For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
23
views
196
references
 Top references
cited by
41
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      414
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Effects of armed conflict on child health and development: A systematic review

      research-article
      Author(s): 1 , 2 , * , 3 , 3
      Editor(s):
      Publication date (Electronic):
      Journal: PLoS ONE
      Publisher: Public Library of Science

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Armed conflicts affect more than one in 10 children globally. While there is a large literature on mental health, the effects of armed conflict on children’s physical health and development are not well understood. This systematic review summarizes the current and past knowledge on the effects of armed conflict on child health and development.

          Methods

          A systematic review was performed with searches in major and regional databases for papers published 1 January 1945 to 25 April 2017. Included studies provided data on physical and/or developmental outcomes associated with armed conflict in children under 18 years. Data were extracted on health outcomes, displacement, social isolation, experience of violence, orphan status, and access to basic needs. The review is registered with PROSPERO: CRD42017036425.

          Findings

          Among 17,679 publications screened, 155 were eligible for inclusion. Nearly half of the 131 quantitative studies were case reports, chart or registry reviews, and one-third were cross-sectional studies. Additionally, 18 qualitative and 6 mixed-methods studies were included. The papers describe mortality, injuries, illnesses, environmental exposures, limitations in access to health care and education, and the experience of violence, including torture and sexual violence. Studies also described conflict-related social changes affecting child health. The geographical coverage of the literature is limited. Data on the effects of conflict on child development are scarce.

          Interpretation

          The available data document the pervasive effect of conflict as a form of violence against children and a negative social determinant of child health. There is an urgent need for research on the mechanisms by which conflict affects child health and development and the relationship between physical health, mental health, and social conditions. Particular priority should be given to studies on child development, the long term effects of exposure to conflict, and protective and mitigating factors against the harmful effects of armed conflict on children.

          Related collections

          Most cited references196

          • Record: found
          • Abstract: found
          • Article: not found

          The lifelong effects of early childhood adversity and toxic stress.

          Jack Shonkoff, Andrew S Garner (2012)
          Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. This converging, multidisciplinary science of human development has profound implications for our ability to enhance the life prospects of children and to strengthen the social and economic fabric of society. Drawing on these multiple streams of investigation, this report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. The implications of this framework for the practice of medicine, in general, and pediatrics, specifically, are potentially transformational. They suggest that many adult diseases should be viewed as developmental disorders that begin early in life and that persistent health disparities associated with poverty, discrimination, or maltreatment could be reduced by the alleviation of toxic stress in childhood. An ecobiodevelopmental framework also underscores the need for new thinking about the focus and boundaries of pediatric practice. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for educational achievement, economic productivity, responsible citizenship, and lifelong health.
          Article 0 comments Cited 611 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors.

            Mina Fazel, Ruth V. Reed, Catherine Panter-Brick … (2012)
            We undertook a systematic search and review of individual, family, community, and societal risk and protective factors for mental health in children and adolescents who are forcibly displaced to high-income countries. Exposure to violence has been shown to be a key risk factor, whereas stable settlement and social support in the host country have a positive effect on the child's psychological functioning. Further research is needed to identify the relevant processes, contexts, and interplay between the many predictor variables hitherto identified as affecting mental health vulnerability and resilience. Research designs are needed that enable longitudinal investigation of individual, community, and societal contexts, rather than designs restricted to investigation of the associations between adverse exposures and psychological symptoms. We emphasise the need to develop comprehensive policies to ensure a rapid resolution of asylum claims and the effective integration of internally displaced and refugee children. Copyright © 2012 Elsevier Ltd. All rights reserved.
            Article 0 comments Cited 198 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Health workers and the weaponisation of health care in Syria: a preliminary inquiry for The Lancet –American University of Beirut Commission on Syria

