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Overview of Study Designs Applicable in Conflict Settings

Are all health research study designs feasible to conduct in conflict settings?
If conducted, would they generate meaningful, or impactful evidence?

Conducting research in conflict settings presents unique challenges that require careful consideration when selecting appropriate study designs. The dynamic nature of conflicts, including security concerns, displacement, and limited resources, necessitates adaptable and context-specific approaches. This article provides an overview of study designs applicable in conflict settings, highlighting their strengths and considerations for their implementation.

  1. Cross-Sectional Studies: Cross-sectional studies are commonly used in conflict settings to assess the prevalence of health conditions, access to services, or the distribution of specific characteristics within a population at a specific point in time. They provide a snapshot of the situation and can be relatively quick and cost-effective. However, they may not capture changes over time or establish causal relationships. Example: A cross-sectional study conducted in a conflict-affected region examines the prevalence of malnutrition among internally displaced persons, helping identify immediate nutritional needs and informing resource allocation for interventions.
  2. Qualitative Studies: Qualitative research methods, such as interviews, focus group discussions, and ethnographic approaches, are valuable for exploring complex social, cultural, and psychological aspects of conflict-affected populations. They provide in-depth insights into lived experiences, perceptions, and social dynamics. However, qualitative studies require time, skilled researchers, and careful consideration of ethical and cultural sensitivities.
  3. Case-Control Studies: Case-control studies compare individuals with a particular outcome (cases) to those without the outcome (controls) to identify risk factors or protective factors. They are useful for investigating rare outcomes or studying populations where it is challenging to establish a cohort. However, selecting appropriate controls and ensuring the comparability of cases and controls can be challenging in conflict settings. Example: A case-control study examines the association between exposure to explosive remnants of war and the risk of limb amputations among conflict-affected populations, helping identify preventive measures and inform mine clearance efforts.
  4. Cohort studies: A cohort study design is an observational study that follows a group of individuals with a common characteristic or exposure over time to assess the relationship between that exposure and specific health outcomes. In cohort studies, there is often a control or comparison group. The comparison group serves as a reference point to which the exposed group is compared. In conflict settings, cohort studies play a crucial role in understanding the long-term health impacts of conflicts on affected populations.

Example: Researchers conduct a prospective cohort study in a region affected by an ongoing armed conflict. They select a cohort of internally displaced persons (IDPs) who have been forced to flee their homes due to the conflict. The study aims to investigate the association between exposure to violence during the conflict (the exposure variable) and the prevalence of post-traumatic stress disorder (PTSD) symptoms (the health outcome) compared with a comparison group of original residents of the region and the prevalence of PTSD symptoms amongst them.

  1. Mixed Methods Studies: Mixed methods studies combine quantitative and qualitative approaches, providing a comprehensive understanding of complex phenomena in conflict settings. By integrating different data sources and perspectives, researchers can triangulate findings, enhance validity, and capture the richness of the context. However, mixed methods studies require substantial resources, interdisciplinary collaboration, and careful integration of data.

Example: A mixed methods study investigates the barriers and facilitators to healthcare access among conflict-affected populations, combining quantitative surveys on healthcare utilization with qualitative interviews to explore individual experiences and systemic challenges.

Conclusion: Selecting appropriate study designs in conflict settings requires careful consideration of the research objectives, context, and available resources. By understanding the strengths and considerations of various study designs, researchers can navigate the challenges and generate meaningful evidence that contributes to addressing the complex health and social issues arising from conflicts. Adaptability, collaboration with local stakeholders, and ethical sensitivity are essential for conducting research that produces actionable insights to improve the lives of conflict-affected populations.


Mazurana, Dyan, Karen Jacobsen, and Lacey Andrews Gale, eds. Research methods in conflict settings: A view from below. Cambridge University Press, 2013.

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Conducting Health Research in Conflict Settings: Navigating Research Challenges for Impactful Evidence

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