The impact of armed conflict on maternal morbidity and mortality at a teaching hospital in the Tigray region of Ethiopia: a pre-war and wartime comparative analysis

The armed conflict in Tigray resulted in a marked deterioration in maternal outcomes and reduced uptake of key obstetric interventions in Ayder Comprehensive Specialized Hospital. As can be indirectly inferred from WHO's severe maternal outcome indicators, delayed access to care, limited resources, and disrupted referral pathways contributed to an increase in severe maternal and maternal near-miss complications. The dramatic decrease in patients from rural areas suggests that many seriously ill women never reached ACSH - likely contributing to an underestimation of the true impact on maternal mortality. Strengthening referral systems, and ensuring supply chains for essential medicines with a policy of preventing and mitigating the impact of conflict on health and specifically on maternal health.