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Published on: February 12, 2018
Effects of armed conflict on child health and development: A systematic review
Ayesha Kadir1,2, Sherry Shenoda3, Jeffrey Goldhagen3
1Malmö Institute for Studies of Migration, Diversity and Welfare, Malmö University, Malmö, Sweden.
Insights
Armed conflicts significantly harm children's physical health and development globally. More research is urgently needed on long-term effects and protective factors for child well-being in conflict zones.
Area of Science:
- Global Health
- Pediatrics
- Conflict Studies
Background:
- Armed conflicts impact over 10% of the world's children.
- Existing research predominantly focuses on mental health, leaving physical health and developmental impacts under-explored.
Purpose of the Study:
- To systematically review and synthesize current knowledge on the effects of armed conflict on child physical health and development.
- To identify gaps in the literature regarding conflict's impact on children.
Main Methods:
- Systematic review of global databases (1945-2017).
- Inclusion of studies on physical and/or developmental outcomes in children under 18.
- Data extraction on health outcomes, displacement, violence exposure, and access to basic needs.
Main Results:
- 155 studies were included, with a predominance of case reports and cross-sectional designs.
- Documented effects include mortality, injuries, illnesses, environmental exposures, and limited access to healthcare/education.
- Violence exposure, including torture and sexual violence, was frequently reported.
Conclusions:
- Armed conflict acts as a form of violence against children and a negative social determinant of health.
- Urgent need for research on mechanisms linking conflict to child health and development.
- Prioritize studies on child development, long-term effects, and protective factors.
Background:
Armed conflicts affect more than one in 10 children globally. While there is a large literature on mental health, the effects of armed conflict on children's physical health and development are not well understood. This systematic review summarizes the current and past knowledge on the effects of armed conflict on child health and development.
Methods:
A systematic review was performed with searches in major and regional databases for papers published 1 January 1945 to 25 April 2017. Included studies provided data on physical and/or developmental outcomes associated with armed conflict in children under 18 years. Data were extracted on health outcomes, displacement, social isolation, experience of violence, orphan status, and access to basic needs. The review is registered with PROSPERO: CRD42017036425.
Findings:
Among 17,679 publications screened, 155 were eligible for inclusion. Nearly half of the 131 quantitative studies were case reports, chart or registry reviews, and one-third were cross-sectional studies. Additionally, 18 qualitative and 6 mixed-methods studies were included. The papers describe mortality, injuries, illnesses, environmental exposures, limitations in access to health care and education, and the experience of violence, including torture and sexual violence. Studies also described conflict-related social changes affecting child health. The geographical coverage of the literature is limited. Data on the effects of conflict on child development are scarce.
Interpretation:
The available data document the pervasive effect of conflict as a form of violence against children and a negative social determinant of child health. There is an urgent need for research on the mechanisms by which conflict affects child health and development and the relationship between physical health, mental health, and social conditions. Particular priority should be given to studies on child development, the long term effects of exposure to conflict, and protective and mitigating factors against the harmful effects of armed conflict on children.
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