武装冲突对妇女和儿童健康的影响。
The effects of armed conflict on the health of women and children.
机构信息
Center for Population Health Sciences, Division of Primary Care and Population Health, Department of Medicine, Stanford University, CA, USA.
Center for Global Public Health, University of Manitoba, Winnipeg, MB, Canada.
出版信息
Lancet. 2021 Feb 6;397(10273):522-532. doi: 10.1016/S0140-6736(21)00131-8. Epub 2021 Jan 24.
Women and children bear substantial morbidity and mortality as a result of armed conflicts. This Series paper focuses on the direct (due to violence) and indirect health effects of armed conflict on women and children (including adolescents) worldwide. We estimate that nearly 36 million children and 16 million women were displaced in 2017, on the basis of international databases of refugees and internally displaced populations. From geospatial analyses we estimate that the number of non-displaced women and children living dangerously close to armed conflict (within 50 km) increased from 185 million women and 250 million children in 2000, to 265 million women and 368 million children in 2017. Women's and children's mortality risk from non-violent causes increases substantially in response to nearby conflict, with more intense and more chronic conflicts leading to greater mortality increases. More than 10 million deaths in children younger than 5 years can be attributed to conflict between 1995 and 2015 globally. Women of reproductive ages living near high intensity conflicts have three times higher mortality than do women in peaceful settings. Current research provides fragmentary evidence about how armed conflict indirectly affects the survival chances of women and children through malnutrition, physical injuries, infectious diseases, poor mental health, and poor sexual and reproductive health, but major systematic evidence is sparse, hampering the design and implementation of essential interventions for mitigating the harms of armed conflicts.
由于武装冲突,妇女和儿童承受着巨大的发病率和死亡率。本系列论文重点关注武装冲突对全球妇女和儿童(包括青少年)的直接(由于暴力)和间接健康影响。根据难民和国内流离失所者国际数据库,我们估计 2017 年有近 3600 万儿童和 1600 万妇女流离失所。通过地理空间分析,我们估计,生活在危险的武装冲突(距离冲突 50 公里以内)附近的非流离失所妇女和儿童的数量从 2000 年的 1.85 亿妇女和 2.5 亿儿童增加到 2017 年的 2.65 亿妇女和 3.68 亿儿童。妇女和儿童因非暴力原因导致的死亡率因附近冲突而大幅上升,冲突越激烈、越持久,死亡率上升幅度越大。全球范围内,1995 年至 2015 年期间,有超过 1000 万 5 岁以下儿童的死亡可归因于冲突。生活在高强度冲突附近的育龄妇女的死亡率比生活在和平环境中的妇女高出三倍。目前的研究提供了零碎的证据,说明武装冲突如何通过营养不良、身体伤害、传染病、心理健康不良以及性和生殖健康不良等间接影响妇女和儿童的生存机会,但主要系统证据稀缺,这阻碍了设计和实施减轻武装冲突危害的必要干预措施。
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