In the Lancet, Zachary Wagner and colleagues 9 expand the understanding of child mortality during armed conflicts. 8 No consensus has been reached on the magnitude of indirect effects of armed conflict on child survival, and further development of methods that estimate the indirect effects of such conflict are needed. 7 Estimates published in 2017 put this indirect effect at five to one-ie, for every death resulting from direct involvement in conflict, there are another five civilian-related fatalities. Typically, only deaths resulting directly from violence are recognised in the estimates of the impact of conflict however, any indirectly attributed deaths from disease and displacement, increased vulnerability of populations because of lack of security, food, and shelter, or disruption of services in such conflict zones are too often invisible and occur mostly in children.
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