Conflict and Health最新文献

{"title":"Menstrual hygiene management among girls and women refugees in Africa: a scoping review.","authors":"Alexis Harerimana, Gugu Mchunu, Julian David Pillay","doi":"10.1186/s13031-025-00657-1","DOIUrl":"10.1186/s13031-025-00657-1","url":null,"abstract":"<p><strong>Background: </strong>Menstrual Hygiene Management (MHM) presents a significant public health challenge for refugee women and girls in Africa. Displaced populations often lack access to menstrual products, adequate Water, Sanitation, and Hygiene (WASH) infrastructure, as well as comprehensive menstrual health education.</p><p><strong>Aim: </strong>This scoping review aimed to understand the state of MHM, identify key challenges, and evaluate existing interventions among refugee women and girls in Africa.</p><p><strong>Methods: </strong>Employing Levac et al.'s framework, the review analysed evidence from databases like CINAHL, Emcare, PubMed, Scopus, and Web of Science, focusing on studies published between 2014 and 2024. Sixteen articles met the inclusion criteria, and both numerical summaries and descriptive analyses were conducted.</p><p><strong>Results: </strong>Refugee women and girls often lack access to both disposable and reusable menstrual products, resorting to unhygienic alternatives such as clothing, leaves, and paper. Inadequate WASH facilities restrict safe and private spaces for menstrual management. Cultural stigma and taboos surrounding menstruation contribute to social exclusion and school absenteeism among girls. The interventions included distributing dignity kits, enhancing WASH infrastructure, and providing menstrual health education; however, they were inconsistently implemented due to resource limitations and cultural obstacles.</p><p><strong>Conclusion: </strong>This study highlights the urgent need for sustainable menstrual health solutions in refugee settings. Without access to necessary products, WASH facilities, and stigma-free education, women and girls risk exclusion, health issues, and interrupted education. Addressing these barriers requires consistent, well-resourced interventions that integrate cultural sensitivity to ensure dignity and long-term impact.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"20"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preserving the scientific integrity of open science in conflict and health.","authors":"Karl Blanchet, Daniela Fuhr","doi":"10.1186/s13031-025-00659-z","DOIUrl":"10.1186/s13031-025-00659-z","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"18"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative assessment of disease and non-battle injuries in Ukraine since the Russian invasion.","authors":"Lynn Lieberman Lawry, Amandari Kanagaratnam, Ashleigh Roberds, Jessica Korona-Bailey, Luke Juman, Miranda Janvrin, Zoe Amowitz, Tiffany E Hamm, John Maddox, Oleh Berezyuk, Tracey Pérez Koehlmoos","doi":"10.1186/s13031-024-00632-2","DOIUrl":"10.1186/s13031-024-00632-2","url":null,"abstract":"<p><strong>Background: </strong>Disease and non-battle injuries (DNBI) often account for more military casualties than those from combat wounds. The February 2022 Russian invasion of Ukraine has severely limited access to care in areas with increasing patient care needs beyond combat injuries. The expansion of the draft resulted in an older military population susceptible to musculoskeletal injuries, while trench warfare and harsh winters create conditions conducive to cold weather injuries and infectious diseases. This study aims to assess the prevalence and scope of DNBI in Ukraine.</p><p><strong>Methods: </strong>We conducted qualitative key informant interviews with Ukrainian military and civilian health care workers from June 2023-February 2024 using an expanded version of the Global Trauma System Evaluation Tool which had components focusing on DNBI. Thematic content analysis was used to derive key themes related to DNBI from interviews.</p><p><strong>Results: </strong>We conducted 36 key informant interviews. Respondents described the wide range of DNBI that Ukrainian soldiers are experiencing. Infectious disease, cold weather injuries, musculoskeletal injuries, sexual assault, and mental health emerged as prevalent concerns. Respondents described the critical shortage of resources and the high burden on military hospitals as barriers to the delivery of adequate care for DNBI.</p><p><strong>Conclusions: </strong>DNBI in Ukraine are directly related to the physical environment and the age and fitness of the military population. The troop shortage has resulted in soldiers with chronic illnesses returning to duty, while the physical environment limits prevention measures for weather-related injuries and infectious diseases. The complex healthcare challenges created by these factors highlight the importance of a military health system with the capacity to provide service members with the full spectrum of care beyond combat injuries.