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Background: Conflicts disrupts access to food, health care, and basic amenities, placing Internally displaced people, particularly women and children, at heightened risk of malnutrition and its associated health consequences. While humanitarian organizations, civil societies and governmental agencies have initiated nutrition interventions in response to this crisis, their facilitators and barriers during implantation remains under studied.
Objectives: To understand and explore the facilitators and barriers in delivering nutrition response to women and children among IDPs in Tigray, Ethiopia.
Methods: A Phenomenological qualitative design is used with purposive sampling. KII and FGD was used on total of 23 participants with the use on informed consent, interview guide, audio recording and field notes. Recordings were transcribed verbatim, translated and archived. And thematic analysis was performed using OpenCode version 4.03 qualitative software.
Results: The delivery of nutrition and health programs faced major barriers due to energy insecurity, network and phone outages, cash and fuel shortages, and limited transport, which delayed reporting, funding access, and aid distribution. Theft, fraud, and suspended food aid, combined with poor communication with IDPs and fragmented efforts before the nutrition cluster was formed, further undermined operations. Program implementation struggled with restrictions on gatherings, educator fatigue, outdated or inaccessible guidelines, overcrowding, repeated registrations, and fluctuating IDP populations. Despite these challenges, facilitators included providing incentives to retain health workers, hiring and training staff with health and nutrition backgrounds, and adopting creative solutions such as fuel rationing, animal transport, shared communication tools, and strong verification measures. Advocacy efforts attracted global funding, while phased education sessions, use of IDP health workers, post-conflict assessments, and SMART surveys improved monitoring. Community engagement was strengthened through help desks and feedback systems. Crucially, the establishment of the nutrition cluster, temporary administration structures, and the peace agreement greatly enhanced coordination, resource mobilization, and program delivery.
Conclusion and recommendation: It is recommended to appeal for additional funding, conduct consistent screening and assessment to monitor needs, and strengthen advocacy efforts highlighting the high malnutrition rates to attract greater support. Improving access to services and ensuring better security conditions are also essential to enhance program delivery and reach vulnerable populations effectively. |
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