Beyond the Battlefield: How Conflict Type Drives Acute Child Malnutrition in Africa

Abstract:

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.

Authors:

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