Articles

Health and healthcare in North Korea: a retrospective study among defectors

To gain insights into the socio-economic and political determinants of ill health and access to healthcare in North Korea.

Authors: Hayoung Lee, Courtland Robinson, Jaeshin Kim, Martin McKee and Jiho Cha

Measuring the psychosocial, biological, and cognitive signatures of profound stress in humanitarian settings: impacts, challenges, and strategies in the field

Evidence of ‘what works’ in humanitarian programming is important for addressing the disruptive consequences of conflict and forced displacement. However, collecting robust scientific evidence, and ensuring co...

Authors: Catherine Panter-Brick, Mark Eggerman, Alastair Ager, Kristin Hadfield and Rana Dajani

Research ethics and refugee health: a review of reported considerations and applications in published refugee health literature, 2015-2018

Public health investigations, including research, in refugee populations are necessary to inform evidence-based interventions and care. The unique challenges refugees face (displacement, limited political prot...

Authors: Emma E. Seagle, Amanda J. Dam, Priti P. Shah, Jessica L. Webster, Drue H. Barrett, Leonard W. Ortmann, Nicole J. Cohen and Nina N. Marano

Impact of conflict on maternal and child health service delivery: a country case study of Afghanistan

Since decades, the health system of Afghanistan has been in disarray due to ongoing conflict. We aimed to explore the direct effects of conflict on provision of reproductive, maternal, newborn, child and adole...

Authors: Shafiq Mirzazada, Zahra Ali Padhani, Sultana Jabeen, Malika Fatima, Arjumand Rizvi, Uzair Ansari, Jai K. Das and Zulfiqar A. Bhutta

Responding to health needs of women, children and adolescents within Syria during conflict: intervention coverage, challenges and adaptations

Women and children suffer disproportionately in armed-conflicts. Since 2011, the protracted Syrian crisis has fragmented the pre-existing healthcare system. Despite the massive health needs of women and childr...

Authors: Chaza Akik, Aline Semaan, Linda Shaker-Berbari, Zeina Jamaluddine, Ghada E. Saad, Katherine Lopes, Joanne Constantin, Abdulkarim Ekzayez, Neha S. Singh, Karl Blanchet, Jocelyn DeJong and Hala Ghattas

C’est vraiment compliqué: a case study on the delivery of maternal and child health and nutrition interventions in the conflict-affected regions of Mali

Mali is currently in the midst of ongoing conflicts which involve jihadist groups, rebels, and the state. This conflict has primarily centered in the North of the country. Humanitarian actors delivering servic...

Authors: Anushka Ataullahjan, Michelle F. Gaffey, Moctar Tounkara, Samba Diarra, Seydou Doumbia, Zulfiqar A. Bhutta and Diego G. Bassani

Understanding the factors affecting the humanitarian health and nutrition response for women and children in Somalia since 2000: a case study

Somalia has been ravaged by more than two decades of armed conflict causing immense damage to the country’s infrastructure and mass displacement and suffering among its people. An influx of humanitarian actors...

Authors: Zahra Ahmed, Anushka Ataullahjan, Michelle F. Gaffey, Mohamed Osman, Chantal Umutoni, Zulfiqar A. Bhutta and Abdirisak A. Dalmar

Maternal and child health service delivery in conflict-affected settings: a case study example from Upper Nile and Unity states, South Sudan

Decades of war left the Republic of South Sudan with a fragile health system that has remained deprived of resources since the country’s independence. We describe the coverage of interventions for women’s and ...

Authors: Samira Sami, Augustino Mayai, Grace Sheehy, Nicole Lightman, Ties Boerma, Hannah Wild, Hannah Tappis, Wilfred Ochan, James Wanyama and Paul Spiegel

Health in conflict and post-conflict settings: reproductive, maternal and child health in Colombia

In conflict-afflicted areas, pregnant women and newborns often have higher rates of adverse health outcomes.

Authors: Sara Milena Ramos Jaraba, Natalia Quiceno Toro, María Ochoa Sierra, Laura Ruiz Sánchez, Marlly Andrea García Jiménez, Mary Y. Salazar-Barrientos, Edison Bedoya Bedoya, Gladis Adriana Vélez Álvarez, Ana Langer, Jewel Gausman and Isabel C. Garcés-Palacio

Impact of conflict on maternal and child health service delivery – how and how not: a country case study of conflict affected areas of Pakistan

In conflict affected countries, healthcare delivery remains a huge concern. Pakistan is one country engulfed with conflict spanning various areas and time spans. We aimed to explore the effect of conflict on p...

