The role of the applied epidemiologist in armed conflict

McDonnell, Sharon M.; Sunderland, Naomi; Bellows, Benjamin; White, Mark; Noji, Eric K.

doi:10.1186/1742-7622-1-4

Cited by 24 publications

(6 citation statements)

References 30 publications

(75 reference statements)

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“…Contrary to evidence from other conflicts [ 8 , 34 - 37 ] as well as from Nepal [ 38 - 40 ] of a negative impact of conflict on the health of populations, we found that in Nepal progress has been made in most health indicators. There does not appear much literature on what made it possible to achieve such progress despite a decade-long armed conflict.…”

Section: Discussioncontrasting

confidence: 99%

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Understanding effects of armed conflict on health outcomes: the case of Nepal

Devkota

Teijlingen

2010

Confl Health

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ObjectiveThere is abundance of literature on adverse effects of conflict on the health of the population. In contrast to this, sporadic data in Nepal claim improvements in most of the health indicators during the decade-long armed conflict (1996-2006). However, systematic information to support or reject this claim is scant. This study reviews Nepal's key health indicators before and after the violent conflict and explores the possible factors facilitating the progress.MethodsA secondary analysis has been conducted of two demographic health surveys-Nepal Family Health Survey (NFHS) 1996 and Nepal Demographic and Health Survey (NDHS) 2006; the latter was supplemented by a study carried out by the Nepal Health Research Council in 2006.ResultsThe data show Nepal has made progress in 16 out of 19 health indicators which are part of the Millennium Development Goals whilst three indicators have remained static. Our analysis suggests a number of conflict and non-conflict factors which may have led to this success.ConclusionThe lessons learnt from Nepal could be replicable elsewhere in conflict and post-conflict environments. A nationwide large-scale empirical study is needed to further assess the determinants of Nepal's success in the health sector at a time the country experienced a decade of armed conflict.

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Section: Discussioncontrasting

confidence: 99%

“…Conflict has both direct and indirect effects on people's health and on the overall health system [ 8 ]. Armed conflicts can also cause the displacement of people and an increase in infectious diseases [ 2 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding effects of armed conflict on health outcomes: the case of Nepal

Devkota

Teijlingen

2010

Confl Health

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“…Both qualitative and quantitative methods should be employed to study collective violence in the complex setting in order to estimate the emergency level and complexity. This would help in developing an early warning network [ 29 , 47 - 49 ]. We hope the results of our study will assist in the advocacy effort, and we call for immediate multidisciplinary intervention and peace-building at the western border of Bangladesh.…”

Section: Discussionmentioning

confidence: 99%

Household exposure to violence and human rights violations in western Bangladesh (I): prevalence, risk factors and consequences

Wang¹,

Modvig²,

Montgomery³

2009

BMC Int Health Hum Rights

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BackgroundThe ruling parties in Bangladesh have systematically used violence against political opponents and criminals. It is essential to 1) determine the magnitude and burden of organised crime and political violence (OPV) and human rights violations in the affected community, and to 2) identify the risk factors and key indicators for developing effective health intervention and prevention measures.MethodsThe population-based study consisted of two parts: a household survey and OPV screening at mobile clinics (presented in Part II). A cross-sectional, multistage cluster household survey was conducted in the Meherpur district in February-March 2008; 22 clusters with a sample size of 1,101 households (population of 4,870) were selected.ResultsAround 83% of households reported being exposed to at least two categories of OPV or human rights violations: 29% reported that the family members had been arrested or detained; 31% reported torture or other cruel, inhuman or degrading treatment or punishment. Crude mortality rate was 17.9/1,000 and under 5 mortality rate was 75/1,000. The annual injury rate was 36%, lifetime experience of violence-related injury was 50%, and pain experience within 2 weeks was reported by 57%. Over 80% of the population over 35 years old complained of pain. High prevalence of injury, lifetime experience of OPV-related injury and pain complaints are related to the level of exposure to OPV and human rights violations. A financial burden was imposed on families with an injured person. A geographical variation was revealed regarding reports of torture and lifetime experience of violence-related injury. A combination of individual, relational, community and societal factors, including variables such as political party affiliation, conflict with other families, household income and residential area, affected the risk of victimisation in the household. The odds ratio for reporting extrajudicial execution of a family member was 9.22 for Awami League supporters, 9.15 for Bangladesh Nationalist Party supporters; and 3.97 for Jamaat-e-Islami Party supporters compared with families with no political involvement.ConclusionThe level of violence and human rights violations is high. The affected population suffers from violence-related injuries and traumas, which could be a factor contributing to poverty. Victimisation is not random.

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“…First, global health scholars can collaborate with public health specialists and local conflict resolution experts to research early warning systems, building on epidemiological modelling of disease tracking to improve statistical indicators and qualitative measures of emerging conflict within and across borders. 27 28 Because individuals suffering from conflict-inflicted injury often seek out medical help, health systems often have unique access to data on early warning signs of incipient conflict.…”

Section: The Prevention Principle: Addressing the Precursors Of Conflmentioning

confidence: 99%

Mitigating the global health threat of violent conflict: a preventive framework

Shapiro

Hua

2020

BMJNPH

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Objective To examine the problem of large-scale violent conflict and the unique preventive role that the global health community can play.Methods We conducted a comprehensive literature review and extrapolated insights from practice-based research and consultation with leaders and grassroot organisations confronting emergent and ongoing large-scale conflict.Results The field of global health has thoroughly investigated the physical and mental health consequences of violent conflict, yet there is a dire need for preventive research and action.Conclusions Global health scholars and practitioners are well-positioned to track early warning signs of violence, construct predictive models of its outbreak, lobby for policy reform to address the structural roots of conflict, and provide mediation and educational support to mitigate emerging conflict.

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The role of the applied epidemiologist in armed conflict

Cited by 24 publications

References 30 publications

Understanding effects of armed conflict on health outcomes: the case of Nepal

Understanding effects of armed conflict on health outcomes: the case of Nepal

Household exposure to violence and human rights violations in western Bangladesh (I): prevalence, risk factors and consequences

Mitigating the global health threat of violent conflict: a preventive framework

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