Conflict and Health最新文献

{"title":"Exploring maternal and neonatal health in a conflict-affected setting: cross-sectional findings from Gaza.","authors":"Belal Aldabbour, Samah Elamassie, Saher Mahdi, Haytham Abuzaid, Tamer Abed, Yaser Tannira, Khaleel Skaik, Yousef Abu Zaydah, Abdelkareem Elkolak, Mohammed Alhabashi, Adham Abualqumboz, Abdelrahman Alwali, Heba Alagha, Mahmoud Eid, Shireen Abed, Bettina Bottcher","doi":"10.1186/s13031-025-00687-9","DOIUrl":"10.1186/s13031-025-00687-9","url":null,"abstract":"<p><strong>Background: </strong>Women experiencing armed conflict during pregnancy face a significantly higher risk of maternal and neonatal complications, including low-birthweight (LBW) babies, due to factors such as violence, stress, food insecurity, and limited access to healthcare. This study aims to explore maternal and neonatal health, as well as antenatal care (ANC) access during the war in Gaza.</p><p><strong>Methods: </strong>This cross-sectional study involved 500 consecutive women and newborns delivered at the three largest obstetric centers in the Gaza Strip over a three-week span in late October and early November 2024. The research collected sociodemographic details, maternal obstetric histories, maternal nutrition variables, maternal stress effects, and other impacts from the conflict, as well as neonatal outcomes, including birthweight. Frequencies, percentages, and the median and interquartile range (IQR) were used to describe the data. The Mann-Whitney test was applied to compare birthweights between populations based on sex and geographical location.</p><p><strong>Results: </strong>The median maternal age was 28. Nearly half (52.63%) had a normal baseline body mass index (BMI). Most (84.03%) reported a very low monthly income. The prevalence of maternal anemia was 50.4%. A majority of participants (62.73%) reported an insufficient quantity of food, while 73.6% noted a lack of dietary diversity. Over half consumed, on average, only two full meals daily, and their diets largely lacked animal protein. Only 36.68% attended eight or more ANC visits, and just 58.4% established their first ANC contact during the first trimester. The most common reason for the lack of ANC was the inability to afford transportation. Moreover, 69.46% adhered to folic acid and iron supplementation. Most (90.42%) participants reported moderate to high stress levels, with 40.92% and 33.93% feeling almost always or often endangered. The prevalence of LBW was 10.8%, and the median weight was 3100 g.</p><p><strong>Conclusion: </strong>This study illustrates the vulnerability of pregnant women during conflicts and emphasizes the responsibility of those involved in conflicts to protect pregnant women and newborns and safeguard their future development and health.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"45"},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661085","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":"Analysis of the possible pathways between social and well-being outcomes: a mixed-method study about community-based sociotherapy for refugees in Nakivale Settlement, Uganda.","authors":"Tessa Ubels, Sara Kinsbergen, Dirk-Jan Koch, Judith Kanshabe, Jochem Tolsma","doi":"10.1186/s13031-025-00682-0","DOIUrl":"10.1186/s13031-025-00682-0","url":null,"abstract":"<p><strong>Background: </strong>Refugees in Nakivale Settlement, southwestern Uganda, are at risk of suffering from both mental health and social problems due to migration-related stressors. Mental health and psychosocial support is offered to improve their well-being. The theories of change of mental health and psychosocial support interventions often assume that individual and social outcomes are interrelated. By analysing changes in well-being and social support after Community-Based Sociotherapy (CBS), we assess the pathways between these outcomes.</p><p><strong>Methods: </strong>This study uses a longitudinal mixed-method approach, analysing survey data from 98 CBS participants at three time points, and 11 focus group discussions. We focus on well-being and social support outcomes. We first analysed the quantitative data (paired t-tests, correlations, random-intercept cross-lagged panel model), followed by a qualitative content analysis to interpret the quantitative findings.</p><p><strong>Results: </strong>We did not find quantitative evidence of within-person influence processes between well-being and social support, and the significantly positive changes in these outcomes between the pre- and posttest declined over time. The qualitative data shed new light on the changes in the lives of the participants after participating in CBS, and the barriers to and facilitators of change.