Perilous medicine in Tigray: a systematic review

Gesesew, Hailay Abrha; Kebede, Hafte Kahsay; Berhe, Kenfe Tesfay; Fauk, Nelsensius Klau; Ward, Paul

doi:10.1186/s13031-023-00524-x

Cited by 7 publications

(1 citation statement)

References 44 publications

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“…Others have been either deliberately attacked or looted, resulting in limited services and care staff. 30,31 It is hoped that recent cease-fire efforts will facilitate a return to normal life.…”

Section: Afterwordmentioning

confidence: 99%

Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study

Aregay,

O’Connor,

Stow

et al. 2023

Palliat�Care

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Background: Ethiopia has a national palliative care guideline, and palliative care is explicitly recognised in the country’s healthcare policy and health sector transformation plans. However, palliative care is not fully delivered in the regional public hospitals and primary health care units. Objective: This study explores perceived policy barriers to deliver palliative care services in rural and regional healthcare settings, which primary healthcare units largely serve. Design: Face-to-face interviews were conducted in a rural region of Ethiopia. Methods: Forty-two participants were recruited from a variety of health settings including primary, secondary and tertiary levels across the region. Interviews were conducted with policymakers from the regional health bureau, pharmacists, medical doctors, health officers (clinical officers) and nurses, including chief nursing officers in leadership roles at all levels of healthcare institutions. Data analysed using thematic analysis. Results: Participants described several barriers related to healthcare policy, including lack of government priority and focus on palliative care; lack of health professionals’ awareness of the national palliative care plans and guidelines; and lack of palliative care integration into the existing healthcare system and the national budget. Participants remarked that palliative care services in the region were mainly limited to HIV patients, often managed with external support and, hence unsustainable. Conclusions: Policy priority and focus is a fundamental component for the provision of palliative care because lack of focus and support from the government have led to inadequate access to palliative care for all in need. Hence, as participants suggested, palliative care should be integrated into all healthcare levels, particularly into the primary health care units and the health extension programme, to facilitate health extension workers to support millions living in rural areas.

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Section: Afterwordmentioning

confidence: 99%

Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study

Aregay,

O’Connor,

Stow

et al. 2023

Palliat�Care

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Prevalence of vicarious trauma, depression, anxiety, stress, post-traumatic stress disorder, and resilience among the Tigrayan diaspora in Australia: A cross-sectional study following the Tigray conflict

Gesesew,

Tesfamicael,

Mwanri

et al. 2025

Journal of Affective Disorders

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The effect of war and siege on children with diabetes admitted to ayder comprehensive specialized hospital in mekelle, tigray, ethiopia: a cross-sectional study

Gebrekidan,

Haftu,

Hailu

et al. 2024

Sci Rep

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The armed conflict in Tigray, which spanned from November 2020 to November 2022, along with the accompanying siege, led to the near-total collapse of Tigray’s healthcare system. Type 1 Diabetes Mellitus, the most common chronic condition in children, requires significant lifestyle adjustments, including daily insulin injections, regular glucose monitoring, and dietary modifications; all of which are severely impacted by war and siege. This study compared Type 1 diabetes care for children at the Ayder Comprehensive Specialized Hospital, Tigray, during the conflict and siege period with that of the pre-war period. We conducted a retrospective cross-sectional survey, analyzing data from September 2019 to August 2020 (pre-war period) and comparing it with data from September 2021 to August 2022 (war and siege period). Descriptive statistics, including frequencies and percentages, were employed, and Pearson’s or Spearman’s correlation analyses were used to evaluate correlations where appropriate. We identified 143 pediatric patients admitted (56 during the pre-war period and 87 during the war and siege period), with a mean age of 109 months in both periods. During the war and siege, a higher proportion of diabetes admissions were due to diabetic ketoacidosis (DKA) (90%) compared to the pre-war period (75%). In the pre-war period, the most common trigger for DKA was infections (35%), while in the war and siege period, it shifted to malnutrition (47%), infections (46%), lack of access to healthcare facilities (31%), and running out of medicines (24%). Complications such as death, renal failure, cerebral edema, and shock were more prevalent during the war and siege periods. The case fatality rate was significantly higher during the war and siege (9%) compared to the pre-war period (0%), correlating strongly with the severity of DKA, the degree of hypokalemia, the presence of complications, and admission during the war and siege. Our study showed the negative impact of war and siege on diabetes care in children demonstrating a high rate of DKA admissions with increased severity, complications, malnutrition, and case fatality rates. People with diabetes especially type 1 deserve great attention during such a crisis as the lack of insulin could lead to severe complications including death.

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Perilous medicine in Tigray: a systematic review

Cited by 7 publications

References 44 publications

Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study

Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study

Prevalence of vicarious trauma, depression, anxiety, stress, post-traumatic stress disorder, and resilience among the Tigrayan diaspora in Australia: A cross-sectional study following the Tigray conflict

The effect of war and siege on children with diabetes admitted to ayder comprehensive specialized hospital in mekelle, tigray, ethiopia: a cross-sectional study

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