Climate Variability, Communal Violence, and Population Health in Africa's Arc of Instability: A Scoping Review of...

Background: Africa's arc of instability - a band of countries stretching from Mauritania through the Sahel to the Horn of Africa - experiences a convergence of climate variability, communal violence, and fragile health systems. Evidence on their joint operation remains fragmented across disciplines, limiting policy-relevant synthesis. Objectives: This scoping review maps the published and grey literature on the joint operation of climate variability, communal violence, and population health in the arc of instability between January 2010 and March 2025; it identifies dominant pathways, populations, and methods, and articulates research gaps. Methods: Following Arksey and O'Malley's framework with Levac et al.'s refinements and reporting against the PRISMA-ScR checklist, five electronic databases (PubMed, Scopus, Web of Science, CINAHL, and Africa Wide Information) and grey literature from UN agencies, humanitarian organisations, and conflict and vulnerability databases were searched. Studies addressing at least two of the three domains in the arc, published in English or French, were included and synthesised narratively. Findings: Of 1623 records screened, 47 studies met the inclusion criteria. Four dominant pathways were identified: (i) resource scarcity, communal violence, displacement, and infectious disease; (ii) drought, food insecurity, and child malnutrition and mortality; (iii) heat extremes, weather events, mental health, and service disruption; and (iv) state fragility, health-system disruption, and maternal and child health deterioration. Pastoralist communities, internally displaced persons, women, and children were the most affected populations. Gaps include scarce longitudinal data, limited mental health surveillance in conflict zones, and under-representation of locally-led research among others. Conclusions: Evidence on the joint operation of climate variability, communal violence, and health in the arc of instability is accruing but remains thin, descriptive, and geographically uneven. A locally-led, transdisciplinary research agenda is needed to inform climate-resilient health systems and humanitarian responses, prioritising primary data collection, mental health surveillance, and longitudinal cohort studies.