</p><p><strong>Conclusions: </strong>Among this group of participants, we found no quantitative and limited qualitative evidence that improvements in well-being led to improved social outcomes, or vice versa. We consider how methodological limitations (i.e. our sample size and limited number of survey items) may have influenced our results, and contextual and temporal explanations for the lack of evidence of pathways. This finding stands in contrast with the theories of change of many mental health and psychosocial support interventions, and therefore calls for consideration of the complex realities of people living in refugee settings, rather than assuming simple pathways.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"44"},"PeriodicalIF":3.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651197","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":"Prevalence and correlates of anxiety, depression, and symptoms of trauma among Palestinian adults in Gaza after a year of war: a cross-sectional study.","authors":"Mohamed R Zughbur, Yaser Hamam, Ashraf Kagee, Majd Hamam, Yara M Hijazi, Mohammed Hamam, Ola Abuolwan, Shameq Sayeed, Guido Veronese","doi":"10.1186/s13031-025-00681-1","DOIUrl":"10.1186/s13031-025-00681-1","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"43"},"PeriodicalIF":3.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644133","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":"Towards universal health care coverage in low- and middle- income countries: integrating refugees into national health systems.","authors":"Fadi El-Jardali, Sara Bennett, Paul Spiegel","doi":"10.1186/s13031-025-00684-y","DOIUrl":"10.1186/s13031-025-00684-y","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 Suppl 1","pages":"80"},"PeriodicalIF":3.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644134","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 in Yemen's conflict zones: comprehensive review focused on strategies and solutions.","authors":"Ahmed Salem, Aiman Rosen, Iman Alharazi, Yaser Gamallat, Aamer Aldbyani, Bushra Amer, Namoonga Chimpandu","doi":"10.1186/s13031-025-00685-x","DOIUrl":"10.1186/s13031-025-00685-x","url":null,"abstract":"<p><p>The nine-year ongoing conflict in Yemen accumulated humanitarian crisis, and severely struggling healthcare system. In the current review, we are trying here to elucidate the many perspective areas where the conflict in Yemen has made it harder to access medical care, emphasizing how the war has negatively affected medical infrastructure, caused a severe shortage of medical supplies, and obstructed access to or the ability to receive medical services. We conducted a comprehensive search across reports from in-ground working organizations like UN, MSF, ICRC, and official authorial channels, including local organizations as well to illustrate how the conflict-induced challenges have drastically limited access to essential services, as well as literature repositories (PubMed MEDLINE, Scopus, Web of Science). Then, data were thematically presented.Our data suggest urgent and thoughtful long-term solutions, including the need of economic support, reconstructing healthcare infrastructure through coordinated efforts, and setting up safe supply lines to ensure a steady flow of medical resources particularly in intensive war zones where mobile clinics could serve as an alternative. Additionally, we highlight the importance of supporting and incentivizing the healthcare workforce to prevent further depletion through training programs that include professional and practical skills and ensuring safe transport to and from medical facilities for both patients and healthcare personnel. Moreover, we recommend implementing targeted programs to improve access to quality healthcare for disproportionately affected populations, guaranteeing access to medical treatment as a right and not a privilege, and most significantly, ensuring that the medical facilities are not targeted. Therefore, these focused recommendations aim to guide policymakers, international donors, and on-ground NGOs in restoring healthcare access and improving the quality of life for millions of Yemenis.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"42"},"PeriodicalIF":3.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638700","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":"Family formation among adolescent Rohingya refugees; trajectories into adolescent marriage and childbearing in Cox's Bazar Bangladesh.","authors":"Linnea A Zimmerman, Shatha Elnakib, Anam Ali, Rumana Akter, Tofajjel Hossain, Tom Traill, Kate Mieth, Tahia Hasan, Tanvir Hasan, W Courtland Robinson","doi":"10.1186/s13031-025-00683-z","DOIUrl":"10.1186/s13031-025-00683-z","url":null,"abstract":"<p><strong>Background: </strong>Although both marriage and childbearing are potentially influenced by humanitarian emergencies, and for many individuals are intrinsically linked life-course events, they are rarely explored together in the literature on humanitarian emergencies. Additionally, literature on child marriage focuses largely on females, neglecting the experiences of males.