{"title":"Households under pressure: a systems framework for modeling the \"watch\" famine archetype.","authors":"Alexandra M Thorn","doi":"10.1057/s41271-026-00646-5","DOIUrl":"10.1057/s41271-026-00646-5","url":null,"abstract":"<p><p>Famines are complex systems that change over time, and in which outcomes differ by household situation and livelihood. The \"watch\" famine system archetype occurs when populations engage in coping strategies to deal with a hunger gap, such as between agricultural harvests, which can interfere with future food production and mask the existence of a crisis to outside observers. I present a framework for modeling household responses to hunger. I used a partial prototype model for agrarian, horticultural, or foraging livelihoods to simulate the role of rationing and foraging as coping responses to insufficient food. Although not all dynamics were included, simulations suggested that while coping mechanisms can improve outcomes, rationing may also produce negative outcomes, due to the increased chance of death with lower energy reserves. I discuss next steps for a more complete framework, generalization to other famine systems, and implications for monitoring and responding to famine systems.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"120-134"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anatomy of a famine: using fuzzy cognitive mapping to understand the crisis in Ayod County, South Sudan, 2017.","authors":"Matthew Day","doi":"10.1057/s41271-026-00643-8","DOIUrl":"10.1057/s41271-026-00643-8","url":null,"abstract":"<p><p>This paper explores Fuzzy Cognitive Mapping (FCM) as an analytical approach for understanding famine as a complex, dynamic system. Traditional approaches, such as the Integrated Food Security Phase Classification (IPC), may not fully capture the non-linear interactions among social, economic, political, and environmental factors that contribute to famine. The IPC relies heavily on cross-sectional survey data and expert judgment, which can introduce errors and biases. This study applies FCM to a retrospective case study of the 2017 Ayod County crisis in South Sudan. FCM combines qualitative and quantitative data, facilitating analysis of dynamic systems even with limited data availability. The findings indicate that FCM identified famine-like conditions from March to June 2017, aligning with subsequent survey data, although Ayod was never formally classified in famine by the IPC. Continued testing of FCM is recommended to assess its suitability as part of a revised analytical toolkit for near-real-time famine risk tracking.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"56-70"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Famine modeling: from theory to practice.","authors":"Paul W Howe, Elena N Naumova","doi":"10.1057/s41271-026-00656-3","DOIUrl":"10.1057/s41271-026-00656-3","url":null,"abstract":"","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Data for famine and extreme emergencies: challenges and opportunities.","authors":"Daniel Maxwell, Peter Hailey, Elena Naumova","doi":"10.1057/s41271-026-00639-4","DOIUrl":"10.1057/s41271-026-00639-4","url":null,"abstract":"<p><p>High-quality data are a pre-requisite for the development of models-whether of famine or food and nutrition-related emergencies. We highlighted challenges, related to data in famines or near-famine emergencies, including data availability, quality, timeliness, and sharing; the misuse of data could be a real threat for applying new advanced data analytic tools, such as artificial intelligence and machine learning. We also explored promising opportunities, such as democratization of data related to famine. With growing demands for real-time assessment and modeling of famine and extreme emergencies, it is increasingly important to understand how predictive models and emerging data-integration technologies are affected by biased, incomplete, inconsistent, or outdated data. As we push for addressing data constraints, we call for ethical data democratization to minimize the risks of data misuse, weaponization, and politization and to enable famine modeling for collective efforts to enhance early warning, real-time analysis, and response.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"148-160"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anastasia Marshak, Sarah King, Shérifath Mama Chabi, Nancy Grace Lamwak, Feysal Abdisalan Mohamud, Heather Stobaugh, Frederica Smith
