Intended for healthcare professionals

Analysis Health in South Asia

Conflict in South Asia and its impact on health

BMJ 2017; 357 doi: (Published 11 April 2017) Cite this as: BMJ 2017;357:j1537
  1. Siddarth David, senior research officer1 2,
  2. Rukhsana Gazi, former scientist3,
  3. Mohammed Shafiq Mirzazada, chief executive officer, founding member45,
  4. Chesmal Siriwardhana, founder member, associate professor in global mental health67,
  5. Sajid Soofi, associate professor and consultant paediatrician8,
  6. Nobhojit Roy, public health specialist, professor of surgery, honorary research fellow1910
  1. 1School of Habitat Studies, Tata Institute of Social Sciences, Mumbai, India
  2. 2Implementing Lancet Commission on Global Surgery in India, India
  3. 3Centre for Equity and Health Systems, International Centre for Diarrheal Research, Dhaka, Bangladesh
  4. 4Aga Khan Health Service, Kabul, Afghanistan
  5. 5Afghanistan National Public Health Association, Kabul, Afghanistan
  6. 6THEME Institute, Colombo, Sri Lanka
  7. 7Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
  8. 8Aga Khan University, Karachi, Pakistan
  9. 9BARC Hospital, HBNI University, Mumbai, India
  10. 10Humanitarian Conflict Research Institute, University of Manchester, Manchester, UK
  1. Correspondence to: S David siddarthdavid{at}

Improving access to healthcare, preventing gender based violence, and providing mental health services are essential to improve the health of people affected by conflict in South Asia, argue Siddarth David and colleagues

According to the Uppsala Conflict Data Program (UCDP), a conflict is a contested incompatibility that concerns government, territory, or both, in which the use of armed force between two parties, of which at least one is the government of a state, results in at least 25 battle related deaths. Low intensity conflicts such as insurgencies, counter-insurgencies, civil strife, terrorism, and communal riots have taken the place of large conventional battles across the world. Such conflicts tend to continue at low levels for a long period of time with sporadic outbursts. Moreover, these protracted low intensity conflicts result in prolonged displacement, cross border migration, and trafficking. Most affected populations are unable to access existing healthcare services owing to lack of documentation, means of livelihood, and social capital.1 Public health aspects such as nutrition, water, and sanitation are also severely affected. Healthcare services are often suspended, withdrawn, or rendered impossible, posing a huge health burden compounded by the health needs of displaced populations.2

Research has shown how protracted conflicts can affect specific health outcomes influenced by impediments to accessing healthcare services, pressures on health systems, burden of unmet health needs, and attacks on health facilities and service providers.2345678910 However, lessons have been also learnt, strategies devised, and innovations created to meet the challenges to health in conflict situations.1112

South Asia, with its shared cultural and geopolitical history, is home to several protracted conflicts both within and between countries (box 1). The countries also share similar developmental, social, and health challenges and have been attempting to foster regional …

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