Ethiopia is currently experiencing several intersecting humanitarian crises including conflict, climatic shocks, COVID-19, desert locust infestation and more, affecting nearly 30 million people. This brief outlines important contextual factors and social impacts of the Northern Ethiopian crisis and offers key considerations to improve the effectiveness of the humanitarian response.
Although baseline data for post-conflict situations are frequently unavailable, there is a clear deterioration in the health conditions of populations during and following conflict. Excess mortality and morbidity, displaced populations, and vulnerability to communicable diseases during and following conflict all call for immediate relief and restoration of basic services. As much as possible, short-term relief and assistance programmes should be implemented in a manner compatible with longer term health system rehabilitation.
This paper presents a framework for analyzing the inputs and policies that make up post-conflict rehabilitation programmes in the health sector. Post-conflict rehabilitation of the health sector can be viewed as three inter-related approaches: (1) an initial response to immediate health needs; (2) the restoration or establishment of a package of essential health services; and (3) rehabilitation of the health system itself. These three approaches should operate synergistically and as part of a continuum.
Using the principles of reputational case selection sampling procedure and thematic search of electronic databases and websites, we implemented a regional synthesis of evidence on the health vulnerabilities of migrant and mobile populations in urban areas of East and Southern Africa. The review identified key health challenges relating to various diseases, including the increasing challenge of non-communicable diseases, such diabetes among migrants by 2030.
While figures are difficult to obtain, our review suggested high levels of urban migrants, including refugees, internally displaced persons (IDPs) and asylum seekers in urban areas of the region, which for undocumented migrants poses particular logistics challenges in terms of administering targeted interventions, more so in contexts where poor socio-economic situations of countries do not provide them with opportunities to become self-reliant and less dependent on humanitarian assistance. This calls for policies, program interventions and research investments targeting vulnerable migrant and mobile groups in the region.
Complex humanitarian emergencies are characterised by a break-down of health systems. All-cause mortality increases and non-violent excess deaths (predominantly due to infectious diseases) have been shown to outnumber violent deaths even in exceptionally brutal conflicts. However, affected populations are very heterogeneous and refugees, internally displaced persons (IDPs) and resident (non-displaced) populations differ substantially in their access to health services. We aim to show how this translates into health outcomes by quantifying excess all-cause mortality in emergencies by displacement status. As standard data sources on mortality only poorly represent these populations, we use data from CEDAT, a database established by aid agencies to share operational health data collected for planning, monitoring and evaluation of humanitarian aid. We obtained 1759 Crude Death Rate (CDR) estimates from emergency assessments conducted between 1998 and 2012. We define excess mortality as the ratio of CDR in emergency assessments over ‘baseline CDR’ (as reported in the World Development Indicators).