Mapping resilience in conflict and recovery: A systems analysis of the health sector in Ethiopia’s Tigray region (2020-2025)
Download this Social Science and Medicine – Health Systems paper here. [opens new tab]
This paper explores the resilience of the health system in Tigray in the period during and following the recent conflict (2020-2025). The aim is to gain an understanding of the dynamic ways in which the health system has responded to the crisis and recovery, highlighting elements of its resilience, including the resilience strategies (adaptation, absorption and transformation), resilience capacities (i.e. underlying broader capacities that the health system must have in place to deploy specific approaches) and resilience pathways.
The study is grounded in the ReBUILD for Resilience resilience framework and adopts a systems thinking approach, drawing on data from a documentary review, key informant interviews and focus groups in Tigray. The findings illustrate the impact of the war on elements of the health system, and the resilience strategies adopted within each element to sustain some extent of health system functionality during the conflict, and the (longer-term) health system recovery. Based on the findings, a causal loop diagram is developed, which helps to identify key emerging resilience capacities (the motivation, dedication and individual coping strategies of health workers; community trust in healthcare providers; and the regional health authority’s leadership), highlighting causal, balancing or reinforcing loops and pathways between elements, and critically exploring how resilience strategies, capacities and pathways connect and interrelate, sustaining some elements of the health system, preventing collapse and potentially supporting a return to a fully functioning healthcare system. Findings provide evidence that could support the reconstruction and recovery efforts in Tigray, and might inform recovery planning in other settings post-conflict.
Download this Social Science and Medicine – Health Systems paper here. [opens new tab]
Further information
This paper is based on the study Health system resilience in Ethiopia’s Tigray region. There’s more on the study, including other outputs, here.
The paper is part of a Social Science and Medicine – Health Systems special edition Developing health systems resilience in fragile and shock-prone settings: Findings from the ReBUILD for Resilience Consortium [opens new tab]
Image: Nurse checks 16 months old Daniel Hagos, using respiratory monitor as his mother Girmanesh Hagos, 20, watches. UNICEF Ethiopia via Flickr. [opens new tab] CC BY-NC-ND 2.0 DEED