RT Journal Article SR Electronic T1 The impact of war on the health system of the Tigray region in Ethiopia: an assessment JF BMJ Global Health JO BMJ Global Health FD BMJ Publishing Group Ltd SP e007328 DO 10.1136/bmjgh-2021-007328 VO 6 IS 11 A1 Hailay Gesesew A1 Kiros Berhane A1 Elias S Siraj A1 Dawd Siraj A1 Mulugeta Gebregziabher A1 Yemane Gebremariam Gebre A1 Samuel Aregay Gebreslassie A1 Fasika Amdeslassie A1 Azeb Gebresilassie Tesema A1 Amir Siraj A1 Maru Aregawi A1 Selome Gezahegn A1 Fisaha Haile Tesfay YR 2021 UL http://gh.bmj.com/content/6/11/e007328.abstract AB The war in Tigray region of Ethiopia that started in November 2020 and is still ongoing has brought enormous damage to the health system. This analysis provides an assessment of the health system before and during the war. Evidence of damage was compiled from November 2020 to June 2021 from various reports by the interim government of Tigray, and also by international non-governmental organisations. Comparison was made with data from the prewar calendar year. Six months into the war, only 27.5% of hospitals, 17.5% of health centres, 11% of ambulances and none of the 712 health posts were functional. As of June 2021, the population in need of emergency food assistance in Tigray increased from less than one million to over 5.2 million. While the prewar performance of antenatal care, supervised delivery, postnatal care and children vaccination was 94%, 73%, 63% and 73%, respectively, but none of the services were likely to be delivered in the first 90 days of the war. These data indicate a widespread destruction of livelihoods and a collapse of the healthcare system. The widespread use of hunger and rape during the brutal war and the targeting of healthcare facilities seem to be key components of the war. To avert worsening conditions, an immediate intervention is needed to deliver food and supplies and rehabilitate the healthcare delivery system and infrastructure.All data relevant to the study are included in the article or uploaded as online supplemental information.