[{"bbox": [96, 153, 1135, 233], "category": "Text", "text": "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, 238, 1135, 372], "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 shock-responsive safety nets for crisis-affected populations, avoiding duplication in interventions."}, {"bbox": [96, 382, 1135, 597], "category": "Text", "text": "This Action will be complementary to other ongoing EU funded projects in the health sector, in particular the project \"Social Determinants for Health for Gender Equality\" which started implementation in late 2021. With an overall budget of EUR 24 000 000, this programme provides support to the four developing regional states (Afar, Benishangul Gumuz, Gambella and Somali) by contributing to addressing sectors indirectly related to the health status of the population. It is also complementary to projects funded by EU Member States active in the sector, mainly France, Germany, Ireland, Italy (also funding social determinants), the Netherlands and Spain. The Action will also benefit from synergies with the Action on Education under the same Individual Measure, in particular with what relates to sexual reproductive health and family planning."}, {"bbox": [85, 622, 341, 654], "category": "Section-header", "text": "## 2.2 Problem Analysis"}, {"bbox": [96, 679, 583, 706], "category": "Section-header", "text": "### Damaged health systems in conflict affected areas"}, {"bbox": [96, 719, 1135, 828], "category": "Text", "text": "The health system in Ethiopia is currently facing unprecedented challenges due to the on-going armed conflict coupled with the impact of COVID-19. The consequences of this crisis are expected to potentially impact in losing the health gains achieved so far, including through the past performance results of the Health Budget Support programme."}, {"bbox": [96, 839, 1135, 1066], "category": "Text", "text": "The conflict has disrupted the health system particularly in northern parts of Ethiopia (Tigray, Amhara, and Afar). It is already overstretched and further weakened to respond to the health needs of the population affected by the conflict. In most parts of these regions, health infrastructures/water, sanitation and hygiene (WASH) facilities, medical equipment and Health Management Information System (HMIS) units/tools are severely damaged and/or demolished. As of January 2022, the Ministry of Health (MoH) reported that a total of 42 hospitals (40 in Amhara and 2 in Afar), 479 health centres (453 in Amhara and 26 in Afar), 1,895 health posts (1,850 in Amhara and 45 in Afar) were damaged and currently not functional. The extent of damage in Tigray cannot be quantified, due to the lack of unrestricted access over the past year."}, {"bbox": [96, 1084, 1135, 1283], "category": "Text", "text": "Currently, health service referral systems are not functional and/or adequate to provide timely and appropriate linkages to other levels of services. This is mainly because the Health Management Information System (HMIS) tools and equipment are severely damaged for which health facilities' institutional data need to be retrieved and/or re-established, but also due to restrictions of movements and lack of functionality of health facilities. Technical and material support needs to be mobilised through different means, including exchanges between health facilities and universities and specialized hospitals (see below). Overall, the financial need for rehabilitation and restoration of damaged health facilities is expected to be significant."}, {"bbox": [96, 1301, 1135, 1501], "category": "Text", "text": "Gender-based violence is experienced by nearly half of Ethiopian women in their lifetimes, a situation exacerbated by the conflict. Despite such a significant problem across the nation, little has been done on its prevention and managing of the victims. According to UNFPA study report¹², only five hospitals in the country have dedicated a separate clinic that provides sexual and gender-based violence victims with clinical services. In other health facilities, survivors of sexual violence are managed like any other patients, denied of time for counselling and psychological rehabilitation. With the current conflict, the extent of the problem is larger: cases have been reported from different parts of the country of primary school girls, elderly women and pregnant women being raped. The"}, {"bbox": [85, 1596, 1143, 1647], "category": "Footnote", "text": "¹² UNFPA Report 2020: Universal Health Coverage Policies and Progress towards the Attainment of Universal Sexual and Reproductive Health and Rights Services in Ethiopia"}, {"bbox": [1038, 1681, 1142, 1706], "category": "Page-footer", "text": "Page 6 of 21"}]