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Introduction <p>Sudan’s already under-resourced health system has been strained by war, with over 10&#xa0;million people displaced and 67% of hospitals rendered non-operational. The disruption has led to limited access to essential services. Children face both physical and psychological consequences. This study explores caregivers’ use of health services, observed behavioral changes in children, reports of sexual harassment, and alignment between caregiver experiences and facility data.</p> Method <p>This descriptive cross-sectional community-based study was conducted among internally displaced caregivers of children in four relatively safe states—Red Sea, Northern, Nahr Elnil, and Kassala—using questionnaires for both caregivers and health facility directors. A total of 437 caregivers and 12 facilities participated. A multistage sampling method was followed by convenience sampling at the community level. Data were analyzed using SPSS version 25 with descriptive and inferential statistics.</p> Results <p>The study included 437 caregivers, 86% of whom were women, with a mean age of 35.4 years (± 9.2 SD). The average age of the children involved in the study was 4.4 ± 4.2 years. Despite 91.8% of children under five having access to basic immunizations, 10% missed essential vaccines, with measles accounting for 50% of missed doses. Pneumonia and gastroenteritis were the most frequently reported illnesses. Psychosocial impacts were prevalent, with 26.8% of children exhibiting fearfulness, anxiety, or irritability.</p> <p>Health facilities findings revealed that 66.7% of facilities experienced disruptions in working hours. Only 25% of facilities had pediatric intensive care units. Key emergency resources, including oxygen therapy (81.8%) and insulin (90.9%), were available in most facilities. T availability of key support staff—such as psychologists and social workers—was notably limited (16.7%).</p> Conclusion <p>Overall, the study’s findings are in partial agreement with other conflict-region research, notably on disease burden, psychosocial impact, and health system degradation. However, Sudan’s context reveals some unique features. Despite extreme displacement, immunization outreach and breastfeeding practices showed higher-than-expected retention. Nevertheless, the weak critical care infrastructure, referral breakdowns, and mental health service gaps highlight urgent needs that require national and international collaboration.</p>

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Child health in war crisis: barriers to healthcare utilization among internally displaced Sudanese caregivers 2024–2025

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月8日

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  • Alaa T. Omer,
  • Alaa A.Y Ahmed,
  • Anmar B. Birier,
  • Baha Aldeen Alshareif,
  • Isra Isameldeen Mohmmed Mohmmedalageel,
  • Logien Abuelgasim Ahmad Ibrahim,
  • Maaza Osman,
  • Mohamed I. Idris,
  • Mohammed Osman,
  • Mudathir Elsiddig,
  • Salah Aldin K. Wedaatalla,
  • Suodad Elhassan,
  • Yagoub Ibrahim

摘要

Introduction

Sudan’s already under-resourced health system has been strained by war, with over 10 million people displaced and 67% of hospitals rendered non-operational. The disruption has led to limited access to essential services. Children face both physical and psychological consequences. This study explores caregivers’ use of health services, observed behavioral changes in children, reports of sexual harassment, and alignment between caregiver experiences and facility data.

Method

This descriptive cross-sectional community-based study was conducted among internally displaced caregivers of children in four relatively safe states—Red Sea, Northern, Nahr Elnil, and Kassala—using questionnaires for both caregivers and health facility directors. A total of 437 caregivers and 12 facilities participated. A multistage sampling method was followed by convenience sampling at the community level. Data were analyzed using SPSS version 25 with descriptive and inferential statistics.

Results

The study included 437 caregivers, 86% of whom were women, with a mean age of 35.4 years (± 9.2 SD). The average age of the children involved in the study was 4.4 ± 4.2 years. Despite 91.8% of children under five having access to basic immunizations, 10% missed essential vaccines, with measles accounting for 50% of missed doses. Pneumonia and gastroenteritis were the most frequently reported illnesses. Psychosocial impacts were prevalent, with 26.8% of children exhibiting fearfulness, anxiety, or irritability.

Health facilities findings revealed that 66.7% of facilities experienced disruptions in working hours. Only 25% of facilities had pediatric intensive care units. Key emergency resources, including oxygen therapy (81.8%) and insulin (90.9%), were available in most facilities. T availability of key support staff—such as psychologists and social workers—was notably limited (16.7%).

Conclusion

Overall, the study’s findings are in partial agreement with other conflict-region research, notably on disease burden, psychosocial impact, and health system degradation. However, Sudan’s context reveals some unique features. Despite extreme displacement, immunization outreach and breastfeeding practices showed higher-than-expected retention. Nevertheless, the weak critical care infrastructure, referral breakdowns, and mental health service gaps highlight urgent needs that require national and international collaboration.