Armed conflict is often measured by territorial gains, military casualties, and geopolitical consequences. Yet one of its most enduring and overlooked consequences is the destruction of health systems and the disproportionate burden placed on the health of women and girls. As conflicts become increasingly protracted, attacks on healthcare facilities, the displacement of civilians, and widespread insecurity have disrupted access to essential healthcare services, including sexual and reproductive care for millions of women and girls. These consequences extend beyond humanitarian concerns, posing significant challenges to global health security and the long-term stability of many communities.
While the health impacts of conflict affect entire populations, women and girls often experience unique vulnerabilities. The collapse of healthcare infrastructure limits access to maternal healthcare, contraception, emergency obstetric services, and treatment for survivors of gender-based violence. Displacement further compounds these challenges, forcing women and girls into overcrowded camps or informal settlements where healthcare services are often limited or unavailable. As a result, preventable illnesses and complications become increasingly difficult to manage, undermining both individual well-being and broader public health outcomes.
Health systems are often among the first institutions to deteriorate during armed conflict. Hospitals and clinics may be damaged or destroyed, healthcare workers displaced, and medical supply chains disrupted. Routine healthcare services that would normally be available, including prenatal care, safe childbirth, contraception, cervical cancer screening, and reproductive health consultation, often become increasingly difficult to access. For many women and girls, these disruptions can have life-threatening consequences.
Conflict also affects survivors of gender-based and conflict-related sexual violence. Survivors often require immediate medical treatment, psychological support, and access to reproductive healthcare, yet these services are frequently unavailable in fragile and conflict-affected settings. Social stigma and the destruction of health infrastructure create additional barriers that prevent women and girls from receiving the care they need. In Our Bodies, Their Battlefields, Christina Lamb demonstrates how women's bodies often become sites of conflict where sexual violence is used to inflict harm on a population beyond the battlefield itself.
Drawing on the experiences of survivors from conflicts around the globe, Lamb documents how sexual violence is not an isolated byproduct of war but is often used deliberately to terrorize communities, displace populations, and exert control. The consequences extend beyond the immediate act of violence, including lifelong physical injuries, unintended pregnancies, sexually transmitted infections, infertility, and profound psychological trauma. These accounts illustrate that protecting women and girls in conflict also requires ensuring access to comprehensive healthcare and survivor-centred support.
Case Studies: Sudan, the Democratic Republic of the Congo, and Afghanistan
The ongoing conflict in Sudan demonstrates how rapidly war can evolve into a public health crisis. Since fighting erupted in 2023, millions of people have been displaced, healthcare facilities have been damaged or forced to close, and humanitarian organizations have struggled to reach affected communities. Women and girls have faced increased reports of conflict-related sexual violence while simultaneously losing access to essential reproductive healthcare. Maternal health services, emergency obstetric care, and medical support for survivors have become increasingly difficult to obtain as insecurity continues to limit humanitarian access.
The Democratic Republic of the Congo (DRC) offers another example of the long-term relationship between conflict and women's health. Decades of armed violence have contributed to persistent sexual violence and fragile healthcare systems. Survivors often face significant barriers to accessing healthcare, while repeated cycles of conflict have weakened the country's ability to provide consistent reproductive and maternal health services. The DRC case demonstrates how health consequences of conflict are not limited to the immediate aftermath of violence but can continue for generations when health systems remain fragile.
Afghanistan illustrates a different dimension of the issue. Years of conflict, political instability, and restrictions affecting women have significantly reduced access to healthcare, particularly for women and girls living in rural communities. Limitations on women's mobility, shortages of female healthcare providers, cuts to foreign aid, and declining healthcare capacity have increased risks associated with pregnancy and childbirth while reducing access to reproductive healthcare services.Â
Although each conflict presents unique circumstances, the consequences are remarkably similar. Weak health systems, displacement, insecurity, and gender inequality combine to create conditions in which women and girls face disproportionate health risks. These impacts extend beyond individual survivors, affecting families, communities, and the long-term recovery of conflict-affected societies.
Women's Health as a Global Health Security Issue
Protecting the health of women and girls in conflict settings must be recognized as a health security priority. When essential health services collapse, the consequences including maternal mortality, untreated reproductive health conditions, and inadequate care for survivors of violence place additional strain on already fragile health systems, hinder post-conflict recovery, and weaken the resilience of affected communities. Communities cannot recover from conflict when large portions of the population are unable to access essential healthcare or when survivors of violence are left without medical or psychological support.Â
Healthy populations are also fundamental to social and economic recovery following conflict, and ensuring access to maternal healthcare, reproductive health services, and comprehensive care for survivors of gender-based violence contributes to improved health outcomes as well as more resilient communities. Recognizing sexual and reproductive healthcare as a critical part of global health security also encourages coordination between humanitarian organizations, governments, and international partners. Rather than viewing women's health solely through a humanitarian lens, policymakers should recognize that protecting access to essential and equitable healthcare services contributes to broader goals of stability and sustainable peace.
Addressing the health impacts of conflict requires coordinated international action. Organizations such as the World Health Organization, the United Nations Population Fund, and humanitarian organizations play essential roles in providing emergency healthcare, supporting reproductive health services, and assisting survivors of gender-based violence. However, protecting women's health also depends on creating secure environments in which healthcare workers can operate safely and humanitarian assistance can reach affected populations.
While NATO is not a humanitarian organization, its broader efforts to promote resilience, support stability, and advance its Women, Peace and Security agenda contribute to conditions that enable humanitarian and health actors to operate more effectively. Strengthening partnerships with international organizations such as the World Health Organization, United Nations Population Fund, and the International Committee of the Red Cross can help improve preparedness and reinforce health systems in fragile and conflict-affected settings.
When conflict disrupts sexual and reproductive healthcare, limits access to maternal health services, and prevents survivors of violence from receiving care, the consequences extend beyond individuals to entire communities and societies. Recognizing women's and girls' health as a pillar of global health security is essential not only for protecting vulnerable populations but also for supporting long-term peace and recovery.
Image credit: IMG-20200120-WA0028 (17 October 2020), depicting Dr. Aminyene Essien Meraiyebu performing an obstetric scan on a pregnant woman in an internally displaced persons camp in Abuja, Nigeria, by Mimiessien via Wikimedia Commons. Licensed under CC BY-SA 4.0
Disclaimer:Â Any views or opinions expressed in articles are solely those of the authors and do not necessarily represent the views of the NATO Association of Canada.
