Exploring health system challenges and gaps for crisis response in Ethiopia: a scoping review of publications and reports from 2020-2024.

Publication date: Jul 04, 2025

Ethiopia’s health system has faced significant challenges due to COVID-19, natural disasters, and conflicts, disrupting healthcare delivery. This scoping review examined health system gaps and responses during crises, aiming to recommend strategies for resilience. We followed a systematic scoping review approach using the five-step methodology: defining the research question, identifying relevant literature, selecting studies, charting the data, and summarizing/analyzing results. The review was guided by PRISMA-ScR and used the Population, Concept, and Context (PCC) framework. We included all English-language studies published between January 2000 and December 2024 addressing challenges or responses of the Ethiopian health system during crises, regardless of study design. PubMed, SCOPUS, Google Scholar, and Google were searched using MeSH terms/keywords. After title, abstract, and full-text screening, 44 articles were included for final analysis. Data were synthesized using descriptive analytical methods and narrative synthesis to summarize and interpret findings. Findings revealed crises severely impacted health services due to shortages of medical supplies, workforce, and infrastructure. Demand surges, transport restrictions, border closures, and financial constraints exacerbated these gaps. Additional challenges included poor data availability, high staff turnover, lack of emergency communication plans, and insufficient funding. The COVID-19 pandemic and the northern Ethiopian conflict notably disrupted routine services, infrastructure, and health information systems. To build resilience, the study recommends: (1) developing scalable emergency plans for essential services, (2) strengthening primary healthcare and community-based systems, (3) maintaining medical stockpiles, and (4) providing crisis-specific training for health workers. These measures aim to enhance preparedness and sustainability in Ethiopia’s health system amid future shocks.

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Concepts Keywords
Ethiopia Crises response
Google Ethiopian
Pandemic Health systems
Sustainability Public health emergencies

Semantics

Type Source Name
disease MESH COVID-19
drug DRUGBANK Factor IX Complex (Human)
drug DRUGBANK Etoperidone
disease MESH emergency
pathway REACTOME Reproduction
disease IDO history
disease IDO country
disease MESH post traumatic stress disorders
drug DRUGBANK Coenzyme M
drug DRUGBANK Fenamole
disease IDO intervention
drug DRUGBANK Tretamine
disease MESH violence
disease IDO process
drug DRUGBANK Ademetionine
drug DRUGBANK Clotiazepam
drug DRUGBANK Methionine
drug DRUGBANK Serine
drug DRUGBANK Trestolone
drug DRUGBANK Oxygen
drug DRUGBANK BCG vaccine
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH morbidity
disease MESH infection
disease IDO facility
disease MESH cholera
drug DRUGBANK Indoleacetic acid
drug DRUGBANK Silver

Original Article

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