By Alyssa Govindan
New estimates from the recently published study in The Lancet on armed conflict and child mortality in Africa revealed that conflicts in Africa have resulted in the deaths of as many as 5 million children under the age of 5 over the last 20 years, with over 3 million of them infants aged one year or younger–a burden several times higher than previous estimates.
The study highlights the enormous toll on children not involved in combat who die from direct injuries, as well as from easily preventable diseases such as dysentery or measles, or from hunger and malnutrition.
Further analyses revealed that conflict heightened the risk of stunting and neonatal mortality, suggesting possible harms to maternal health and care during pregnancy, labor and delivery.
The new data reveals that previously quoted statistics from the Global Burden of Disease Study, which reported that armed conflict accounts for 0.4 % of deaths of young infants, has been substantially underestimated, and could be ten times higher. An infant born within 30 miles of armed conflict was eight percent more likely to die within the first year of life than in peacetime. Additionally, in areas of higher intensity conflict, an infant’s chance of dying was 27 percent greater than it would have been in peacetime. Further, estimates for civilian infant deaths outnumbered armed conflict deaths by more than three to one.
Researchers analyzed data that covered location, duration and intensity of 15,000 armed conflict ‘events’ across 35 African countries. The study found that the effects of armed conflict extend far beyond death of combatants and physical devastation.
The indirect consequences of conflicts on children are so prominent that they span across all aspects of health. Conflict settings make it difficult for pregnant women to reach a hospital or clinic, and increase the risk of infant death resulting from complicated delivery. When water and sanitation infrastructure is destroyed, contaminated drinking water often leads to debilitating diarrheal diseases. When families are forced to leave their farms to seek safety, malnutrition increases, leading to stunting and sometimes death. Vaccination and regular health visits decrease making it easier and more likely for deadly infectious diseases to spread. Families living as far as 250 km (or 155 miles) from a conflict zone were negatively affected, in part as a result of damage to infrastructure, resulting in lack of access to food, safe water, vaccines and shelter.
The study further documented long-term effects of armed conflict, due to a compromised environment, long after a conflict ends. It often takes years to rebuild or replace the infrastructure for clean water and sanitation, for food security and for health clinics, the latter of which provide access to vaccinations, pre- and ante-natal care. Meanwhile, civilians suffer the consequences.
“This study leads to several analyses into the burden of conflict beyond Africa, into additional spillovers of conflict on families and health systems, mechanisms by which conflicts increase mortality risk, and the effectiveness of potential interventions for building resilience and expediting recovery in conflict zones” – The Lancet
The impact of conflict on children who are presumably not combatants underscores the indirect toll of conflict on civilian populations and the importance of developing interventions to address child health in conflict areas. From mental health to malnutrition, maternal health and beyond, conflict perpetuates poor health long after the violence has ceased.