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Cited by 105Health and Conflict StudiesChild Nutrition and Water AccessDisaster Response and Management

Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps: a retrospective study

Spiegel, Paul, Sheik, Mani, Gotway-Crawford, Carol, Salama, Peter·2002·The Lancet
DOI 10.1016/s0140-6736(02)11915-5
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Abstract

Background An estimated 35 million people have been displaced by complex humanitarian emergencies. International humanitarian organisations define policies and provide basic health and nutrition programmes to displaced people in postemergency phase camps. However, many policies and programmes are not based on supporting data. We aimed to identify associations between age-specific mortality and health indicators in displaced people in postemergency phase camps and to define the programme and policy implications of these data.Methods In 1998-2000, we obtained and analysed retrospective mortality data for the previous 3 months in 51 postemergency phase camps in seven countries. We did multivariate regression with 18 independent variables that affect crude mortality rates (CMRs) and mortality rates in children younger than 5 years (<5 MRs) in complex emergencies. We compared these results with recommended emergency phase minimum indicators.Findings Recently established camps had higher CMRs and <5 MRs and fewer local health workers per person than did camps that had been established earlier. Camps that were close to the border or region of conflict or had longer travel times to referral hospitals had higher CMRs than did those located further away or with shorter travel times, and camps with less water per person and high rates of diarrhoea had higher <5 MRs than did those with more water and lower rates of diarrhoea. Distance to border or area of conflict, water quantity, and the number of local health workers per person exceeded the minimum indicators recommended in the emergency phase.Interpretation Health and nutrition policies and programmes for displaced people in postemergency phase camps should be evidence-based. Programmes in complex emergencies should focus on indicators proven to be associated with mortality. Minimum indicators should be developed for programmes targeting displaced people in postemergency phase camps.

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  • Refugees living in protracted camps generally have lower crude and under-five mortality rates than surrounding host communities, and possibly lower maternal mortality rates.

    “Previous studies using UNHCR data have shown that refugees living in protracted camps generally have lower crude and under-five mortality rates than surrounding host communities, and possibly lower maternal mortality rates [16, 17].”

    From Neonatal mortality burden and trends in UNHCR refugee camps, 2006–2017: a retrospective analysis (2021) · cites this paper as [17]

  • Pneumonia and diarrhoea are major avoidable causes of child deaths during the initial emergency phase of a complex humanitarian emergency.

    “Child mortality can be particularly high during the initial emergency phase of a complex humanitarian emergency, and pneumonia and diarrhoea are major avoidable causes of these deaths.82”

    From Global burden of childhood pneumonia and diarrhoea (2013) · cites this paper as [82]

  • Child mortality can be particularly high during the initial emergency phase of a complex humanitarian emergency.

    “Child mortality can be particularly high during the initial emergency phase of a complex humanitarian emergency, and pneumonia and diarrhoea are major avoidable causes of these deaths.82”

    From Global burden of childhood pneumonia and diarrhoea (2013) · cites this paper as [82]

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Authors
Spiegel, P., Sheik, M., Gotway-Crawford, C., & Salama, P.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Johns Hopkins University (US)
Corresponding author
Spiegel, Paul
ORCID
Spiegel, Paul
Venue
The Lancet
Publisher
Elsevier BV
Published
2002-12
Volume
360
Issue
9349
Pages
1927-1934
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(02)11915-5
OpenAlex
W2135999783
Cited by
105
References
25
Citations by year
2026: 2 · 2025: 2 · 2024: 10 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 8 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 6 · 2014: 1 · 2013: 6 · 2012: 6
FWCI
11.62
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Funders
United Nations High Commissioner for Refugees
Topics
  • Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
Keywords
displaced persons, mortality, child mortality, complex emergencies, health policy, water access, diarrhea, evidence-based programming
MeSH terms
Adult, Africa, Asia, Child, Child, Preschool, Diarrhea, Female, Food Supply, Health Policy, Health Services, Humans, Infant, Male, Middle Aged, Mortality, Refugees, Respiratory Tract Infections, Retrospective Studies, Sanitation

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