Armed conflict and treatment interruptions: A systematic review and meta-analysis in Amhara, Ethiopia

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Public Health Pub Date : 2025-02-19 DOI:10.1016/j.puhe.2025.01.039

Mihretie Gedfew, Addisu Getie, Temesgen Ayenew, Baye Tsegaye Amlak, Mengistu Abebe Meselu, Abebe Dilie Afenigus, Haile Amha

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Abstract

Background

Armed conflicts significantly disrupt healthcare systems, leading to infrastructure destruction, shortages of medical supplies, and reduced access to essential health services. The Amhara region has experienced prolonged conflict, raising concerns about its impact on healthcare delivery. Understanding the extent of these disruptions is crucial for informing policy responses and humanitarian interventions.

Objectives

This systematic review and meta-analysis aimed to assess the impact of armed conflict on healthcare delivery in the Amhara region.

Study design

Systematic review and meta-analysis.

Methods

Conducted between June 1 and July 10, 2024, this meta-analysis followed PRISMA guidelines. A comprehensive search was performed across PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, ScienceDirect, and the Cochrane Library. Eligible studies included English-language observational studies and grey literature addressing healthcare disruptions, infrastructure damage, and health crises. Data were analyzed using STATA Version 14, and study quality was assessed using a modified Newcastle-Ottawa Scale.

Results

Twelve studies, encompassing 12,037,279 participants, were included. The pooled prevalence of health impacts was 76.71 % (95 % CI: 76.63–76.78). The conflict rendered 60 % of healthcare facilities nonfunctional, disrupted medical supplies for 70 % of the population, and reduced service availability by 80 %. Chronic disease management, mental health services, maternal care, and immunization programs experienced significant declines. Subgroup analyses indicated a higher prevalence of health impacts in studies published after 2022 (70.72 %) compared to those published before 2022 (28.35 %).

Conclusion

Armed conflict in the Amhara region has severely disrupted healthcare services, leading to facility closures, medical supply shortages, and significant declines in essential health services. Urgent interventions are required to restore healthcare infrastructure and services.

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武装冲突与治疗中断：埃塞俄比亚阿姆哈拉地区的系统回顾和荟萃分析

武装冲突严重扰乱了卫生保健系统，导致基础设施遭到破坏，医疗用品短缺，并减少了获得基本卫生服务的机会。阿姆哈拉地区经历了长期冲突，令人担忧其对医疗保健服务的影响。了解这些破坏的程度对于为政策应对和人道主义干预提供信息至关重要。本系统综述和荟萃分析旨在评估武装冲突对阿姆哈拉地区医疗服务的影响。研究设计：系统回顾和荟萃分析。方法本荟萃分析于2024年6月1日至7月10日进行，遵循PRISMA指南。在PubMed/MEDLINE、EMBASE、CINAHL、b谷歌Scholar、ScienceDirect和Cochrane图书馆进行了全面的搜索。符合条件的研究包括英语观察性研究和解决医疗保健中断、基础设施破坏和健康危机的灰色文献。数据采用STATA Version 14进行分析，研究质量采用改良的Newcastle-Ottawa量表进行评估。结果纳入12项研究，共12,037,279名受试者。健康影响的总患病率为76.71 %（95 % CI: 76.63-76.78）。冲突使60% %的保健设施无法运转，70% %的人口的医疗供应中断，服务供应减少80% %。慢性病管理、精神卫生服务、孕产妇保健和免疫规划经历了显著下降。亚组分析表明，与2022年之前发表的研究（28.35 %）相比，2022年之后发表的研究（70.72 %）中健康影响的患病率更高。阿姆哈拉地区的武装冲突严重扰乱了保健服务，导致设施关闭，医疗供应短缺，基本保健服务大幅下降。需要采取紧急干预措施，以恢复保健基础设施和服务。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.