              Fouad M. Fouad, Annie Sparrow, Ahmad Tarakji … (2017)
              The conflict in Syria presents new and unprecedented challenges that undermine the principles and practice of medical neutrality in armed conflict. With direct and repeated targeting of health workers, health facilities, and ambulances, Syria has become the most dangerous place on earth for health-care providers. The weaponisation of health care-a strategy of using people's need for health care as a weapon against them by violently depriving them of it-has translated into hundreds of health workers killed, hundreds more incarcerated or tortured, and hundreds of health facilities deliberately and systematically attacked. Evidence shows use of this strategy on an unprecedented scale by the Syrian Government and allied forces, in what human rights organisations described as a war-crime strategy, although all parties seem to have committed violations. Attacks on health care have sparked a large-scale exodus of experienced health workers. Formidable challenges face health workers who have stayed behind, and with no health care a major factor in the flight of refugees, the effect extends well beyond Syria. The international community has left these violations of international humanitarian and human rights law largely unanswered, despite their enormous consequences. There have been repudiated denunciations, but little action on bringing the perpetrators to justice. This inadequate response challenges the foundation of medical neutrality needed to sustain the operations of global health and humanitarian agencies in situations of armed conflict. In this Health Policy, we analyse the situation of health workers facing such systematic and serious violations of international humanitarian law. We describe the tremendous pressures that health workers have been under and continue to endure, and the remarkable resilience and resourcefulness they have displayed in response to this crisis. We propose policy imperatives to protect and support health workers working in armed conflict zones.
              Article 0 comments Cited 111 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Ayesha Kadir:
                ORCID: http://orcid.org/0000-0001-8596-0729
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Sherry Shenoda: Role: ConceptualizationRole: Data curationRole: InvestigationRole: Writing – review & editing
                Jeffrey Goldhagen: Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Jai K. Das: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 16 January 2019
                Publication date Collection: 2019
                Volume: 14
                Issue: 1
                Electronic Location Identifier: e0210071
                Affiliations
                [1 ] Malmö Institute for Studies of Migration, Diversity and Welfare, Malmö University, Malmö, Sweden
                [2 ] Médecins Sans Frontières, Geneva, Switzerland
                [3 ] Division of Community and Societal Pediatrics, University of Florida College of Medicine—Jacksonville, Jacksonville, Florida, United States of America
                Aga Khan University, PAKISTAN
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-8596-0729
                Article
                Publisher ID: PONE-D-18-25363
                DOI: 10.1371/journal.pone.0210071
                PMC ID: 6334973
                PubMed ID: 30650095
                SO-VID: 629e7a83-cdd2-4dc9-bb49-f6ffacec5640
                Copyright © © 2019 Kadir et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 6 September 2018
                Date accepted : 17 December 2018
                Page count
                Figures: 6, Tables: 1, Pages: 37
                Funding
                The University of Florida-Jacksonville College of Medicine provided partial funding for the study. There was no additional external funding received for this study.
                Categories
                Subject: Research Article
                Subject: People and Places
                Subject: Population Groupings
                Subject: Age Groups
                Subject: Children
                Subject: People and Places
                Subject: Population Groupings
                Subject: Families
                Subject: Children
                Subject: Medicine and Health Sciences
                Subject: Pediatrics
                Subject: Child Health
                Subject: Medicine and Health Sciences
                Subject: Public and Occupational Health
                Subject: Child Health
                Subject: Medicine and Health Sciences
                Subject: Critical Care and Emergency Medicine
                Subject: Trauma Medicine
                Subject: Traumatic Injury
                Subject: Social Sciences
                Subject: Political Science
                Subject: War and Civil Unrest
                Subject: Biology and Life Sciences
                Subject: Population Biology
                Subject: Population Metrics
                Subject: Death Rates
                Subject: Medicine and Health Sciences
                Subject: Critical Care and Emergency Medicine
                Subject: Trauma Medicine
                Subject: Traumatic Injury
                Subject: Head Injury
                Subject: Medicine and Health Sciences
                Subject: Pediatrics
                Subject: Social Sciences
                Subject: Sociology
                Subject: Education
                Subject: Schools
                Custom metadata
                Data Availability All relevant data are within the manuscript and its Supporting Information files. The review is registered with PROSPERO, where the full search strategy is available: https://www.crd.york.ac.uk/PROSPEROFILES/36425_STRATEGY_20170427.pdf.

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

                Comments

                Comment on this article

                scite_

                Similar content414

                See all similar

                Cited by45

                See all cited by

                Most referenced authors1,274

                See all reference authors