Estimates of crisis-attributable mortality


Retrospective estimation of mortality in Somalia, 2014-2018: a statistical analysis

Warsame, A., * Frisson, S., Gimma, A., Checchi, F
London School of Hygiene & Tropical Medicine
January 2020
*corresponding author:

Somalia has experienced recurrent climate and armed conflict-driven crises over the past three decades. The frequent nature and scale of these crises have weakened the Somali population’s ability to withstand shocks and increased their vulnerability to their health impacts.

In 2010-2012, as a result of successive seasons of failed rains and severely limited access to humanitarian aid for the most vulnerable populations, extreme food insecurity and famine conditions occurred across south-central Somalia. A study conducted in 2013 by the London School of Hygiene and Tropical Medicine (LSHTM) and Johns Hopkins University, and commissioned by the United Nations, estimated that this crisis claimed some 256,000 deaths. Roughly half of these deaths were in children under the age of 5. The majority occurred in southern Somalia, particularly among internally displaced persons (IDP). More than 1 in 10 IDP children living in Bakool, Banadir, Bay, Lower Shabelle and Middle Juba, and some 1 in 5 in Bakool and Banadir are estimated to have died during the crisis period.

In 2016, another extended cycle of poor seasonal rainfall, against a backdrop of ongoing conflict, returned many parts of Somalia to acute food insecurity. During 2017-2018, large-scale population movements, as well as widespread outbreaks of cholera and measles, added complexity to an already precarious situation. These factors were compounded by cyclones and resultant floods, bringing the total number of IDPs to 2.6 million at the end of 2018, with millions more in need of humanitarian aid. During this latest crisis, central and north-east Somalia (Puntland) were heavily affected.


Download the following:

  1. Somalia Mortality Estimation 2010-2012
  2. Somalia Mortality Estimation 2014-2018 Report
  3. Somalia Mortality Estimation 2014-2018 FAQ
  4. Somalia Mortality Estimation 2014-2018 Policy Brief


South Sudan 

Estimates of crisis-attributable mortality in South Sudan, December 2013- April 2018: A statistical analysis

Checchi, F*., Testa, A., Warsame., A. Quach, L., & Burns, R.
London School of Hygiene & Tropical Medicine
September 2018
*corresponding author:

The conflict in South Sudan has likely led to nearly 400,000 excess deaths in the country’s population since it began in 2013, with around half of the lives lost estimated to be through violence, according to a major new report by the London School of Hygiene & Tropical Medicine. Most of the death toll occurred in the northeast and southern regions of the country, and appeared to peak in 2016 and 2017. Those killed were mostly adult males but also included women and children. Unexpectedly, the share of infant mortality was low, and estimates of the under-five death rate were no higher during the war period than before it.

As of early 2018, the war had caused the displacement of about two million people within South Sudan and a further 2.5 million as refugees to neighbouring countries. Although a Compromise Peace Agreement was signed in August 2015, temporarily leading to shared government, it broke down in July 2016, resulting in the conflict gaining intensity and spreading geographically. The humanitarian response to this crisis is among the largest worldwide, targeting about six million people with a total funding requirement of 1.7 billion USD in 2018, less than 50% met as of current UN figures.

The authors say the findings indicate that the humanitarian response in South Sudan must be strengthened, and that all parties should seek urgent conflict resolution. The research team used an innovative statistical approach to predict deaths which were attributable to crisis for every month and county of the period of interest, and say this approach has the potential to support those involved in humanitarian response and policy to make real-time decisions. The research was funded by the United States Institute of Peace.

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