POLICY DEVELOPMENT IN WARTIME - ESTABLISHING THE BAITO HEALTH SYSTEM IN TIGRAY, ETHIOPIA

This paper documents health experiences and the public health activiti es of the Tigray People's Liberation Front (TPLF). The paper provides background data about Tigray and the emergence of its struggle for a d emocratic Ethiopia. The origins of the armed struggle are described, a s well as the impact of the conflict on local health systems and healt h status. The health-related activities and public health strategies o f the TPLF are described and critiqued in some detail, particular atte ntion is focused on the development of the baito system, the emergent local government structures kindled by the TPLF as a means of promotin g local democracy, accountability, and social and economic development . Important issues arise from this brief case-study, such as how emerg ing health systems operating in wartime can ensure that not only are b asic curative services maintained, but preventive and public health se rvices are developed. Documenting the experiences of Tigray helps iden tify constraints and possibilities for assisting health systems to ada pt and cope with ongoing conflict, and raises possibilities that in th eir aftermath they leave something which can be built upon and further developed. It appears that promoting effective local government may b e an important means of promoting primary health care.