The Challenge of Armed Conflict on the Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B, and Syphilis in the War-Torn Tigray Region of Northern Ethiopia: A Mixed-Methods Study.
1
Multi-Sectoral Response for HIV/AIDS Prevention and Control Core Process, Tigray Regional Health Bureau, Mekele, Ethiopia
2
Health Science college, Reproductive health, Axum University, Axum, Ethiopia
3
Tigray Regional Health Bureau, Mekele, Ethiopia
4
Tigray Health Reserch Institution, Mekele, Ethiopia
5
Health Science College, Epidemiology, Mekelle University, Mekelle, Ethiopia
Popul. Med. 2026;8(Supplement Supplement 1):A2352
ABSTRACT
BACKGROUND:
Approximately 39 million people worldwide are living with HIV, 68% of them residing in sub-Saharan Africa. Since the start of the armed conflict in the Tigray region in November 2020, the provision of prevention mother-to-child transmission (PMTCT) services has been severely hampered. The aim of the study was to assess the impact of the conflict on the triple elimination of mother-to-child transmission (MTCT) of HIV, hepatitis B virus (HBV), and syphilis in the Tigray region, 2025.
METHODS:
A mixed-method institutional-based study was conducted from October 2020 to December 2023. The quantitative study included all pregnant women attending antenatal care (ANC), as well as HIV-positive pregnant and breastfeeding women enrolled in PMTCT clinics across six Tigray zones, excluding the western zone due to security concerns. The qualitative component included 37 people living with HIV (PLHIV) who served as mother support group members. Quantitative data were entered into Excel and analyzed using SPSS, whereas qualitative data were manually summarized.
RESULTS:
Of the 170,966 pregnant women who attended ANC, 42,267 (25%) had their HIV status checked, 21,164 (12.4%) were screened for syphilis, and 16,522 (9.7%) were screened for HBV. Among HIV-exposed newborns, 248 (11.9%) were lost to follow-up, while 28 (1.5%) died. Many women asserted that they received these comprehensive services before the conflict, but the majority said there was significant disruption during and after the war’s onset.
CONCLUSIONS:
Since the onset of conflict, a substantial proportion of women have remained unaware of their HIV, syphilis, and HBV status. To achieve the goals of triple MTCT elimination, the regional government and health partners must work urgently to restore and strengthen PMTCT services throughout the Tigray region.
Approximately 39 million people worldwide are living with HIV, 68% of them residing in sub-Saharan Africa. Since the start of the armed conflict in the Tigray region in November 2020, the provision of prevention mother-to-child transmission (PMTCT) services has been severely hampered. The aim of the study was to assess the impact of the conflict on the triple elimination of mother-to-child transmission (MTCT) of HIV, hepatitis B virus (HBV), and syphilis in the Tigray region, 2025.
METHODS:
A mixed-method institutional-based study was conducted from October 2020 to December 2023. The quantitative study included all pregnant women attending antenatal care (ANC), as well as HIV-positive pregnant and breastfeeding women enrolled in PMTCT clinics across six Tigray zones, excluding the western zone due to security concerns. The qualitative component included 37 people living with HIV (PLHIV) who served as mother support group members. Quantitative data were entered into Excel and analyzed using SPSS, whereas qualitative data were manually summarized.
RESULTS:
Of the 170,966 pregnant women who attended ANC, 42,267 (25%) had their HIV status checked, 21,164 (12.4%) were screened for syphilis, and 16,522 (9.7%) were screened for HBV. Among HIV-exposed newborns, 248 (11.9%) were lost to follow-up, while 28 (1.5%) died. Many women asserted that they received these comprehensive services before the conflict, but the majority said there was significant disruption during and after the war’s onset.
CONCLUSIONS:
Since the onset of conflict, a substantial proportion of women have remained unaware of their HIV, syphilis, and HBV status. To achieve the goals of triple MTCT elimination, the regional government and health partners must work urgently to restore and strengthen PMTCT services throughout the Tigray region.
| eISSN: | 2654-1459 |
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