Intended for healthcare professionals


Protecting women and children in conflict settings

BMJ 2019; 364 doi: (Published 12 March 2019) Cite this as: BMJ 2019;364:l1095
  1. Zulfiqar A Bhutta, professor1 2 ,
  2. Michelle F Gaffey, senior research manager1,
  3. Karl Blanchet, director3,
  4. Ron Waldman, professor4,
  5. Kamran Abbasi, executive editor5
  1. 1Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
  2. 2Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
  3. 3Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, London, UK
  4. 4Milken Institute School of Public Health, George Washington University, Washington DC, USA
  5. 5The BMJ, London, UK
  1. Correspondence to: Z A Bhutta zulfiqar.bhutta{at}

Children and their families urgently need better evidence, better care, and better outcomes

A recent Save the Children report highlighted that some 357 million children, one in every six children in the world, currently live in a conflict zone.1 Almost half of them live in severe conflict settings. Wagner et al 2 estimate that a child born within 50 km of an armed conflict event in Africa has a 7.7% excess risk of dying in infancy. This equates to 5.2 more deaths per 1000 births than during periods without conflict in the same region (95% confidence interval 3.7 to 6.7). Predictably, this effect increases with severity of conflict.

These new estimates of the mortality burden are important given that the accuracy of commonly-cited crude estimates of maternal …

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