[{"bbox": [96, 153, 1164, 207], "category": "Text", "text": "communities in conflict affected areas. By working with children and adolescent victims of GBV, it will also\nstrengthen the existing child protection systems."}, {"bbox": [96, 219, 1164, 325], "category": "Text", "text": "This Action builds on an ongoing intervention funded under Individual Measure 1 in support of primary healthcare in conflict affected areas. It is aligned with the Ethiopia's Resilient Recovery and Reconstruction Planning Framework (3RF) and the reforms envisaged by the Health Sector Transformation Plan (HSTP-II), in particular with its objectives of a) accelerating progress towards universal health coverage, and b) improving health system responsiveness."}, {"bbox": [96, 337, 1164, 418], "category": "Text", "text": "This Action falls under Priority Area 2 of the MIP with the Federal Democratic Republic of Ethiopia, Human Development, particularly its objective of improving equitable access, quality and internal efficiency in the delivery of basic services. It contributes to the achievement of SDG 3 (good health and wellbeing) and SDG 5 (gender equality)."}, {"bbox": [96, 429, 1164, 563], "category": "Text", "text": "A number of EU MS (France, Spain and Italy) are collaborating with EU in the health sector, including under Individual Measure 1. This Action builds upon the synergies created and will strengthen them further (including with a financial contribution to Expertise France). Despite not being an official TEI, this Action is an example of a promising Team Europe approach. This Action is contributing to the implementation of the Global Gateway strategy, with a combination of hard and soft components in one of the Global Gateway investment priorities, i.e. health."}, {"bbox": [87, 589, 506, 620], "category": "Section-header", "text": "1.3 Zone benefitting from the Action"}, {"bbox": [87, 637, 1143, 664], "category": "Text", "text": "The Action shall be carried out in the Federal Democratic Republic of Ethiopia, included in the list of ODA recipients."}, {"bbox": [87, 697, 323, 729], "category": "Section-header", "text": "2 RATIONALE"}, {"bbox": [87, 762, 234, 789], "category": "Section-header", "text": "2.1 Context"}, {"bbox": [96, 808, 1135, 969], "category": "Text", "text": "Ethiopia is the second most populous country in Africa with around 126 million people (of which 39% are 0-14 years old) and the population growth remains high at around 2.5% per year, despite having been decreasing for the past three decades¹. The UN estimates that its population will reach 200 million by 2050, becoming one of the world's ten largest countries. Education and health access and utilization have increased over the last decade as the number of primary health posts, health centres, and schools increased. Nonetheless, Ethiopia is also one of the poorest ranking 175 out of 191 countries at the Human Development Index (2021/2022)²."}, {"bbox": [96, 980, 1135, 1086], "category": "Text", "text": "While the Pretoria Cessation of Hostilities Agreement (CoHA) signed between the Ethiopian government and the Tigray People's Liberation Front (TPLF) in November 2022 ended the armed conflict in the North and introduced a peace and reconstruction process, the situation in northern Ethiopia remains volatile as is evidenced in armed confrontations between federal government forces and regional militias in Amhara region."}, {"bbox": [96, 1098, 1135, 1206], "category": "Text", "text": "The two-year conflict in northern Ethiopia resulted in significant loss of life and contributed to an acute humanitarian crisis in the country. The fighting caused significant damage to health facilities, translating into thousands of health facilities becoming non-functional³. This increased pressure on an already strained health system, which was under difficulties since the start of the COVID-19 pandemic."}, {"bbox": [96, 1217, 1135, 1430], "category": "Text", "text": "In addition to health infrastructure damage, the conflict has also led to loss of livelihoods as well as psychological distress and sexual abuse of women and girls. Girls and women faced the risk of sexual transmitted diseases, unwanted pregnancy, unsafe abortion and depression. Gender-based violence (GBV) is experienced by at least a quarter of Ethiopian women in their lifetimes, a situation exacerbated by the conflict. Due to the conflict, many people have had limited access to humanitarian assistance and basic services. SGBV increased due to disruption of protection systems. Children and women are disapportaionally affected by the conflict. As a result of these multiple factors, adolescent girls and young women resorted to adapt negative coping mechanisms such as child labor, child marriage, transactional sex and unsafe migration for their survival."}, {"bbox": [87, 1476, 770, 1502], "category": "Footnote", "text": "¹ UNFPA, World Population Dashboard, Ethiopia. Consulted on 09 October 2023."}, {"bbox": [87, 1501, 757, 1525], "category": "Footnote", "text": "² UNDP, Human Development Reports, Ethiopia. Consulted on 09 October 2023"}, {"bbox": [87, 1525, 1143, 1646], "category": "Footnote", "text": "³ The 2022 *Ethiopia Conflict Impact Assessment and Recovery and Rehabilitation Planning (CIARP)* shows that the conflict resulted in varying levels of damage to the facility infrastructure including damage of walls by bullets and heavy artillery, damage to electric and water systems as well as massive looting of medical, surgical and laboratory equipment including ambulances rendering health facilities dysfunctional. It is reported that 2815 health facilities, 5 blood banks, 2 pharmaceutical hubs/stores and 144 ambulances were either partially or completely damaged in Tigray, Afar and Amhara regions."}, {"bbox": [1038, 1682, 1143, 1706], "category": "Page-footer", "text": "Page 4 of 23"}]