Authors: Jai K. Das, Zahra Ali Padhani, Sultana Jabeen, Arjumand Rizvi, Uzair Ansari, Malika Fatima, Ghulam Akbar, Wardah Ahmed and Zulfiqar A. Bhutta

Health services for women, children and adolescents in conflict affected settings: experience from North and South Kivu, Democratic Republic of Congo

Insecurity has characterized the Eastern regions of the Democratic Republic of Congo for decades. Providing health services to sustain women’s and children’s health during protracted conflict is challenging. T...

Authors: Chiara Altare, Espoir Bwenge Malembaka, Maphie Tosha, Christopher Hook, Hamady Ba, Stéphane Muzindusi Bikoro, Thea Scognamiglio, Hannah Tappis, Jerome Pfaffmann, Ghislain Bisimwa Balaluka, Ties Boerma and Paul Spiegel

Reproductive, maternal, newborn and child health service delivery during conflict in Yemen: a case study

Armed conflict, food insecurity, epidemic cholera, economic decline and deterioration of essential public services present overwhelming challenges to population health and well-being in Yemen. Although the maj...

Authors: Hannah Tappis, Sarah Elaraby, Shatha Elnakib, Nagiba A. Abdulghani AlShawafi, Huda BaSaleem, Iman Ahmed Saleh Al-Gawfi, Fouad Othman, Fouzia Shafique, Eman Al-Kubati, Nuzhat Rafique and Paul Spiegel

Investigating the delivery of health and nutrition interventions for women and children in conflict settings: a collection of case studies from the BRANCH Consortium

Globally, the number of people affected by conflict is the highest in history, and continues to steadily increase. There is currently a pressing need to better understand how to deliver critical health interve...

Authors: Anushka Ataullahjan, Michelle F. Gaffey, Samira Sami, Neha S. Singh, Hannah Tappis, Robert E. Black, Karl Blanchet, Ties Boerma, Ana Langer, Paul B. Spiegel, Ronald J. Waldman, Paul H. Wise and Zulfiqar A. Bhutta

Child marriage practices among the Rohingya in Bangladesh

Previous research suggests that child marriage may be accelerated during times of crisis and insecurity as resources are scarce and child marriage may be a survival strategy for girls and their families. In 20...

Authors: Andrea J. Melnikas, Sigma Ainul, Iqbal Ehsan, Eashita Haque and Sajeda Amin

A systematic literature review of the ethics of conducting research in the humanitarian setting

Research around humanitarian crises, aid delivery, and the impact of these crises on health and well-being has expanded dramatically. Ethical issues around these topics have recently received more attention. W...

Authors: William Bruno and Rohini J. Haar

Improving pediatric TB diagnosis in North Kivu (DR Congo), focusing on a clinical algorithm including targeted Xpert MTB/RIF on gastric aspirates

The incidence of tuberculosis (TB) in the Democratic Republic of the Congo (DRC) is 323/100,000. A context of civil conflict, internally displaced people and mining activities suggests a higher regional TB inc...

Authors: Daan Van Brusselen, Erica Simons, Tony Luendo, Delphine Habarugira, Jimmy Ngowa, Nadine Neema Mitutso, Zakari Moluh, Mieke Steenssens, Rachelle Seguin, Hilde Vochten, Lucien Ngabo, Petros Isaakidis and Gabriella Ferlazzo

Conducting operational research in humanitarian settings: is there a shared path for humanitarians, national public health authorities and academics?

In humanitarian contexts, it is a difficult and multi-faceted task to enlist academics, humanitarian actors and health authorities in a collaborative research effort. The lack of research in such settings has ...

Authors: Enrica Leresche, Claudia Truppa, Christophe Martin, Ariana Marnicio, Rodolfo Rossi, Carla Zmeter, Hilda Harb, Randa Sami Hamadeh and Jennifer Leaning

“Emerging Technologies and Medical Countermeasures to Chemical, Biological, Radiological, and Nuclear (CBRN) Agents in East Ukraine”

Since 2014, Ukraine has been beset by an armed conflict with international and internal dimensions. The nature of this conflict is multidimensional, and disaster preparedness and response in this context must ...

