Tatah Lambed, Nkunzimana Tharcisse, Foley Louise, de Brauw Alan, Rodriguez-Llanes Jose Manuel
MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Delegation of the European Union to the Republic of Niger, Niamey, Niger.
Heliyon. 2022 Dec 5;8(12):e12096. doi: 10.1016/j.heliyon.2022.e12096. eCollection 2022 Dec.
Refugees may be perceived as a burden to their host communities, and nutrition insecurity is a critical area of contention. We explored the relationship between refugee presence and a host community's resilience in nutrition outcomes in Cameroon. We also tested an analytical framework for evaluating community resilience during shocks. We used data from repeated cross-sectional Demographic and Health Surveys in Cameroon (2004 and 2011), data on refugee movement, and data on extreme climatic events, epidemics, and conflicts from multiple sources. Outcome variables were maternal underweight, maternal anaemia, and child underweight, anaemia, stunting and wasting. The exposure variable was residence within an area in which refugees settled. We used a genetic matching algorithm to select controls from the rest of the country after excluding areas experiencing concurrent shocks. We used a difference-in-differences analysis to compare outcomes between the exposed and control areas. The 2004 survey comprised 10,656 women and 8,125 children, while the 2011 survey comprised 15,426 women and 11,732 children. Apart from anaemia which showed a decreasing trend in both the refugee-hosting community and the rest of the country, all other indicators (wasting, underweight and stunting) showed increasing trends in the refugee-hosting community but decreasing trends in the rest of the country. The matched control group showed a similar trend of decreasing trend for all the indicators. Controlled comparisons showed no evidence of an association between changes in nutrition outcomes and the presence of refugees. These findings contest a common perception that refugees negatively impact hosting communities. The difference-in-differences analysis and an improved matching technique offer a method for exploring the resilience of communities to shocks.
难民可能被视为所在社区的负担，而营养不安全是一个关键的争议领域。我们探讨了喀麦隆难民的存在与所在社区营养状况恢复力之间的关系。我们还测试了一个用于评估危机期间社区恢复力的分析框架。我们使用了喀麦隆重复横断面人口与健康调查（2004年和2011年）的数据、难民流动数据以及来自多个来源的极端气候事件、流行病和冲突数据。结果变量包括孕产妇体重不足、孕产妇贫血以及儿童体重不足、贫血、发育迟缓与消瘦。暴露变量是居住在难民定居的地区。在排除同时遭受危机的地区后，我们使用遗传匹配算法从该国其他地区选取对照。我们使用差分分析来比较暴露地区和对照地区的结果。2004年的调查涵盖了10,656名妇女和8,125名儿童，而2011年的调查涵盖了15,426名妇女和11,732名儿童。除了贫血在接纳难民的社区和该国其他地区均呈下降趋势外，所有其他指标（消瘦、体重不足和发育迟缓）在接纳难民的社区呈上升趋势，而在该国其他地区呈下降趋势。匹配的对照组所有指标也呈现出类似的下降趋势。对照比较显示，没有证据表明营养状况的变化与难民的存在之间存在关联。这些发现对难民会对接纳社区产生负面影响的普遍看法提出了质疑。差分分析和改进的匹配技术提供了一种探索社区对危机恢复力的方法。
