Evaluation of Nutrition Interventions in Children in Conflict Zones: A Narrative Review

Abstract

Food and nutrition insecurity becomes increasingly worse in areas affected by armed conflict. Children affected by conflict, or in war-torn settings, face a disproportionate burden of malnutrition and poor health outcomes. As noted by humanitarian response reviews, there is a need for a stronger evidence-based response to humanitarian crises. To achieve this, we systematically searched and evaluated existing nutrition interventions carried out in conflict settings that assessed their impact on children's nutrition status. To evaluate the impact of nutrition interventions on children's nutrition and growth status, we identified published literature through EMBASE, PubMed, and Global Health by using a combination of relevant text words and Medical Subject Heading terms. Studies for this review must have included children (aged ≤18 y), been conducted in conflict or postconflict settings, and assessed a nutrition intervention that measured ≥1 outcome for nutrition status (i.e., stunting, wasting, or underweight). Eleven studies met the inclusion and exclusion criteria for this review. Five different nutrition interventions were identified and showed modest results in decreasing the prevalence of stunting, wasting, underweight, reduction in severe or moderate acute malnutrition or both, mortality, anemia, and diarrhea. Overall, nutrition interventions in conflict settings were associated with improved children's nutrition or growth status. Emergency nutrition programs should continue to follow recent recommendations to expand coverage and access (beyond refugee camps to rural areas) and ensure that aid and nutrition interventions are distributed equitably in all conflict-affected populations.

Humanitarian led community-based surveillance: case study in Ekondo-titi, Cameroon

“…Crisis areas are prone to food insecurities which could easily lead to malnutrition, especially amongst under five children [17]. The active screening of children 6 months to 59 months by CHWs and reporting SAM cases through the CBS system led to the early identification and eventual management of 43 children with SAM.…”

Impact of a Pilot School-Based Nutrition Intervention on Dietary Knowledge, Attitudes, Behavior and Nutritional Status of Syrian Refugee Children in the Bekaa, Lebanon

“…Despite the high vulnerability of refugee children to the adverse consequences of food insecurity and poverty, few studies to date were conducted to explore the health and nutritional status of refugee children in complex emergencies and protracted crises [ 8 , 9 , 10 ]. In fact, the limited research conducted within crisis-settings focuses primarily on assessing the prevalence of malnutrition among young children (<5 years), such as stunting, wasting, and anemia [ 11 ], with less emphasis being placed on the nutritional status of school-aged children.…”

Association of Exposure to Civil Conflict With Maternal Resilience and Maternal and Child Health and Health System Performance in Afghanistan

“…Humanitarian crises, including war, natural disasters, and population displacement, negatively affect population health and development. 1,2,3,4,5 Recent analyses have shown significant excess of child mortality in Africa due to conflict, 6 collapse of health systems, and deterioration of protective infrastructure that further exacerbate mortality and morbidity in conflict settings. 1,2,3…”