Authors: Sonny S. Patel, Robert M. Grace, Patrick Chellew, Mykola Prodanchuk, Olha Romaniuk, Yuriy Skrebets, Sergii A. Ryzhenko and Timothy B. Erickson

Simple ideas to mitigate the impacts of the COVID-19 epidemic on refugees with chronic diseases

Authors: Muhammad Fawad, Fatima Rawashdeh, Parveen K. Parmar and Ruwan Ratnayake

Pathways towards scaling up Problem Management Plus in Turkey: a theory of change workshop

A considerable evidence base has been produced in recent years highlighting the effectiveness of brief scalable psychological interventions for people living in communities exposed to adversity. However, pract...

Authors: Daniela C. Fuhr, Ceren Acarturk, Ersin Uygun, Michael McGrath, Zeynep Ilkkursun, Sadaf Kaykha, Egbert Sondorp, Marit Sijbrandij, Peter Ventevogel, Pim Cuijpers and Bayard Roberts

Health status of rescued people by the NGO Open Arms in response to the refugee crisis in the Mediterranean Sea

The migration over the Mediterranean has become one of the deadliest sea voyages in last few years. The NGO Open Arms works in the area since 2015, with the objectives of protecting and reporting human rights ...

Authors: Guillermo Cañardo, Jesús Gálvez, Juanfe Jiménez, Núria Serre, Israel Molina and Cristina Bocanegra

Health policy mapping and system gaps impeding the implementation of reproductive, maternal, neonatal, child, and adolescent health programs in South Sudan: a scoping review

Pregnant women, neonates, children, and adolescents are at higher risk of dying in fragile and conflict-affected settings. Strengthening the healthcare system is a key strategy for the implementation of effect...

Authors: Loubna Belaid, Pontius Bayo, Lynette Kamau, Eva Nakimuli, Elijo Omoro, Robert Lobor, Baba Samson and Alexander Dimiti

Sexual violence against women and girls in South Sudan

This Letter to the Editor is in reference to the article by Murphy M, Ellsberg M and Contreras-Urbina M, “Nowhere to go: disclosure and help-seeking behaviors for survivors of violence against women and girls ...

Authors: Dilshad Jaff

Accountability strategies for sexual and reproductive health and reproductive rights in humanitarian settings: a scoping review

Many of the 35 million women and girls aged 15–49 requiring humanitarian assistance have inadequate access to the sexual and reproductive health (SRH) services to which they are entitled. Ensuring accountabili...

Authors: Marta Schaaf, Victoria Boydell, Mallory C. Sheff, Christina Kay, Fatemeh Torabi and Rajat Khosla

Displacement-related factors influencing marital practices and associated intimate partner violence risk among Somali refugees in Dollo Ado, Ethiopia: a qualitative study

Child and forced marriage have negative health consequences including increased risk of intimate partner violence (IPV) for women and girls. War and humanitarian crises may impact decision-making around marria...

Authors: Vandana Sharma, Adaugo Amobi, Samuel Tewolde, Negussie Deyessa and Jennifer Scott

Mental health and psychosocial support for families of missing persons in Sri Lanka: A retrospective cohort study

The International Committee of the Red Cross (ICRC) has developed its ‘Accompaniment model’ to address the multi-faceted needs of relatives of people who go missing during armed conflict. In Sri Lanka an Accom...

Authors: Ida Andersen, Bhava Poudyal, Arundathi Abeypala, Carla Uriarte and Rodolfo Rossi

Obituary for Dr. Peter Salama

Authors: Paul Spiegel

Correction to: Injury-related deaths before and during the Islamic State insurgency – Baghdad, Iraq, 2010–2015

The original publication of this article [1] contained an incorrect author name.

Authors: Matthew Goers, Eva Leidman, Abdul-Salam Saleh Sultan, Ahmed Hassan and Oleg Bilukha

A validation study of the Zanmi Lasante Depression Symptom Inventory (ZLDSI) in a school-based study population of transitional age youth in Haiti

The Zanmi Lasante Depression Symptom Inventory (ZLDSI) is a screening tool for major depression used in 12 primary care clinics in Haiti’s Central Plateau. Although previously validated in a clinic-based sampl...