</p><p><strong>Objective: </strong>To understand how trajectories of family formation for adolescent females and males have been affected by mass displacement. We compare time to first marriage and time to first birth following marriage between age cohorts of 15-19 and 20-24 year-old female and male Forcibly Displaced Myanmar Nationals.</p><p><strong>Methods: </strong>We use data from 1,565 females and 722 males aged 15-24, collected within fifteen camps in Cox's Bazar, to estimate hazard of first marriage and of child marriage and data from 643 married females to estimate hazard from marriage to first birth.</p><p><strong>Results: </strong>Females aged 20-24 had a 31% increased hazard of marriage overall and 42% increased hazard of child marriage relative to females aged 15-19 (95% CI: 1.07-1.87) and an 84% higher incidence rate (95% CI: 1.46-2.33). For males, there was a higher hazard of marriage by age 25 amongst males aged 20-24 relative to age 15-19 (HR: 1.80, 95% CI: 1.10-2.94), but no statistically significant difference in the hazard of marriage by age 18. Approximately 20% of females gave birth within a year of marriage and 70-75% within three years post-marriage, across age cohort and age at marriage. There were no statistically significant differences in hazard of first birth by either age cohort or age at marriage.</p><p><strong>Discussion: </strong>Displacement may have increased risk of child marriage for adolescents, as evidenced by higher child marriage rates amongst males and females who were age 14-18 at the time of displacement. Displacement did not affect time to childbirth following marriage, which remains high amongst both age cohorts. Efforts to reduce child marriage and adolescent child marriage must address limited opportunities for adolescents in situations of displacement.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"41"},"PeriodicalIF":3.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621194","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":"Exploring factors that shaped Syrian refugees integration into Lebanon's national health system using Kingdon's Multiple Streams Framework.","authors":"Fadi El-Jardali, Gladys Honein-AbouHaidar, Lama Bou-Karroum, Sabine Salameh, Sarah E Parkinson, Rima Majed","doi":"10.1186/s13031-025-00680-2","DOIUrl":"10.1186/s13031-025-00680-2","url":null,"abstract":"<p><strong>Background: </strong>Since the start of the Syrian conflict in 2011, neighboring country Lebanon has hosted the largest number of refugees per capita in the world. To meet refugees' health care needs, Lebanon adopted an integrated model of care. This paper explores the key factors and events that have shaped the policy on the integration of Syrian refugees into the Lebanese national health system through a policy analysis.</p><p><strong>Methods: </strong>The research team adopted a qualitative approach that employed in-depth interviews with 12 key informants (2 ministers, 4 non-governmental organizations, 3 advocacy group representatives, and 3 healthcare managers) and document review. Thematic framework analysis was used to analyze the data guided by the Kingdon's Multiple Streams Framework.</p><p><strong>Results: </strong>Problem factors that influenced Lebanese health policy towards Syrian refugees include the sheer number of refugees with urgent health care needs who entered a fragile, highly privatized health care system, and political and sectarian dissension around the refugee issue, both of which contributed to a slow government response. In the policy stream, international non-governmental organizations concerned with refugee health started to engage with local authorities. In December 2014, the Lebanon Crisis Response Plan strategy was issued by the government and various partners that iterated the strategy to respond to Syrian refugees' needs. Under the political stream, Lebanon's historical experience with Palestinian refugees, and specifically concerns regarding fear of domiciliation, influenced the unofficial implementation of a 'no camp policy' strategy at the onset of the crisis, which in turn shaped healthcare integration. Further, international non-governmental organizations joined efforts to fund and supplement health care services, while think tank policy organizations advocated for refugees right to healthcare and host community support.</p><p><strong>Conclusion: </strong>This study highlights the role of global actors, such as UNHCR, WHO among others, as the main entrepreneurs in integrating refugees into the Lebanese health care system. It also underscored the ad-hoc non-systematic approach with which the policies around refugee health response were made in Lebanon and the influence of political factors. Although the mutual benefits to both host and refugee communities were recognized, many challenges threaten integration, foremost among them the model's financial sustainability.