{"title":"Seasonality and risk factors of relapse to acute malnutrition: a multi-country prospective cohort study in Mali, South Sudan, and Somalia, 2021-2022.","authors":"Anastasia Marshak, Sarah King, Shérifath Mama Chabi, Nancy Grace Lamwak, Feysal Abdisalan Mohamud, Heather Stobaugh, Frederica Smith","doi":"10.1057/s41271-026-00648-3","DOIUrl":"10.1057/s41271-026-00648-3","url":null,"abstract":"<p><p>Despite the effectiveness of community-based management of acute malnutrition (CMAM) in treating severe acute malnutrition (SAM), recent data show that up to 60% of treated children relapse into acute malnutrition (AM) within six months. A key gap in understanding relapse is the limited evidence on seasonal timing and drivers. We analyzed rolling study enrollment data from April 2021 to November 2022, tracking 1,689 recently recovered SAM children for six months, compared to 1,060 same-sex, age-matched counterparts without AM in the past year. The results show that AM and relapse are highly seasonal, with the highest prevalence during transitions between dry and rainy seasons, and rainy and harvest periods. The seasonal AM peaks occurred earlier, at greater amplitude, and for longer durations for recently recovered SAM children than their matched counterparts, highlighting their increased vulnerability and need for targeted follow-up prior to known seasonal peaks to maximize cost-efficiency amid limited funding.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"28-43"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Modeling the dynamics of human starvation: incorporating lessons from famines past and present.","authors":"Alexandra M Thorn, Merry Fitzpatrick","doi":"10.1057/s41271-026-00647-4","DOIUrl":"10.1057/s41271-026-00647-4","url":null,"abstract":"<p><p>Famines are crises characterized by starvation and malnutrition-related mortality. But representative nutrition and mortality data is often impossible to collect under common famine conditions, impeding real-time estimations and near-term projections of famine severity and therefore allocation of humanitarian assistance. As a supplement to survey data, systems models may be able to project individual outcomes based on more readily available data, to guide food assistance rations, and to predict trajectories of population-level malnutrition and starvation mortality. We provide an overview of systems dynamics modeling, discuss how it has been used to understand energy and nutrient dynamics in the human body, and discuss possible applications of these models, as well as the critical research needs to apply systems dynamics models to real-world crises. We then highlight complicating aspects of famine systems that should be considered as these models are applied. The literature includes several models that could be adapted to help identify critical areas for nutrition research on the biological progression of starvation under famine conditions. By incorporating additional physiological detail, these models could be parameterized to inform humanitarian public health responses to food crises, but improved data sharing will be crucial to model development.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"135-147"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bingjie Zhou, Anastasia Marshak, Kenneth K H Chui, Elena N Naumova, Erin Boyd
{"title":"Heading toward a famine: modeling seasonality of malnutrition in Yemen, 2018-2023.","authors":"Bingjie Zhou, Anastasia Marshak, Kenneth K H Chui, Elena N Naumova, Erin Boyd","doi":"10.1057/s41271-026-00649-2","DOIUrl":"10.1057/s41271-026-00649-2","url":null,"abstract":"<p><p>Yemen continues to experience one of the most severe child malnutrition and food insecurity crises on the planet. Seasonal synchronization of malnutrition often serves as an early marker of emerging famine. In this study we compiled data collected by the humanitarian agencies on several potential drivers of malnutrition such as food insecurity, conflict events, and environmental indicators (rainfall, temperature, and normalized difference vegetation index) in Yemen from 2018 to 2023. We characterized the seasonality of malnutrition outcomes and explore spatiotemporal synchronization using non-linear time series analyses. Our findings demonstrate significant seasonal profiles in child malnutrition, which could be synchronized with the peak in food insecurity and peaks in environmental indicators. The quantification of seasonal characteristics in term of seasonal peaks and their amplitude pave the way to build strong foundation for deeper understanding of famine evolution from a complex system perspective by defining processes and triggers that amplify malnutrition and escalate faming formation.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"82-96"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erin Coughlan de Perez, Paul Howe, Catalina Jaime, Mothusi Nyofane, William Masters, Daniel Maxwell, Sophia Marks Miller, Ntlele Mphonyane, Komal Rathod, Udita Sanga, Akriti Sharma, Alexandra Thorn, Dennis Dela Torre, Carolyn Van Sant
