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5 million children likely died because of conflict in Africa: study

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Three infants die of war-related causes for every direct combat death in Africa, according to a new study highlighting the long-lasting impact of war on children who grow up around it.

More children die from preventable causes in the aftermath of conflict than during the actual fighting, according to the study. Some of the primary war-related causes of death include starvation, malnutrition, preventable diseases and lack of basic services.

“What we’re showing is that the effects [of war] last for a long time and require a long-term, sustained response,” said Eran Bendavid, the study’s lead author and an associate professor of medicine at Stanford University.

The study could help relief workers identify better ways to help civilians in violence-prone countries over time, Bendavid said.

Bendavid and his team suggest as many as five million children under five died as an indirect result of armed conflict in Africa from 1995 to 2015. An estimated three million of those children who died were age one or younger, according to the paper published in the latest edition of The Lancet.

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“What we’re doing is really, for the first time, trying to get a clear estimate of the effects of war,” Bendavid told Global News on Thursday.

Bendavid’s study factors in deaths caused by malnutrition, preventable diseases and the loss of basic human necessities, such as access to clean water and sanitation, as a result of nearby violence.

“Those areas of conflict are falling behind,” Bendavid said. “Now we have a clear estimate of where and how much, and a better sense of what we can do about it.”

The study “expands the understanding of child mortality during armed conflicts,” experts Emelda A. Okiro and Philip Ayieko wrote in an accompanying commentary. They hailed the paper for examining the long-term health impacts of violence on children based on the geographical area.

“It is clear that armed conflict has a huge effect on child survival and that targeted interventions are needed,” Okiro and Ayieko wrote.

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However, the study numbers might be off due to issues with the data, migration patterns and the methods used to estimate the deaths, Okiro and Ayieko wrote.

“Despite these limitations, [the study] makes a substantial contribution to the understanding of the indirect effects of conflict on child mortality,” wrote Okiro, of the Kenya Medical Research Institute in Nairobi, and Ayieko, of the London School of Hygiene and Tropical Medicine in Mwanza, Tanzania. The two researchers were not involved in the study.

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When asked about the commentary casting doubt on his methods, Bendavid says his estimates are “really the best possible way to do it.”

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“We’re looking at all the conceivable implications that would threaten the numbers,” he said. “None of these are really changing our base estimate.”

Bendavid and his team counted the number of births and child deaths in each country and compared the number of deaths in times of war and peace.

A child born within 50 kilometres of a conflict area was on average 7.7 per cent more likely to die before reaching the age of one than a child born in peacetime, the authors found. Larger-scale conflicts increased the risk of children dying, up to 26.7 per cent for children near conflicts where more than 1,000 people were killed.

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Children also remained at a higher risk of death for up to eight years after a conflict, and within 100 kilometres of the fighting, the study found.

Researchers used data from demographic health surveys and the Uppsala Conflict Data Program, which categorizes violence based on location and the nature of the conflict. The dataset includes information for 35 of the 54 countries in Africa.

On average, the study authors found 65 of every 1,000 live-birth children did not live past their first birthday in the countries they studied.

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That’s 12 deaths more than the United Nations‘ latest estimates from 2016. The UN lists the infant mortality rate in sub-Sahara Africa at 53 deaths for every 1,000 births.

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Canada’s infant mortality rate is 4.5 deaths per 1,000 births, according to statistics from 2016.

The UN is aiming to bring the global infant mortality rate down to 12 deaths per 1,000 births by 2030 as part of its sustainable development goals.

Bendavid says his estimates will help with meeting the UN’s sustainable development goals in Africa.