from 1940 in September (pre-war) to 331(16.6%) in May (during the war). This study also revealed a 95.5% reduction of laboratory service provision to HIV/AIDS patients during the war in January and with similar trends thereafter (P<0.001). CONCLUSION: The war has led to a significant decline of HIV service provision in the rural health facilities and most part of the region during the first eight months of active war in Tigray.
