Exploring Associations Between WaSH-Related Health Outcomes and Terrorist Activities in the Sahel: A Scoping Review.

Objectives: The G5 Sahel countries have faced political instability and terrorist activities for over a decade. With the regional lack of water, sanitation and hygiene (WaSH), there is an increased risk of adverse health outcomes. This scoping review aims to document WaSH-related health outcomes associated with terrorist activities, identify gaps in the humanitarian and political response and propose actionable recommendations to address them. Methods: We followed the PRISMA standards, including literature from PubMed and Web of Science. Country-specific timeframes for terrorist activities were used. Results: Data was extracted from 54 out of 2,320 publications on 22 December 2023. While malnutrition and diarrheal diseases were frequently reported as health outcomes - consistent with inadequate WaSH services - the lack of studies directly linking these outcomes to terrorist activities is notable. Only one article explicitly established a direct link between health outcomes and terrorist activities. Conclusion: The scarcity of studies directly linking terrorist activities to health outcomes reveals a significant research gap and highlight the need for more focused investigations into the health impacts of political violence in the Sahel region.