Children's Health, Conflict and the Climate Crisis: How is aid adapting in the face of multiple fragilities?

The changing climate is causing more frequent extreme weather events which will intensify in strength and duration (IPCC 2021). An estimated 60% of countries considered most at risk of the impacts of climate change are also affected by armed conflict (ICRC 2021). This is an additional dual burden on some of the world's poorest populations who are already exposed to multiple fragilities. Research into these complex burdens on health is a burgeoning field though studies researching how combinations of fragilities impact one of the most vulnerable groups - children - remains limited (Akresh 2016).



This research will identify and explore the relationship between children's health, conflict, and the climate crisis and answer the following key research question:



How is humanitarian aid adapting - if at all - to counter the multiple fragilities impacting children's health, including conflict and climate change?

Mixed research methods integrating quantitative and qualitative data will be used and will

focus on the population displaced by conflict in the Democratic Republic of Congo (DRC) to Dzaleka refugee camp, Malawi. Malawi is a country with a history of both producing and receiving refugees (Mvula 2009) and strong engagement with issues of climate change (Schensul et al. 2013). DRC is listed a Medium-intensity Conflict on the World Bank Group (WBG) list of fragile and conflict-affected situations (FCSs) (WBG 2021) and both DRC and Malawi are predicted to be severely impacted by the climate crisis - ranking 178th and 163rd out of 182 countries respectively - by Notre Dame Global Adaptation Initiative (ND-GAAIN) (2021).



The first stage will involve a document review to understand the context, climate impacts, health indicators (from Demographic and Health Surveys (DHS) data), relevant policies, national agendas, humanitarian agencies and projects in DRC and Malawi. Next, quantitative secondary data analysis of climate data and health indicators to look for correlations, and mapping of climate impacts along with relevant policies and interventions will be undertaken. This will be key to understanding what information organisations can access, identifying organisations incorporating the climate crisis and adaptation into projects, and noting gaps. Potential co-benefits from integrated strategies and examples of best practice will also be identified and examined.



The qualitative stage will involve field research in country or using internet conferencing technology to undertake interviews and focus groups with key stakeholders from the projects. Participants will be chosen based on their ability to best inform the research (Creswell & Creswell 2017) and will include representatives of humanitarian organisations and implementing partners, and civil society leaders representing or working with child refugees.

The aim of the interviews and focus groups is to understand the processes through which interventions are designed, and how they are experienced, as well as to understand interactions and possible relationships between climate, health and aid practice.



An Implementation Science (IS) approach using Process or Complex Evaluation studies research will be used to explore how interventions and projects were proposed, why they were designed in the way that they were, and to identify any contextual effects on outcomes (see Ridde, Pérez & Robert 2020). In addition, an interpretative case-study approach will provide detail and context (see Crowe et al. 2011).



The research will identify gaps in provision and knowledge and contribute detailed case study examples, opportunities for integrated approaches and examples of best practice. These will inform evidence-based design and implementation of aid policies and projects to improve the lives of children in FCSs in the face of the global climate crisis.