Articles

Conflict and COVID-19: a double burden for Afghanistan’s healthcare system

The novel coronavirus disease (COVID-19) has put an additional strain on Afghanistan’s weak healthcare system. Prior to the pandemic, the government and its allies had already problems in providing high qualit...

Authors: Don Eliseo Lucero-Prisno III, Mohammad Yasir Essar, Attaullah Ahmadi, Xu Lin and Yusuff Adebayo Adebisi

Addressing COVID-19 in humanitarian settings: a call to action

Refugees and internally displaced persons in humanitarian settings are particularly susceptible to the spread of infectious illnesses such as COVID-19 due to overcrowding and inadequate access to clean water, ...

Authors: Jude Alawa, Nawara Alawa, Adam Coutts, Richard Sullivan, Kaveh Khoshnood and Fouad M. Fouad

“To die is better for me”, social suffering among Syrian refugees at a noncommunicable disease clinic in Jordan: a qualitative study

The conflict in Syria has required humanitarian agencies to implement primary-level services for non-communicable diseases (NCDs) in Jordan, given the high NCD burden amongst Syrian refugees; and to integrate ...

Authors: Lucy Maconick, Éimhín Ansbro, Sara Ellithy, Kiran Jobanputra, Mohammad Tarawneh and Bayard Roberts

The intergenerational impact of war on mental health and psychosocial wellbeing: lessons from the longitudinal study of war-affected youth in Sierra Leone

Globally, one in four children lives in a country affected by armed conflict or disaster often accompanied by exposure to a range of adversities including violent trauma and loss. Children involved with armed ...

Authors: Theresa S. Betancourt, Katrina Keegan, Jordan Farrar and Robert T. Brennan

Help-seeking, trust and intimate partner violence: social connections amongst displaced and non-displaced Yezidi women and men in the Kurdistan region of northern Iraq

Conflict and displacement impact the social fabric of communities through the disruption of social connections and the erosion of trust. Effective humanitarian assistance requires understanding the social capi...

Authors: Alison Strang, Oonagh O’Brien, Maggie Sandilands and Rebecca Horn

Systematic human rights violations, traumatic events, daily stressors and mental health of Rohingya refugees in Bangladesh

Almost 900,000 Rohingya refugees currently reside in refugee camps in Southeastern Bangladesh. Prior to fleeing Myanmar, Rohingya experienced years of systematic human rights violations, in addition to other h...

Authors: Andrew Riley, Yasmin Akther, Mohammed Noor, Rahmat Ali and Courtney Welton-Mitchell

Assessing the capacity for conflict and health research in Lebanon: a qualitative study

Conflicts pose new challenges for health systems, requiring rapid and practical approaches to meet emerging needs on the ground. Lebanon has been highly influenced by surrounding conflicts in the Middle East a...

Authors: Nassim El Achi, Gladys Honein-Abouhaidar, Anthony Rizk, Elsa Kobeissi, Andreas Papamichail, Kristen Meagher, Abdulkarim Ekzayez, Ghassan S. Abu-Sittah and Preeti Patel

Predictors of social support, physical health and mental health among food insecure internally displaced persons in Turkana, Kenya

Food insecurity and the mental and physical health of internally displaced persons (IDPs) is a public health concern. The aim of this study was to determine the predictors of social support, physical and menta...

Authors: Catherine Gichunge, Daniel Mutiso and Jenny Brynjarsdottir

Evaluating the reliability and validity of secondary reporting to measure gender-based violence in conflict and disaster

Accurately identifying the magnitude of gender-based violence (GBV) in humanitarian settings is hindered by logistical and methodological complexities. The ‘Neighborhood Method’, an adapted household survey th...

Authors: Lindsay Stark, Les Roberts, Gary Yu, Timothy M. Tan, Aishwarya Nagar and Alastair Ager

Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment

Rural Afghan populations have low skilled birth attendance rates and high maternal and infant mortality. Insecurity and armed conflict, geographic barriers, and cultural norms often hinder women’s access to fa...

Authors: Leila C. Dal Santo, Sayed Haroon Rastagar, Shafiqullah Hemat, Sayed Omar Alami, Subarna Pradhan, Jenae Tharaldson, Lisa S. Dulli and Catherine S. Todd

A predictive model for healthcare coverage in Yemen

The ongoing war in Yemen continues to pose challenges for healthcare coverage in the country especially with regards to critical gaps in information systems needed for planning and delivering health services. ...

Authors: Mark P. Suprenant, Anuraag Gopaluni, Meredith K. Dyson, Najwa Al-Dheeb, Fouzia Shafique and Muhammad H. Zaman

COVID-19 control in low-income settings and displaced populations: what can realistically be done?

COVID-19 prevention strategies in resource limited settings, modelled on the earlier response in high income countries, have thus far focused on draconian containment strategies, which impose movement restrict...

Authors: Maysoon Dahab, Kevin van Zandvoort, Stefan Flasche, Abdihamid Warsame, Ruwan Ratnayake, Caroline Favas, Paul B. Spiegel, Ronald J. Waldman and Francesco Checchi

Morbidities & outcomes of a neonatal intensive care unit in a complex humanitarian conflict setting, Hajjah Yemen: 2017-2018

The protracted conflict in Yemen has taken a massive toll on the health system, negatively impacting the health of children, especially the most vulnerable age group; the newborns.

