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Background <p>Continuance of global progress toward the eradication of malnutrition in all forms requires the steering of resources to priority areas. Armed conflict is a key driver of malnutrition, yet its impact differs given the conflict intensity, duration and type. In this study, we investigate the relationship between conflict type, specifically state-based and non-state conflict, and under-5 acute malnutrition in conflict-affected African populations.</p> Methods <p>We link malnutrition data from small-scale surveys held in the Complex Emergency Database, conducted across 11 conflict-affected African populations between 1999 and 2015, with conflict data from UCDP/PRIO. We estimate associations between conflict type and the prevalence of global acute malnutrition (GAM) and severe acute malnutrition (SAM) whilst controlling for relevant covariates, using Bayesian beta-regression, which allows aggregation of survey data.</p> Findings <p>Holding other factors constant, non-state conflict was significantly (<i>p</i> &lt; 0.05) associated with a higher prevalence of GAM and SAM (15.27% and 4.83%) relative to state-based conflict (9.03% and 1.26%). In addition, we find heterogeneous impacts of prior military expenditure as a share of GDP, overseas development assistance (ODA) and precipitation variability on under-5 acute malnutrition by conflict type. Namely, prior military expenditure and lower-than-normal precipitation were associated with increased malnutrition prevalence under state-based conflict, yet to a lesser degree under non-state conflict. We find a significant mitigating role of ODA on GAM, irrespective of conflict type. For SAM, ODA was more negatively associated with malnutrition prevalence under non-state conflict relative to state-based conflict.</p> Interpretation <p>The study extends the current literature by finding a heterogenous relationship between conflict type and under-5 acute malnutrition, namely we estimate a significantly higher malnutrition burden in African populations affected by non-state conflict relative to state-based conflict. Our findings underscore the importance of context-specific resource planning when addressing malnutrition burden in humanitarian crises.</p>

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Beyond the battlefield: how conflict type drives acute child malnutrition in Africa

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月18日

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  • Thomas Jideofor Ogbu,
  • Rebecca Louise Jones,
  • Debarati Guha-Sapir

摘要

Background

Continuance of global progress toward the eradication of malnutrition in all forms requires the steering of resources to priority areas. Armed conflict is a key driver of malnutrition, yet its impact differs given the conflict intensity, duration and type. In this study, we investigate the relationship between conflict type, specifically state-based and non-state conflict, and under-5 acute malnutrition in conflict-affected African populations.

Methods

We link malnutrition data from small-scale surveys held in the Complex Emergency Database, conducted across 11 conflict-affected African populations between 1999 and 2015, with conflict data from UCDP/PRIO. We estimate associations between conflict type and the prevalence of global acute malnutrition (GAM) and severe acute malnutrition (SAM) whilst controlling for relevant covariates, using Bayesian beta-regression, which allows aggregation of survey data.

Findings

Holding other factors constant, non-state conflict was significantly (p < 0.05) associated with a higher prevalence of GAM and SAM (15.27% and 4.83%) relative to state-based conflict (9.03% and 1.26%). In addition, we find heterogeneous impacts of prior military expenditure as a share of GDP, overseas development assistance (ODA) and precipitation variability on under-5 acute malnutrition by conflict type. Namely, prior military expenditure and lower-than-normal precipitation were associated with increased malnutrition prevalence under state-based conflict, yet to a lesser degree under non-state conflict. We find a significant mitigating role of ODA on GAM, irrespective of conflict type. For SAM, ODA was more negatively associated with malnutrition prevalence under non-state conflict relative to state-based conflict.

Interpretation

The study extends the current literature by finding a heterogenous relationship between conflict type and under-5 acute malnutrition, namely we estimate a significantly higher malnutrition burden in African populations affected by non-state conflict relative to state-based conflict. Our findings underscore the importance of context-specific resource planning when addressing malnutrition burden in humanitarian crises.