BACKGROUND Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. METHODS A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. RESULTS Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. CONCLUSION Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards.

中文翻译：

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埃塞俄比亚 COVID-19 大流行期间卫生用品配给和提供高风险临床服务的道德挑战和困境：一线卫生工作者的经验。

背景道德推理和敏感性在公共卫生中始终很重要，但在公共卫生应急准备的敏感和复杂领域尤其重要。在这里，我们探讨了埃塞俄比亚冠状病毒病 19 (COVID-19) 大流行期间一线卫生工作者遇到的道德挑战和困境。方法对全国19家公立医院的一线医务人员进行调查。卫生工作者被邀请填写一份自填问卷。使用描述性统计对数据进行加权和分析。结果 向285名一线卫生工作者发放问卷，其中217人做出答复（答复率为76.1%）。受访者经常表示，在直接用于预防和治疗 COVID-19 的保健品方面遇到配给困境。大多数（83.9%）的卫生工作者认为他们非常频繁或频繁地遇到道德挑战。几乎所有人[215(99.1%)]都声称有限的资源直接用于治疗和预防COVID-19。对于不同的服务，提供基本临床服务出现困难的频率在 77% 到 98.7% 之间。超过一半的研究参与者表示，他们在每天或每周提供临床护理方面遇到了困难。关于配给策略，隔离 COVID-19 治疗单位和限制入院是三分之二的卫生工作者每天或每周最常用的配给策略。结论 在 COVID-19 期间，一线卫生工作者遇到了许多道德上具有挑战性的情况。超过一半的卫生工作者报告说，他们在分配资源和提供计划生育服务、妇幼保健、免疫接种和慢性病护理等不同临床服务时遇到了道德挑战。由于呼吸机和病床等资源有限，医疗保健提供者面临着决定谁可以获得这些资源、谁不能获得这些资源的艰巨任务。总体而言，COVID-19 大流行给医疗保健提供者带来了许多道德挑战，强调医疗保健提供中道德考虑的重要性。通过意识到这些困境并制定政策来解决这些问题，医疗保健提供者可以确保他们在坚持道德标准的同时为患者提供尽可能最好的护理。