On 4 November 2020, clashes erupted between the military and regional forces in the Tigray region of northern Ethiopia. The federal government declared a state of emergency for six months, and a large-scale humanitarian crisis emerged with a surge of internally displaced persons and movement of refugees into neighboring countries. Despite the announcement of an official end to military operations at the end of November 2020, there has been continued conflict across the region and insecurity particularly in Tigray, Afar and Amhara regions with significant impact on the safety and protection of civilians. After several months of restricted movement due to insecurity and on-going clashes, particularly in remote rural areas, unfettered access was granted by the Federal Government on 3 March to humanitarian actors to operate in the area. Total numbers of internally displaced people in the region are still difficult to confirm as humanitarian needs assessments are still restricted to accessible or partially accessible areas. Incidents of violence and general insecurity continue to pose a threat to local populations; women and girls are particularly vulnerable and exposed to sexual violence, exploitation, unintended pregnancy, and increased maternal mortality deprived access to critical health care services.
Following the opening of humanitarian access by the Federal Government to support the scale-up of the response in Tigray, humanitarian partners are in a race against time to reach those in need with immediate lifesaving services across the region. According to the 2021 Humanitarian Needs Overview issued on March 5, from the 4.5 million people currently estimated to be in need in Northern Ethiopia, 3.5 million are in accessible and partially accessible areas. Despite the improvements in humanitarian access of the last months, armed confrontations and general insecurity continue to hold back the ability of partners to move and scale-up the response in large areas of Tigray. Active hostilities have been reported in North-Western, Central, Eastern, South-Eastern and Southern Zones. According to OCHA, an estimated 2.5 million people in rural areas have not received any essential services over the last four months. Given the fluid insecurity and access situation, it is still not possible to identify the full scale of displacement, but according to the Regional Bureau of Labor and Social Affairs (BOLSA), there are an estimated 1.7 million people displaced across the region . According to the IOM Displacement Tracking Matrix (fourth round from March 23), verified displacement figures for 178 accessible sites, show 1,064,176 IDPs (235,882 households) across Tigray, Amhara and Afar regions. The three woredas hosting the largest number of IDPs are Shire, Adwa and Adigrat with 445, 309, 129,524 and 100,168 IDPs, respectively. While the main focus of the response is on Tigray, over the past months the neighboring regions of Amhara and Afar have been experiencing the overspill effects of internal displacement and a pressing humanitarian situation due to intercommunal conflict.
Access to life-saving health services by the affected-populations remains challenging as the ongoing assessments indicate that 141 of the 198 assessed hospitals and health centers were either partially or fully damaged . According to the health cluster, maternal health services have been drastically disrupted with only 17% of them providing antenatal care and delivery. Lack of medical supplies (43%), lack of health staff (26%), and the absence of medical equipment (16%) are among the major challenges faced by health facilities to provide access to health services across the region. While accurate data is still in process, it is estimated that about 101,982 women are currently pregnant and 5,099 will experience complications if no access to emergency obstetric care is made available in the next months. Of particular concern are also the reports from UN partners on the ground regarding protection of vulnerable populations and risk of genderbased violence, particularly due to the overcrowded living conditions in the majority of IDP sites. Although gender-based violence is largely underreported, at least 22,500 survivors of sexual violence are estimated to seek clinical management of rape services while only 1% of health facilities currently have capacity to provide the comprehensive services in the region. All of this amid the COVID-19 pandemic in the country which has recorded 243,631 confirmed cases and 3,392 deaths since the last reporting period. The numbers of tests in conflict affected areas remain very low.
UNFPA is scaling up the response with its approach to prevent and respond to gender-based violence, bridging protection, gender equality and MHPSS, and commitment to sexual and reproductive health and rights in Tigray, Afar and Amhara regions. Activities are being tailored to address the general interruption of SRH/GBV services to restore pre-crisis capacity through government health facilities and the humanitarian response on the ground. UNFPA has humanitarian response presence in Addis Ababa, and in Tigray, Amhara and Afar regional offices to oversee activities and responses under our mandate areas - SRHR, GBV, MHPSS and PSEA.