Background: Essential medicine satisfy the priority health care needs of the population. It is   intended to be available within the context of functioning health systems at all times, in adequate amounts, in the appropriate dosage, with assured quality, and at a price, that individuals and the community can afford. In Northern Ethiopia, there had been major armed conflict and large-scale displacement since November 2020 impending availability of essential medicines and supplies. Thus, this study is aimed to assess impact of armed conflict on availability of essential medicines and supplies, and readiness of health care facilities for service provision in armed conflict areas of Amhara region, 2022.

Methods: A mixed method study was conducted in health care facilities affected by armed conflict from May 16-19, 2022. Service availability and readiness assessment tool recommended by WHO was used to collect data. Key informant interview guides were used to explore the health services readiness and provision among chief executive director of the health care facility. Data were exported to excel from the ODK and further to SPSS version 26 for analysis. Descriptive statistics and proportion were used to describe data. Qualitative data were used for triangulation purpose.

Results: A total of 151 health care facilities of which 128 (84.8%) health centers and 23 (15.2%) hospitals were included in the study. Only 45% and 77.5% of health facilities had procurement plan and ordered essential medicine respectively, and limited use of  stock card and updated for available items. Essential medicines and supplies were available in limited number of health facilities. In 88.7% DPT HiB HepB and polio vaccines were available whereas, in 43% combined oral contraceptives, and 35.8% injectable contraceptives were available. Regarding cold-chain management, 55.6 % have system to monitored temperature. Drugs and supplies costing about 60,243,358 USD were either damaged or looted during armed conflict in the health facilities.

Conclusion: More than half of the health facilities do not have essential drugs and supplies to provide basic lifesaving services. So strengthening collaborative efforts of the national and regional government, and other stakeholders to improve the health care service delivery system in the armed conflict-affected area urgently needed.

Key words: Health care facility, Service availability, Readiness, Armed conflict