Open Access Highly Accessed Opinion

The intergenerational effects of war on the health of children

Delan Devakumar1*, Marion Birch2, David Osrin1, Egbert Sondorp3 and Jonathan CK Wells4

Author Affiliations

1 Institute for Global Health, University College London, London, UK

2 Medact, London, UK

3 Royal Tropical Institute, Amsterdam, Netherlands

4 Childhood Nutrition Research Centre, Institute of Child Health, University College London, London, UK

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BMC Medicine 2014, 12:57  doi:10.1186/1741-7015-12-57

Published: 2 April 2014



The short- and medium-term effects of conflict on population health are reasonably well documented. Less considered are its consequences across generations and potential harms to the health of children yet to be born.


Looking first at the nature and effects of exposures during conflict, and then at the potential routes through which harm may propagate within families, we consider the intergenerational effects of four features of conflict: violence, challenges to mental health, infection and malnutrition. Conflict-driven harms are transmitted through a complex permissive environment that includes biological, cultural and economic factors, and feedback loops between sources of harm and weaknesses in individual and societal resilience to them. We discuss the multiplicative effects of ongoing conflict when hostilities are prolonged.


We summarize many instances in which the effects of war can propagate across generations. We hope that the evidence laid out in the article will stimulate research and – more importantly – contribute to the discussion of the costs of war; particularly in the longer-term in post-conflict situations in which interventions need to be sustained and adapted over many years.

War; Conflict; Developmental origins; Children; Mental health