Authors: Paul Eze, Fatoum Al-Maktari, Ahmed Hamood Alshehari and Lucky Osaheni Lawani

Lessons learned evaluating the baby friendly spaces program for south Sudanese refugees in Gambella, Ethiopia: strengthening research and programmatic partnerships to address maternal and child health and psychosocial needs in humanitarian emergencies

During humanitarian crises, women and children are particularly vulnerable to morbidity and mortality. To address this problem, integrated child health interventions that include support for the well-being of ...

Authors: M. E. Lasater, G. M. Woldeyes, K. Le Roch, X. Phan, A. Solomon-Osborne and S. M. Murray

Distribution of hygiene kits during a cholera outbreak in Kasaï-Oriental, Democratic Republic of Congo: a process evaluation

Cholera remains a leading cause of infectious disease outbreaks globally, and a major public health threat in complex emergencies. Hygiene kits distributed to cholera case-households have previously shown an e...

Authors: Lauren D’Mello-Guyett, Katie Greenland, Sharla Bonneville, Rob D’hondt, Maria Mashako, Alexandre Gorski, Dorien Verheyen, Rafael Van den Bergh, Peter Maes, Francesco Checchi and Oliver Cumming

Navigating the crisis landscape: engaging the ministry of health and United Nations agencies to make abortion care available to Rohingya refugees

Unintended and unwanted pregnancies likely increase during displacement, making the need for sexual and reproductive health (SRH) services, especially safe abortion, even greater. Attention is growing around b...

Authors: Tamara Fetters, Sayed Rubayet, Sharmin Sultana, Shamila Nahar, Shadie Tofigh, Lea Jones, Ghazaleh Samandari and Bill Powell

Infectious disease outbreaks among forcibly displaced persons: an analysis of ProMED reports 1996–2016

The United Nations Refugee Agency (UNHCR) estimates the number of forcibly displaced people increased from 22.7 million people in 1996 to 67.7 million people in 2016. Human mobility is associated with the intr...

Authors: Angel N. Desai, John W. Ramatowski, Nina Marano, Lawrence C. Madoff and Britta Lassmann

Systematic review of factors associated with quality of life of asylum seekers and refugees in high-income countries

The stressful experiences that many asylum seekers and refugees (AS&R) are exposed to during forced migration, and during resettlement in host countries, can have a profound impact on their mental health. Comp...

Authors: Catharina F. van der Boor, Rebekah Amos, Sarah Nevitt, Christopher Dowrick and Ross G. White

Adapting acute malnutrition treatment protocols in emergency contexts: a qualitative study of national decision-making

Each year, an estimated 17 million children suffer from severe acute malnutrition (SAM) and 33 million from moderate acute malnutrition (MAM), with many of the most severe cases found in extremely food insecur...

Authors: Naoko Kozuki, Mamoudou Seni, Amin Sirat, Omar Abdullahi, Mena Fundi Eso Adalbert, Marie Biotteau, Amelia Goldsmith and Sarah L. Dalglish

No implementation without cultural adaptation: a process for culturally adapting low-intensity psychological interventions in humanitarian settings

Despite the widely recognised importance of cultural adaptation to increase the effectiveness of psychological interventions, there is little guidance on its process. Developed based on existing theory, we applie...

Authors: Camila Perera, Alicia Salamanca-Sanabria, Joyce Caballero-Bernal, Lya Feldman, Maj Hansen, Martha Bird, Pernille Hansen, Cecilie Dinesen, Nana Wiedemann and Frédérique Vallières

Contextual factors associated with depression among urban refugee and displaced youth in Kampala, Uganda: findings from a cross-sectional study

Advancing mental health among refugee and displaced adolescents and youth is critically important, as chronic psychological stress can have lifelong harmful impacts. These groups experience socio-environmental...

Authors: Carmen H. Logie, Moses Okumu, Simon Mwima, Robert Hakiza, Doreen Chemutai and Peter Kyambadde

Factors predicting symptoms of somatization, depression, anxiety, post-traumatic stress disorder, self-rated mental and physical health among recently arrived refugees in Germany

There is a large body of research indicating increased prevalence rates of mental disorders among refugees. However, the vast majority of the evidence available on risk factors for mental disorders among refug...

Authors: Yuriy Nesterko, David Jäckle, Michael Friedrich, Laura Holzapfel and Heide Glaesmer

A social ecological approach to understanding service utilization barriers among male survivors of sexual violence in three refugee settings: a qualitative exploratory study

Post-sexual violence service utilization is often poor in humanitarian settings. Little is known about the service uptake barriers facing male survivors specifically.

Authors: Sarah K. Chynoweth, Dale Buscher, Sarah Martin and Anthony B. Zwi

Challenges of providing healthcare worker education and training in protracted conflict: a focus on non-government controlled areas in north west Syria

Without healthcare workers (HCWs), health and humanitarian provision in Syria cannot be sustained either now or in the post-conflict phase. The protracted conflict has led to the exodus of more than 70% of the...

Authors: Yamama Bdaiwi, Diana Rayes, Ammar Sabouni, Lina Murad, Fouad Fouad, Waseem Zakaria, Mahmoud Hariri, Abdelkarim Ekzayez, Ahmad Tarakji and Aula Abbara

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