Project Snapshot

  • Lifesaving Health, WASH and Protection Assistance for Crisis-affected IDPs and Host Communities in the Eastern Zone of Tigray Region
  • Goal: To provide lifesaving health, protection, WASH and gender equality services to 65,000 crisis-affected people in Eastern Tigray, Ethiopia, focusing on immediate humanitarian needs and longer-term development outcomes.
  • Target group: Internally Displaced Persons (40%), host communities (60%), women/girls, elderly, people with disabilities (total reach: 65,000)
  • Where: Ethiopia, Tigray Region, Eastern zone: Hawzen, Ganta-hafeshum, Erob and Gulomekeda woredas (districts)
  • Duration: 2 years (May 1 2022 - April 30 2024)

The Situation

Humanitarian conditions continue to deteriorate across Ethiopia, with 23.5 million people requiring life-saving assistance in the first quarter of 2021. The conflict in Tigray began in November 2020, and a State of Emergency was declared on  November 4, 2021, exactly one  year later. Humanitarian needs in the Tigray region are extremely dire and continue to deteriorate, with 5.2 million (90%) of its six million people requiring urgent assistance. 

There are over 2 million Internally Displaced People (IDPs) living in centers and host communities in Tigray. The Eastern zone of Tigray region faced chronic food shortages and above average malnutrition rates even before the conflict erupted. Disrupted supply chains, unstable markets , and a missed harvest are making the already critical nutrition situation worse. The four targeted woredas have extremely limited access to markets, and face  security threats including looting, theft, killings, and abductions. Most water sources  (boreholes and hand pumps) are not functioning due to the lack of fuel and electricity, damage, looting, and vandalism. 

There has been an alarming rise in sexual and gender-based violence and psychosocial trauma as a result of the conflict. CARE’s Rapid Gender Analysis, conducted in April 2021, found reports of an overwhelming amount of sexual violence when the conflict broke out, while women fled to safety, and in the camps. Further impacts are regularly being reported, including child marriage. There have been reports of abduction of girls, and of boys being abducted and pulled into the violence by Tigrayan forces. As a result of the conflict and sexual violence, many women and girls have experienced unwanted pregnancies, and pregnant women and girls are being denied access to the care they need.


CARE is providing lifesaving health, Water, Sanitation and Hygiene (WASH), protection, and gender equality assistance to people affected by the conflict in Eastern Tigray. As an innovative new “nexus” pilot, this project aims to respond to the immediate and urgent needs of the conflict-affected community, while also bridging the gap to work towards longer-term sustainable development. 

CARE is providing essential primary health care, including acute malnutrition and sexual and reproductive care services. CARE is mobilizing mobile health and nutrition teams to provide primary health care, nutrition, and sexual and reproductive health services, and is strengthening the existing primary health care centres through training, equipment, medicines and supplies. CARE will also focus on longer-term capacity building for health institutions, and improving women’s access  to vital health services. CARE will also establish mother-to-mother support groups at the community level to identify and refer cases of acute malnutrition, and prevent and respond to COVID-19. 

CARE is restoring water supply systems for schools and primary healthcare centres, building gender-sensitive and ventilated pit latrines, establishing gender-balanced water management committees, conducting hygiene promotion campaigns, and distributing hygiene items to IDP households. For the longer term, CARE will upgrade water supply systems to solar powered systems, expand existing or create new water systems, and train auto-mechanic students on solar-power maintenance. 

CARE will support survivors of gender-based violence (GBV) with psychosocial support and  first aid, and referrals to other services, as well as hosting awareness raising sessions with the community. CARE will train local service providers on GBV response best practices, conduct safety audits in targeted locations, and distribute dignity kits to affected women and girls. 

CARE will implement the ‘Social Analysis and Action’ approach which will bring together groups to discuss and challenge social norms related to gender. In addition, CARE will work with women and girls to build their confidence, negotiation, and communication skills.

Project Targets

  • Provide 21,648 patients with primary health care consultations.
  • Train 460 health staff .
  • Support 47,250 people with access to safe drinking water.
  • Provide 7,200 individuals with access to ventilated pit latrines.
  • Support 80 survivors of GBV with response services.
  • Reach 32,000 people with community awareness-raising activities on GBV prevention and response.
  • Support 2000 people to challenge negative gender norms through the “Social Analysis and Action” approach.
  • Train 160 women and girls in confidence, negotiation, and communication skills.
  • Establish 4 Mobile Health and Nutrition Teams.
  • Support 25 Primary Healthcare Centers through training, equipment, medicines and supplies.
  • Establish 40 Mother-to-Mother nutrition groups.
  • Train 135 community-based health workers on COVID-19 prevention.
  • Rehabilitate 6 Water Supply Schemes.
  • Train 78 Water Management Committee members on operation and maintenance of water supply schemes.
  • Distribute 7000 gender-sensitive WASH NFI kits.
  • Upgrade 46 water supply systems, construct 24 new systems, and expand 4 existing systems.
  • Provide 7000 women and girls with dignity kits.