Health impacts of armed conflict in Ethiopia: a scoping review of evidence from 2018 to 2023

Abstract

Background: Armed conflict is becoming a major public health threat in contemporary society with both immediate and long-term consequences. In Ethiopia, recurrent and protracted internal conflicts have severely disrupted health systems and affected vulnerable populations. However, a comprehensive synthesis of the health impacts of armed conflict in the Ethiopian context has been lacking.

Method: We conducted a scoping review using the Arksey and O'Malley framework, guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Comprehensive searches were conducted in PubMed and Google Scholar, supplemented by targeted searches of organizational websites. Studies published in English up to December 2023 that assessed the impacts of armed conflict on health in Ethiopia were included. Data were charted and thematically analyzed.

Results: Of 230 identified, 19 studies met the inclusion criteria. The studies addressed six thematic areas. Maternal and reproductive health (n = 5), mental health (n = 5), health system disruption (n = 4), nutrition (n = 4), chronic diseases (n = 2), and malaria outbreak (n = 1). Health system disruption (51%), gender-based violence (40%), post-traumatic stress disorder (40%), depression (66.5%), anxiety (63%), chronic diseases treatment disruption (80%), and malaria outbreak; 26.5/1000 attack rate and 43% slide positive rate were key findings.

Conclusion: This scoping review revealed that armed conflict in Ethiopia has had a profound and interrelated impact on public health, disproportionately affecting women, children, and internally displaced populations. The findings underscore the urgent need for coordinated, multisectoral interventions that restore essential health services, strengthen mental health support, and ensure continuity of care for chronic and infectious diseases. Future research should focus on underexplored areas such as nutrition, malaria, and chronic disease management using diverse and longitudinal study designs.

Keywords: Armed conflict; Chronic disease; Ethiopia; Health system; Malaria; Malnutrition; Mental health; Sexual and reproductive health.

Fig. 1

PRISMA Flow Chart

Fig. 2

Distribution of reviewed studies by thematic area: maternal and reproductive health (n = 5), mental health (n = 5), health system interruption (n = 4), nutrition (n = 4), chronic disease (n = 2), and malaria (n = 1)

Fig. 3

Distribution of reviewed studies by geographic region: Amhara Region (n = 9), Tigray Region (n = 5), Somali (n = 3), and Oromia (n = 2)