Child public health interventions for conflict-affected populations: A systematic review

Background Armed conflict causes pervasive harm to children, and humanitarian responses to support them face significant challenges. This review aims to summarise the evidence on the effectiveness of interventions to treat, protect, and promote child public health in conflict-affected populations.

A systematic review was performed, with searches of major databases and the grey literature from 1 January 2012 – 20 February 2025. Included studies provided data on child or caregiver outcomes associated with interventions to support children affected by armed conflict. Studies on nutrition and perinatal interventions were excluded. Data were extracted on the setting, population, intervention design, study type, and findings.

The searches yielded 3,601 records. 51 intervention studies met inclusion criteria, 39% of which were trials. Studies were mainly from Africa (51%), the Middle East (25%) and Asia (18%). The majority of studies focused on mental health and psychosocial support (MHPSS) (N=29, 57%). MHPSS, child protection, and/or parenting interventions were the focus of trials as well as intersectoral interventions. Somatic child health interventions (N=19, 37%) focused on immunisation, adolescent sexual and reproductive health, toxic stress, and telemedicine services. Five studies measured development outcomes and one intervention targeted children with disabilities. Over half of the studies were carried out amongst displaced populations. Intervention design varied widely within and between sectors. Studies showed promising results, particularly for non-specialist MHPSS interventions. Only 20% of studies assessed intervention safety.

The evidence for child public health interventions to support conflict-affected populations is increasing, with increased numbers of studies over time, and improved study design, execution, and reporting. However, the evidence remains poor, limited to a few topic areas and with continued geographical disparities. There is a lack of studies from Central and South America, the Caribbean, North Africa, West Africa, Southeast Asia, and the Pacific. There are notable gaps in evidence on the safety of interventions, their medium- and long-term impacts, sustainability, and interventions for child development and children living with disabilities. Competing Interest Statement The authors have declared no competing interest. Funding Statement The authors received no specific funding for this work. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data are provided within the manuscript or supplementary information files.