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"19"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Health and well-being of older populations affected by humanitarian crises in low- and middle-income countries: a scoping review of peer-reviewed literature.","authors":"Sarah Al Omari, Stephen J McCall, Layal Hneiny, Abla Mehio Sibai","doi":"10.1186/s13031-025-00652-6","DOIUrl":"10.1186/s13031-025-00652-6","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"17"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"What other option did I have?\"- The effect of conflict and displacement on child marriage and early childbearing among displaced Rohingya adolescents.","authors":"Kate Mieth, Tahia Hasan, Adrija Chakrabarty, Kenna Lee, Adrita Kaiser, Tanvir Hasan, Shatha Elnakib, Caitlin Jackson, W Courtland Robinson, Linnea A Zimmerman","doi":"10.1186/s13031-025-00656-2","DOIUrl":"10.1186/s13031-025-00656-2","url":null,"abstract":"<p><strong>Background: </strong>Humanitarian emergencies are postulated to increase rates of early marriage and early childbearing, as drivers of both are heightened or exacerbated in crisis settings. There is a critical need for research that explores the causal mechanisms that motivate family formation, i.e. the process from marriage into childbearing, and how this process is affected by conflict and displacement.</p><p><strong>Objective: </strong>This paper aims to describe how displacement and living within a camp context has affected norms and drivers around family formation, focusing on the lived experience of female and male adolescents and young adults.</p><p><strong>Methods: </strong>We coded and analyzed qualitative data from forty-nine in-depth interviews and sixteen focus group discussions conducted with Forcibly Displaced Myanmar Nationals aged 15-24 who arrived in Cox's Bazar during or after October 2016.</p><p><strong>Results: </strong>Participants largely agreed that rates of child marriage have increased post-conflict and displacement. They attributed this increase to a variety of drivers, including fears around protection, socioeconomic need, lack of education and employment opportunities, and a perceived loosening of restrictions around legal age of marriage within camp. While some of these were pre-existing drivers exacerbated by conflict and displacement, others were new drivers that developed as a result. The ways that adolescents and young adults experienced each driver were highly gendered. Conversely, conflict and displacement had seemingly little effect on cultural expectations to demonstrate fecundity immediately after marriage. Finally, participants felt that adverse living conditions within camp have significantly lowered fertility intentions and have increased cultural acceptance and adoption of family planning.</p><p><strong>Conclusions: </strong>Our results demonstrate that many Rohingya families view child marriage as a practical tool to overcome challenges associated with being displaced, and early childbearing as an inevitable natural consequence of child marriage. The Government of Bangladesh must ease restrictions on income-generating opportunities as well as continue working with humanitarian organizations to provide and fund education and skills-building opportunities for both adolescent girls and boys, who otherwise have no alternatives to child marriage and few other opportunities to productively contribute to their communities.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"16"},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of resilience in general health and mental wellbeing among Syrian and Palestinian refugees in Lebanon: a mixed methods study.","authors":"Jinan Usta, Dana Janbek, Miya Abboud, Jumana Antoun, Rafika Al Ghrawi, Monica Adhiambo Onyango","doi":"10.1186/s13031-025-00653-5","DOIUrl":"10.1186/s13031-025-00653-5","url":null,"abstract":"<p><strong>Background: </strong>This pilot study explored the challenges experienced by Syrian and Palestinian refugees in Lebanon and the role of resilience in general health and mental wellbeing.</p><p><strong>Methods: </strong>This was a mixed methods cross-sectional study conducted in the cities of Beirut and Tripoli in Lebanon. Two hundred Syrian and Palestinian refugees were surveyed and 20 of them participated in in-depth interviews. Descriptive statistics summarized the demographic characteristics, depression, anxiety, resilience, somatic symptoms, and technological use. Associations between resilience and depression, anxiety, and somatic symptoms were measured by calculating Pearson correlation coefficients and Spearman's rank correlation coefficients. Inductive and deductive coding and analysis was used in qualitative data.