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 Suppl 1","pages":"79"},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610329","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":"Mental health and structural injustice: a qualitative investigation of interlocking patterns of disadvantage among displaced populations in Nairobi, Kenya.","authors":"D B Nieuwe Weme, M M Wanga, P B Mastaki, J Osur, W A Tol","doi":"10.1186/s13031-025-00660-6","DOIUrl":"10.1186/s13031-025-00660-6","url":null,"abstract":"<p><strong>Background: </strong>Urban refugees face systemic disadvantages that significantly impact their mental health and overall wellbeing. Research on refugee mental health often examines risk factors in isolation, overlooking broader systemic patterns. This study applies a structural injustice framework to investigate how interconnected disadvantages shape the mental health of urban refugees.</p><p><strong>Methods: </strong>A thirteen-month study examined the wellbeing of Somali and Congolese refugees in Nairobi, employing ethnographic methods, including 69 in-depth interviews, field notes, and observations. Findings were interpreted using Powers and Faden's structural injustice theory.</p><p><strong>Results: </strong>Analysis revealed a systemic pattern linking immigration status, sexual and gender-based violence, and limited access to livelihoods. These interconnected factors impact all six elements of wellbeing identified by Powers and Faden and exhibit the theorized characteristics of structural injustice: pervasive, profound, asymmetric, and near-inescapable.</p><p><strong>Discussion: </strong>The study highlights the structural nature of challenges faced by urban refugees in Nairobi, emphasizing the need to address interconnected systemic barriers. Understanding these patterns is essential for identifying effective interventions and mitigating risks to refugee mental health and overall wellbeing.</p><p><strong>Conclusion: </strong>The theory as used in this study sheds new light on the interconnected nature of the environment urban refugees live in. This holistic approach to wellbeing provides clarity on vulnerabilities related to specific social groups.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"40"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555848","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":"Post-crisis health reality and wellbeing of children within Syria: a scoping review of research from 2012 to 2024.","authors":"Seba Harphoush, Fatema Ahmed, Ihab Harphoush, Rasha Kadoun, Soha Harphoush, Rami Al Asaad, Zhong Li","doi":"10.1186/s13031-025-00673-1","DOIUrl":"10.1186/s13031-025-00673-1","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"39"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555849","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":"Support for children born of rape in the Democratic Republic of the Congo: mother's experiences and challenges.","authors":"Euphrasie Kaningini Wamunzila, Frieda Vandeninden","doi":"10.1186/s13031-025-00674-0","DOIUrl":"10.1186/s13031-025-00674-0","url":null,"abstract":"<p><p>The repercussions of rape extend far beyond the act itself. Women who become pregnant as a result of rape are frequently forced to keep unwanted children, as abortion is generally perceived as unacceptable and illegal within the community. The aim of this study is to examine the socioeconomic challenges encountered by mother of children born of rape in the care of this children. The methodological approach of this study is based on a qualitative analysis. Semi structured interviews were conducted with 33 female survivors of sexual violence with children born of rape in the eastern DRC in the Kabare territory of the Katana groupement. The findings reveal that while all survivors experience trauma, those who give birth require distinct support. Mothers face numerous challenges in their caregiving roles, including financial hardship, fear of employment, low educational levels, loss of assets, lack of spousal support, and social stigmatization. Consequently, children born of rape encounter significant obstacles, especially for boys, in accessing basic services because of their mothers' trauma, absence of paternal support, maternal ignorance, and societal stigma. Specific measures should be taken to improve the quality of life for both mothers and children affected by rape, fostering resilience and empowering them to overcome the numerous challenges they face.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"19 1","pages":"38"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546130","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}