The issue of war and conflict in a nation state and the impact on citizens, especially on women and children, is critical in terms of research and peace-building processes. Kudakwashe & Richard (2015) explored the causal factors resulting in armed conflicts across the world . According to the authors, factors which lead to armed conflict included ethnic and religious differences, limited access and inequitable distribution of resources, and lack of proper governance systems in place . Although these factors certainly seem to be factors exacerbating the internal and external conflicts in the worst conflict zones of the world, the most critical element to understand is the disproportionate effect of conflict on women and children.
Conflict-causing factors are not only limited to resources (or lack thereof), economic or otherwise. There are other hidden motives and indirect contributing factors. For instance, even a peaceful country like Canada has an economic interest in the $15-billion arms deal with Saudi Arabia . Much of the turmoil in the Middle East is due to these ‘special interests’. Factors resulting in conflict include, lack of fair and equitable political and governance systems, unequal participation of women in political and peace building processes, and a lack of focus on gender equity and women’s rights. In most parts of the world, including the United States, women are still considered as second-class citizens . Countries that claim to advocate for democracy and respect of human rights need to walk the talk. All these factors along with a myriad of socioeconomic and sociocultural issues further exacerbate the status, inclusion, and treatment of women, especially in conflict zones .
Armed conflict and war coupled with gender-based violence and sexual exploitation result in negative intergenerational health effects, including but not limited to, adverse physical, mental, social, psychological, and bio-psychosocial health outcomes .
Additionally, according to Ugalde et al. (2000), the health costs of war are not tangible, thus making monitoring difficult . The paper reported the three key areas of underassessment in health cost evaluation of war as psychosocial behaviours; environmental destruction; and disruption to policy making . The authors noted that it is easier to monitor conventional health indicators and relatively difficult to measure the impact of war on the aforementioned indicators. That said, in order to ensure optimal healthcare delivery and policy making, regular reporting and monitoring mechanisms for all countries, regardless of conflict-risk levels must be in place. This requires consistent and constant support of multilateral agencies via development aid, health systems strengthening, etc.
Furthermore, a human rights-based approach (HRBA) must be pursued, ensuring that accountability forms the fundamental basis of HRBA, especially in light of growing allegations of sexual abuse and misconduct in the humanitarian aid organizations [7; 8; 9]. The accountability principle must include not only the State and State officials, but also create monitoring mechanisms and responsibilities for international organizations, and other non-State actors. This is essential not only for peace building and nation building but also trust building between and among conflicting states and international aid agencies.
Lastly, it is certainly important to focus on positive transformations such as that of Nepal’s experience  and emulate that in the Middle East and other humanitarian emergency and conflict-affected settings. The Machel Study  is also seminal in advocating for building women’s capacities and roles as peace builders .
In conclusion, robust accountability, governance mechanisms and women-inclusive approaches that enhance women’s participation in bilateral and multilateral peace building institutions are needed, in order to prevent conflict, and sustain peace across the globe.
 Kudakwashe, M. A., & Richard, B. (2015). Causes of armed conflicts and their effects on women. International Journal of Research, 2(4), pp.77-85. Retrieved from https://www.ijrhss.org/pdf/v2-i4/11.pdf
 Saudi-Canadian relations and the arms deal: A guide to the story so far. (2019, January 2). Retrieved from https://www.theglobeandmail.com/politics/article-saudi-arabia-canada-arms-deal-explainer/
 Rosen, S. P. (2014, August 5). Women in the U.S. Are Still Second-Class Citizens: Not Interested? You Should Be. Retrieved from https://www.huffpost.com/entry/women-in-the-us-are-still-wage-gap_b_5018490
 Hudson, V. M., Ballif-Spanvill, B., Caprioli, M., & Emmett, C. F. (2012). Sex and world peace. Columbia University Press.
 McKay, S. (1998). The effects of armed conflict on girls and women. Peace and Conflict, 4(4), 381-392. Retrieved from https://doi.org/10.1207/s15327949pac0404_6
 Ugalde, A., Selva-Sutter, E., Castillo, C., Paz, C., & Cañas, S. (2000). The health costs of war: can they be measured? Lessons from El Salvador. BMJ, 321(7254), 169-172. doi: 10.1136/bmj.321.7254.169
 McKenzie, S. (2018, July 31). Sexual abuse ‘endemic’ in international aid sector, report finds. Retrieved from https://www.cnn.com/2018/07/30/uk/sexual-abuse-aid-sector-uk-report-intl/index.html
 Einbinder, N. (2018, August 16). Amid Allegations of Abuse, Aid Workers Describe Culture of Sexual Misconduct. Retrieved from https://www.pbs.org/wgbh/frontline/article/amid-allegations-of-abuse-aid-workers-describe-culture-of-sexual-misconduct/
 Taylor, L. (2019, February 11). Rise in sexual abuse cases in aid groups as more victims speak up. Retrieved from https://www.reuters.com/article/us-global-aid-harassment/rise-in-sexual-abuse-cases-in-aid-groups-as-more-victims-speak-up-idUSKCN1Q000X
 Devkota, B., & van Teijlingen, E. R. (2010). Understanding effects of armed conflict on health outcomes: the case of Nepal. Conflict and Health, 4(1), 20. Retrieved from https://conflictandhealth.biomedcentral.com/articles/10.1186/1752-1505-4-20
 Snoubar, Y., & Duman, N. (2016). Impact of Wars and Conflicts on Women and Children in Middle East: Health, Psychological, Educational and Social Crisis. European Journal of Social Science Education and Research, 3(2), 211-215. doi: 10.26417/ejser.v6i2.p211-215