</p><p><strong>Results: </strong>Refugees' migration journey was characterized by fear, lack of safety, and lack of food. In Lebanon, they experienced discrimination, racism, and challenges in meeting necessities. The three most important challenges experienced by refugees were securing electricity (40.8%), getting medicines (41.6%), and accessing medical care (37%). The mean resilience score was 68.20 ± 19.35. Palestinian refugees had higher mean resilience scores (77.01 ± 17.4) compared to Syrian (61.34 ± 19.45) and Syrian Palestinian (61.14 ± 14.69) refugees. Majority of participants had high levels of somatic complaints with a mean PHQ-15 score of 14.29 ± 6.77. The median GAD-7 score was 14.7 [11.0, 20.0], with the majority of participants (n = 161, 80.5%) reporting moderate or severe anxiety. The mean PHQ-9 score was 15.38 ± 7.33, with most of the participants (n = 121, 60.5%) reporting moderately severe or severe major depression symptoms. Higher resilience levels were associated with lower anxiety, depression, and somatic levels. Religion, friends, family, and good communication were reported as helping refugees cope with challenges.</p><p><strong>Conclusion: </strong>Resilience impacts physical and mental health. Participants with high resilience were found to have better mental and physical health outcomes. Those with higher resilience also reported stronger ties and use of these factors to overcome their challenges.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"15"},"PeriodicalIF":3.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between conflict intensity and health outcomes in contemporary conflicts, while accounting for the vulnerability and functioning of healthcare services.","authors":"Siddarth Daniels David, Anneli Eriksson","doi":"10.1186/s13031-025-00654-4","DOIUrl":"10.1186/s13031-025-00654-4","url":null,"abstract":"<p><strong>Background: </strong>Armed conflict can be described as human development in reverse. In addition to the direct consequences of violence, there are numerous ways in which armed conflict may have indirect effects on people's health and well-being. Studies give varying results, and health impacts seem to differ from context to context. We aimed to determine how conflict intensity is associated with health outcomes, accounting for existing vulnerabilities and the functioning of healthcare services in countries experiencing armed conflict.</p><p><strong>Method: </strong>This study is based on panel data on conflict intensity, vulnerability, healthcare service functioning, and health outcomes in 42 conflict-affected countries between 2000 and 2019 and uses fixed-effects panel regression analysis to determine the associations between conflict intensity and health outcomes.</p><p><strong>Results: </strong>Conflict intensity was positively associated with the health outcomes included in this study. As the conflict intensity increased, the mortality and prevalence of these outcomes also increased, although this increase was not statistically significant for half the outcomes (8/16). After adjusting for the vulnerabilities and functioning of healthcare services, this positive association became significant for all health outcomes. Vulnerability and functioning of healthcare services were strong predictors of outcomes. Subgroup analysis revealed that conflict intensity was more significantly associated with outcomes in countries with high and medium vulnerability scores.</p><p><strong>Conclusion: </strong>Existing vulnerabilities and healthcare system conditions are known to impact health outcomes. The association between conflict intensity and health outcomes strengthens when existing vulnerabilities and the state of healthcare services are considered. This underscores the importance of incorporating strategies to address socioeconomic inequities and strengthen healthcare system capacity in interventions for conflict-affected regions. This also raises additional concerns for long-term negative health effects related to the increasing trend of attacks on health care in contemporary conflicts.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"14"},"PeriodicalIF":3.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Health and well-being of older populations affected by humanitarian crises in low- and middle-income countries: a scoping review of peer-reviewed literature.","authors":"Sarah Al Omari, Stephen J McCall, Layal Hneiny, Abla Mehio Sibai","doi":"10.1186/s13031-025-00647-3","DOIUrl":"10.1186/s13031-025-00647-3","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"13"},"PeriodicalIF":3.