Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 4;25(1):928.
doi: 10.1186/s12913-025-13084-y.

Exploring health system challenges and gaps for crisis response in Ethiopia: a scoping review of publications and reports from 2020-2024

Asmamaw Atnafu  1 , Getachew Teshale  1 , Endalkachew Dellie  1 , Young Su Park  2
Affiliations

Exploring health system challenges and gaps for crisis response in Ethiopia: a scoping review of publications and reports from 2020-2024

Asmamaw Atnafu et al. BMC Health Serv Res. .

Abstract

Background: Ethiopia's health system has faced significant challenges due to COVID-19, natural disasters, and conflicts, disrupting healthcare delivery. This scoping review examined health system gaps and responses during crises, aiming to recommend strategies for resilience.

Method: We followed a systematic scoping review approach using the five-step methodology: defining the research question, identifying relevant literature, selecting studies, charting the data, and summarizing/analyzing results. The review was guided by PRISMA-ScR and used the Population, Concept, and Context (PCC) framework. We included all English-language studies published between January 2000 and December 2024 addressing challenges or responses of the Ethiopian health system during crises, regardless of study design. PubMed, SCOPUS, Google Scholar, and Google were searched using MeSH terms/keywords. After title, abstract, and full-text screening, 44 articles were included for final analysis. Data were synthesized using descriptive analytical methods and narrative synthesis to summarize and interpret findings.

Results: Findings revealed crises severely impacted health services due to shortages of medical supplies, workforce, and infrastructure. Demand surges, transport restrictions, border closures, and financial constraints exacerbated these gaps. Additional challenges included poor data availability, high staff turnover, lack of emergency communication plans, and insufficient funding.

Conclusion and recommendations: The COVID-19 pandemic and the northern Ethiopian conflict notably disrupted routine services, infrastructure, and health information systems. To build resilience, the study recommends: (1) developing scalable emergency plans for essential services, (2) strengthening primary healthcare and community-based systems, (3) maintaining medical stockpiles, and (4) providing crisis-specific training for health workers. These measures aim to enhance preparedness and sustainability in Ethiopia's health system amid future shocks.

Keywords: Crises response; Ethiopian; Health systems; Public health emergencies.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA article selection process adapted from PRISMA 2020 for new systematic reviews which included searches of databases
See this image and copyright information in PMC

References

    1. Brecher M, Wilkenfeld J. A study of crisis. University of Michigan Press; 2022.
    1. Bookchin M. The modern crisis. AK Press; 2022.
    1. Kentikelenis A, Papanicolas I. Economic crisis, austerity and the Greek public health system. Eur J Public Health. 2012;22(1):4–5. - DOI - PubMed
    1. Kieny M-P, Evans DB, Schmets G, Kadandale S. Health-system resilience: reflections on the Ebola crisis in western Africa. SciELO Public Health. 2014;92:850–850. - PMC - PubMed
    1. Massuda A, Hone T, Leles FAG, De Castro MC, Atun R. The Brazilian health system at crossroads: progress, crisis and resilience. BMJ Global Health. 2018;3(4):e000829. - DOI - PMC - PubMed

Publication types

LinkOut - more resources