Global Observatory on War, Conflict and Health

With the establishment of the Global Alliance on War, Conflict and Health, there is a concerted effort to “strengthen action on war and conflict as threats to health and uphold justice and accountability as the foundations for peace and health,” [Horton, 2020].

With this purpose in mind, the Alliance is developing a global observatory to monitor key indicators relevant to war, conflict and health including indicators related to health status, risk factors, service coverage, and health systems. The prolonged nature of crisis and the multidimensional and multilayered ramifications of armed conflict on health necessitate global monitoring.

So far, the Global Alliance has undertaken a series of steps towards the development of the Global Observatory. First, a systematic scoping review of existing health observatories was conducted to inform the scope, function and design of the proposed observatory. A total of 16 observatories relevant to health were identified. Data regarding institutional affiliation, observatory type, purpose of observatory, types of information provided, funding sources, use and design of observatories were extracted.

The findings of this mapping highlighted the potential for an indicator-specific observatory that provides timely country-level data in an accessible way targeted towards researchers, policymakers, and practitioners. To inform the development of indicators for the observatory, the Global Alliance engaged two researchers to conduct a systematic review to identify indicators relevant to war, conflict and health. A total of 194 different resources and dashboards of organizations’ websites, networks, observatories, Toolkits, and Journals relevant to armed conflict and health were screened. The indicators were disaggregated by the domain which is the stage of conflict (Prevention, Preparedness, Response, Recovery), and the type of indicators based on the logical framework (Process, output, outcome, impact). Through this process, 255 indicators were identified. These indicators were categorized into the following domains: Consequences of war and conflict on public health; Populations affected; Type of risks; Research monitoring; Response and policy, Peace, Safety and Security, and Type and Intensity of Conflict.

After the indicator mapping and data extraction process, eight consultative interviews were conducted with experts in the field of armed conflict and health on the indicator list and a prioritization exercise was also conducted. Criteria for indicator selection included relevance/usefulness, clarity, technical merit, measurability, time bound, achievability, cost-effectiveness of data collection, validity, and ethical implications. The list of indicators was further narrowed down to 140 indicators. Next steps will involve further prioritization processes to support the finalization of a core set of indicators to be included in the Global Observatory. An associated guidebook will be prepared that includes meta data for each indicator including indicator definition including numerator and denominator, rationale for inclusion, associated domain, disaggregation, and possible data sources. The Global Observatory is expected to launch soon.

Acknowledgements: We thank Carine Naim, American University of Beirut and Jason Fink, University of Washington School of Public Health for their support on these projects through their graduate thesis projects. This work was supervised by Manahil Siddiqi, MPH and Amy Hagopian, PhD at the University of Washington School of Public Health in consultation with the Global Alliance Steering Group.