Authors: Rupinder K. Legha, Margaret E. Gerbasi, Mary C. Smith Fawzi, Eddy Eustache, Tatiana Therosme, J. Reginald Fils-Aime, Giuseppe J. Raviola, Emmeline Affricot, Ermaze Louis Pierre, Yoldie Alcindor, Jennifer Severe, Katherine A. Boyd, David J. Grelotti, Sarah Darghouth, Andrew Rasmussen and Anne E. Becker

Episodes of violence suffered by migrants transiting through Libya: a cross-sectional study in “Médecins du Monde’s” reception and healthcare centre in Seine-Saint-Denis, France

The Central Mediterranean Route, passing through Libya, is one of the most dangerous for migrants. Episodes of violence have been documented but have not been accurately quantified. The objective of the study ...

Authors: L. Reques, E. Aranda-Fernandez, C. Rolland, A. Grippon, N. Fallet, C. Reboul, N. Godard and N. Luhmann

Male and LGBT survivors of sexual violence in conflict situations: a realist review of health interventions in low-and middle-income countries

Conflict-related sexual violence (CRSV) against women and girls has been the subject of increasing research and scholarship. Less is known about the health of men, boys and lesbian, gay, bisexual, transgender ...

Authors: Ligia Kiss, Meaghen Quinlan-Davidson, Laura Pasquero, Patricia Ollé Tejero, Charu Hogg, Joachim Theis, Andrew Park, Cathy Zimmerman and Mazeda Hossain

Introduction to the special collection: developing valid psychological measures for populations impacted by humanitarian disasters

Authors: Andrew Rasmussen and Nuwan Jayawickreme

Addressing noncommunicable diseases among urban refugees in the Middle East and North Africa - a scoping review

More than 5.5 million Syrian refugees have fled violence and settled in mostly urban environments in neighboring countries. The Middle East and North Africa (MENA) region accounts for 6% of the global populati...

Authors: Zahirah Z. McNatt

Injury-related deaths before and during the Islamic State insurgency – Baghdad, Iraq, 2010–2015

Following a period of low intensity conflict during 2009–2012, the emergence of the Islamic State of Iraq and Levant (or Islamic State) in 2013 was associated with a resurgence of violence in Baghdad, Iraq’s c...

Authors: Matthew Goers, Eva Leidman, Abdul-Salam Saleh Sultan, Ahmed Hassan and Oleg Bilukha

Challenges and lessons learned in re-filming the WHO mhGAP training videos for Sri Lankan context - a qualitative study

Understanding and addressing the unmet mental health needs burden in the Northern Province of Sri Lanka is the subject of the COMGAP-S two-phase study. Phase Two involves the implementation of the World Health...

Authors: Shannon Doherty, Giselle Dass, Anne Edward, Gergana Manolova and Madonna Solomon

Nowhere to go: disclosure and help-seeking behaviors for survivors of violence against women and girls in South Sudan

Despite high rates of violence against women and girls (VAWG) in conflict and humanitarian contexts, many survivors do not tell anyone about their experience or seek help from support r services (e.g. health, ...

Authors: Maureen Murphy, Mary Ellsberg and Manuel Contreras-Urbina

Applying trauma systems concepts to humanitarian battlefield care: a qualitative analysis of the Mosul trauma pathway

Trauma systems have been shown to save lives in military and civilian settings, but their use by humanitarians in conflict settings has been more limited. During the Battle of Mosul (October 2016–July 2017), t...

Authors: Kent Garber, Adam L. Kushner, Sherry M. Wren, Paul H. Wise and Paul B. Spiegel

Mobile clinics in humanitarian emergencies: a systematic review

Despite the widespread reliance on mobile clinics for delivering health services in humanitarian emergencies there is little empirical evidence to support their use. We report a narrative systematic review of ...

Authors: Catherine R. McGowan, Louisa Baxter, Claudio Deola, Megan Gayford, Cicely Marston, Rachael Cummings and Francesco Checchi

Opportunities and challenges for delivering non-communicable disease management and services in fragile and post-conflict settings: perceptions of policy-makers and health providers in Sierra Leone

The growing burden of non-communicable diseases in low- and middle-income countries presents substantive challenges for health systems. This is also the case in fragile, post-conflict and post-Ebola Sierra Leo...

Authors: Sophie Witter, Guanyang Zou, Karin Diaconu, Reynold G. B. Senesi, Ayesha Idriss, John Walley and Haja Ramatulai Wurie

The refugee post-migration stress scale (RPMS) – development and validation among refugees from Syria recently resettled in Sweden

Despite the growing recognition of the impact of post-resettlement factors on the mental health of refugees, a clear definition of the concept of post-migration stress, as well as an updated, valid instrument ...