{"title":"Famine risk under climate change: assessing the impact on local food production and the potential role of adaptation strategies.","authors":"Erin Coughlan de Perez, Paul Howe, Catalina Jaime, Mothusi Nyofane, William Masters, Daniel Maxwell, Sophia Marks Miller, Ntlele Mphonyane, Komal Rathod, Udita Sanga, Akriti Sharma, Alexandra Thorn, Dennis Dela Torre, Carolyn Van Sant","doi":"10.1057/s41271-026-00645-6","DOIUrl":"10.1057/s41271-026-00645-6","url":null,"abstract":"<p><p>While climate change will impact all aspects of the food system, it is not clear how it will influence the risk of famine: situations of extreme starvation. Drawing on theory for how and why famines occur, we analyze the ways that changes in extreme weather might alter local agricultural yields. We present CMIP6 projections of the change in risk for specific climate changes that are relevant to agriculture: heat, frost, precipitation, and dry spells. Then, we analyze crop model projections that estimate crop yields under future climate projections. In crop models run with a future scenario in which people plant the same crops as today, we find that calorie production from attainable crop yields is projected to decrease in much of Central America, Eastern South America, much of Africa, the Eastern Mediterranean, South Asia, parts of Southeast and East Asia, and Australia. However, under a scenario in which people are allowed to switch crops, we find that there is global potential for adaptation to climate change, with certain crops in every region that are projected to increase attainable yield under climate change. There are also major yield gaps that could be closed with adaptation investments. Based on the theory and analysis, we conclude that climate change may act as a contributing, rather than determinative, factor to famine-related risk. Given that adaptation will ultimately influence whether climate change will increase the probability of famine, we recommend investments in adaptation, especially in conflict-affected regions.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"12-27"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Modeling the 1998 Bahr el Ghazal famine in Southern Sudan.","authors":"Steven Arquitt, Paul Howe, Luka Biong Deng Kuol","doi":"10.1057/s41271-026-00641-w","DOIUrl":"10.1057/s41271-026-00641-w","url":null,"abstract":"<p><p>This paper explores the use of system dynamics modeling to better understand the 1998 Bahr el Ghazal famine in southern Sudan. Based on expert interviews and a literature review, it presents a set of causal loop diagrams that clarify the complex dynamics involved in the crisis, demonstrating how three major political 'holds' permitted a self-reinforcing famine system to form. A simulation of this model generates similar outcomes in mortality and malnutrition to those that occurred in the actual crisis. Based on this analysis, the paper suggests several ways that modeling could have supported a more effective response at the time of the crisis and may be able to strengthen efforts to prevent famines in the future.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"44-55"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A systems analysis of structures, dynamics, archetypes of the Somalia famine, 2011-2012.","authors":"Udita Sanga","doi":"10.1057/s41271-026-00658-1","DOIUrl":"10.1057/s41271-026-00658-1","url":null,"abstract":"<p><p>The 2011-2012 Somalia famine was a complex humanitarian disaster shaped by interacting environmental, economic, social, and political factors. This paper applies a qualitative systems analysis to examine famine structure, dynamics, and archetypes to demonstrate how systems modelling can deepen understanding of famine as a complex system. The study addresses three questions: (1) what key variables and feedback dynamics created pressures and constraints within the Somalia famine system; (2) how system components interacted to produce outcomes such as food insecurity, malnutrition, and mortality; and (3) which system archetypes characterized system behaviour. Using a causal loop diagram (CLD), the study maps interdependencies across environmental, biophysical, economic, social, health, political, and institutional domains within the famine system. The CLD illustrates the specific reinforcing feedbacks that acted as pressures, constraining feedbacks that acted as holds and balancing feedbacks that acted as stabilizers of the system. We observe three key system archetypes: Escalation, Fixes that fail and Shifting the burden. Overall, the study demonstrates that famine emerges from dynamic system interactions rather than isolated drivers, highlighting the value of systems thinking for improving explanation, policy insight, and intervention design in complex humanitarian crises.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"71-81"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}