Background COVID-19 has proved to have an indirect impact on essential health services in several parts of the world which could lead to increased morbidity and mortality and loss of the gains made in the past decades. There were no synthesized scientific evidences which could show the impact of COVID-19 epidemics/pandemic on essential health services in Tigray, Northern Ethiopia. Therefore, this study aimed to assess the impacts of COVID-19 epidemics/pandemic on essential health services provision in Tigray, Northern Ethiopia. Methods A pre-post study design was used to assess the impacts of COVID-19 on essential health services delivery in Tigray, Northern Ethiopia in the second quarter of 2020 (Post COVID-19) compared to similar quarter in 2019 (Pre COVID-19). The study focuses on five categories; namely; maternal, neonatal and child health care; communicable diseases with a focus on HIV and TB-HIV co-infection; prevention of mother to child transmission of HIV; basic emergency, outpatient, inpatient and blood bank services, non-communicable diseases and road traffic accidents (RTAs). Analysis was done using Stata version 14.0 software package. The effects of COVID-19 epidemics/pandemic were calculated taking the differences between post COVID -19 and pre COVID-19 periods and the levels of service disruptions presented using proportions. Wilcoxon sign rank test was done and a significance level of ≤0.05 was considered as having significant difference among the two quarters. Results There were significant increase in institutional delivery, delivery by Caesarian Section (CS), still birth, postnatal care within 7 days of delivery, the number of children who received all vaccine doses before 1st birthday, the number of under 5 children screened and had moderate acute malnutrition, the number of under 5 children screened and had severe acute malnutrition and children with SAM admitted for management. However, there were significant decrease in HIV testing and detection along with enrolment to antiretroviral therapy (ART) care, number of patients with cardiovascular disease (CVD) risk ≥ 30% received treatment, RTAs, total units of blood received from national blood transfusion service (NBTS) and regional blood banks, total number of units of blood transfused and emergency referral. There were no significant changes in outpatient visits and admissions. Conclusion Despite commendable achievements in maintaining several of the essential health services, COVID-19 has led to an increase in under nutrition in under five children, decline in HIV detection and care, CVD, cervical cancer screening and blood bank services. Therefore, governments, local and international agencies need to introduce innovative ways to rapidly expand and deliver services in the context of COVID-19. Moreover, lower income countries have to customize comprehensive and coordinated community-based health care approaches, including outreach and campaigns. In addition, countries should ensure that NCDs are incorporated in their national COVID-19 response plans to provide essential health care services to people living with NCDs and HIV or HIV-TB co-infection during the COVID-19 pandemic period.

The study aimed to assess willingness to pay for community-based health insurance and its correlates among households in Wukro and Setit-humera towns, Tigray, Northern Ethiopia for the year 2016. A community-based survey was conducted in Wukro and Setit-humera towns of the Tigray region from August 30 to October 05, 2016. A total of 823 households were enrolled using a two-stage sampling. A structured, pre-tested, and interviewer-administered questionnaire was used.  Data were entered and analyzed using SPSS version 20. Frequencies, mean, and median were calculated. Bivariate and multiple variable logistic regressions were fitted. Odds Ratio with 95% CI was used to see the associations between selected independent variables and the outcome variable. Willingness to pay for community-based health insurance (CBHI) in the two towns was 93.4% with a 95% CI (91.6-95.0). The median amount of money that households are willingness-to-pay (WTP) was 11.1 USD. The mean amount of money an individual household is willing to pay was significantly higher in Setit-humera than in Wukro town. Participants who knew their monthly income were two times more likely to be willing to pay for CBHI [Adjusted odds ratio (AOR) =2.6, 95% CI; 1.1, 8.1]; and willingness was higher among households who perceived that the cost of care is affordable in health facilities [AOR=2.6, 95% CI; 1.02, 7.1]. The study has shown a high level of willingness to pay for health insurance. Perceived affordability and knowledge of monthly income were significant factors that affect willingness to pay for community-based health insurance. Therefore, it can be operationalized in urban settings provided that the community is aware and sensitized focusing on the benefits of health insurance. Besides, the premium needs to be carefully set to consider the community’s ability to pay.