Civil war and death in Yemen: Analysis of SMART survey and ACLED data, 2012–2019

PLOS Global Public Health · 13 authors, 8 centres

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TL;DR

This corresponds to a 17.8% increase in deaths, translating to an estimated 168,212 excess deaths between 2015 and 2019.

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This corresponds to a 17.8% increase in deaths, translating to an estimated 168,212 excess deaths between 2015 and 2019. A large share (67.2%) of excess deaths were due to direct combat-related violence. Analysis at the governorate level found no statistical association between a constructed insecurity index and excess death rates. The authors note the pre-crisis health system was already deteriorating and that survey data from highly insecure areas may be inaccessible, potentially underestimating the true toll.

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other

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epidemiology

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ORIGINAL PAPER

PMC10022117

Civil war and death in Yemen: Analysis of SMART survey and ACLED data, 2012–2019

PLOS Global Public Health

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ABSTRACT

Abstract Conflict in Yemen has displaced millions and destroyed health infrastructure, resulting in the world’s largest humanitarian disaster. The objective of this paper is to examine mortality in Yemen to determine whether it has increased significantly since the conflict began in 2015 compared to the preceding period. We analysed 91 household surveys using the Standardized Monitoring and Assessment of Relief and Transitions methodology, covering 2,864 clusters undertaken from 2012–2019, and deaths from Armed Conflict Location & Event Data Project database covering the conflict period 2015–2019. We used a Poisson-Gamma model to estimate pre-conflict ( μ p , baseline value) and conflict period ( μ c ) mean death rates using household survey data from 2012–2019. To analyse changes in the distribution of deaths and estimate nationwide excess deaths, we applied pre- and post-conflict death rates to total population numbers. Further, we tested for association between excess death and security levels by governorate. The national estimated crude death rate/10,000 in the conflict period was 0.20 (95% CI: 0.17, 0.24), which is meaningfully higher than the estimated baseline rate of 0.19 (95% CI: 0.17, 0.22). Applying the conflict period rate to the Yemeni population, we estimated 168,212 excess deaths that occurred between 2015 and 2019. There was an 17.8% increase in overall deaths above the baseline during the conflict period. A large share (67.2%) of the excess deaths were due to combat-related violence. At the governorate level, posterior crude death rate varied across the country, ranging from 0.03 to 0.63 per 10,000 per day. Hajjah, Ibb, and Al Jawf governorates presented the highest total excess deaths. Insecurity level was not statistically associated with excess deaths. The health situation in Yemen was poor before the crisis in 2015. During the conflict, intentional violence from air and ground strikes were responsible for more deaths than indirect or non-violent causes. The provision of humanitarian aid by foreign agencies may have helped contain increases in indirect deaths from the conflict.

CITATION EXPORT

Debarati Guha Sapir, Jideofor Thomas Ogbu, Sarah Elizabeth Scales et al.. Civil war and death in Yemen: Analysis of SMART survey and ACLED data, 2012–2019. PLOS Global Public Health. (2022). https://doi.org/10.1371/journal.pgph.0000581

AUTHORS

13 · 8 CENTRES

Debarati Guha Sapir, Jideofor Thomas Ogbu, Sarah Elizabeth Scales, Maria Moitinho de Almeida, Anne-Francoise Donneau, Anh Diep, Robyn Bernstein, Akram al-Masnai, Jose Manuel Rodriguez-Llanes, Gilbert Burnham, Amrish Yashwant Baidjoe, Amrish Yashwant Baidjoe, Julia Robinson

1Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
2Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
3Epidemiology Program, College of Health Sciences, University of Delaware, Newark, Delaware, United States of America
4Public Health Department, Biostatistics Unit, University of Liege, Liege, Belgium
5CDC Zambia, Lusaka, Zambia
6Oxfam GB, Oxford, United Kingdom
7European Commission, Joint Research Centre, Ispra, Italy
8Medicins Sans Frontiers - Operational Centre Brussels, London School of Hygiene & Tropical Medicine, LUXEMBOURG