Delivery
Lessons learnt: Rebuilding health service delivery after conflict
By Iman Abdulkarim Mubarek & Miki Wondimeneh
The crisis in Ethiopia's northern region has caused significant disruption across the health service. Regions such as Afar, Amhara and Oromia have been affected by disruptions in primary health services over the past two years.

Throughout this time, we have continued to provide assistance in these areas to improve immunisation performance and support the recovery of health services. Lack of data to assist decision-making, interruption of routines, and restricted engagement of partners are key factors that limit services and slow recovery. In order to speed up the recovery of health services, the team has been supporting in the following areas.

  • Enabling data-driven decision making: Often there is an extended lead time to deliver support in conflict-affected regions driven by a lack of data. In Afar, one of the regions most affected by the conflict, there was limited data on the number of health facilities that had been damaged and size of the population affected. We developed a health facility functionality dashboard that maps the status of health facilities across the entire region and size of the population served by each health facility. This enables the regional administration to quickly identify potentially underserved communities and guide resource prioritisation to rapidly restore services.  

 

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Figure 1: Afar health facility functionality tracking dashboard

  • Ensuring routines are maintained: In conflict-affected areas, performance management meetings are often disrupted. In regions where connectivity is good, we sustained performance routines through virtual review sessions. This has allowed the government to sustain performance and quickly identify and solve operational challenges.

  • Leveraging partner networks to enable quick problem solving: Effective problem solving often becomes a question of resources. In Oromia for example, one in four health facilities did not have functional cold chain equipment. We helped the government to ensure the quick maintenance of over 200 pieces of cold chain equipment since September 2021 by engaging partners in the regional problem solving sessions.

 

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Figure 2: Maintained fridges in Oromia region: Sep 21-Feb 21

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