Effects of armed conflicts on childhood undernutrition in Africa: a systematic review and meta-analysis

Undernutrition is defined as not consuming enough nutrients and energy to meet one's needs for maintaining good health. It is exacerbated by armed conflict. Individuals cannot stick to jobs because of a lack of safety during conflicts, which has an impact on families' ability to purchase food. However, there is a paucity of evidence on pooled evidence on the impact of armed conflict on childhood undernutrition among children aged 6 to 59 months in Africa. Therefore, this review aimed to examine the effects of armed conflict on the magnitude of undernutrition, particularly stunting, underweight, and wasting among children in Africa.

A comprehensive literature search was conducted using electronic databases (PubMed, Hinari, and Google Scholar database) to locate potential studies. Heterogeneity between studies was checked using Cochrane Q test statistics and I² test statistics. Small-study effects were checked using Egger's statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence and associated factors of undernutrition among children aged 6-59 months in Africa.

Of a total of 585 articles retrieved from the databases, 12 studies met our inclusion criteria. The pooled prevalence of wasting, stunting, and being underweight among conflict-affected African countries was 20.25% (95%CI = 15.08-25.43), 34.18% (95% CI = 26.34-42.02), and 24.00% (95%CI = 16.35-31.65), respectively. The most consistent factors associated with childhood stunting, wasting, and being underweight in Africa were low mother's education, prolonged duration of armed conflict, and rural place of residence.

The severity of malnutrition crises will be assisted by a better understanding of the variables associated with child malnutrition, which will improve the effectiveness of development and humanitarian responses. We urge that health planners, policymakers, and the general public prioritize children with acute malnutrition in Africa's conflict-affected areas.

PROSPERO CRD42022367487.