4 - Public Health in Settings of Conflict and Political Instability

Abstract

Conflicts are increasing and becoming more prolonged, causing some of the highest numbers of forcibly displaced persons in a generation. The relationship between conflict and displacement and morbidity is complex and intersects with political, social, military, economic, and demographic factors. Excess morbidity and mortality in conflict and displacement settings are primarily driven by indirect causes, while direct war-related injuries and mortality usually represent a small proportion of the overall negative consequences of conflict on the health status of the affected population. The main causes of death during conflict and displacement tend to remain similar as in pre-crisis situations, with communicable diseases predominating in low-income countries and non-communicable diseases occurring more frequently in adults in middle-income countries. Conflict and displacement have multi-dimensional effects on the functioning of the health system that adversely affects access to and provision of healthcare. Attacks on health facilities, shortages of human, material and financial resources, reduced access to health facilities, limited availability of data as well as insufficient coordination and leadership are a few of the challenges that exist.