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

气候变化正在导致更频繁的极端天气事件，其强度和持续时间将加剧（IPCC 2021）。据估计，60%被认为最有可能受到气候变化影响的国家也受到武装冲突的影响（红十字国际委员会，2021年）。这对世界上一些最贫穷的人口来说是一个额外的双重负担，他们已经面临多种脆弱性。对这些复杂的健康负担的研究是一个新兴领域，尽管研究脆弱性组合如何影响最脆弱群体之一-儿童-的研究仍然有限（Akresh 2016）。 这项研究将确定和探讨儿童健康、冲突和气候危机之间的关系，并回答以下关键研究问题：人道主义援助如何适应-如果有的话-以应对影响儿童健康的多重脆弱性，包括冲突和气候变化？将采用定量和定性数据相结合的混合研究方法，重点关注因刚果民主共和国冲突而流离失所到马拉维Dzaleka难民营的人口。马拉维是一个既有生产难民又有接收难民的历史的国家（Mvula，2009年），并积极参与气候变化问题（Schensul等人，2013年）。刚果民主共和国被列入世界银行集团（WBG）脆弱和受冲突影响局势（FCS）名单（WBG 2021）的中等强度冲突，预计刚果民主共和国和马拉维将受到气候危机的严重影响-在182个国家中分别排名第178位和第163位-由圣母院全球适应倡议（ND-GAAIN）（2021）。 第一阶段将涉及文件审查，以了解刚果民主共和国和马拉维的背景、气候影响、健康指标（来自人口与健康调查数据）、相关政策、国家议程、人道主义机构和项目。接下来，将对气候数据和健康指标进行定量二级数据分析，以寻找相关性，并绘制气候影响沿着相关政策和干预措施。这将是了解组织可以获得哪些信息，确定将气候危机和适应纳入项目的组织并指出差距的关键。还将确定和审查综合战略和最佳做法范例的潜在共同惠益。 定性阶段将涉及在国内进行实地研究，或利用互联网会议技术与项目的主要利益攸关方进行访谈和重点小组讨论。参与者将根据他们为研究提供最佳信息的能力进行选择（Creswell & Creswell 2017），并将包括人道主义组织和执行伙伴的代表，以及代表儿童难民或与儿童难民合作的民间社会领导人。访谈和焦点小组的目的是了解设计干预措施的过程，以及如何体验这些干预措施，并了解气候、健康和援助做法之间的相互作用和可能的关系。 使用过程或复杂评估研究的实施科学（IS）方法将用于探索如何提出干预措施和项目，为什么它们以它们的方式设计，并确定对结果的任何背景影响（见Ridde，Pérez & Robert 2020）。此外，解释性案例研究方法将提供细节和背景（见Crowe等人，2011年）。 这项研究将查明在提供和知识方面的差距，并提供详细的案例研究实例、综合办法的机会和最佳做法实例。这些将为援助政策和项目的循证设计和实施提供信息，以改善面临全球气候危机的FCS儿童的生活。

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.