The war in Ukraine severely impacts children’s health

Children in Ukraine are particularly hard hit by the consequences of the war. A new study, published in Nature Communications Medicine, shows that children’s access to healthcare has deteriorated sharply since the Russian invasion began in 2022, and that their physical, psychological and social health has been profoundly affected.

“The war in Ukraine has major consequences for children’s physical and mental health. Children suffer not only direct injuries from violence and bombings, but also from the collapse of the healthcare system”, says Denise Bäckström, scientific lead of the study and affiliated researcher at Linköping University and the Swedish Defence University.

The study is the first to systematically compile the research published so far on children’s health and healthcare in Ukraine during the war. The research team has reviewed more than one hundred scientific articles, reports and case studies to create a comprehensive picture of the situation. Contributing researchers come from Linköping University, Karolinska institutet and the Swedish Defence University.

“Our results show that better protection, more knowledge and long-term measures are needed to support children’s recovery”, says Denise Bäckström.

Healthcare under severe strain

The healthcare system in Ukraine has been severely weakened by the war. Hospitals, clinics and paediatric units have been destroyed, closed or relocated to safer areas. A lack of staff, equipment, medicines and functioning medical transport means that many children do not receive the care they need.

Vaccination programmes have been interrupted, and children with chronic illnesses such as cancer, diabetes and tuberculosis do not receive continuous treatment. Particularly vulnerable are children with disabilities and children living in institutions, where access to both medical care and psychosocial support has deteriorated sharply.

Significant increase in mental health problems

The research also shows a marked rise in mental health issues among children. Many experience post-traumatic stress symptoms, anxiety and sleep difficulties after being exposed to flight, separation from family members or direct acts of war.

“Mental health must be seen as a central part of healthcare efforts, both during and after the war”, says Denise Bäckström.

Children who have lost parents or been forced to leave their homes are especially vulnerable. At the same time, resources within child psychiatry are very limited and vary greatly between regions.

Maternal and neonatal care affected

Maternal and neonatal care are also under heavy pressure. Maternity wards have been bombed or closed, and pregnant women are sometimes forced to give birth in shelters or temporary clinics. This has led to more complications during pregnancy and childbirth, as well as an increase in premature births. Limited access to medical equipment and specialist staff means that newborns are at greater risk of death or long-term health problems.

Mapping of research and knowledge gaps

By using a so-called scoping review, in which existing research is systematically mapped, the researchers have identified several critical knowledge gaps—particularly regarding the long-term effects on children’s health and which healthcare interventions work best in a wartime context. Unlike a traditional systematic review, a scoping review also includes so-called grey literature, meaning material published outside traditional commercial or academic publishers.

“This provides information that is not disseminated through traditional scientific journals or books, but which can nevertheless be valuable for research”, says Aida Alvinius, Professor of Leadership and Command & Control at the Swedish Defence University.

“The knowledge now emerging can help not only Ukraine but also other countries to be better prepared for future crises”, says Denise Bäckström.

Vaccinations, psychiatric support and treatment of chronic diseases

The results also highlight which areas require the most support, both in the acute phase and in the long term.

“For example, this may involve ensuring that children continue to have access to vaccinations, psychological support and treatment for chronic illnesses even during wartime”, says Denise Bäckström.

The study will also serve as a guide for future research.

“The results clearly show where knowledge is lacking—for example regarding the long-term effects on children’s health and which healthcare interventions actually work”, says Denise Bäckström.