Post-conflict African states face profound challenges in rebuilding medical systems, with unique contextual factors influencing recovery. Ethiopia's experience offers critical insights into the methodological complexities of health system reconstruction, where standard approaches may be inadequate. This methodology article outlines a context-sensitive methodological framework for studying and guiding the reconstruction of obstetrics and gynaecology services in post-conflict Ethiopia. It identifies key methodological challenges and proposes adaptable strategies for research and implementation. The proposed methodology is a mixed-methods, participatory action research framework. It combines systematic document analysis of recovery policies, key informant interviews with health workers and administrators, and community-based focus groups. The design emphasises iterative feedback loops with local stakeholders to ensure cultural and logistical relevance. As a methodology article, it presents a framework rather than empirical results. A central finding from the framework's development is the critical importance of integrating traditional birth attendant networks into formal health systems, identified as a key theme for improving maternal health outreach. Rebuilding medical systems in post-conflict settings requires methodologies that are flexible, participatory, and grounded in local realities. The proposed framework offers a structured yet adaptable approach for navigating the complex interplay of infrastructural, human resource, and socio-cultural factors in Ethiopia and similar contexts. Researchers and practitioners should adopt co-design principles, engaging local communities from the outset. Methodologies must prioritise ethical considerations around trauma and incorporate monitoring mechanisms that capture non-quantifiable aspects of recovery, such as trust in health services. post-conflict health systems, methodology, obstetrics, gynaecology, Ethiopia, participatory research, maternal health, Africa This article contributes a practical methodological framework for health services research in post-conflict African settings.
Gebremedhin et al. (Fri,) studied this question.