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of contact tracing performance during an Ebola virus disease outbreak in a complex security environment: the case of North Kivu province, Democratic Republic of the Congo, 2018-2020.","authors":"Willy Ngalamulume, Harry César Kayembe, Guy Mutombo, Mathias Mossoko, Annie Mutombo, Didier Bompangue","doi":"10.1186/s13031-025-00650-8","DOIUrl":"10.1186/s13031-025-00650-8","url":null,"abstract":"<p><strong>Background: </strong>Contact tracing remains a pillar public health strategy for containing Ebola virus disease (EVD). During the 2018-2020 EVD outbreak in the Democratic Republic of the Congo (DRC), contact tracing was implemented on an unprecedented scale. Here, we assessed performance of contact tracing implemented in affected health zones, and identified risk factors associated with incomplete follow-up.</p><p><strong>Methods: </strong>We performed a retrospective descriptive data analysis of 129,749 contacts in the contact line lists of North Kivu province between August 1, 2018 to June 25, 2020. Coverage, completeness, timeliness, and duration of contact tracing were determined to assess the performance of contact tracing implemented by field actors. Bivariate and multivariate logistic regression models were used to identify factors associated with incomplete contact tracing.</p><p><strong>Results: </strong>Overall, more than 90% of all contacts initially identified and listed were monitored. However, 9.1% of contacts who had monitoring initiated had completed the 21 days follow-up. The median days between identification and the start of follow-up and duration contact follow-up were 3 (1-6) and 17 (12-19), respectively. The risk of incomplete follow-up was higher among contacts from urban and conflict-affected health zones.</p><p><strong>Conclusion: </strong>Our findings indicate the necessity of prioritizing contact tracing in urban areas. This can be achieved by engaging locally trusted stakeholders to build community confidence. Furthermore, integrating digital contact tracing solutions may enhance the efficacy of traditional manual contact tracing.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"12"},"PeriodicalIF":3.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare accessibility, utilization, and quality of life among internally displaced people during the Sudan war: a cross-sectional study.","authors":"Hind Elmukashfi ShamsEldin Elobied, Muhannad Bushra Masaad Ahmed, Ahmed Balla M Ahmed, Romaysa Abdelrahman Hassan Salih, Sohaib Mohammed Mokhtar Ahmed, Abdulhadi M A Mahgoub, Abdelmoula Hashim Abdelmagid Mohamed, Eman Hamid Abdallah Elamin, Al-Romaysa M Osman Khalafalla El-Haj, Mohamed Al-Hadi Hamed Abd-Allah, Arwa Yagoub Elmadani Ibrahim, Yousuf Alnoor Younis Mohamed, Arig Elias Shabo","doi":"10.1186/s13031-025-00655-3","DOIUrl":"10.1186/s13031-025-00655-3","url":null,"abstract":"<p><strong>Background: </strong>The ongoing war in Sudan has triggered a massive displacement crisis, leaving internally displaced people (IDP) struggling to access healthcare services. This study aimed to investigate healthcare access, utilization, and the quality of life among Sudanese IDP during the conflict.</p><p><strong>Methods: </strong>This cross-sectional study was carried out among Sudanese internally displaced people in six states. Quality of life was assessed using the WHOQOL-Bref questionnaire. Accessibility, utilization, and the consequences of not accessing healthcare were evaluated using an author-designed questionnaire, which was piloted prior to the study. Chi-square tests were used to analyze associations between categorical variables, while ANOVA was applied to assess differences in quality-of-life domains based on displacement duration and living conditions. Multinomial logistic regression identified predictors of healthcare affordability, with significance set at p < 0.05.</p><p><strong>Results: </strong>Among 612 participants, 40.3% reported facilities being very close, 13.0% faced waits over 2 h, and 54.3% found healthcare unaffordable. Only 33.6% always had access to qualified staff, and 22.8% of IDP visited public healthcare facilities supported by non-governmental organizations. The psychological domain had the highest quality-of-life mean score at 49.7 (18.1). Worsened symptoms (44%) were a common consequence of healthcare inaccessibility, while lack of transport (37.9%) was the most common barrier. Availability of qualified staff significantly increased the likelihood of seeking care (χ² = 11.30, p = 0.022). Quality-of-life domains varied significantly by displacement duration and living situation (p < 0.011).</p><p><strong>Conclusion: </strong>This study revealed significant variations in healthcare access and utilization among Sudanese IDP, with quality-of-life domains lower than those of IDP in other countries. Interventions should prioritize innovative solutions like telemedicine, targeted support for vulnerable groups, and expanding health insurance coverage to enhance access and long-term health outcomes.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"11"},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}