237 - Needs Assessment to Evaluate Multi Sectoral Approach to Support Child Health in Tigray, Ethiopia

Publication Number: 1224.237

Mary Mottla, Boston Children's Hospital, Andover, MA, United States; Michelle Niescierenko, Boston Childrens Hospital, Boston, MA, United States; david P. lewander, Boston Children's Hospital, boston, MA, United States; Suzan Song, George Washington University School of Medicine and Health Sciences, Bethesda, MD, United States; Mahlet Fitsum. Mekonen, OSSHD, Mekelle, Tigray, Ethiopia

Background: The 2020-2022 war in Tigray, Ethiopia was one of the deadliest in recent history, with over 600,000 deaths and 3 million internally displaced persons (IDPs) Multiple reports have documented alleged war crimes and acts of genocide. Boston Children's Hospital and local non-governmental organizations OSSHD and NALA plan to deploy a multisectoral school-based mental health, nutrition, and water, sanitation & hygiene program to address ongoing child health stressors. In a setting with persistent high rates of IDPs understanding the association between displacement and health burdens is critical to intervention success.

Objective: To understand the health and mental health burdens amongst adolescents in Tigray, Ethiopia. The aims included analyzing the association between displacement status and these conditions.

Design/Methods: This was a retrospective review of surveys completed by OSSHD in October 2024 of adolescents 11-19 attending school in two woredas in Tigray. The exposure was current displacement status; primary outcome was self-reported mental health problems by students. Secondary outcomes included nutrition and health concerns, and symptoms of mental health concerns. We conducted multivariable logistic regression for the health outcomes and the exposure of displacement adjusting for child level factors.

Results: Results included 458 adolescents, 56.3% were female and the average age was 15.7 (Table 1). Of respondents, 73.6% had been displaced of which 43.0% were still displaced. Currently displaced adolescents were more likely to report a recent illness (OR 1.65, 95% CI 1.1-2.5), and more likely to report going 24 hours without eating in the past 2 weeks (OR 6.0, 95% CI 2.0-18.0). Respondents were asked to self-report current mental health problems (Table 2). Adolescents who were displaced were more likely to endorse feeling depressive symptoms of hopelessness, sadness, thoughts of self harm and loss of appetite "a lot" or "always" compared to those who were not displaced (OR 3.0, 95% CI 1.3-7.0). They were also more likely to endorse wanting to be alone and excessive anger "a lot" or "always" (OR 2.2, 95% CI 1.3-3.5).

Conclusion(s): Adolescents who remain displaced in Tigray had an increased likelihood of recent physical illness, food insecurity, and mental health burden symptoms concerning for depression and mood changes. Even within the greater population exposed to recent war, particular attention in a school-based intervention needs to be focused on these youth. Given these associations, efforts must increase to rehouse the large population of displaced families in Tigray.

Table 1: Demographics of Adolescent Respondents


Table 2: Top Three Self-Reported "Mental Health Problems" Identified By Respondents