Authors: Andreas Malm, Petter Tinghög, Jurgita Narusyte and Fredrik Saboonchi

Household recovery in Mosul one year after the defeat of ISIS

Widespread devastation to structures and households in Mosul occurred during the three years of ISIS control and the military liberation campaign by Iraqi forces assisted by coalition forces. Military operatio...

Authors: R. Lafta, M. Al-Nuaimi, L. R. Sultan and G. Burnham

Violent conflict and breastfeeding: the case of Iraq

This study explores the relationship between armed conflict and breastfeeding practices of Iraqi mothers. To date, the relationship between violent conflict and breastfeeding is surprisingly understudied. Espe...

Authors: Vidya Diwakar, Michael Malcolm and George Naufal

Social ecological factors associated with experiencing violence among urban refugee and displaced adolescent girls and young women in informal settlements in Kampala, Uganda: a cross-sectional study

Research on violence targeting urban forcibly displaced adolescent girls and young women (AGYW) is limited, particularly regarding polyvictimization (exposure to multiple forms of violence). Yet there is a glo...

Authors: Carmen H. Logie, Moses Okumu, Simon Mwima, Robert Hakiza, Kibathi Peter Irungi, Peter Kyambadde, Emmanuel Kironde and Manjulaa Narasimhan

Dua Ti Dawa Ti: understanding psychological distress in the ten districts of the Kashmir Valley and community mental health service needs

An extensive body of research exists looking at the level of psychological distress in populations affected by political conflict. Recommended response to psychological distress in humanitarian crises is still...

Authors: Tambri Housen, Shabnum Ara, Akmal Shah, Showkat Shah, Annick Lenglet and Giovanni Pintaldi

Trauma in the Kashmir Valley and the mediating effect of stressors of daily life on symptoms of posttraumatic stress disorder, depression and anxiety

The negative psychological impact of living in a setting of protracted conflict has been well studied, however there is a recognized need to understand the role that non-conflict related factors have on mediat...

Authors: Tambri Housen, Annick Lenglet, Showkat Shah, Helal Sha, Shabnum Ara, Giovanni Pintaldi and Alice Richardson

A forgotten group during humanitarian crises: a systematic review of sexual and reproductive health interventions for young people including adolescents in humanitarian settings

Young people including adolescents face barriers to healthcare and increased risk of poor sexual and reproductive health (SRH), which are exacerbated in humanitarian settings. Our systematic review assessed th...

Authors: Lauren Jennings, Asha S. George, Tanya Jacobs, Karl Blanchet and Neha S. Singh

Mortality and health survey, Walikale, Democratic Republic of the Congo, 2017: an example of the use of survey data for humanitarian program planning

During humanitarian crises, health information systems are often lacking and surveys are a valuable tool to assess the health needs of affected populations. In 2013, a mortality and health survey undertaken by...

Authors: Eve Robinson, Vittoria Crispino, Adelaide Ouabo, Francklin Brice Soung Iballa, Ronald Kremer, María Eugenia Serbassi, Marit van Lenthe and Antonio Isidro Carrion Martin

Researching violence against women and girls in South Sudan: ethical and safety considerations and strategies

Globally, it is estimated that at least one out of every three women experiences violence by an intimate partner and/or non-partner throughout their lifetime. Women and girls are at even higher risk of violenc...

Authors: Manuel Contreras-Urbina, Alexandra Blackwell, Maureen Murphy and Mary Ellsberg

Programmatic implications for promotion of handwashing behavior in an internally displaced persons camp in North Kivu, Democratic Republic of Congo

Diarrhea and acute respiratory infections (ARI) account for 30% of deaths among children displaced due to humanitarian emergencies. A wealth of evidence demonstrates that handwashing with soap prevents both di...

Authors: Lauren S. Blum, Anicet Yemweni, Victoria Trinies, Mimi Kambere, Foyeke Tolani, Jelena V. Allen, Thomas Handzel, Susan Cookson and Pavani K. Ram

Socio-cultural change in conflict and post conflict settings: five decades of giving birth in Cambodia

This paper explores the changing experience of giving birth in Cambodia over a 53-year period. During this time, Cambodian people experienced armed conflict, extreme privation, foreign invasion, and civil unrest.

Authors: Bandeth Ros, Gillian Lê, Suzanne Fustukian and Barbara McPake