Since 1990, considerable progress has been made towards improving child health in the world. Nonetheless, worldwide 50 million children younger than five years had acute malnutrition in 20141 and nearly 6 million children died in 2015. The burden is particularly heavy in Africa, where conflict, political fragility and drought are more prevalent. These events affect food security and nutrition by limiting food accessibility, impacting health services and disturbing the care structure within the society.
Several studies have documented the negative effect of conflict and drought, on child health and nutrition. Ethiopia has been affected by drought and starvation on a large scale since the mid-1980s. Untimely, abnormally low and infrequent rainfall has been increasing the frequency and impact of droughts in recent years. Drought is the most complex and detrimental natural hazard and has a substantial impact in countries such as Ethiopia where the economy and livelihood are predominantly dependent on subsistence rainfed agriculture. The country has also experienced several conflicts, both within the country and with neighbouring states such as Eritrea and Somalia.
Nevertheless, in the decade 2000–2011, the country showed improvements in key economic and development indicators, and in 2014 Ethiopia was on track to achieve six of the eight millennium development goals (MDGs).16 Yet child undernutrition is still a concern, with an estimated 4 819 770 (40%) of the child population of 12 049 424 being stunted and about 1 084 448 (9%) being wasted in 2014. According to the Cost of Hunger in Africa study, undernutrition in Ethiopia was responsible for an estimated 378 000 child deaths in 2005–2009 and cost about 16.5% of the country’s gross domestic product (GDP), an estimated 4.7 billion United States dollars, in 2009 alone.
The problem of undernutrition is worse in crisis-affected areas within the country, where food insecurity is heightened due to climate shocks and conflicts. Although several small-scale surveys have been conducted by humanitarian organizations in crisis-affected areas, we only found one study which investigated the associations among child undernutrition, conflict and variability in the general ecosystem in East Africa including Ethiopia. Wasting reflects recent weight loss and has been shown to be a good predictor of child mortality.
Consequently, it is a preferred index of nutritional status in humanitarian emergencies and a proxy indicator for the general health and welfare of the entire population. Thus, examining the effects of drought and conflict on the prevalence of wasting in children would provide knowledge to guide intervention strategies. Moreover, generated estimates could be a useful baseline for future surveys in crisis-affected areas. We sought to provide summary estimates of the prevalence of wasting among children aged 6–59 months and investigate the effects of drought and conflict on the prevalence of childhood wasting in regions of Ethiopia that had sufficient data available