Individuals who have been displaced from their homes due to conflict, violence, or other natural or man-made calamities but have not crossed recognized borders are referred to as internally displaced persons (IDPs). More than 20 million individuals are internally displaced over the world. More than half of them live in Sub-Saharan Africa . Approximately 59% of the world's children live in conflict-affected countries in 2016 .
Internally displaced individuals are housed in and out of official camps in several African countries for short or extended periods of time, typically in areas with inadequate shelter and food . Armed conflict is more likely to occur in poorer nations, particularly in thinly populated rural areas, and areas where land and water are challenged [5, 15]. Many studies demonstrated that such conflicts have negative health consequences for people, particularly children .
According to UNICEF data from 2018, an estimated 2.8 million Ethiopians have been evacuated. 1.5 million of the displaced people are children. According to OUNCHA 2018, Gedeb is one of the most conflict-prone districts, with the biggest number of conflict-related displacements. As a result, the Guji-Gedeo conflict has gradually evolved into the district's primary source of displacement, resulting in 274,548 internally displaced persons (IDPs) or returnees.
Women and children are particularly vulnerable in emergencies due to societal, economic, and medical issues. Many internally displaced persons, particularly children, suffer from poor health and malnutrition as a result of the conflict. According to studies, IDP has a high rate of morbidity and death [6, 12, 13]. In poor nations, epidemics of infectious diseases among vulnerable people are connected to the highest levels of malnutrition . Refugees and internally displaced individuals (IDPs) in Ethiopia, particularly women and children, require protection from unequal allocation of humanitarian aid based on ethnicity. A total of 4.2 million youngsters required food assistance. 370,000 persons needed treatment for SAM (severe acute malnutrition) .
IDPs totaled 274,548 in Gedeo and were scattered across the Gedeo zone, including the districts of Dilla Zuria, Gedeb, Kochere, Wonago, and Yirgachefe. Approximately 64% of refugees live in host communities in the Gedeb area, and they are occasionally "camp-like," congregating around religious groups such as schools, churches, mosques, and mission houses. The healthcare system has inevitably been impacted by displacement. As a result, in IDPs, the mortality of children under the age of five shows an increase. All of the IDPs in the Gedeo zone were thought to be Gedeos fleeing the Gedeo-Guji conflict .
In many poor countries, malnutrition is a major public health issue, especially during times of crisis. It is aggravated in conflict-affected areas. Children in conflict-affected areas bear an unbalanced burden of malnutrition and health issues. Developing countries account for almost 90% of the world's malnourished youngsters. It is one of Ethiopia's most serious health issues for mothers and children and is also thought to be a factor in child deaths [3, 6].
In 2011, one in four children (26 percent, or 165 million) was stunted, one in six (16 percent, or 101 million) was underweight, and one in twelve (8 percent, or 52 million) was wasting. In Ethiopia, 38 percent of children under the age of five were stunted, 24% were underweight, and 10% were wasting. Besides, anthropometric indicators for young children were collected in the 2016 EDHS to provide outcome measures of nutritional status, 38 percent of children under 5 are considered short for their age or stunted (below − 2 SD), and 18 percent are severely stunted (below − 3 SD) [6, 8].
Children's malnutrition in Ethiopia is caused by a number of complex, multidimensional, and interconnected factors operating at many levels , such as a lack of clean water, lack of sanitation, inadequate health care, displacement, and instability. All of these factors increase the risk of illness, and mortality among displaced children . Malnourished children continued to be unable to reach their full physical and mental potential. Children with severe malnutrition suffer from a lack of physical growth and motor development, as well as a lower IQ, increased behavioral issues, and poor social skills . To combat hunger and, to some extent, undernutrition, Ethiopia adopted a national nutrition program, developed an infant and young child feeding manual, and conducted monthly child growth and monitoring programs. Despite the development of several interventions, malnutrition remains a major child health issue, particularly among displaced children .
However, there are few data on the factors that influence nutritional status in children aged 6 to 59 months who returned to the Gedeb District after being forced internally displaced in Guji-Gedio. Furthermore, no previous research on the topic has been done in the study area. The study's findings could be used at the regional, national, and international levels to address the issue of children's nutritional status by informing society about the severity of the conflict in the study area.