A recent study on armed conflict highlighted the far-reaching effects of modern warfare on the health of women and children.

The study, published in the journal The Lancet, explores the changing nature of war and conflict, its short- and long-term health effects on women and children, strategies for identifying best responses, and interventions supported by in-country assessments and studies.

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Lead author, Professor Zulfiqar Bhutta from the Centre for Global Child Health, The Hospital for Sick Children in Toronto, says: “The new estimates provide compelling evidence of the enormous indirect toll of modern warfare caused by easily preventable infectious diseases, malnutrition, sexual violence, and poor mental health, as well as the destruction of basic services such as water and medical facilities.”

He continues: “Today, more than half of the world’s women and children are living in countries experiencing active conflict. The international community cannot continue to ignore their plight. It’s time for a radical rethink of the global response that confronts challenges to insecurity, access, politics, coordination.”

According to the estimates made in the study, the number of women and children affected by armed conflict around the world has risen steadily since 2000.

In 2017, one in 10 (10 per cent) women and almost one in six (16 per cent) children worldwide were either forcibly displaced by conflict or living dangerously close (ie, within 50 km) to conflict zones. Around a third of those affected live in Pakistan, Nigeria, and India.

The researchers wrote: In 2019, there were 54 ongoing state-based armed conflicts in 35 countries, averaging 20 years or more. Climate change and new health threats such as the Covid-19 pandemic have further complicated the response. At the same time, new medical capabilities such as modern trauma care offer opportunities for improved health provision.

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The authors recognise that humanitarian agencies and national authorities face a wide variety of barriers to delivery, from limited funding and shortages of skilled health care workers (eg, midwives and nurses in Pakistan and Syria) to insecurity (eg, attacks and kidnapping of health workers in Colombia and Somalia), and mistrust due to the politicisation of aid.

The authors of the study believe that as a first step towards filling the guidance gap, humanitarian health actors including global and local agencies and NGOs, and academia working in conflict settings should establish a decision-making framework to guide the selection of priority interventions and improve accountability.

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