Tigray Health Research Institute, Tigray, Ethiopia.
Health Res Policy Syst. 2024 Sep 3;22(1):121. doi: 10.1186/s12961-024-01176-w.
An estimated 2.5 million people have been internally and externally displaced in the Tigray region of northern Ethiopia in conflict and post-conflict settings. This induced a loss of access to basic and essential healthcare services. The situation was overwhelming, causing service inaccessibility, inadequate health facilities, unstable security to access the services, shortage of supplies and drugs, and medical equipment's in the region. The regional public health emergency management is one service delivery set up for the critically ill. It is characterized by weak emergency management capacities, poor coordination and integration. In addition, the system falls in to two independent sectors in the Tigray Health Bureau (THB), Tigray Health Research Institute (THRI). This leads to a fragmented system, an unclear leadership and governance role and a poor service delivery setup and tracking mechanism. The situation leads to resource duplication and poor business practice. Indeed, this type of service delivery setup secures personal and professional interest more than community interest. The situation exacerbated the occurrence of recurrent outbreaks in the region, with, for instance, zoonotic diseases (anthrax and rabies), acute watery diarrhoea, measles, malaria, yellow fever, and coronavirus disease 2019 (COVID-19) approaching to their level of epidemic. Moreover, they will spike as an epidemic in the future. All these circumstances made it evident that the system need reform to adhere with legal global, national, and regional frameworks, guidelines and proclamations. The system should have one service delivery set up at regional level. It must fall into regional public health institutes (PHIs) to adhere its service packages to the current advancements. Furthermore, integrated effort need from program implementers, relevant stakeholders and policy-makers should be committed and work together in the review and reform process.
据估计，在埃塞俄比亚北部提格雷地区的冲突和冲突后环境中，有 250 万人在国内和国外流离失所。这导致人们无法获得基本和必要的医疗保健服务。情况令人难以承受，导致服务无法获得、卫生设施不足、获取服务的安全不稳定、用品和药品短缺以及该地区的医疗设备短缺。区域公共卫生应急管理是为重病患者提供的一项服务。其特点是应急管理能力薄弱、协调和整合不力。此外，该系统在提格雷卫生局（THB）和提格雷健康研究所（THRI）分为两个独立部门。这导致系统碎片化，领导和治理角色不明确，服务提供和跟踪机制不佳。这种情况导致资源重复和不良的业务实践。事实上，这种服务提供模式更注重个人和职业利益，而不是社区利益。这种情况加剧了该地区反复爆发疫情的情况，例如，人畜共患疾病（炭疽和狂犬病）、急性水样腹泻、麻疹、疟疾、黄热病和 2019 年冠状病毒病（COVID-19）接近流行水平。此外，它们将来会爆发成流行病。所有这些情况都表明，该系统需要改革，以遵守全球、国家和区域法律框架、准则和宣言。该系统应在区域一级建立一个服务提供系统。它必须归入区域公共卫生机构（PHIs），以使其服务包符合当前的发展。此外，方案执行者、相关利益攸关方和决策者需要作出综合努力，共同参与审查和改革进程。
