[{"bbox": [96, 151, 1135, 314], "category": "Text", "text": "delivery of basic services. Furthermore, the Action aligns with the Gender Action Plan III,⁶ the EU Disability Rights Strategy 2021-2030,⁷ the EU vision of the future Africa-EU partnership as per its Communication \"Towards a Comprehensive Strategy with Africa\"⁸ and especially with the Partnership for Sustainable Growth and Jobs, which aims at increasing access to quality education, skills, research, innovation, health and social rights. Finally, it also contributes to the 2030 Agenda for Sustainable Development through the SDG 3 (global health and wellbeing), which is also closely linked to SDG 5 (gender equality)."}, {"bbox": [96, 326, 1135, 460], "category": "Text", "text": "The Action will link up with the EU's past and ongoing humanitarian aid funded actions in the health sector, aimed at providing life-saving emergency healthcare access to vulnerable people in locations hit by conflict, natural hazards and underprivileged conditions. Such linkage and coordination will be done with a view to strengthening resilience, promoting access to quality and sustainable services, addressing the root causes of humanitarian crises and developing resilience of crisis-affected populations, avoiding duplication in interventions."}, {"bbox": [96, 470, 1135, 658], "category": "Text", "text": "This Action will complement and further strengthen interventions from Individual Measure 1 by replicating the rehabilitation of important referral/specialized hospitals from Amhara (where the rehabilitation of Dessie Hospital already started in 2022 and is progressing well) in the two other conflict affected regions: in Tigray with Adwa hospital and in Afar with Aba'ala hospital. That way, the EU will provide a regionally balanced approach and significantly widens the access to specialised medical services in all conflict-affected areas. The Action will also complement EU funding to restoration of primary healthcare and MHPSS and GBV trauma support in conflict affected areas, implemented through UNICEF and Medicins du Monde."}, {"bbox": [85, 684, 341, 714], "category": "Section-header", "text": "## 2.2 Problem Analysis"}, {"bbox": [96, 731, 492, 758], "category": "Section-header", "text": "### Health facilities damaged by the conflict"}, {"bbox": [96, 768, 1135, 930], "category": "Text", "text": "The northern Ethiopia conflict has created high humanitarian needs across Tigray, Afar and Amhara regions, which remains largely unaddressed. Important health infrastructures, such as health facilities (hospitals and health centres), WASH and waste disposal systems, IT infrastructure, and medical equipment amongst others, have been severely damaged and rendered non-functional, thereby hindering the provision of basic essential health services to communities. Hostilities have resulted in massive population movements, and individual's access to health services is being seriously limited."}, {"bbox": [96, 940, 1135, 1076], "category": "Text", "text": "Facility level assessments⁹ in Adwa hospital (Tigray region) and Aba'ala hospital (Afar region) indicated that critical health services are severely affected due to damage on health infrastructures, looted/damaged medical and non-medical equipment, destruction/non-functional power & water supply system, damage on waste disposal system, etc. These two hospitals are the main referral hospital (tertiary level) of the regions, serving catchment population of (estimated) 1.2 million and 82 000 people respectively."}, {"bbox": [96, 1085, 1135, 1353], "category": "Text", "text": "In **Adwa hospital**, the Regional Health Bureau was constructing a new building before the conflict while providing services in an old building. During the conflict, the old building was severely damaged and has already stopped functioning. Service provision in the new building is yet to start with some finishing infrastructure and electromechanical works, installation of water supply system and upgrading the waste disposal system. It also require equipping with the necessary medical equipment and supplies. Infrastructure damage in **Aba'ala hospital** is relatively not significant, requiring fixing of broken doors, window and part of the roofing damaged by bullets and heavy artilleries. The critical damage in Aba'ala hospital is on the water supply system which is completely destroyed and requiring drilling of deep borewell, which is expensive given the location of the hospital. Like in Adwa hospital, medical equipment were looted/damaged, including gynaecology and intensive care, diagnostic & imaging, operation theatre /OR/equipment."}, {"bbox": [96, 1362, 1135, 1472], "category": "Text", "text": "Additionally, infrastructure and equipment for clinical treatment of GBV survivors are also not available in both Adwa and Aba'ala hospitals. The Government standard requires to establish One Stop Centre (OSC) for treatment of GBV survivors at hospital level, which is missing in both hospitals. According to standards, they would need to count on equipment and trained professionals, particularly for gynaecological/obstetric interventions."}, {"bbox": [96, 1482, 488, 1509], "category": "Section-header", "text": "### GBV Survivors living with unmet needs"}, {"bbox": [85, 1549, 416, 1574], "category": "Footnote", "text": "⁶ join-2020-17-final_en.pdf (europa.eu)"}, {"bbox": [85, 1574, 384, 1598], "category": "Footnote", "text": "⁷ KE0221257ENN_002 proof 2.pdf"}, {"bbox": [85, 1598, 594, 1622], "category": "Footnote", "text": "⁸ Africa-EU Partnership - European Commission (europa.eu)"}, {"bbox": [85, 1622, 824, 1646], "category": "Footnote", "text": "⁹ Expertise France Rapid Asessment report on Adwa and Aba'ala hospitals, March 2023."}, {"bbox": [1038, 1681, 1144, 1706], "category": "Page-footer", "text": "Page 6 of 23"}]